One last political post before the election. I have been working on a graphic on the political violence scenario and how it has drastically changed in the past 8 years. Part of the issue with aggression and violence is that it is generally very difficult for most people to talk about. They lack the vocabulary and for a long time there was the suggestion that it may have been the fault of the victim. It took far too long to recognize that this was a dynamic in domestic violence situations and modernize those laws to set limits on the violence and ultimately prevent homicides. Another factor that recently came to light was the issue of firearm access by perpetrators of domestic violence. A recent court case challenged the ban on firearms possession by these men and contrary to the general trend of increasing gun extremism that ban was upheld (United States v. Rahimi).
I do not intend to elaborate on what is contained in the
table. I encourage any reader to do your own research on what I have
posted. I have extensive references, but with these political posts – most people do not seem to be
interested, especially when they run counter to the conventional wisdom or prevailing
political rhetoric. Instead I will make some general comments on aggression,
violence, and its effects.
As an acute care psychiatrist, I was faced with the problem
on a daily basis. Aggressive and violent
people brought to my care generally by the police or paramedics. The people I saw were involved in fights, shootouts,
violent confrontations with the police, homicides (real and attempted),
vandalism, threatening behavior, and suicide attempts. The behaviors were extreme enough to
precipitate 911 calls and for emergency responders to bring them to my hospital. Not all hospitals take these calls because
not all hospitals are set up to deal with violence and aggression. The staff and the physicians need to approach it as a treatable problem. That is the first lesson. Violence and
aggression – even when it is caused by psychiatric illness is not considered a
medical problem. It is considered a
moral problem. In other words – the person
intended to commit violent acts because they are either morally deficient or
simply have no moral code. The vast majority of people I treated in this
situation had a severe psychiatric disorder and did not know what they were
doing. They could not appreciate the wrongfulness of their act.
In order for the person with aggression to be admitted to my
unit – they had to have a psychiatric diagnosis rather than just criminal
behavior. That is an imperfect triage
criterion and in a few cases, people were admitted with either criminal
behavior or aggressive behavior that was goal directed to get what they want.
Common examples include intimidating people for money or sex or just disagreeing
with them. The associated excuses would be: “Well he/she had it coming.”, “They
were just there when I went off.”, or "They did not give me what I wanted.” These are all attitudes that people use who
see others as strictly a means to an end. Other people are just there to be manipulated
to get what they want. They are not seen as people just struggling along like everyone
else with important goals and relationships. Resentment is a common theme and
many of the perpetrators see themselves as getting a bad deal in life, not getting what other people have, and that may include loyalty in relationships.
All of that is a backdrop to the actual aggression or
violence. No matter how egregious that
violence and aggression is – it is very common to see it minimized after the
fact. That minimization can take the form of complete denial “I wasn’t there”
to partial denial “I did not mean to kill him.”
On the less obvious end – aggression can include threatening
behavior that involves appearing to be very angry and using profanity in
someone’s presence for no clear reason, throwing objects, destroying property,
right up to specific threats to kill or injure a person. There is some confusion over how well these
behaviors predict actual violent acts that result in injury but there are two considerations. The argument has been made that psychiatrists
really can not predict violence very well and that may be true for routine evaluations
of relatively stable people in outpatient setting. The prevalence of violence in that population
is so low that I would not anticipate being able to predict it. That changes in an acute care setting where
the transition from verbal aggression or aggression toward property to physical
violence against people happens very quickly. The goal is always to stop it before the
physical phase.
At the societal
level, the laws have slowly been changing to catch up. Domestic violence laws lagged for decades
until many states adopted the law that if a call occurred, an arrest had to be
made. The law about domestic violence convictions leading to no gun possession
was a similar development. Finally, terroristic
threat laws made it illegal to threaten people before any physical violence
occurred. These terroristic threats laws have developed over the past 30 years
and are really a major development compared with the idea that the person making
the threats hasn’t done anything yet and we can’t do anything unless they do something.
It is hard to imagine how many people
were directly threatened and heard that response from law enforcement.
The driving force behind these legal changes was recognition
of what the victims were going through. In some cases, years of harassment,
needing to take extraordinary measures to assure their safety, and suffering
the effects of this extreme stress in the form of chronic insomnia, anxiety,
panic attacks, post-traumatic stress disorder, depression, and physical
symptoms. In many cases jobs and
families were disrupted.
The groups I named in the above graphic have been through all of that and more. In the Insurrection there were estimates of 140-170 officers injured and 5 dead – one from injuries sustained at the scene and 4 subsequently by suicide. I have not seen any specific reports of the number of police affected by mental health symptoms but expect it is significant. Various efforts have been made to minimize the event and the media seems to go along with them. Even though the popular press does say that one party and one candidate has been lying continuously that the 2020 election had been “stolen” – very little is done on a day-by-day basis to confront this lie. Nobody is saying that we have a Presidential candidate who attempted to overthrow the elected government of the United States and currently has operatives in place to disrupt the current election. That may be why 1 out of 3 election workers report being harassed often to the point that they quit volunteer jobs that they have been in for decades.
The remaining groups in the table are self-evident. We have all seen people screaming and
threatening in school board town hall meetings.
There are substantiated reports of severe threats to public health
officials and disaster workers. This is all politically motivated aggression and
violence that is precipitated by misinformation and political rhetoric. A good
recent example was the attempt to connect anti-immigrant rhetoric to hurricane relief
and suggest that funds were being diverted to undocumented immigrants. Gun
extremism and abortion clinic violence predates the most recent cycle but are
good examples of the process. Make emotional inaccurate claims, blame somebody
for the problem even if they are law abiding, and let the chips fall where they
may. This process just keeps repeating
itself with a party that always doubles down, never acknowledges they are wrong,
and never acknowledges what they are really doing – dividing people and turning
them against one another. This line of rhetoric also distracts from the
fact that the party in question really has no acceptable policy. When their self-proclaimed genius economic
policy was vetted by Nobel laureates in economics it was found to be seriously
deficient.
When I posted this graphic on another site I was immediately
confronted with the question about violence and crime created by undocumented
immigrants. I responded with
a study
done by the Department of Justice based on the arrest records of the most
right wing state in the US – Texas. That study shows that these people are much
less likely to be arrested for violent or property crimes than citizens born in
the US. Even without knowing about it –
it makes sense. The people at the southern border are fleeing corrupt governments
and criminals in South and Central America. The last thing they want to see happen is to
be deported back to their country of origin. Because they are undocumented, they
need to maintain as low a profile as possible. That would include no encounters
with law enforcement.
The idea that political violence could be compared to
violence by undocumented immigrants is a feature of the rhetoric used to
obscure the real problem. That real problem is that there should be no political
violence at all in the United States. Politics
in this country is supposed to operate on the peaceful transfer of power and no
party using its power to intimidate either the voters or the election process. We
are way past that at this point and it is all on one party. The political violence is a direct effect of dishonesty and manipulation. There has not been an adequate effort by the
opposition to push back in many of these areas and that leads me to have grave
concerns about the upcoming election.
I am hoping that the vote rejects political violence and all that involves so that people can feel safe and we can start to focus on real problems instead of contrived political problems. You can get rid of political violence by voting it out - at least in this election. It will be a worse problem to get rid of if it becomes institutionalized.
George Dawson, MD, DFAPA
Supplementary 1: Unfortunately I have to keep adding boxes. The latest is a direct comment form former President Trump. Before anyone suggests he was just "joking" or "nobody takes him seriously" or tires to explain it in any other way consider this. This is unprecedented discourse in an American election. It follows Trump threatening to use the military against his perceived "enemies form within." It should be fairly clear that he considers political opponents or in many cases people who just disagree with him as enemies. Violent rhetoric aside - this is not an attitude any reasonable politician can have when they are supposed to represent all of the American people.
