Violence and Aggression in the Health Care Sector

Everything has two sides, including violence. This can be called good or nice aggression. We perceive aggressive behaviour only in an emotionally negative way, which is why it evokes emotional thoughts of something bad (destructive). This perception of aggression is deep-rooted in our sub consciousness. Nevertheless, it is also possible to use this expression with a positive emotional meaning (Janata, 1999). These definitions deal with a type of aggression that aims to “destroy something” or to hurt somebody. Our brain centres that are older from the developmental point of view and are situated in our limbic system, the amygdala, which are responsible for this form of violence that is common to both animals and men. Particularly destructive aggression is mentioned in the theoretical terminology and expert practice. Constructive aggression that is mentioned less often in expert texts is ambivalent to the destructive form. It is a form of aggression specific only for human behaviour and thinking that is controlled by the youngest brain centres from the developmental point of view – cortical areas of frontal lobes (Janata, 1999). This form of behaviour creates relations and forces that make it possible to establish new relationships, helps people to make their decisions, with their expressing, opinion forming, adaptation or reaction to conflict situations (Frielingsdorf, 2002). This adult or agonal aggression is partially inborn; it is shaped in the course of life and achieves its manifestation already in adolescence. Adolescence is an exemplary period of formation, for which a relative long so called second defiance period is typical. From the etiological point of view, it is a stage that is acceptable biologically as well as psychologically and moreover it is fully realised (Poněšický, 2002). 

People who are constructive aggressive show a high level of diligence and conscientiousness (Hubálek, 2011). Esteem for artistic creativity, art, science, discoveries and intellect, knowledge of foreign languages, use of modern technological and communication technologies, inner self-confidence and harmony, but also a sense of belonging and solidarity belong to characteristics and value orientation of these individuals. In terms of reduction of manifestations of aggression, constructive aggression may play a significant role according to German authors. Gugel and Jäger (1995) call upon the use of own aggressive impulses and perceptions in a constructive way that leads to a non-violent way of handling and thinking. Their theory involves three levels which can be performed so that it is possible to mitigate or eliminate aggressive behaviour. The first level is a personal one – a man shall live self-consistently in a harmony and use aggressive behaviour only in necessary cases. The second level is an institutional one and is aimed at a non-aggressive environment, supporting the formation of conditions increasing safety measures from the view of individual institutions. The third level is a social and international one that shall strive for political and social changes in favour of prevention and protection against violence. 

The use of constructive aggression offers a hypothetical question, if it is possible in certain situations with escalated emotions to turn own “negative emotions energy” to good purpose (to defence) and not to pay back in the same way (de-escalation of violence). Similar reactions are used by some philosophical views or martial arts (aikido, judo). But it is not possible to determine if this mechanism is real or not without any knowledge of causes of violent incidents.