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Joel Dvoskin

Former Acting Commissioner of Mental Health for the State of New York

Joel Dvoskin gives “insights into defusing violence, resolving crises”

March 6, 2014 | Education and Events | Comments
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This article was written by Dennis Grantham, Editor-in-Chief of Behavioral Healthcare featuring Conference ’14 speaker, Joel Dvoskin.

In an address to policymakers and law-enforcement personnel at the Crisis Intervention Team International Conference, forensic and clinical psychologist Joel Dvoskin, PhD, ABPP suggested that in order for society to deal effectively with a threat of violence, society must understand the path that led to it.

First, he explained, there’s a purely “cognitive” pathway to violence: “You’ve got something I want, and I’ve got a gun.” For this type of violence, the criminal justice system is about the best that I can come up with. There’s no easy solution for people who think that they have a right to take things from other people.”

But violence like this represents “a minority of violence in our society.” Much more violence is triggered along what he calls “an emotional, affective pathway, when people experience negative emotions that cause distress and escalate to a point where bad things happen.”  In these cases, traditional law enforcement approaches are not the best solutions.

“How many of you would describe yourselves as violent?” he asks, looking for hands but finding none. “People like you don’t consider yourselves to be violent people,” he suggests. But then he asks, “How many of you can say that under no circumstances could you ever become violent?”

For police, who must be prepared to use force, such a pledge is impossible, Dvoskin noted. “But even ordinary citizens – people who have nothing to do with law enforcement – all admit that ‘under some circumstance, I might become violent.’” He suggested three common scenarios – a threat to one’s children, a sense that one is cornered with no way out, and a threat to the life of another – all rooted in two powerful emotions:  fear and anger.

“People will do a lot to stop feeling fearful or stop feeling angry,” Dvoskin explains, noting that “when these emotions reach uncontrollable extremes, they can cause a great deal of damage.” Whether they do or not for people in crisis frequently depends on the actions of front-line professionals. Dvoskin offered these guidelines for reducing the risk of crisis-related violence:

  1. Assess risk of violence or suicide: “The best way to find out somebody’s intentions is to ask them,” he recommends, noting that in the past, many professionals avoided asking about suicidal intent for fear of “suggesting” it to a person in crisis. He says that too many professionals still avoid another essential query – whether a person in crisis is considering violence toward others – “for exactly the same ridiculous reason.”“There’s no one who knows more about their intentions that that person does. And I’ll tell you from personal experience that people are often all too willing to tell you.”
  2. Identify and reduce the threat.  Violent intent is usually driven by the desire to eliminate a threat. “If you ask a person in crisis, ‘are you thinking of hurting someone?’ and they reply, ‘Not if you get out of my face,’ you should say ‘thank you,’ and get out of their face,” Dvoskin says.“Threats are your friends,” he asserts, because they provide us with a warning and often, a way to mitigate that threat. When a person in crisis identifies what threatens them, it provides an opening. Into that opening, “you need to provide an option, a way to avoid the violence.” Using supportive and respectful follow-up questions, professionals can often identify and explore ways to reduce the perceived threat.
  3. Watch body language.  Communicating effectively in a crisis situation can be difficult. “Sometimes the person you’re speaking with cannot express their fear or their anger in words.” To reduce the risk of provoking the person in crisis, afford them plenty of personal space. “Don’t make them show you their feelings with threatening body language,” Dvoskin says.
  4. Reflect optimism. “This is hard to teach, but one of the beauties that you can bring to a crisis is to communicate to the person – verbally or nonverbally – that you can see a safe way out of the horrible place that they are in,” he says. “Of all the gifts that professionals can bring, your ability to reflect hope is the most important. That’s what people in crisis have the least of and what they need the most.”
  5. Offer safety.  Dvoskin related the story of a troubled New Yorker, standing on the sidewalk, waving a sword and spouting obscenities at bystanders. He asks: “What is going to happen if a policeman runs forward, gun pointed, and shouts, ‘Drop the sword or I’ll shoot?’ If you believe as I do that that the person with the sword is acting out of fear, then they are going to cling more tightly to that weapon.”He suggests an alternative: “What a more thoughtful officer might say is, ‘Hey, I’ve got great news. You don’t need your sword anymore. I’ve got a gun and I am going to make sure that no one can hurt you.’” Amid laughs from the audience, Dvoskin made his point: “Which do you think is going to get a better response – the language of coercion and threat, or the language of safety?”
  6. Mobilize protective factors.  “We know a lot about why people commit violence. But we rarely reflect on why they don’t,” Dvoskin says, noting that it is important to help people in crisis recall the many times that they coped successfully with past difficulties. “See those times as victories,” he advises.  “Then, explore what made the person courageous enough to deal with yesterday’s problems and what has changed to make them consider violence today.”