I was incredibly grateful to receive the NZCCP Research/Study Award to fund a research project exploring people’s experiences of dissociation while perpetrating violence. Dissociation is defined as the ‘disruption of and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior’ (American Psychiatric Association, 2013, p. 291). I wish to thank the NZCCP and the Department of Corrections for their support in allowing this project to become a reality. Thank you also to my PhD supervisor and co-author, Devon Polaschek, the other part of the ‘we’ referred to in this report.

Background

This research project was born out of my PhD research in which first-person accounts of family violence events were gathered to develop an event-based model of family violence and identify pathways through it. The initial development of the model and its pathways was based on interviews with men and women that were completing family violence perpetrator treatment programmes in the community (Stairmand et al., 2020b). We then tested the generalisability of the model and its pathways to a high-risk sample; that is, men completing a high-intensity prison-based treatment programme designed for men with extensive histories of violent offending (Stairmand et al., 2020a).

For both samples, we found that approximately one-quarter to one-third of family violence events fit within the ‘automated violence’ pathway. In this pathway, participants’ accounts of their violence were consistent with an automated, script-driven process. In hindsight, this pathway captured participants’ experiences of either extreme emotion dysregulation or dissociative symptoms while perpetrating violence. When reviewing the literature to make sense of this finding, I was surprised to discover that there was not much literature on this topic. The handful of research studies to date that directly examined peoples’ experiences of dissociation while using violence found that a large minority of participants (22%–36%) had experienced dissociative symptoms while perpetrating violence (LaMotte & Murphy, 2017; Simoneti et al., 2000; Webermann & Murphy, 2019). However, those studies focused on measuring the presence of dissociative symptoms rather than understanding the experience of them. Furthermore, those studies only included participants who had perpetrated family violence and not other types of violence.

As I completed my PhD research and then my clinical psychology training, the lack of research exploring people’s experiences of dissociative violence continued to gnaw at me. Although a small number of studies had convincingly established that dissociation while using violence was a relatively common experience, it continued to be largely overlooked in violence theories and research (see Moskowitz, 2004 for a detailed review). Through my clinical work in providing offence-focused assessment and treatment at the Department of Corrections, I also came across examples of dissociative violence in other contexts (e.g. violence towards rival gang members, strangers and friends or associates). Anecdotal accounts from other researchers that explored violence in New Zealand prisons indicated that they had made the same observation (Brennan-Tupara, 2023).

Our Research

The aim of our research was to explore peoples’ experiences of dissociative violence, including the circumstances in which it occurred, the nature of the violence perpetrated and peoples’ understanding of their use of violence in this context. Because we are in the process of publishing our research in an academic journal (Stairmand & Polaschek, 2023), I have provided only a brief and informal overview of our research methodology and findings here.

First, I reviewed the participant transcripts from my PhD research and identified eight cases from the ‘automated violence’ pathway where dissociative symptoms were featured. I then returned to the prison-based special treatment unit where I had interviewed men for my PhD research, and conducted more interviews. This time, I specifically asked the men to describe events in which they had experienced dissociation while using violence. I interviewed another 14 men, nine of whom described dissociative violence and were included in this study. I qualitatively analysed the collected data using reflexive thematic analysis (Braun & Clarke, 2006, 2022), as this approach fit well with the aims of the research.

At the final stage of analysis, three overarching themes and two subthemes were generated. The first theme explored participants’ experiences of feeling overwhelmed by unpleasant emotions (e.g. hurt, betrayal and fear) immediately before experiencing dissociative symptoms. Some participants had reported that something about the event had reminded them of prior traumatic experiences (e.g. being sexually propositioned by the victim after experiencing childhood sexual abuse), whereas other participants reported that the victim had done something to threaten an important attachment relationship (e.g. cheating on them, hurting a loved one).

The second theme explored participants’ experiences of disconnecting from, and then subsequently reconnecting to, their usual ways of experiencing themselves and the world. A range of dissociative symptoms were described, including not feeling any emotions or physical pain, not feeling like themselves, watching themselves do the violence, time slowing down and periods of memory loss. Participants experienced these symptoms as odd and unexplainable. Participants’ reconnection coincided with the end of their use of violence. This either occurred spontaneously or as a result of external intervention.

The final theme explored the ‘extreme’ nature of participants’ violence, both objectively and subjectively. Participants typically used prolonged violence that caused serious injury or death. They often described feeling scared, shocked and ashamed by their violence and what they were capable of.

Implications for Clinical Practice

The findings have multiple potential implications for clinical practice. These include the following.

  • Trauma-focused treatment should be offered before or alongside offence-focused treatment.

  • Dissociative symptoms during violence perpetration may pose barriers to meaningful engagement in offence-focused assessment and treatment (e.g. completing treatment tasks such as developing an offence map, and applying skills taught in the treatment during future instances of dissociative violence)…

  • …unless we adapt our ‘usual’ clinical practice to take these into account (e.g. by providing psychoeducation on dissociation and the link to childhood trauma, or by broadening or shifting the focus of treatment to factors that contribute to dissociative states).

  • Screening for dissociative violence may be useful.

  • A trauma-informed approach could also be extended to risk assessment (e.g. by considering how risk factors for violence may relate to dissociative symptoms: Does a person’s explanation of their offending reflect emotional detachment as a dissociative symptom, or a lack of empathy? How can we support people to discuss and reflect on their violence use in a non-therapeutic context?).

Limitations

These findings need to be considered in the context of the limitations of our research. These limitations include: our reliance on participants’ retrospective accounts of violent events; the small sample size that did not allow us to explore any potential differences in peoples’ experiences; and we did not investigate potential patterns across events for individual participants. The latter two limitations also suggest potential avenues for further research.