Paul, Michael and Wayne; three violent men whose histories are relayed by Carol Boland in her paper “Can Violent Men Change?” The stories of Paul and Wayne make chilling reading as two men from vastly different backgrounds that end up at the same psychological place where they attempt to murder their wives and children who have left them. Carol uses personality theory and in particular the theory of narcissism to explain how this could be. Paul grew up in a world where he could ‘do no wrong’ with a childhood that taught him no strategies to deal with what he perceived to be the ‘outrageous and unwarranted rejection’ of his abused wife’s decision to leave. By contrast Wayne’s childhood was dominated by abuse and humiliation and a powerful sense of shameful inadequacy with the result that he was hypersensitive to criticism and reacted violently. The humiliation implicit in his partners decision to leave him resulted in the same behavior as Paul.  

By contrast she presents the case of Michael, a man who has been equally violent yet is able to engage with the therapist and not only acknowledge his violence but act to change it.

Carol makes a cogent point. Violent men can change but ‘we need to be more skilled at recognizing who they are’. Central to this is understanding the quality of their own parenting  ‘particularly any information that helps us to understand what they internalized about personal responsibility and remorse’ For those who are steeped in defensive shame like Michael and Wayne it is impossible to predict whether they can respond. However initial screening to distinguish the still-reachable from the too-defended which both appeals to the man’s self-interest and rewards vulnerability and responsibility to change is crucial. In addition it is crucial that we warn the partners of violent men how they leave and be aware that a history of physical violence is no predictor. Never humiliate them, she warns, ‘if possible, simply leave when he is not around. ’She concludes by saying that anti-violence programs must be thoroughly and reliably assessed and that therapist should be unafraid to state that some men are unable or unwilling to change and that services must be provided to properly protect woman and children.
 

Boland, C. (2008) Can violent men change? Context: The Magazine for Family Therapy and Systemic Practice in the UK. 97: 6-9.

When people think about therapists working with abused children, they usually imagine child-friendly rooms with therapists gently encouraging the development of therapeutic alliances from which the children can begin to repair their psychological harm. The image relies on a number of assumptions and implies a number of possibilities: the child is able to access the therapist regularly and indefinitely, the therapeutic goal(s) are clear and achievable, and the children are eventually able to pour out their hearts with the conviction that the therapist can make it all better. Eventually, the image implies, the child will emerge from the therapeutic process either healed or with sufficient resilience to withstand whatever depredations or deprivations remain to be faced.

Sadly, therapy with these clients is rarely so straightforward. In this sometimes confronting but always-realistic presentation Carol will address many of the dilemmas therapists face in attempting to help their child clients. She will be starting from the following positions
1. The second most powerless person after the child client is the therapist

2. Before the therapist can hope to achieve any therapeutic change, he / she must negotiate a potential mine field of services and individuals with often competing or contradictory policies and agendas

In the political arena, South Australia remains steadfastly against the use of controlled crying. However, the debate has been refuelled since the Victorian government announced plans to train 200 maternal and child health nurses in the controversial method. Not only has the controversy fuelled debate among parents and professionals, log onto any parenting forum and you will see the sparks fly from both camps, but the baby sleep game is becoming big business. There is a growing number of ‘baby whisperers’ and ‘sleep experts’, not to mention publishing companies, making a mint out of criticising the method, while thousands of sleep deprived and desperate parents try to wade through the conflicting advice. On the one hand, controlled crying has been shown in a number of well designed controlled studies to significantly improve both infant sleep and maternal mental health. On the other hand, parents are being told that; controlled crying is ‘detrimental to children and can have serious long-term effects’ (Anni Gethin, health social scientist and Beth Macgregor, psychologist, authors of Helping Your Baby To Sleep), that controlled crying ‘is not an evidence-based practice’ and that such ‘rigid regimes can also be associated with infant depression’ (Pinky McKay, International Board Certified Lactation Consultant, and author of Sleeping like a baby, Parenting by Heart, 100 Ways to Calm the Crying, and Toddler Tactics). The difficulty in this debate, is that the scientific evidence is very one sided and actually in favour of controlled crying. No study to date has shown anything but positive outcomes for infants and parents. However, as opponents of the technique are quick to point out, no evidence of harm is very different to evidence of no harm. The opposing camp base their argument on attachment theory and recent research into our body’s stress management system the- hypothalamic-pituitary-adrenal (HPA) axis. Attachment theory would suggest that leaving an infant to cry and not attending to their needs, teaches the infant that their parent cannot be relied upon. The result of this is said to be insecure attachment between parent and child and a state of learned helplessness for the infant. Recent research into the HPA axis has shown that brain is flooded with cortisol when under stress and that chronic stress can permanently affect the brains ability to regulate cortisol re-uptake. Here is the vital question in this debate - Is three or four nights of controlled crying, in the context of a loving home, enough to damage the development of attachment and does it amount to the kind of trauma that has been shown to affect the functioning of the HPA axis? Opponents of the technique have not been able to answer this question and as yet have no scientific evidence to back their theories of irreparable damage. Ironically, in order to provide this evidence they would have to do the very thing they are so passionately opposed to- run a randomised controlled trial of controlled crying. So, in the midst of the controlled crying debate is a rather interesting ethical debate.