Q & A
(917) 710-7578 firstname.lastname@example.orgHoward Z. Lorber, csw
Psychotherapist & Anthropologist
I heard some practitioners in our field make a distinction between
“rehabilitation” and “treatment” for batterers. The drift of their
discussion tended to laud “rehabilitation” and condemn “treatment.” Now,
this is, from my point of view, a curious distinction and I didn’t know what
was meant by it, so I asked. They had a difficult time with their answer, and,
ultimately, stated that they would have to ‘think about it’. My sense is
that this is an important distinction and, like so many terms in our field,
stand in need of clarification.
time ago the philosopher, Wittgenstein, started to change the way we look at
language. He compared language to a ‘tool kit’. Like the tools in the kit,
though there are important differences among them (as he said “nothing could
be more different than glue and a chisel”) they “[are] used in a family of
ways.” That is, while the glue is used to pull things together and the chisel
is used to cut things away, they are both necessary to make a chair. To
understand the tool, then, one needs to understand how the tool is used by
itself and with others in the kit. That which makes the meaning of a word is the
use to which that word it put and the context in which it is used. Nothing new
in this really; this is the way we go about understanding our clients or
anybody when we work with them. And, as with our clients, we don’t simply take
their words at face value, but evaluate how these meanings developed
historically. To understand the meaning of “rehabilitation” and
“treatment”, then, we need to look at how they are used and what sort of
context they have.
first glance one would think that “rehabilitation” and “treatment” are
equivalent tools in our linguistic tool kit much the way two different sorts
of hammers, say a maul and a claw, are rough equivalents. Both can drive home a
nail, even though, in fact the former is best used to break iron and
concrete and the latter is designed to drive and pull nails. In the case of
“rehabilitation” and “treatment” it is thought by some that if, like the
maul and claw, if they are inserted in the context of ‘facilitating
change’, they mean, if not exactly the same thing, something very similar. The
reasoning goes something like this: if you intend to rehabilitate someone, you
are literally trying to re-fit (re-habilitate) them to perform socially; if you
involve someone in “treatment” you are attempting to facilitate change so
the person can overcome their interpersonal “difficulties in living” (H.S.
Sullivan, The Interpersonal Theory of Psychiatry); helping someone
resolve interpersonal difficulties is re-fitting someone for social life --
i.e., facilitating change; the terms are, thus, equivalent. Yet nothing could be
farther from the case.
key interpersonal ‘difficulty’ for batterers, at a behavioral level, is that
they are violent in their relationships. Our direct task, then, is to work
toward the goal of stopping the inappropriate ‘use of hands’ in
relationships. In this sense ‘re-habilitate’ refers back to a slightly
different and earlier meaning of the term: to change the way the hands are used
socially. Bluntly, we want the hitting to stop. This is, of course, not the only
thing wanted or needed: we are trying to effect change so that the conditions
that foster such inappropriate social use of then hands in the family no longer
exist. How is this to be effected?
the history of criminology there have been two standard answers: we can either
punish those who are doing wrong so they won’t do it again, or we can try,
somehow, to show them, or convince them, that what they are doing is the wrong
way to be, so they would want to stop.
origin of the word ‘penitentiary’ in the 19th century comes from the notion
that the wrongdoer should have time and place to reflect on the wrongs committed
so they wouldn’t do them again. It was an attempt to move away from strategies
of pure punishment: hanging, drawing and quartering, branding, and cutting off
ears, noses and lips, were seen as more and more ineffective as deterrents
to criminal behavior since the crime rate continued to rise. On the other hand,
it was and still is believed that society as opposed to individuals should
reserve to itself the right to punish social wrongs, i.e., wrongs against its
members as representatives of itself.
penitent was intended as a process for accepting guilt for wrongs in order to
correct one’s wrong behavior. In short, this is punishment internalized in order
to provide a deterrent to wrongdoing. The penitential process was supposed to
rehabilitate re-fit the wrongdoer for society. The origin of
‘rehabilitation’, then, is the use of law as a means of effecting the
conversion of social guilt into personal guilt.
a conversion shifts the issue from the external to the internal, from the power
of the society to regulate behavior to the self-regulation of behavior.
Implicitly, ‘rehabilitation’ requires the acceptance of social guilt as
(self) punishment. The fly in the ointment, as those who are quite open in their
desire for punishment of wrongdoers are happy to point out, is that
‘rehabilitation’ in this sense does not stop wrongdoing.
should this be so? It is because the attempt to effect a system of (self)
punishment, of internalized guilt, leads to internal conflict and resentment.
Isn’t this just the sort of thing that Freud spoke of, though from quite a
different perspective, in his Totem and Taboo and Civilization and its
Discontents? In these works the socialization of the child is bound up in
the internalization of the Oedipal struggle and the development of guilt,
conflict and resentment from the repression of instinctual aims. Isn’t
‘rehabilitation’ simply this? Isn’t ‘rehabilitation’ equivalent to
this sort of socialization? This socialization process requires the internalization
of guilt; that is, it requires self-punishment and builds in conflict and
the guilty individual to remain within society, that is, to remain within significant
relationships, that individual must build up defenses against self
-punishment. That is, they must build up processes of thought and action that
relieve themselves from the inner conviction that they are, in some profound
sense, “bad.” Isn’t this sense of “badness” what’s meant when we
speak of the batterer’s “low self esteem”?
defensive process that provide this sort of relief is something that R.W.D.
Fairbairn (Psychoanalytic Studies of the Personality) called “the moral
defense”. In this process the individual, having internalized and repressed a
sense of self as “unconditionally bad,” continually fears its re-emergence.
The means of muting and mitigating this hopeless feeling state is the attempt to
recognize the self as merely “conditionally bad ... leaving] room for hope
owing to the possibilities of repentance and forgiveness.” (Op. Cit.:
165) Repentance and forgiveness, in their turn, ‘prove’ the individual
“conditionally bad” to themselves as well as to others. This ‘proof’
leaves open the possibility of the re-emergence of the sense of self as
“unconditionally bad,” and so on, ‘round and ‘round in a cyclical
manner. In other words, an individual’s acceptance and internalization of
guilt is, at one in the same time, an internalized self-punishment and an
attempt to mitigate the hopeless state of “unconditional badness”. As only
mitigated, however, the sense of hopelessness underlies and continually tries
to ‘break through’, so the individual is left with conflict and
resentment, internally and toward those empowered to forgive. If this process
sounds familiar to us it is because it parallels, actually it underlies,
the “batterers’ cycle” as developed by Leonore Walker (The Battered
this cycle is so familiar to us I won’t do any extensive presentation of it
here. To refresh our memories though, the batterers cycle has three
phases, the acute battering phase, the “contrite, loving phase,” and the
phase of anxiety and build—up to the next acute battering phase. As a cycle,
one can break in at any point since each phase is equally significant in the
process. The usual pattern is to start with e either the build—up or the acute
battering phases. I’m going to start, however, with the contrite loving phase
because of its particular defensive qualities.
Walker’s “contrite, loving phase” the aggressor comes to the victim asking
for forgiveness and undertakes the process of ‘courting’ the battered mate.
In the aftermath of the outbreak of violence the aggressor senses the
emergence of the repressed feeling of being “unconditionally bad” because of
those very acts of violence. In order that the self not be regarded as
“unconditionally bad,” the mate is sought for forgiveness so that the
batterer can be proved to be merely “conditionally bad.” The mate then can
act as the external conscience (super ego), on the one hand, and as the object
of desire, on the other. The mate, in turn, for a variety of dynamic reason, is
enabled to fulfill their own internal need to sense themselves as good. That is,
the one battered can find, in the batterer’s desire for forgiveness, the
external realization of themselves as “conditionally good” and thus
(internally) forgiven for the aggression they bear toward their own sense of
badness. This process in turn sets off, on both parts, fantasies of merger and a
sense of dependency. This, in turn, leads to a growing fear of the loss of self
and a need to guard their “self-esteem.” Once again they will then be lead
right back into the build—up to the acute battering phase, continuing the
cyclical process. The batterer’s contrition and acts of penitence remain
indesolulably contradictory so long as they do not lead out of the morass of
so it is with the ‘rehabilitation’ process. so long as the ‘re-fitting’
of an individual requires the penitential process of accepting social guilt as
self punishment, the individual remains locked into conflict and resentment.
can be done to help extricate the people with whom we work, and our programs,
from this bind?
people break out of the cycle of their defenses against their feelings of
“unconditional badness,” that is their struggle with self-punishment, is the
work of psychotherapeutic treatment. This treatment will work to show the
individual how they protect themselves against the sense that they have lost
themselves in their mate, and that their feelings of rejection because they
cannot, in fact, merge and be ‘one’ with that mate. The treatment process
will, further, facilitate the development of an independent, differentiated,
sense of having a self, in order that the individual’s dependency needs become
expressible without the guilty feeling that these needs will gobble up either
themselves or their mate. In the development of a differentiated self both the
rageful, destructive impulses arising from thwarted dependency needs and the
need to be ‘forgiven’ for having these needs will be reduced. The violent
acting out of these defenses against the neurotic sense of loss of self and
attendant self/other punishment will then be extinguished.
the beginning of this piece I introduced Wittgenstein’s notion that we understand
words by how they are used. Now we are in a better position to understand the
meaning of “rehabilitation” and clearly distinguish it from “treatment.”
Making this distinction clear will help us better develop programs and clinical
approaches that steer clear of the contradiction noted above.
it has been developed and as it has been used, the ‘rehabilitation’ process,
whatever its proponents assert it to be, is an essentially punitive process.
Thus it should come as no surprise that those who seek to develop rehabilitative
schemes see them belonging to the criminal justice system. Moreover, it is a
particularly pernicious process in that it demands the internalization of
self-punishment while being radically blind to the damaging internal processes
it engenders. The substitution of external punishment for internal not only
changes its venue, it places the guilty at the moral boundaries of society —
it alienates rather than integrates. The treatment process, on the other hand,
addresses the operation of the internalized self-punitive processes, the
defenses against this internalization, and the violent acting out of these
defenses. Treatment looks not to the “control” of impulses by making an alliance
with an individual’s self-punishment; rather it looks to change the way feelings
are generated, received and acted upon so the desire for punishment and
penitence are no longer needed. By helping the individual move from his
isolation and fear, the treatment process facilitates his sense of integration,
both internally as a self and socially as an individual.
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