Rethinking Violence: Dr Gary Slutkin

This story was published in issue 1 of The Alpine Review in 2012.

Human history is filled with trial-and-error learning, misunderstandings and misclassifications; humans trying to solve problems without fully comprehending the cause of them. Dr. Gary Slutkin, founder of Cure Violence, argues that as a society we have been looking at violence and aggression in a naive and outdated way.
Artwork by SCRMN

AR — Tell us about your work and Ceasefire (Ed: Ceasefire is now known as Cure Violence). How did it all begin?

Gary Slutkin — I’m an infectious disease doctor by training. For most of my life I’ve been working on rather standard infectious disease epidemics like tuberculosis, cholera and AIDS. In 1995, I transitioned to working on the problem of violence. My job transition was not led by my feeling that violence was an infectious or contagious issue, it was more led by the magnitude of the problem of violence and my view that there was a very large gap in the strategy and approaches to it. The gap needed to be filled and a strategy needed to be designed.

How long did it take to develop the CeaseFire approach and how did this connection between violence and infectious diseases emerge?

We spent five years designing it, piloted it, got results, replicated it and finally we got to the point where it’s been demonstrated that the methods we use have an impact. They make a neighbourhood safer and they reduce shootings and killings. Along the way, it became clear to me that I was approaching this as an infectious disease as I was analyzing the curves of infectious diseases. Then I began to rethink the characteristics of infectious diseases in populations as well as in individuals. I saw that in fact violence had all of these characteristics. It clusters, it has the type of wave-curve characteristics, it’s transmissible, it has incubation periods within a person, latency and even carrier states.

I began to realize that a lot of these types of violence, whether you’re talking about war, or street violence, or intimate partner violence, or child abuse, even suicide, they are kind of interchangeable in that exposure to one can lead to a greater likelihood of another. In other words, exposure to war causes people to be more likely to do violence against a spouse or against a peer.

There is something about violence that is contagious that leads you to do it to others if it was done to you. Not even necessarily back — yes there is retaliation when one event leads to another so that you retaliate against the person or group — but it also leads you to do violence in other ways towards people who were not even the cause of it.

This is the ‘transmission’ aspect of the infection, in a way?

There’s something going on in the brain, which we’re now understanding much better, which is how scripts and circuits are modeled and copied. The brain picks up and copies; this is in the cortex, the frontal lobe and probably in the parietal lobe, too. The brain also picks up the propensity to do violence through effects on the emotional or limbic system. It causes dysregulation and hostile attribution; in other words, it causes you to be more quickly reactive and to blame other people more quickly. There are brain processes that cause violence to be picked up and then transmitted to others in the same way that the intestine picks up cholera and causes more cholera to be sent out of the body for other people to pick it up. These are some of the invisible processes of picking up thoughts and behaviours through brain circuits and then passing it on to others who pick it up through their brain circuits.

If you can really capture all of this, you’re now becoming aware that our ideas about morality and reality may be different than we may have thought. In other words, the person who picked up the disease of violence initially wasn’t necessarily good or bad, one way or another, they were just someone who picked up this problem and that by nature of it, passes it on to others.

It causes us to question, “What is it even to be a human being?” in that we’re so, in a way, susceptible (which is again, an infectious disease term). So as a result, you get waves of human behaviour. Including violent behaviour as was seen in the London riots, which spread to over a dozen cities in four days, or the Arab Spring which passed through about a dozen countries in about 2 years, or WWI which, over the course of 4 years, caused 15–20m deaths. Rwanda: in 4 months 800 000 people killed. There is this potential among humans because we’re ‘social,’ which just means our brains pick things up from each other, to have epidemic violent outbreaks.

We’ve been seeing this since the history of man, in all the wars that have gone on and all of the other types of epidemics of diseases. We’ve been seeing diseases as one thing and violence as another, but maybe they’re all the same.

Are we adopting these new ways of thinking?

We’re in a transitional moment now just like where we were in the 1880s when we were one after another discovering these microorganisms, anthrax, plague, tuberculosis, leprosy, cholera; we were figuring out what their characteristics were and then in the decades that followed we were developing new scientific strategies. Before we knew about the real causes, and before we figured out the strategies, these diseases were causing havoc, just like violence still is. It hasn’t even been 150 years after the microorganisms have come to our attention and the strategies have been worked out. We’re now at a place where we can rethink the problem of violence — and we must.

Violence as a disease means science is required to find a cure. What is the science behind the CF approach?

Violence is indeed a contagious disease. It meets all of the characteristics of a disease. It has characteristic signs and symptoms. It has to do with the body having a set of behaviours or behaviours that are done to it. It has identifiable causes — some diseases don’t even have identifiable causes. It’s transmissible; it causes morbidity, mortality and early death. It’s communicable, that is to say one event leads to more events. It shows up on the street corner, one fight causes many fights. It shows up as soccer riots, it shows up as war. These things that we call a soccer riot or that we call war, they’re really just epidemic violence that we’ve just so categorized.

It’s a scientific moment where the social psychology of the past 40–50 years, the 10–20 past years of MRI’s and brain scanning, these are the tools that are revealing what microscopy and bacterial and viral cultures revealed for the infectious disease field. And now we also have proof of concept that if you treat it in this manner, the results are statistically and scientifically demonstrated to work. We’re getting the science out on the causation, transmission and getting scientific confirmation of the application of this strategy. This is revolutionary — for this field not to think in terms of good and bad — but in terms of transmissible thoughts and behaviours.

What does violence as disease ‘look like’? How visible can it be?

Looking at curves of violence in Chicago, in Detroit, in LA, in Canada, in Brazil, in Rwanda, in Mexico, the shapes of them, the nature of them; they are curvilinear rather than linear. They consist of multiple waves. Epidemics consist of many epidemics: one builds on another and so on. Also looking at maps… When you look at the maps of violence you see this clustering, it’s very dense here and then around it it’s a little less dense. Then there’s what you might call hot spots, what we epidemiologists call epicentres. Looking at the maps and curves you see there is a process going on that looks like an infectious process. I started to think about violence as a behaviour because I had been previously working in sexual behavior. The study of HIV/AIDS is largely about changing sexual behaviours — in health we’re always trying to work with behaviour: eating behaviour, exercise behaviour, smoking behaviour. I started to ask myself, “Where does behaviour really come from? Where do we get our behaviours?” I tried to do this in a more concrete way than just nature/nurture. How are behaviours really picked up? It turns out that if you really read the last 40–50 years of social psychology, that field has pretty much landed, not on reinforcement, or Pavlov, or reward and punishment, not even so much on trial and error which is still a part of everything a little bit, but it really has landed on observational learning or modeling or copying; the incredible importance of imitation.

What part does imitation (of behaviours) play in the mix?

It’s very profound how much we copy, model and imitate, but it still requires putting it together. Whereas Leeuwenhoek designed the microscope and saw these bugs, no one knew what these bugs did, or their importance for another 200 years. He just saw them. They were swimming around on the microscope slide, but it wasn’t until Pasteur started to work with them, because the beer and wine and milk industries wanted to know why their products were going well or going poorly, that he figured out that they actually did something. But it was Robert Koch who linked them with disease. What I’m trying to do is connect these dots because I think that these findings of social learning and the findings of the brain research lead us to say that these brain circuits and theses dysregulations in the limbic systems are causing a social contagion very specific to violence.

We don’t take violence in through our mouths like cholera or in through our nose or/and mouth like tuberculosis, measles and flu. We take it in through our eyes by observing and then through other traumatic exposure like being physically hit or hurt. We take it in a different way and we process it differently; the gut or the lung does not process it, the brain is processing it. Violence is a physiological process.

Some would argue it’s also a moral process. What are your thoughts?

It’s not a moral process. You can say that it’s moral, no one can take that away from it; it’s all definition. But the strategies for effectively reducing the problem are going to be more effective if they’re scientifically derived rather than moralistically derived. I don’t know too many problems that have really been solved through moralistic conversation. They’ve ordinarily just made arguments and caused punishments, aggravations of problems or confusion.

I’m biased by science and that’s what we’re doing here, we’re applying science, but the purpose of the application of science could be considered moral. For the purpose of seeing and hearing about less people being murdered, or shot, or injured or hospitalized, paralyzed or dead or otherwise traumatized, the solutions that we’re working with are scientifically derived.

Let’s rewind to remember: moralistic explanations and solutions were applied to leprosy, plague, cancer and mental illness among other things, with bad results for centuries. We were putting people in dungeons for these other things before we figured those problems out more. It’s not that we’re smarter now, we just know more. Our brains are the same size, but science is progressing.

In a nutshell, how can we control the contagion? What is the method?

What that means in terms of disease control is that we need specific systems made up of people that can interrupt these processes. You recruit people — we call them violence interrupters — from within the same groups and train them in persuasion so that they can interrupt events and dissuade people from doing violent events and then more fully change thinking. That really needs to be put in place, and then the general public needs to understand what’s really going on in their brains/minds at a higher level than we are used to. This is the next step. We need to know that we’re susceptible.

We need to develop more of a resistance — by this knowledge — and we should also be able help our friends, and allow them to help us not get caught up in it. We have this inherent weakness — it’s also a strength in terms of evolution that got us this far — to copy and model and fight for your group. But it’s a weakness now as it is a different time in history when it’s important that we not do violence, but rather that we connect and collaborate and work across these different groups.

It’s a combination of developing these infrastructures of interruption and educating widely about your own susceptibility and how to help others who are also susceptible from catching this disease and transmitting it.

We have to shift the overall norms of society, just like we shifted from drinking unclean to drinking clean water, or from a certain amount of smoking behaviour to less, a certain amount of sexual behaviour to less, we have to shift the norms about the acceptability of violence without overdoing considerations that have to do with ‘bad people’ or ‘enemies’.

The world has become hyperconnected and hypervisible now that social media and access to information is so widespread; does this fuel contagion?

The result of this additional hyperconnectivity is more contagions, definitely. There was a visual image of a burning police car in Tottenham that spread to all these cities in the UK, so the violence spread to these various cities in the UK faster than the people themselves moved from one city to another. The visual images facilitated the copying of those behaviours. Likewise in the Arab Spring.

How long things keep themselves going will depend on contexts and circumstances, but we’re in a time period where this is going to happen more and more; there will be contagions of behaviours of all kinds.

The flip side is that technology could also be used in a positive manner. Would you agree?

Absolutely. We’re just starting this. It is a collaboration called PeaceTXTthat we have with Medic Mobile and Ushahidi, which is beginning in Kenya as a public education message. The plan is to promote very specific ways of motivating behaviours. The main messages are to help your friend not do it, to walk away and to re-frame violence as a thing of the past, rather than something that is positive and acceptable.

The CeaseFire strategy is moving into a new space. If it’s done properly and strategically, then we’ll win and the violence will go down more and faster. New or potential outbreaks will be intercepted and interrupted more quickly and effectively in many different situations, communities and countries. The time for changing our approach and changing our results regarding violence — from our neighbourhoods to war — is now. We are beginning to apply the science.

Have you experienced any resistance in places that you’ve been attempting to apply CeaseFire methods?

The principal challenge is changing the way we think about the problem. The idea that people need more punishment, they need to be threatened more, they need to be taught a lesson, that idea still exists. So ‘clamping down’ and aggressive responses are still popular. The reason they’re popular is because they feed into everyone’s feeling of helplessness and anger, and because sometimes they will produce a very short-term result. If you hit your kid he’ll shut up immediately (same for an animal). But gradually you find out that the child has actually learned to do violence and ignore and go around — and it’s one of the biggest predictors of being violent [being physically punished]. So, these aggressive tactics whether it’s at home, in the community or in war, they always have repercussions. Whether they are called unintended consequences, or collateral damage, it’s really not something different and it can’t be separated; it’s negative. But these responses are still believed in.

In closing, are there emotions that fuel contagion better than other?

Hate is very transmissible, it’s learned, it’s actually taught, and it moves very well. Anger and blame, these are emotions that travel in a space that takes up the sadness space. In other words, if you’re frustrated or sad or feeling any kind of grievance, anger feels better. Anger and hatred spreads very well unfortunately.


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