Uncontained rage: a psychoanalytic perspective on violence.

Explosions of violent behavior have periodically riveted public attention. While such behavior may be associated with a major psychiatric illness, there is a continuing challenge to understand the emotional underpinnings of such behavior, the sources of aggression, hostility, anger, hate, rage, and violence. Analysts from Freud to Karl Menninger to Kernberg and Kohut have speculated as to the confluence of psychological and real forces that prompt violent outbursts. Other analysts have explored the manifestations of aggression and rage in infancy and childhood. An instance of a violent outburst is presented, and underlying factors are explored. Critical elements prompting such behavior include: (1) an individual perceives a narcissistic injury that is experienced as being profoundly unfair; (2) the individual has no hope for achieving a reasonable resolution of the injury; (3) the individual reaches the decision that the injury cannot be tolerated further and must be responded to with action; (4) the individual has access to weapons to enhance the capacity and potency to respond; and (5) the individual feels a sufficient sense of potency and/or disregard of the consequences to initiate violence.