Can We Treat Violence?

Can We Treat Violence?

                                                                                                           

Professor Gwen Adshead



a lecture at Gresham College London.

 

In these lectures, I have tried to emphasise the complexity of violence as a human behaviour and suggested that it can be considered a form of communication; albeit a harmful and dangerous one. I have suggested that while numerically far too common, violence is still an unusual way for humans to break the law or express distress. I have also emphasised that different types of relationship underpin different types of violence: that there is violence against people one knows well, and there is violence against strangers, and these are not the same.

I want now to consider the 'treatment' of violence. An immediate objection may be that the word treatment is inappropriate; that violence is not an illness, and that the language of treatment minimises the harm done by, and the cruel intentions of the perpetrator. Space does not permit me to explore this issue in any depth here; suffice to say that I accept that warning and agree with it to some extent. (I discuss this argument in detail in a chapter in a forthcoming book: Crisp & Harrosh, in press). However, in the context in which I work as a doctor, treatment is the word we use for those interventions that are offered to mentally disordered offenders who are detained in secure hospitals. It is relevant that prisoners are offered 'interventions' by psychologists working in prison, not 'treatment'; although sex offenders are offered a 'treatment' programme (about which I say more later).

The tension is both linguistic and philosophical. It arises because 'treatment' is usually reserved for people called 'patients', who are facing a problem not of their choosing. Treatment is usually reserved for conditions or problems that will help someone feel 'better' in themselves; less discomfort, less pain. But in the case of violent crime, there is often a demand that the offender should not feel good about himself; and should not suffer less discomfort or pain, but should suffer more because they have chosen their situation when they offended. Although it is a mantra of the criminal justice system that it is the loss of liberty that is the punishment, not the spending of the time in prison, nevertheless there is a strong voice in most communities that argues that violent offenders should suffer as part of their punishment.

We also sometimes say that the treatment will restore someone to their 'normal' self. Another objection to the use of the word 'treatment' is that we (the non-offending citizenry) may not want prisoners to be returned to their 'normal' selves; in fact, we may want prisoners to undergo a significant change of mind, feelings and behaviour. Bluntly, we want offenders not to feel better, but to behave better: to 'become' better people. Health care interventions are usually seen as being morally neutral, and doctors have traditionally felt uneasy about operations and treatments with moral aspects (abortion being the most obvious example). Interventions of any kind that might change people permanently are usually seen as being rather serious and special; and requiring consent of the person who undergoes them.