Discussion of “Violence: The Malignancy of Our Times! is There Hope?”

We are indebted to Dr. Benedek for her critically important and thoughtful presentation dealing with a crucial area of human behavior that affects us all. Dr. Benedek has been most comprehensive in her remarks, focusing on the increased prevalence of violence in the United States. Multiple causal factors for violent behavior have been cited, including poverty, unemployment, racism, lack of education, availability of guns, use of drugs, and mental illness.

Dr. Benedek's emphasis is on the epidemic proportions of domestic violence. I agree with Dr. Benedek that many important roots of human violence originate in the profound impact of domestic abuse, especially when it occurs at critical early stages of development. Evidence is rapidly accumulating about the personal cost of such early life experiences, not just in terms of suffering at the time but also long-term sequelae such as dissociative disorders, severe personality disorders, and posttraumatic stress disorder (PTSD). In particular, the recent burgeoning awareness of, and interest in, PTSD is consistent with Dr. Benedek's remarks, with the emphasis on domestic violence. It is increasingly recognized that PTSD is not just a new term for shell shock or combat fatigue but a chronic and disabling condition resulting from the small but deadly wars and battles going on next door and around the corner.

Dr. Benedek focuses especially on abuse against women and states that men perpetrate more aggressive actions against their female partners than women do against their male partners, which is certainly clear regarding physical and sexual abuse. In reviewing forms of abuse, she includes emotional and psychological abuse as precursors to, or accompanying aspects of, physical abuse. I would suggest that emotional and psychological abuse can be quite crippling in their own right, even if not accompanied by physical abuse, especially if directed at, over time, a vulnerable small