Violence and Anger Disorders: A Case Study

Violence and Aggression Disorders

I met a male friend in Hualien who exhibits violent and aggressive behavior.
He often speaks loudly to his girlfriend or relatives, whether intentionally or unintentionally, causing his girlfriend to experience mental stress, insomnia, and autonomic nervous system disorders.
This has led her to quit smoking, yet she feels compelled to smoke again.
In front of friends, he presents one persona, while behind closed doors, he behaves differently with his girlfriend.
Although he has previously used methamphetamine, I believe this is not an excuse.
His girlfriend, who has good intentions, feels as though he is deliberately trying to hurt her.
When she is happy, he tends to lash out unpredictably.
In summary, he often contradicts her and creates a hostile atmosphere, using it as an excuse to become physically aggressive.
His girlfriend, despite being in the right, ends up apologizing in a subdued manner.
After becoming good friends with her, I began to notice some subtle signs of distress.
It seems he is slowly and cleverly causing harm, making her feel less than human.
My friend feels pity for him but has given up hope for his improvement, which affects others around him.
My friend often feels suicidal but tells himself he needs to break free from this four-year-long shadow that has loomed over him since he was 16.

Li Mei, 30~39 year old female. Ask Date: 2005/05/16

Dr. Tang Xinbei reply Psychiatry

Dear Limey,
Your question is somewhat complex, so I will try to clarify a few points:
1.
Your friend, who is only twenty years old, seems to be troubled by her boyfriend's issues.
Her boyfriend has been using drugs, specifically methamphetamine, which appears to have altered his personality.
He has become suspicious, feels persecuted, experiences emotional instability, has unexplained outbursts of anger, and even exhibits violent tendencies.
Since I have not seen him in person, I cannot confirm a diagnosis, but it is very likely that he is experiencing methamphetamine-induced psychosis.
Additionally, there may be underlying personality issues, as many studies both domestically and internationally indicate that individuals who abuse drugs often have concurrent personality disorders.
It is advisable to involve his family and seek psychiatric care for him as soon as possible for further evaluation and necessary treatment.
2.
Your friend seems to be experiencing emotional distress due to her boyfriend's behavior and emotional state, leading to symptoms such as anxiety, insomnia, and autonomic nervous system dysregulation.
Consequently, her mood has been affected, resulting in feelings of depression and difficulty quitting smoking.
It appears that you are very concerned about your friend, and since you seem to be older than her, I hope you can continue to provide her with care and support, encouraging her to leave this relationship and cut ties with her boyfriend.
Of course, this is not an easy task for many people, and you could accompany her to psychiatric appointments, where professionals can further assess her situation, help her understand the impact of this complicated relationship, and teach her how to cope and adjust.
She can learn new methods and techniques to face challenges and overcome difficulties.
Wishing you peace and joy!

Reply Date: 2005/05/16

More Info

Understanding violence and anger disorders is crucial, especially in the context of interpersonal relationships. The case you presented highlights a complex interplay of emotional distress, substance abuse, and the impact of one individual’s behavior on another’s mental health. This situation is not uncommon, as many individuals who struggle with anger and violence often have underlying psychological issues that manifest in harmful ways.

Your friend’s behavior, characterized by violent outbursts and emotional volatility, suggests the possibility of an underlying anger disorder or even a personality disorder. Anger disorders can range from intermittent explosive disorder, where individuals experience sudden episodes of intense anger, to more pervasive issues like antisocial personality disorder, which can include a disregard for the feelings and rights of others. The fact that your friend has a history of substance abuse, specifically with amphetamines, complicates the situation further. Substance abuse can exacerbate underlying mental health issues, leading to increased aggression and impulsivity.

The impact of your friend’s behavior on his girlfriend is significant. It is evident that she is experiencing considerable emotional distress, which can manifest as anxiety, insomnia, and even physical health issues like autonomic nervous system dysregulation. The cycle of abuse often leads to a phenomenon known as "trauma bonding," where the victim feels a strong emotional attachment to the abuser despite the harm they cause. This can make it incredibly difficult for the victim to leave the relationship, as they may feel responsible for the abuser's emotions or fear the consequences of leaving.

In terms of treatment, it is essential for your friend to seek professional help. Therapy, particularly cognitive-behavioral therapy (CBT), can be effective in addressing anger management issues. CBT helps individuals recognize and change negative thought patterns that contribute to their anger and violent behavior. Additionally, if substance abuse is a factor, a comprehensive treatment plan that includes substance abuse counseling is critical. This may involve detoxification, rehabilitation, and ongoing support groups.

For the girlfriend, it is equally important to seek support. She may benefit from individual therapy to process her experiences and develop coping strategies. Support groups for individuals in abusive relationships can also provide a safe space for her to share her feelings and gain insight from others who have faced similar challenges.

It is also important to address the broader context of their relationship. Open communication about feelings and boundaries is essential, but it can be challenging in a dynamic where one partner is frequently aggressive. Encouraging your friend to engage in anger management classes or workshops could provide him with tools to better manage his emotions and reduce the likelihood of violent outbursts.

In conclusion, the situation you described is a complex interplay of emotional and psychological factors that require a multifaceted approach to treatment. Both individuals involved need support and professional intervention to break the cycle of violence and emotional distress. Encouraging them to seek help is a vital step toward healing and recovery.

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