Violence, trauma and substance abuse.

A review of the relevant literature concerning posttraumatic stress disorder, violence, domestic violence suggests that violence behavior, trauma, and substance abuse have a substantial connection; it also suggests that shame is a powerful agent for rage. Shame permeates many levels of society: the individual, the family, institutions and the community. The policies of the criminal justice system are directed towards promoting more shame in a population that has been saturated with shame in the many levels of the culture. Attention is focused on the role of alcohol and other drug use in the cycle of violence. Violent behavior, violent individuals, and victims of violence are deeply affected--emotionally, physically, politically, and spiritually--by drug use. This suggests that any program designed to promote healing violent behavior, for victims and/or perpetrators, should include attention to each of these spheres. This article describes a program that I have developed in the San Francisco City and County Jails. The program includes three groups: a Stress Reduction Group, a Personal Writing Group, a Partner Abuse Group, and an Anger and Conflict Management Group. The milieu is described, as well as the components, methods and rationale for each group.