Animal Cruelty ' Therapy'?

[Meerkat]

We have a pt who tortures animals (I'll spare you the details---it's nauseating)...and some staff members decided to let him have fruit as a substitute for his urges. He is given a spoon or a pencil and stabs, mutilates, smashes, etc the fruit in this hazy-eyed gaze.

Somehow this doesn't seem right to me. Isn't this feeding in to destructive urges? Sure, I'd much rather see an orange violated than an animal...but this doesn't sit well with me. Any opinions?

[Meraki]

I must say I am a little alarmed by the responses referring to this child/youth as a serail killer waiting to happen and also to the proposed solution of locking him up.

Perhaps my reaction to these responses comes from the fact that the model of care in my area is much much different. I have worked child /adolescent inpatient psych for 9 years, having seen more than 2000 admissions of the most acute and complex kids and 99.9% return to the community upon discharge (and our length of stay is 2 weeks). There is no option of lock-up for us and for that i am grateful, I guess I don't see how it would benefit the child to be removed from family, from society and locked up.

Our model of care focuses on the needs of the child / youth. And in this situation my assessment would focus on what are this child's current and historical unmet needs? What traumatic experiences has he gone through? What relationship permanence is there in his life?

Although we know little clinical details that fact that he is quiet and isolative indicates he may never have developed an appropriate outlet to deal with difficult or distressing situations and emotions. He may be filled with pent up anger, sadness, and hurt, which may all be legitimate feelings depending on what he has been through in his life (absence of mother etc...)

Also the fact that he is able to transfer his "mutilation" onto a fruit tells me in fact he is probably not "serial killer" / antisocial material. Usually the antisocial personality hurts animals to show their sense of power by being able to end life, they like to cause pain and the high comes from watching something suffer. None of these benefits are present if one attacks an orange...there is no suffering / no pain / no death, there is no power.

This is a child / youth who is obviously in need of help...that could provide him with stability, with caring people in his life, with anger management, with counselling, with frequent outlets to express himself...what are his strengths and how can you build that into a treatment plan that can be executed in the community...etc...?

As psychiatric professionals I would hope to see more compassion and more of a focus on this child's needs rather than a lock him up and thow away the key approach.

[rn/writer, RN]

I must say I am a little alarmed by the responses referring to this child/youth as a serail killer waiting to happen and also to the proposed solution of locking him up.

Perhaps my reaction to these responses comes from the fact that the model of care in my area is much much different. I have worked child /adolescent inpatient psych for 9 years, having seen more than 2000 admissions of the most acute and complex kids and 99.9% return to the community upon discharge (and our length of stay is 2 weeks). There is no option of lock-up for us and for that i am grateful, I guess I don't see how it would benefit the child to be removed from family, from society and locked up.

Our model of care focuses on the needs of the child / youth. And in this situation my assessment would focus on what are this child's current and historical unmet needs? What traumatic experiences has he gone through? What relationship permanence is there in his life?

Although we know little clinical details that fact that he is quiet and isolative indicates he may never have developed an appropriate outlet to deal with difficult or distressing situations and emotions. He may be filled with pent up anger, sadness, and hurt, which may all be legitimate feelings depending on what he has been through in his life (absence of mother etc...)

Also the fact that he is able to transfer his "mutilation" onto a fruit tells me in fact he is probably not "serial killer" / antisocial material. Usually the antisocial personality hurts animals to show their sense of power by being able to end life, they like to cause pain and the high comes from watching something suffer. None of these benefits are present if one attacks an orange...there is no suffering / no pain / no death, there is no power.

This is a child / youth who is obviously in need of help...that could provide him with stability, with caring people in his life, with anger management, with counselling, with frequent outlets to express himself...what are his strengths and how can you build that into a treatment plan that can be executed in the community...etc...?

As psychiatric professionals I would hope to see more compassion and more of a focus on this child's needs rather than a lock him up and thow away the key approach.

There is a concommittent imperative to balance the child's needs with the needs of those around him to be safe. Not to mention HIS need to be prevented from continuing to kill and mutilate small creatures with the very real possibility that such behavior will escalate. This is especially true in light of the fact that his father doesn't appear to take such behavior very seriously.

Transferring attacking behavior to fruit is NOT an indication that this boy doesn't have the potential to be dangerous. He may be picturing a hamster when he's stabbing the thing. And it may be the only outlet he has under the circumstances. If he continued to "go after" fruit and leave animals alone after his release, maybe that would demonstrate a de-escalation of his rage, but if his animal attacks resume with availability, I'd say the fruit desecration was merely a substitute for the "real thing" and I'd be quite concerned.

To be sure, serial killers are an exceedingly small portion of the population and we shouldn't be branding this kid just yet. But consider that those who progressed to that point almost universally had a history of torturing, mutilating, and/or killing small animals. Most also engaged in fire-starting and had problems with bedwetting, so these areas would be of great importance to investigate.

Yes, there needs to be a thorough evaluation of this child to see what he truly needs (and it ain't stabbing oranges) and then serious efforts made to provide whatever is indicated. But keeping this kid contained and preventing him from continued killing is not mutually exclusive with that goal. In fact, clamping down on the animal cruelty may well increase his internal pressure to the point that his anger and frustration (and their real causes) may erupt and become open enough to address.

At the very least, confining him and removing the means to commit further acts of violence would buy some time.

[Meerkat]

Thank you for the very intelligent posts. Let me add that when given the fruit, the boy said it didn't help him, because it wasn't 'alive'. To me that's pretty scary.

[Meerkat]

I forgot to add, there was some bed wetting early on, but not now. No idea about fire setting.

[indigo girl]

Thank you for the very intelligent posts. Let me add that when given the fruit, the boy said it didn't help him, because it wasn't 'alive'. To me that's pretty scary.

I agree it is scary. You know, sometimes you have to go the extra mile, and do whatever it takes when your gut tells you a dangerous situation has been handled badly. Who runs your facility? Can you talk to your director of nurses about your concerns? Would you talk to his docs?

I read this thread while on vacation and could not post (forgot my code). I found it profoundly disturbing because I remembered you had said that the boy said stabbing the fruit did not help him because it was not alive. I kept thinking about that. And, that is what you need to impress upon whoever you can, who can help you to get this child the help he needs. If it means that he has to stay in a locked ward, than it is better than letting him go as he is. If his father continues to enable his behavior with his denial of it, this child may be better off being a ward of the state. It is so completely unethical to release him as he is, and so dangerous.

[Meerkat]

I agree it is scary. You know, sometimes you have to go the extra mile, and do whatever it takes when your gut tells you a dangerous situation has been handled badly. Who runs your facility? Can you talk to your director of nurses about your concerns? Would you talk to his docs?

I read this thread while on vacation and could not post (forgot my code). I found it profoundly disturbing because I remembered you had said that the boy said stabbing the fruit did not help him because it was not alive. I kept thinking about that. And, that is what you need to impress upon whoever you can, who can help you to get this child the help he needs. If it means that he has to stay in a locked ward, than it is better than letting him go as he is. If his father continues to enable his behavior with his denial of it, this child may be better off being a ward of the state. It is so completely unethical to release him as he is, and so dangerous.

I agree completely. Unfortunately, he was discharged the week before last. He's out there, probably killing animals...because I can guarantee, 4 days of inpatient treatment didn't 'cure' him. I really feel that the Powers That Be let him down, and let his community down.

[indigo girl]

I agree completely. Unfortunately, he was discharged the week before last. He's out there, probably killing animals...because I can guarantee, 4 days of inpatient treatment didn't 'cure' him. I really feel that the Powers That Be let him down, and let his community down.

I would not be able to sleep if I were them. I do hope that some supervisory agency is doing some kind of monitoring however useless?