The Seeds of Aggression

12. January 2009 by admin.

By
Martin Masar, MSW/LCSW

Violence in our world remains at epidemic proportions. This article discusses a methodology for aggression intervention, by considering the origin and purpose of aggression. An examination of aggression from this perspective can lead to more effective, healthier and permanent solutions in our mental health work. Examining the multiple functions of aggression and then designing an intervention, might lead the practitioner beyond just problem-solving, to development of an intervention designed to address why the aggression was used to problem-solve. If a clinical intervention is designed to resolve or alleviate a difficulty, then it is logical the intervention will address the cause or purpose of the difficulty. In this presentation we will examine the multiple functions of aggression and then discuss a format used to develop effective intervention strategies. Violence at epidemic levels globally, calls for understanding the seeds of aggression and interventions designed to address lasting and permanent change.

Michael, almost 17 years old, was a young man, who learned to survive by using his strength and aggression to his advantage. He demonstrated his use of aggression with acts of violence towards others. Over time his aggression increased. Michael was raised in a world of anger, defiance and hatred. During his childhood he was repeatedly beaten. He learned that “might makes right.” In Michael’s mind the world was a terrible place, where he had come to expect the worst.

As I began therapy sessions with Michael he would demonstrate his aggression through the use of strong words and threats. Late one afternoon he stormed into the office lobby demanding to speak with me. He was very angry and threatening to hurt others. I welcomed Michael to my office. For the longest time he sat there quietly. Eventually he began to talk and each time I suggested a different problem-solving method, he would react with verbal assaults. I let him talk and began to notice the intensity of his anger decreasing. When he paused, I asked what inside of him made him so angry. Lifting his pant legs above his knees, he turned around. On the back of each leg were many scars – the product of his childhood torture. Michael’s scars symbolized the origin of his aggression. In Michael’s mind his aggressive behavior was his way of insuring he would never be scarred again.

An examination of aggression only from its effect or outcome limits our interventions to the effects. We spend time problem-solving the current situation, rather than understanding why the aggression was used to problem-solve. Examining aggression from its origin and then purpose leads to a myriad of strategies aimed at the cause, not the effect. We begin by examining different perspective of aggression.

Aggression can be a difficult behavior to change. In many persons it was imprinted through early learning, was repetitively demonstrated, when utilized was successful; it gained immediate reward and experienced few if any punishments or disappointments. (Reilly & Shopshire, 2006)
Aggression can be exhibited as an overt behavior. It is initiated by a variety of emotions and translated through cognitive perceptions. It is an emotional, behavioral and cognitive phenomenon, requiring interventions that address all three spheres. (Reilly & Shopshire, 2006)

The pioneering research of Jean Gervais and Richard Tremblay (2005) examines aggression in young children. Their research concludes that aggressive acts in young children are more frequent than their older counterpart adolescents. This phenomenon, they suggests, relates to the young child’s immature brain development, possible genetic temperament and includes the lack of ability for social awareness and self control. Dr. Gervais suggests aggression has a biological, genetic or inherited aspect, independent of the child’s subsequent learning. As the child grows and learns, he/she begins to understand and learn both social and personal control due to the relationship between the caregiver and the child. John Ratey (2001) and Emil Coccaro (2004) also discuss genetic involvement of aggression. Dr. Ratey indicates that aggression “used to be blamed on the environment,” however; new research suggests a genetic component affecting temperament. To further the point, Dr. Coccaro states aggression “has a substantial genetic component. What you really have is predispositional issues.”

In early childhood, the language centers of the brain go through a process of rapid growth. (Pally, 2002) As these centers grow, they seek knowledge to help understand and make sense of their environments. Thereafter, the brain develops narratives or stories that are stored and called upon in future decision–making and problem-solving. Learning and memory are the basis of all behavior. (Pinel, 2006) We use these stored memories in our decision-making for the rest of our lives. (Siegel, 1999) As this process develops our memory systems categorize and assimilate the information. This helps us make emotional and cognitive connections between places, events and ourselves. These connections direct and guide our actions and behavior.

We can see how early life experiences that are negative, abusive or harmful would affect the way we perceive (emotions) and interpret (cognitions) an event or situation. This happens because we have learned and remembered a variety of different narratives throughout our early childhood. This could lead the person to choose potentially maladaptive or inappropriate behaviors, which makes sense to them due to the negative narratives gained in early childhood, but may be inappropriate for the actual event or situation.

The learning of aggressive behavior can occur in a variety of situations. These include observation, imitation, personal experience and rehearsal. (Goldstein, Glick & Gibbs, 1998) Aggression may also include a combination of both learning and biology or genetics. A young child exposed to various experiences begins to acquire a knowledge base for the future use of aggression. This combined with genetic effects, would influence early cognitive perceptions. The child’s experiences may also be reinforced by a variety of other sources, such as care givers, schools, communities, neighborhoods, and media. All of these elements play a role in the manifestation and learning of aggression.
If the demonstration of aggression is viewed as a product of learning, then in an obvious, but often over-looked area, aggression regulation in adolescent may be an absence of alternative knowledge or learning. (Goldstein, Glick & Gibbs, 1998) Given the prevalence of aggression in our lives today, the acceptance of aggression as an appropriate means to and end, and the popular though unfortunate role models that use aggression, very little attention is given to the development and learning of more appropriate, healthy alternatives.

The use of aggression can have a powerful emotional effect. When aggressive, the individual may experience a release of body chemicals, which produce a pleasure sensation. This sensation gives a feeling of well-being and when tied to the aggressive behavior, has a tremendous and powerful reinforcement affect. (LeDoux, 1996; Pliszka, 2003) Daniel Siegel (1999) takes this a step further indicating that past traumatic experiences and other disruptive events can produce “maladaptive emotional regulation.” Here, due to traumatic stress and/or abuse the brain lacks the ability to achieve emotional regulation, or to self regulate. In either situation above the inability to self-regulate or regain emotional control may be intensified if the traumatic experiences are engrained within deep memory. Steven Pliszka (2003) writes that early childhood abuse and other negative childhood experiences, can produce stress levels that can permanently alter the brain’s functioning and the individual’s ability to ever self-regulate. If we presume that aggression is pure learning, then we can deduce that new learning can effectively alter and reduce episodes of aggression. However, to understand that aggression can also be a permanent brain impairment, gives quite a different scenario.

Aggression can serve as a function and come into existence through the acquisition of learning and memory. As a function, aggression can serve a socially identified outcome. Coccaro (2004) calls this “socially-sanctioned aggression.” For example, the coach of a sports team instructs the player, “Get aggressive!” Here channeled aggression into the opponent of the opposite team is viewed as a positive end result of aggression. The same case is true during acts of war, where aggression is seen as an adaptive response to environmental circumstances. Another example is the parent protecting their child from pending harm. The onset emotion maybe fear, which drives the otherwise calm parent to an act of aggression. Here aggression maybe a process driven by such emotions as fear, self-protection, safety, or even a sports team victory.

There are different types of aggression. An aggressive act can be proactive, reactive, (Vitiello & Stoff, 1997) or instrumental and noninstrumental. Proactive aggression is considered well-planned, directive and without emotion. Reactive aggression is impulsive, hostile and with emotion. Instrumental aggression is directed, intentional and purposeful; and noninstrumental aggression is non-directed, random, impulsive and unintentional. Emil Coccaro (2004) breaks down aggression into socially-sanctioned, medical, premeditated and impulsive. Socially-sanctioned aggression is an individual who is responding aggressively because of the situation in which they are placed. For example, war or a sporting event. Medical aggression is exhibited in response to some type of medical or biological condition that otherwise takes over the better judgment of the individual. An example of this might be poisoning or a medical illness. Next, premeditated aggression is seen in individuals that actively plan an aggressive event. It is goal directed and might be considered sociopathic in diagnostic terms. Finally, impulsive aggression is generally in response to a personal stressor, which triggers an aggressive response. Intermittent Explosive Disorder is often tied to impulsive aggression.

As we break-down the types of aggression, in the following paragraph we will examine how information is processed and a behavioral response determined. Prior to an action or behavior, an individual’s brain processes information is mere seconds and then determines the appropriate course of action. This is based on a variety of stored memories or experiences. (Siegel, 1999)

There are various stages of information processing we all go through as part of our decision to act aggressively. First the event or situation must be received and understood by the brain. This includes information such as the tone of voice, facial expression, body language, physical proximity, intention, and others. Next, this information, which is now received and understood, must be interpreted. Is the information friendly, neutral, educational, or hostile? Our brain then selects a goal for our interaction and generates possible responses. We then choose among the possible responses and carry out our interaction or behavior. (Siegel, 1999; Applegate & Shapiro, 2005) If we view an event as educational, we might calmly sit and listen; however, if an event is determined to be hostile, we might choose to act in an aggressive manner. Imagine how difficult or distorted the above information processing may become, if the individual has experienced or learned maladaptive responses or if the individual is under the influence of mind altering drugs, or if the individual has perceptual or cognitive distortions.

Some myths about aggression:

• Aggression is inherited. Evidence from research studies are mixed on this myth. Authors studying genetics and neuroscience suggest a biological or genetic component to aggression and others suggest no biological connection, rather a learned environmental phenomenon. (Gervais, 2003; Ratey, 2001) Recognizing a balance of influence between genetics and environment might provide the most reasonable consideration.
• Anger [aggression] automatically leads to violent outcome. Channeled aggression, such as in a sporting game, does not necessarily lead to violence. Controlled aggression can be used to assert energy.
• You must be aggressive to get what you want. Aggression and assertiveness are frequently confused. Aggression is usually used to control or dominate, whereas assertiveness, can be used to express oneself and in controlled manner.
• Venting anger [aggression] is always desirable. Research studies indicate the expression of aggression through such things as hitting a pillow and screaming, only reinforces aggressive behavior.
(Reilly & Shopshire, 2002)

An intervention is considered a procedure or technique that is designed to interrupt, interfere with or modify an ongoing maladaptive process. (Reber, 1995) A maladaptive response limits the individual’s ability to develop alternative behaviors. Maladaptive can also be seen as a behavior that causes psychic stress or emotional discomfort. And, a maladaptive behavior can have situational, cultural, personal, and social conditions, where demonstration of a behavior in one environment is appropriate, while demonstration of that same behavior in another is inappropriate.

An examination of violence is not enough; and an examination of aggression as a maladaptive behavior it not enough. Developing problem–solving strategies aimed at the effects of the aggression is not enough. As we move forward we need to examine a methodology for aggression intervention, by considering its origin and purpose. Rather than discuss the hundreds of creative interventions for aggression, various concepts will be discussed to assist the practitioner in determining what constitutes an effective intervention for the individual’s aggression. Imagine, as discussed previously, a parent acting aggressively out of fear for the certain harm of her child. Would our interventions ask the parent to just walk away or take a time out?

When developing an intervention for a particular behavior i.e., aggression, the following considerations should be evaluated and assessed:

• What is the purpose of the intervention?
o Is it to increase an action or behavior?
o Is it to decrease an action or behavior?
 The choice above is dependent on the severity of the behavior. The learning of new strengths and demonstration of new behaviors, builds from a strength based model.
• Will the intervention target the individuals’ emotion, cognitions or behaviors?
 The choice is a determination of the therapist; however, each area is essential in the therapeutic process, if we are to address the seeds of aggression.
• Was the action of the individual culturally, socially, personally or even age appropriate?
 Consider the context in which the aggression was exhibited.
• Will the intervention address the individual’s perception of the event?
o The event itself?
o How the event was felt?
 (emotion)
o How the event was processed?
 (cognition)
o Or how the person chose to behaviorally respond to the event?
 (behavior)
• Was the aggressive action considered proactive, reactive, instrumental, noninstrumental, socially-sanctioned, medical, premeditated or impulsive?
• Will the intervention seek to address social skills or awareness?
o Was there a lack of social understanding or misinterpretation?
• Will the intervention address relationships skills?
• Will the individual’s insight be addressed?
 (cognition)
• Does the individual find the release of aggression as pleasurable or uncomfortable?
o The more an individual finds aggression as pleasurable – the more difficult change becomes.
• Will the intervention seek to improve empathy?
o (Empathy helps the individual see the other person’s point of view)?
• Was the aggressive act driven by cognitive distortions?
o Consider A – B – C – D:
 What was the activating situation or event?
 What does the person believe as true about the event?
 What were the cognitions regarding the event and consequences?
 What is the most reasonable decision?
• Is the aggressive person viewed as “bad”?
o This reflects the therapist’s perceptions. If the aggressive person is viewed as “bad” we may tend to design punitive or disciplinary interventions. However, if the actions of the individual are viewed as a conditioned or learned response, we may choose an intervention that reflects the acquisition of new skills and/or behaviors?
• Was the aggressive act driven by an absence of knowledge?
o The individual just did not know what else to do.
• Will the intervention consider the age of the individual?
o Their maturation level?
o Their cognitive level?
• Will the intervention seek to reward new behaviors? If so, how?
• Will the identified intervention motivate the individual?
o Motivation is a powerful element in change.
• Did the aggressive act have a functional on dysfunctional purpose?
o Consider the types of aggression listed earlier.
• What theoretical orientation will the therapist use within the intervention?
o Cognitive Behavioral Therapy?
o Person Centered Therapy?
o Dialectic Behavioral Therapy?
o Others
• Does the intervention consider possible brain damage, a medical condition, drug induced aggression, or other brain altering conditions?
o Consider a complete medical and neurological evaluation.
• Was the aggressive event a reaction to fear, safety, guilt, shame, embarrassment, humiliation, etc?
o What emotion(s) were at the cause of the aggression?
• Was the aggressive event a reaction to jealousy, revenge, limit setting, selfishness, anger, defiance, etc?
o Same
• Will the intervention involve education, role play, unconscious emotions, deep memory, and coping strategies?
o Role-play has been found to be extremely helpful in the learning of new behaviors. (Beaulieu, 2006) Cognitive and behavioral rehearsals are just as important as physical exercise. Would you participate in a sporting event without practice?
• If the intervention serves to stop or extinguish a behavior, what new skills will be taught in place?
• Interventions should include recognition of affect, cognition, sensation and behavior.
o This bridges information across the various domains of the brain. This process of “neural integration” enables the person to integrate information across the various sections of their brain and builds self-awareness. This improves the ability for self-regulation, which leads to conscious awareness and more effective adaptive behavior. (Fonagy, Gergely, Jurist, & Target, 2002)

An examination of aggression through consideration of the above interventions, also seeks to assess if patterns exist. In the analysis of information consider replicated patterns, similar events or triggers, times and place, or any other events that appear to coincide with the aggression. This may help determine how aggression is used in a particular context or situation and may give rise to further exploration of the individual’s origin of aggression. And finally, to assess and gather the information needed calls for access to the individual’s history, school records, in-person interviews, testing and any other information that might be helpful. The more we know about an individual, the better we become at developing interventions to assist them.

Understanding and intervening with aggression at its origin and purpose can lead to more effective, healthier and permanent interventions in our mental health work. Examining the multiple functions of aggression and then designing an intervention, can lead the practitioner beyond just problem-solving, to development of an intervention designed to address why the aggression was used to problem-solve.

In this article we examined the multiple functions of aggression and discussed a format to develop effective intervention strategies. Understanding the seeds of aggression calls for the development of interventions designed to address the origins of aggression, which can lead to lasting and permanent change.

Remembering Michael:

As Michael left my office that day, I walked him to the lobby door and watched him return to his unit. The sun, in all its brilliance, gave away the scarring on his legs. I imagined how hard it must be for Michael to be teased about his legs. For a moment I was lost in a dream, trying to understand how a very young child could ever protect themselves against such vicious abuse. I wondered if anyone ever heard his screams.

In the months that followed Michael slowly improved. At first, there were very few days when he was not aggressive, but ever so slowly he began to show improvement. Michael and I developed his intervention plan. While it was built on exhibiting and rewarding positive behavior, it also called for him to write a brief paragraph when he misbehaved. In this paragraph, Michael was to describe the negative incident, how he responded and what he could have done differently.

Admittedly, Michael spent a lot of time writing his paragraphs. One day, while reviewing another set of paragraphs, Michael wrote the following (the grammar and spelling are Michael’s): I got in staffs face. I did no hit him this time. I feel bad tonite. I dont know why I feel this way. I no I let you down again. I run from my problems and I hit people. I am sorey for what I did. All I want is you give me a chance. (M. Masar, case file, 2005)

Reading Michael’s paragraph I just filled with emotion. Michael was connecting. For the first time in his life he was reaching out and trying to understand his aggressive behavior. He was connecting his behavior to both himself and others; and he was searching for answers. After several moments of quiet excitement, I went to Michael’s unit. Finding him in his room, I asked if he would like to visit. He cautiously agreed and moved the bedding around so I would have a place to sit. After a minute or two of cordial talk, I read the paragraph above to Michael. I believe he could see my eyes light up, hands shake and voice break ever so slightly. After I finished reading the paragraph, I put it aside and waited for Michael to speak. In a gentle voice he said, “So maybe I done better?” Looking earnestly at Michael I told him, “You done GREAT!” And maybe it was his smile or maybe it was his eyes, but in that moment, I believe that hurt child deep within Michael, sitting crossed legged in front of me – stopped screaming.

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References

Applegate, J.S., Shapiro, J.R. (2005). Neurobiology for clinical social work. New York: W.W. Norton & Company.

Beaulieu, D. (2006). Impact techniques: Applying our knowledge of human memory systems to psychotherapy. www.americanpsychotherapy.com; winter annals.

Coccaro, E. (2004). Understanding aggressive behavior through neuroscience. http://www.bioethics.gov/transcripts/sep04/session2.html.

Fonagy, P., Gergely, G., Jurist, E.L. Target, M. (2002). Affect regulation, metalization and the development of the self. New York: Other Press.

Gervais, J., Tremblay, R.E. (2005). Origins of Human Aggression. National Film Board of Canada. www.nfb.ca. Canada.

Goldstein, A.P., Glick, B., Gibbs, J.C. (1998). Aggression replacement training. Champaign, Illinois: Research Press.

LeDoux, J.E. (1996). The emotional brain: The mysterious underpinning of emotional life. New York: Simon & Schuster.

Pally, R. (2000). The mind-brain relationship. London: Karnac books.

Pinel, J.P.J. (2006). Biopsychology (6th ed.). Boston, Massachusetts: Pearson, A&B.

Pliszka, S.R. (2003). Neuroscience for the mental health clinician. New York: The Guilford Press.

Ratey,J.J. (2001). A user’s guide to the brain: Perception, attention, and the four theaters of the brain. New York: Vintage Books.

Reber, A.S. (1995). Dictionary of psychology. New York: Penguin Books.

Reilly,P.M., Shopshire,M.S. (2006). Anger management for substance abuse and mental health clients: A cognitive behavioral therapy manual. DHHS Pub. (SMA) 06-4213, Rockville, MD.

Siegel, D.J. (1999). The developing mind. New York: The Guilford Press.

Vitiello, B., Stoff, D.M. (1997). Subtypes of aggression and their relevance to child psychiatry. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 307-315.
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