Violence in the Family as a Disorder of the Attachment and Caregiving Systems

It seems to me that as psychoanalysts and psychotherapists we have been appallingly slow to wake up to the prevalence and far-reaching consequences of violent behavior between family members, and especially the violence of parents. As a theme in the analytic literature and in training programs, it has been conspicuous by its absence. Yet there is now abundant evidence not only that it is much commoner than we had hitherto supposed but that it is a major contributory cause of a number of distressing and puzzling psychiatric syndromes. Since, moreover, violence breeds violence, violence in families tends to perpetuate itself from one generation to the next.

Why family violence as a causal factor in psychiatry should have been so neglected by clinicians-though, of course, not by social workers-would be a study in itself and cannot be entered into here. But the concentration in analytic circles on fantasy and the reluctance to examine the impact of real-life events have much to answer for. Ever since Freud made his famous, and in my view disastrous, volte-face in 1897, when he decided that the childhood seductions he had believed to be etiologically important were nothing more than the products of his patients’ imaginations, it has been extremely unfashionable to attribute psychopathology to real-life experiences. It is not an analyst's job, so the conventional wisdom has gone, to consider how a patient's parents may really have treated him or her, let alone to entertain the possibility, even probability, that a particular patient may have been the target for the violent words and violent deeds of one or both parents. To focus attention on such possibilities, I have often been told, is to be seduced by our patients’ prejudiced tales, to take sides, to make scapegoats of perfectly decent parents. And in any case, it is asserted, to do so could be of no help to the patient, would in fact be