Child Abuse Review, Volume 23, Issue 2, March/April 2014, Pages 130141

The Relevance of Long-Term Antecedents in Assessing

the Risk of Familicide-Suicide Following Separation
Authors

Mark Sachmann, Carolyn Mary Harris Johnson

First published: March 2014Full publication history

DOI: 10.1002/car.2317View/save citation
Cited by: 3 articles

Abstract
Familicide-suicide following separation is under-researched and remains a poorly understood
phenomenon. Findings from previous research are inconclusive in relation to both risk factors
and perpetrator motivation. This article explores the relevance of long-term biopsychosocial
antecedents in cases of familicide-suicide that occurred in Western Australia between 1986
and 2005. A conceptualisation of the hypothesised risk factors in familicide-suicide is
proposed based on attachment theory, personality dysfunction, the neurobiology of trauma
and the possible unconscious motivation of perpetrators, which may prove helpful in
assessing the risk of familicide-suicide in family court cases. The research identified and
articulated a number of warning signs to familicide-suicide that are often not identified, or
appreciated, by decision makers. Suggestions are offered for changes to practice that may be
helpful in identifying and responding to high-risk cases in a way that enhances safety.
Copyright 2014 John Wiley & Sons, Ltd.

Key Practitioner Messages

Clinicians need to be aware of the dynamic psychosocial risk factors associated with violent
acting out such as:

The combination of Cluster B personality diagnoses.

A history of domestic violence.

Early childhood trauma requires good interagency communication and

cooperation.

Familicide-Suicide: The Puzzle

Familicide-suicide incorporates the triple taboos of murder, suicide and child killing, and has always
presented a puzzle to researchers attempting to understand the offence, and to practitioners attempting
to assess risk with a view to prevention. Previously, understanding of this offence has been limited by
researchers adopting, primarily, either a focus on perpetrators and their motivation, or on victims and
their circumstances (Sidebotham, 2013). Through this research, a picture is now beginning to emerge
which has the potential to provide a better understanding, and through this, to enhance screening and
optimise prevention strategies.
The Term Familicide
Familicide is an evolving term sometimes used in the literature to describe murder-suicide within the
nuclear family where the spouse and children are killed (Alder and Polk, 2001), sometimes to describe
massacres, including members of the extended family, whether or not the perpetrator suicides
(Ewing, 1997), sometimes to describe murder of the spouse and children where the perpetrator does
not necessarily suicide (Daly and Wilson, 1988), and sometimes to describe offences where all the
children but not the spouse are killed, whether or not the perpetrator's suicide attempt is successful
(Johnson, 2005).
Other writers use combinations of terms or select another term altogether. For example, Brookman
(2005) refers to offences that might elsewhere be described as familicide as family annihilation.
Generally, in criminological literature, familicide refers to acts of multiple intra-familial homicide
followed by the suicide, or attempted suicide, of the perpetrator. In the public arena, the term is used
far more loosely. This is problematic when comparing research findings. Few studies of familicide
deal with it in a targeted way, but rather as a sub-category of a broader homicide data-set. Some
exceptions are Johnson (2005, 2008); Johnson and Sachmann (2014); Liem et al. (2013); Websdale
(2010) and Wilson et al. (1995).
Problems in Data Collection and Comparison
There are problems with data collection because homicide statistics do not usually record the victimoffender relationship in sufficient detail to determine whether or not the offence is a familicide-suicide
(Johnson, 2008; Liem et al., 2013). This is the case in Australia where the National Homicide
Monitoring Program (Dearden and Jones, 2008) compiles data on all multiple deaths in intra-familial
homicide from the separate jurisdictions of six states and two territories. However, it is only by
examining detailed data from a range of sources in each jurisdiction separately that it can be
determined which cases constitute familicide, and each jurisdiction requires multiple and separate
ethics approvals to access homicide data. This makes national and international comparisons
extremely difficult. It appears from the literature that familicide-suicide has been found to be a rare
offence in those countries where it has been examined. For example, in England, Wales and Canada
(Wilson et al., 1995) and in the US (Liem et al., 2013; Websdale, 2010). The two Western Australian
studies on which this article is based considered only familicide following separation, but this was
also found to be rare. In a population of 2.5 million (Australian Bureau of Statistics, 2013), it occurs
on average less than once per annum (Johnson, 2005, 2008) and comprises a small proportion of the
total number of Western Australian homicide incidents (n = 36) of which upwards of 50 per cent occur
between intimates or family members (Mouzos, 2005).
Explanations of the Offence
Previous authors have posited differing explanations of the offence. Malmquist (2006) raised the issue
of psychotic depression being a factor in many familicide cases. He explains that anger towards the
self, which usually inhibits the offender, becomes mobilised and externalised in familicide. However,
it is not clear from Malmquist's description of this process as to how, or why, this occurs or what

trigger may cause it. Wilson et al. (1995) propose masculine uxorial proprietariness, based on
evolutionary psychology, to be a significant factor. While this may explain a man killing his wife after
separation, it does not explain killing his children. They reported a higher incidence of non-paternity
amongst perpetrators of familicide than in the general population, but biological children still
outnumbered stepchildren as victims.
Offence Characteristics
Although in the vast majority of familicide-suicide offences, the perpetrator is male, not all offence
characteristics are as homogeneous. Variations include the number of victims killed, their relationship
to the perpetrator, whether or not the perpetrator kills their partner, the mode of homicide-suicide
employed, the relationship status between the parents and the family circumstances preceding the
offence. These psychosocial disparities have contributed to the difficulty in determining risk factors
and understanding perpetrator motivation.
Motivation
Previous researchers attempted to classify the offence by perpetrator motivation. Resnick (1969);
Ewing (1997) and Alder and Polk (2001) proposed that familicide following separation is often
motivated by the offender's wish to retaliate against his wife for leaving the relationship. However,
Polk (1994) in his earlier work examining a wider cohort of homicide identified two distinct types of
familicide, which he termed depression driven and retaliation driven. He noted that some cases
appeared to have evidence of both dynamics, while not offering an explanation as to why this might
be so.
In support of Polk's findings, Johnson (2005) concluded that revenge was a major factor in a small
cohort of Western Australian familicide cases that followed separation, but also noted a deepening
depression (or most certainly significantly lowered mood states) in perpetrators following separation
from their partners. She also noted the reported lack of individuation in perpetrators, and their failure
to accept the finality of the separation. She posited that the motivation for revenge might explain why
in cases that involve separation the woman is often not killed, but allowed to survive, apparently so
that she may experience the pain of living without her children. This helps to set familicide-suicide
following separation apart from other forms of familicide that occur in the context of the perpetrator's
perception of a loss of status and/or community shaming, where the perpetrator's motivation appears
in part to be an altruistic attempt to protect them from ensuing hardship. In these cases, the couple is
usually still cohabiting and the woman is almost always murdered (Ewing, 1997; Websdale, 2010).
Whilst Ewing (1997); Johnson (2005); Polk (1994) and Websdale (2010) capture the essence of the
perpetrator's need to control partner and family and report the homicidal-suicidal rage as a final
attempt to retain control, there remain questions about why the need to control is so strong in these
individuals. What seems to be missing from the puzzle here is information about how and why any
individual can get to the point where killing those closest to him appears to be a valid solution to the
stressors currently being experienced.
Towards Understanding and Prevention
Given the slowly emerging research on familicide, the rarity of the offence and the lack of access to
perpetrators due to suicide, how might we begin to conceptualise the dynamics of the offence in a way
that might help us to better understand it, and thus enhance risk screening and prevention? Because of
its complexity, we do not believe that familicide-suicide will be successfully addressed with
reductionist theoretical explanations, simplistic solutions or a basic checklist of hypothesised risk
factors. Neither do we believe that risk factors are static, they are dynamic. The risk factors relate to
the perpetrator's shifting psychosocial perception of his intimate relationship and how these
synergistically influence his personality and early life experiences. For these reasons, we believe that
it is essential to seek information beyond the immediate antecedents to the offence.

Rationale
Given the nature of the offence, familicide-suicide does not lend itself to prospective studies;
therefore retrospective studies are clearly indicated. While it is acknowledged that retrospective
examinations have their methodological shortcomings, it is not possible to research this area in any
other meaningful manner. Hence, this is the methodological approach adopted in two similar studies
(the combined data of which are used for this paper) to attempt to develop a theoretical understanding
of familicide-suicide (Johnson, 2005,2008). This is similar to the approach that might be taken in a
medical pathography (see the Method section).
The Studies
The first study considered seven cases of familicide-suicide following separation (Johnson, 2005) and
the second (Johnson, 2008) two cases, providing a total of nine. These studies were combined to map
the long-term antecedents of all cases of familicide following separation that occurred in Western
Australia over a 20-year period (19862005) plus an earlier case, included due to the low incidence of
the offence.
Method
Each of the two original studies employed a qualitative approach as the research was exploratory and
total n small. Descriptive data were collected from police reports, coroner's and family court
counselling service records, newspapers and electronic media archives (Dow Jones, 2011). In-depth
interviews were also undertaken with four secondary victims and a surviving perpetrator, who also
completed the Child Trauma Questionnaire (Bernstein and Fink, 1998). All data for each offence were
collated in a working file and then demographics and offence details were transferred onto a
spreadsheet for further analysis, while a thematic analysis was undertaken of the qualitative data.
This article combines the findings from the two studies and then draws from attachment theory,
personality dysfunction and the neurobiology of trauma to formulate an understanding of the
psychological processes underpinning familicide-suicide following separation.
In many respects, this method represents a cohort pathography. Wherein behaviours, symptoms and
psychodynamics are retrospectively evaluated in relation to an individual, together with cohort
similarities, and a retrospective diagnosis and risk factor analysis are undertaken, articulated and
analysed.
Findings
There was evidence that seven of the nine perpetrators had a history of threats to kill self and/or
family members, eight had a history of domestic violence (in the remaining case, very little
information of antecedents could be found) and all evidenced premeditation of the offence. There was
no evidence that any of the perpetrators had been psychiatrically assessed or treated, although one
man reportedly had been prescribed antidepressants by his general practitioner.
For a more detailed account of the findings and method used, see Johnson and Sachmann (2014).
Risk Factor Profile
The assessment of individuals with vulnerabilities to violent acting out is a difficult and complex
undertaking. It is acknowledged that screening protocols aimed at predicting rare violent outcomes
have nominal predictive value (Dolan and Doyle, 2000; Mossman, 2009; Ryan et al., 2010).
Moreover, the risk of high levels of false positives, inherent in prediction, is a confounding issue
(Ryan et al., 2010). Nonetheless, we argue that attempting to better understand potential risk factors
and how they may coalesce into elevating the risk for violent outcomes is a worthwhile undertaking in
attempting to better understand the phenomenon. None of this undermines the benefits of early

detection and treatment for psychiatric disorders and the role that this may play in reducing violent
outcomes.
From the data collected, the authors identified a biopsychosocial risk profile that warrants
examination and discussion (Johnson and Sachmann, 2014). The areas identified were: (i) early
adverse childhood experiences (abuse and resulting attachment disturbances); (ii) significant
psychodynamic influences; (iii) history of domestic violence; and (iv) specific diagnostic profiles,
typically in the form of cluster B personality disorders.
The presence of the proposed risk factors and their dynamic synergistic interaction represents a risk
profile that should alert the clinician, and relevant authorities, to the increased risk of potential violent
acting out in the form of familicide/suicide. The screening therefore needs to focus specifically on
these areas in order to better conceptualise the possibility of increased risk. The deficit in this area of
study, clinical practice and government policy is combining these focal areas of screening with a
psychodynamic understanding, and in doing so, identifying the dynamic interplay of these
experiences, forms of relating and diagnostic vulnerabilities representing an increased risk for
familicide-suicide. We are proposing that clients with this risk profile need to be identified and
appropriately managed.
A synoptic description of the identified risk factors will now be outlined.
Early Childhood Experiences (Trauma and Attachment)
Violent perpetrator typology research has found that anxious-avoidant, preoccupied, disorganised
attachment typologies render an individual vulnerable to intense abandonment anxiety and rage and
that this may manifest in violent acting out (Dutton et al., 1994; Holtzworth-Monroe and Stuart, 1994;
Holtzworth-Monroe et al., 1997a; Mauricio and Lopez, 2009; Waltz et al., 2000). Furthermore,
anxious-avoidant, preoccupied and disorganised attachment has been demonstrated to be significantly
represented in individuals with borderline personality disorder (Agrawal et al., 2004; Levy et
al., 2005).
Childhood trauma is an identified risk factor for borderline personality disorder and antisocial
personality disorder (American Psychiatric Association, 2000). So it can be seen that the
biopsychosocial foci being recommended here have considerable overlap in terms of risk factors. For
example, childhood trauma is a risk factor for affective dysregulation, attachment disturbances and
suicidality, but it is also a risk factor for the development of BPD (Ogata et al., 1990; Paris and
Zweig-Frank, 1997; Sachmann, 2001; Zanarini et al., 1997).

History of Domestic Violence

A significant majority of the perpetrators had a history of domestic violence. It is not the authors
contention to assert that domestic violence is a stand-alone risk factor for familicide-suicide, but
rather domestic violence in conjunction with the other profiled risk factors increases the risk of
extreme violent acting out. The domestic violence manifested by the perpetrators was characterised by
the following: omnipotent control in the form of stalking, micro-managing their partners day-to-day
activities, tying up and gagging their partners, failing to accept separation, and threats to kill their
partners, their children and other family members.
Diagnostic Vulnerabilities: Borderline Personality Disorder and Antisocial Personality Disorder
Research findings on the correlation between cluster B personality disorders and domestic violence
show high rates of BPD, antisocial personality disorder and narcissistic personality disorder diagnoses

among male perpetrators (Babcock et al., 2000; Dutton, 1998; Hamberger et al., 1996; HoltzworthMonroe and Stuart, 1994; Holtzworth-Monroe et al., 1997b; Mauricio and Lopez, 2009).
Poor impulse control, affective dysregulation, prominent narcissistic features and paranoid belief
systems are associated with general physical violence, domestic violence and destructive acting out
behaviours directed towards the self (Holtzworth-Monroe et al., 1997a; Roizen, 1993). The presence
of cluster B pathology, or significant cluster B traits, is central to our formulation. Disturbances of
attachment such as insecure (fearful or preoccupied) and disorganised forms have been identified as
risk factors for, and predictors of, domestic violence (Adamson, 1998; Holtzworth-Munroe et
al., 1997b). Other research has also demonstrated that insecure attachment increases the risk of
domestic violence (Babcock et al., 2000).
The synergistic combination of early childhood trauma resulting in a propensity for narcissism, lowerlevel defence mechanisms, suicidal ideation and affective dysregulation; marked regressive
tendencies, fears of abandonment and rejection, child-like narcissism and omnipotent control in the
form of stalking behaviours; domestic violence; and diagnostic profiles in the form of cluster B
personality disorders, specifically borderline personality disorder and antisocial personality disorder,
all combine to render an increased risk of violent acting out.
Other psychodynamic characterological risk factors include acute vulnerabilities to regression,
inability to differentiate self from other and a mindset that is incapable of envisaging life without the
other. Rage against the self, based on poor self-esteem emanating from a perception of being less
than, is displaced onto the other. Highly destructive aggressive impulses to destroy the other
dominate the perpetrator's psychology, combined with an inability to appreciate the future welfare of
children as independent from that of the father (i.e. the belief that surviving the separation of their
parents was a worse outcome than death).
Such a regressed psychology renders the individual highly reactive and ultimately dependent upon the
emotional atmosphere of the interpersonal context. Herein, an interpersonal context that is perceived
as abandoning, emotionally unavailable and hence potentially harmful will influence the individual's
mental status to be characterised by similar psychodynamics.
Therefore, it can be seen that the individual's prevailing psychodynamic mental state is not static and
may quickly change in relation to external psychosocial factors.
Psychodynamics
Areas of questioning that relate to fundamental psychodynamic- and personality-derived risk factors
are as follows:

Do they conceive the possibility of a life without their partner?

Do they feel that they cannot exist separately?

Do they persistently use alloplastic defences (i.e. a marked tendency to blame partner
and environmental contexts for their own dysfunctional behaviour I would not
have hit her had she just shut up)?

Does their perception of their partner go from being all bad to all good sometimes
mid-sentence?

Do they have a need for omnipotent control? Have they engaged in domestic violence
and/or stalking behaviour?

Are they pathologically jealous of their partner? Do they have obsessive thoughts
about their partner having another relationship/affair?

Do they feel intensely rejected and abandoned by their partner when she attempts to
assert some control or attempts to leave?

Is actual or perceived rejection met with rage? Is the rage directed towards self/other?

Is there the presence of intense poorly regulated anger, impulse control and affective
dysregulation?

Do they emphasise vulnerability when abandoned and rejected, designed to induce

rescuing responses from their partner.

The vulnerability to need to control, if not dominate, one's partner is an important psychodynamic risk
factor in domestic violence. This is frequently the result of defensive omnipotent control, poor
impulse control, affect dysregulation and disturbed attachment dynamics often emerging from
childhood abuse experiences, and resulting diagnostic outcomes (i.e. cluster B personality disorders).
These biopsychosocial vulnerabilities are typically activated in response to rejection and
abandonment. Moreover, stalking behaviours, often the direct behavioural manifestation of the
defence of omnipotent control, are again designed to regain control and to communicate to the
abandoning partner that they are not able to ultimately abandon them and that they are in fact always
in control.
Our alternative theoretical formulation for familicide-suicide is based on a synergistic combination of
attachment style, personality dysfunction and hypothesised psychodynamic factors as an explanation
for the failure of perpetrators to manage the trauma of separation. While other conceptual
formulations incorporating attachment theory and personality dysfunction have been proposed for
domestic violence (Holtzworth-Monroe and Stuart, 1994; Mauricio and Lopez, 2009; Waltz et
al., 2000), we offer explicit formulations and analyses of the various attachment themes, individual
psychodynamics, defensive functioning and finally behavioural sequelae that represent risk factors for
familicide-suicide based on our research.
This formulation augments current theories of familicide-suicide by incorporating what is known
about the psychological process of attachment, personality and the neurobiology of trauma. We
propose that, in familicide-suicide, it is the perpetrator's lack of individuation that makes it difficult to
separate, and increases the risk of lethality to the other and to the self. Figure1 and the following
discussion identify and articulate our hypothesised psychodynamic process leading up to and
culminating in an act of familicide-suicide. They focus on six fundamental psychosocial foci:
symbiosis, separating, abandonment, attempts to reunify, realisation and finally the lethal solution.

Hypothesised psychodynamic process leading to familicide.

Symbiosis
The individual who has experienced abuse in childhood may not be able to adequately adjust to future
relationship breakdowns because of his need for symbiosis and his vulnerability to abandonment
anxiety. He is psychologically unable to experience coexisting disparate images of himself and his
partner, but rather has a single dominating perception at any one time (accompanied by a dominating
affect). This compartmentalisation of experiences of self and other renders personality integration
impossible and relational dynamics highly chaotic and potentially explosive. When he feels good, he
feels good about her. When he feels bad or rejected, then his perception of her is tainted by his
subjective experience. He oscillates between an intense need to fuse, possess and control, to the other
extreme of acute desire to reject, abandon and destroy. The overwhelming negative emotions

experienced when wanting to destroy may lead to violent acting out behaviour, even to homicide,
suicide or homicide-suicide.
Separating
In relationships characterised by male-perpetrated violence, the woman is usually the one who
precipitates the separation, even though she may have similar dependency needs to her partner. She
may have tried to leave a number of times, particularly when she sees violence escalating to
potentially lethal proportions, but been cajoled and/or threatened until she returned. Loss of his
partner causes the man to feel fragmented and less than whole (I am not in a relationship; therefore I
do not fully exist). He feels depressed and sees no future for himself. He regresses both
psychologically and emotionally.
Abandoned
Abandonment highlights the man's poorly integrated sense of self, primitive defensive functioning
(i.e. splitting/projective identification and emotional regulatory dysfunction). He may at first deny the
loss, but soon becomes consumed with thoughts of retrieving the other. He is overwhelmed by
destructive emotions such as depression, anxiety and rage that he feels unable to understand and
control, and defends against this by attempting to forcibly control his environment instead. His
attempts are primarily directed towards desperately seeking the object of his attachment in order to
reunite, control and feel whole again.
Attempts to Reunify
He may use a variety of regressive defences, manipulative behaviours and statements of acute need to
emphasise his psychological vulnerability in an attempt to induce rescuing responses from his partner
and thereby achieve reunification. This may include threats, promises, suicidality (attempts to
emphasise his vulnerability and loving dependency on his partner) and stalking. We believe that
stalking may be conceptualised as an unconscious pathological need for omnipotent control of the
other, manifested in a form of proximity-seeking behaviour that has its origins in the infant's need
for symbiosis. This need for proximity and control may lead to multiple breaches of restraining orders
and indicates a high risk to his partner.
Realisation
When the man realises that the woman does not intend to return he splits off the part of himself that
feels all bad (depressed) and projects it onto the source of the disequilibrium, his partner. This
projection is necessary since his narcissism will not allow him to accept that he owns these feelings
and his need to control them must be achieved by controlling her. Thus, depression and rage exist
simultaneously. The threat is experienced most intensely when he perceives that there is no chance of
reconciliation. Up until that point even though a physical separation may have occurred, he may
believe that reconciliation is possible or inevitable. He remains hopeful of returning to the proximity
of the other. This may explain why in some cases familicide-suicide immediately follows
separation, in others may occur directly following a court order and yet in others may not occur until
after the court process is complete. When all hope of reconciliation is gone, the perpetrator's
coexisting rage and depression lead to the lethal solution.
The Lethal Solution
The lethal solution emanates from a retaliatory motivation, where the rage is expressed in murdering
the children, to cause the maximum pain to their mother who at this time is experienced as all bad.
However, there is also a simultaneous depression with strong suicidal elements that emanates from the
feelings of rejection, loss and emptiness. The self is all bad. It is an expression of defensive
omnipotent control aimed at destroying the relationships that the woman loves most of all. In effect,
having control over life and death.

Conclusion
A risk factor profile informing a new screening measure needs to be incorporated into the family court
process. This screening measure would also incorporate input from family members and obtain
information pertaining to risk that may otherwise not be identified. This paradigm would allow for
communication, collaboration and referral between community agencies in an attempt to secure better
outcomes for families. The need for inter-agency collaboration is paramount, as the complete picture
of the potentially violent partner is scattered throughout the medical, court, social services and child
protection systems. Therefore, it is only via a coordinated and integrated case management approach
that the complete picture may be obtained.
When the concept of prevention is examined, collaborative case management has more to offer than a
model where the family court operates in isolation. The child protection authorities need to be a key
player, working with the court to ensure children's safety in an ongoing way. There needs to be an
extension of professional input to include clinical work with families rather than simple risk
assessments with feedback to the court if concerns are identified.
Careful consideration should be given to those who supervise access, as family members whose life
experiences may parallel those of the perpetrator are unlikely to perceive risk, or to be able to
intervene effectively to protect children. Finally, judicial decisions should be informed by
comprehensive psychological profiles including adult attachment assessments and a clear appraisal of
the long-term antecedents. The judicial officer may then be in possession of information that is more
likely to promote effective preventative interventions.