In the first instance, we should return to the attachment triangle in chapter two, which described the developmental pathway of the personality disordered offender. Figure 4.1 shows how one might compare the development of a core understanding of oneself in relation to others – patterns of interpersonal relating – to a triangle of the here-and-now, linking these patterns to intimate and social relationships as well as the relationship with the offender manager and MAPPP.
In other words, if the development of attachment and early experiences of trauma sets up a repeated pattern of relating to others, what does this suggest that we – the offender manager, the hostel, MAPPP or the community mental health team – might expect in terms of behaviour and interpersonal functioning?
If we return to the case of Billy (detailed in previous chapters), we know that he experienced his mother as seductive and loving, but also as erratic and rejecting of him. His father was apparently a rapist, and a subsequent positive relationship with his step-father was abruptly severed with his sudden death. In adolescence he was placed in Local Authority care, and the only attention he received was in the form of sexual abuse by a male staff member – the sexual contact was unwanted but better than no attention at all. In adulthood, Billy began by selling his body to men, working as a rent boy; this reflected the sexual way in which he defined himself. He went on to have intense, but brief and conflictual relationships with women. Finally, the index offence – indecent assault – appeared to have been an expression of rage, triggered by the victim’s understandable rejection of him.
What might we therefore expect in terms of Billy’s relationship with others, following his release from prison into an approved premises?
An alternative way of developing a community management plan would be to focus on what we know about core and secondary personality characteristics. Table 4.2 outlines the core beliefs, and interpersonal styles of each of the personality disorders (as defined by DSM-IV). These ideas are drawn from Millon and Padesky, and link closely to cognitive behavioural theories of personality disorder.
Self-schema relates to the individual’s core belief about himself, usually drawn from early developmental experiences and/or inherent traits, and reinforced over the years.
World schemas describe the key traits with which the individual views himself in relation to the world around him/her.
Expressive acts refers to the way in which others experience the personality disordered individual, the observable behaviours
The interpersonal strategy describes the primary means by which the individual approaches and relates to others.
Personality type | Self-schema | World schema | Expressive Acts | Interpersonal strategy |
---|---|---|---|---|
Paranoid | Right/noble | Malicious | Defensive | Suspicious or provocative |
Schizoid | Self-sufficient | Intrusive or unimportant | Impassive | Isolated or unengaged |
Schizotypal | Estranged | Varies | Eccentric | Secretive |
Antisocial | Strong/alone | A jungle | Impulsive | Deceive or manipulate |
Borderline | Bad or vulnerable | Dangerous | Spasmodic | Attach or attack |
Histrionic | Inadequate | Seducible | Dramatic | Charm or seek attention |
Narcissistic | Admirable | Threatening | Haughty | Compete or exploit |
Avoidant | Worthless | Critical | Fretful | Avoid |
Dependent | Helpless | Overwhelming | Incompetent | Submit |
Obsessive-compulsive | Competent or conscientious | Needs order | Disciplined | Control or respectful |
Consider Peter again. In chapter two he was identified as being largely narcissistic – with a few antisocial traits – in his presentation and history. That is, he repeatedly holds an extremely positive view of himself as admirable and right, experiencing others as potentially posing a threat to this self image if they stand up to him or thwart him. Almost always, he is experienced by others as haughty and contemptuous in his attitudes, and others often feel that he pushes them into a competitive stance, or that he uses and manipulates them. How might these characteristics be reflected in his pattern of offending – sexual assaults on pubescent boys – and in his behaviour with others?
Any risk management plan, with Peter, would have to consider the relationship between his personality traits and his offending and behaviour, and try to disentangle those aspects which were primarily linked to future risk from those characteristics which were perhaps annoying but ‘harmless’.