Although psychiatry often has to work with aggressive patients, the huge amount of coercion and exclusion based on aggression, teaches us that psychiatry does not know how to handle violence. In 1948 Lacan wrote an essay on aggressiveness, trying to approach the phenomenon within a structural framework, albeit without the conceptual tools to work this through. His later work, notably the differentiations between the imaginary, the symbolic and the real, helps us to read aggression in a structural fashion, taking anxiety at the core of the problem. The author wants to expand this by making a differentiation between implicated violence and non-implicated violence. The former is about the aggression as we usually understand it: between subjects, with the feeling one is implicated in it and grounded in anxiety. The latter is carried out as a collective, grounded within discourse that veils anxiety. This violence is essentially dehumanizing for both victims and perpetrators. One is violent because it ‘needs to be done’, justifying its action through discourse. The author explains how in clinical practice, we should read the violence of mental health workers (like coercion or exclusion) and its accompanying anxiety, rather than simply denouncing it. If not, we risk that implicated violence will alter to non- implicated violence, making it even harder to tackle. The author concludes with an example of her own clinical practice and analysis.
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