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Brief Treatment and Crisis Intervention Advance Access published May 16, 2008

The Dynamics of Murder-Suicide in Domestic
Situations

Katherine van Wormer, MSSW, PhD

This paper explores dynamics involved in the commission of homicide followed by
suicide. British and U.S. government and advocacy sources are used in addition to news
accounts to examine this phenomenon. Domestic violence-related crimes are contrasted
with elderly ‘‘altruistic’’ murder-suicide, school shootings, and political terrorism. Suicide
is argued to be a primary motive in many domestic homicide situations. Limitation of the
availability of firearms is seen as an important means of prevention in conjunction with
a harm reduction safety plan.

KEY WORDS: domestic homicide, murder-suicide, homicide-suicide, domestic violence,
partner violence.

In the United States and Britain, as elsewhere, and Wales, three times as many women are
a woman is more vulnerable to violence in her killed by a sharp instrument or by strangula-
home than in public. In the United Kingdom, tion as by shooting. Over the past decade, about
domestic violence costs the lives of more than four times as many females who were killed as
two women every week (Home Office, 2005b), males who were killed were partners or ex-
and in the United States, with a much larger partners of the murderer (Home Office, 2005a).
population, estimates are that more than three As in the United States, far more males than
females are victimized by homicide of a general
women a day are killed by their intimate part-
nature; they are killed often in fights with other
ners (Rennison, 2003).
men (Bureau of Justice Statistics, 2005).
Homicide is a leading cause of traumatic
An extensive search by Aldridge and Browne
death for pregnant and postpartum women in
(2003) revealed 22 empirical research studies on
the United States, accounting for 31% of mater-
risk factors for spousal homicide. In the United
nal injury deaths (Family Violence Prevention
Kingdom, 37% of all women who were murdered
Fund, 2006). In the United Kingdom, pregnancy were killed by their current or former intimate
is a period of high risk as well. partner compared to 6% of men. The most com-
Whereas in the United States, women who are mon cause of an intimate partner’s death in Eng-
killed are most often killed by guns, in England land and Wales was being attacked with a sharp
implement or being strangled. By contrast, the
From the University of Northern Iowa, Cedar Falls.
Contact author: Katherine van Wormer, Professor, most common cause in the United States for spou-
Social Work Department, University of Northern Iowa, sal homicide was getting shot. Nine major risk
30 Sabin Hall, Cedar Falls, IA 50614. E-mail:
katherine.vanwormer@uni.edu.
factors are found that may help predict the prob-
doi:10.1093/brief-treatment/mhn012
ability of a partner homicide and prevent future
victims (Aldridge & Browne, 2003).
ª The Author 2008. Published by Oxford University Press. All rights reserved. For permissions, please e-mail:
journals.permissions@oxfordjournals.org.

1
VAN WORMER

As anyone who reads or watches local or na- the women committing murder-suicide in the
tional news reports in the United States will be study tended to kill their children and then
aware, a spate of murder-suicides is taking themselves. Men, on the other hand, tended to
place. The dynamics are relatively similar; a bat- kill their spouses or partners.
tered woman had told her partner or he had More recently, in the first epidemiological
inferred from her behavior that she was making study of instances of homicide-suicide in
a break in the relationship; the man loaded his England and Wales, Barrachlough and Harris
gun and shot her and then himself, killing them (2002) studied death certificates for all murder-
both. Most of these domestic cases are not suicides over a 4-year time span. They found
reported nationally; they are in headlines in that 3% of male, 11% of female, and 19% of
the local paper. child homicides were of this type. Similarly,
Because government data in the United of all suicides, 0.8% male and 0.4% female
Kingdom and the United States providing na- deaths occurred in homicide-suicide incidents.
tional statistics on homicide that ends in sui- The typical cases involved families of low socio-
cide are hard to come by, other, less official economic status.
and comprehensive sources must be consulted. Data provided by the Home Office (2005a) for
A recent development in the United States is England and Wales, which are difficult to ana-
a promising development, however, for future lyze because the circumstances and timing of
research. The emerging state-based National suicides following homicide are not clearly
Violent Death Reporting System (NVDRS) re- spelled out, provide support for earlier findings
cently has begun providing data on homicide- by Barraclough and Harris (2002) of a low in-
suicide for a sample of American states. The cidence of murders ending in suicide. One
majority of the research that is available, how- can determine that of the 659 homicides that
ever, is not focused on domestic homicide were committed in 2004, 19 individuals com-
situations. mitted suicide before indictments could be is-
sued. We do not know the nature of the
homicides, however.
Homicide-Suicide in the United Personal correspondence with Kathryn
Kingdom Coleman of April 10, 2007, of the Direct Com-
munications Unit of the Home Office provided
An analysis of the London Times’ reports of data on suicide following homicide in which the
murder (1887–1990) by Danson and Soothill victim was a partner or ex-partner. From the
(1996) revealed a total incidence of 6% of years 1997–2006, there were on average 12
2,274 cases of murder followed by suicide in cases each year of male-on-female homicides
the United Kingdom. Around the turn of the that ended in suicide. Official Home Office
20th century, as the researchers suggest, this sources reveals that there are around 100
figure of murder-suicides was much higher at male-on-female homicides for each year (see
approximately one in three. Murder-suicides, e.g., Home Office, 2004). So this means that only
according to Danson and Soothill, are mostly a small percentage—around 10% of these inti-
family affairs, especially in cases of female per- mate homicides ends in suicide in England and
petrators. There is a much higher proportion Wales. As further indicated in the government
of British male murder-suicides, in general, how- report, the methods of homicide were by means
ever, and males much more likely than females to of a sharp instrument, poison or drugs, beating,
commit their crimes with guns. Overwhelmingly and strangulation.

2 Brief Treatment and Crisis Intervention
The Dynamics of Murder-Suicide

Homicide-Suicide in North America residents (NationMaster.com, 2007). The differ-
ence in homicide rates between large American
A rare finding in the American literature is the and British cities is even more pronounced.
research presented by Bossarte, Simon, and Guns are by far the most common weapon
Barker (2006) who analyzed data from the used in these crimes (Violence Policy Center
NVDRS. This active state-based surveillance [VPC], 2006). One could speculate that if you
system includes data from seven states for shoot someone, it is relatively easy to then turn
2003 and 13 states for 2004. The incident-level the gun on yourself. If you stab or strangle
structure facilitates identification of homicide/ someone, however, suicide becomes much more
suicide incidents. Results revealed that within difficult. In any case, the high rate of spousal
participating states, 65 homicide/suicide inci- murder-suicides is consistent with the murder-
dents (homicide rate ¼ 0.230/100,000) occurred as-extended-suicide hypothesis of Palermo
in 2003 and 144 incidents (homicide rate ¼ (1994).
0.238/100,000) occurred in 2004. Most victims Notably, in 1992, the Journal of the American
(58%) were current or former intimate partners Medical Association (JAMA) reviewed the epide-
of the perpetrator. Among all male perpetrators miology, patterns, and determinants of murder-
of intimate partner homicide, 30.6% were also suicide and made a strong case for the need for
systematic data gathering so that prevention
suicides. A substantial proportion of the vic-
strategies can be developed (Marzuk, Tardiff,
tims (13.7%) were the children of the perpetra-
& Hirsch, 1992). Although there is no standard-
tor. Overall, most victims (74.6%) were females
ized definition of murder-suicide, the JAMA re-
and most perpetrators were males (91.9%). A
port proposed that the term murder-suicide be
recent history of legal problems (25.3%) or fi-
restricted to a situation in which the suicide fol-
nancial problems (9.3%) was common among
lows the homicide by 1 week at the most. Extrap-
the perpetrators.
olating from the test statistics available, it is
From Statistics Canada (2005), we learn that
probable that in the United States the murder-
over the past 40 years, 1 in 10 solved homi-
suicide represents 1.5% of all suicides and 5%
cides were cases in which the suspect took of all homicides annually, according to this re-
his or her own life following the homicide. view. In Denmark, on the other hand, 42% of
About three-quarters of these victims were homicides are of this variety.
killed by a family member. Virtually all the in- JAMA’s summary of data on the mother/
cidents (97%) involved female victims killed child murder-suicide indicated that only a tiny
by a male spouse. And, as Easteal (1994) dem- fraction of mothers who commit infanticide
onstrated in an earlier study, one-third of kill themselves although they often attempt
‘‘spousal’’ homicides in the United States and or plan to do so. Mothers who kill their chil-
Canada end in suicide. Few other varieties of dren typically suffocate, drown, or stab them;
homicide end in this way. firearms are rarely used. The depressed, sui-
Probably related to the availability of guns, the cidal mother may psychotically perceive her
homicide rate in the United States is much higher child as an extension of herself. A form of ‘‘de-
than the British rate, although the difference has luded altruism’’ may be the motive, according
diminished in recent years. According to an in- to this report.
ternational comparative study, the homicide rate According to the VPC (2002), at least 662 peo-
in the United States is 0.04 per 1,000 residents, ple died in murder-suicides in the United States
whereas in the UK, the rate is 0.014 per 1,000 during the 6-month period of the 2002 study.

Brief Treatment and Crisis Intervention
VAN WORMER

That averages out to about two such killings Ansonia, CT: A 27-year-old man strangled
per day. Three-fourths of the murder-suicides his wife, and then jumped off the roof to his
involved ‘‘intimate partner’’ situations; of death. The two were Albanian; theirs was an
these, 94% involved male attacks on women. arranged marriage, one reportedly fraught
The most recent study by VPC (2006) re- with difficulty.
ported 591 murder-suicide deaths nationwide Milwaukie, OR: A couple in their 80s who
between January 1 and June 30, 2005. This had often been seen strolling arm-in-arm was
averages out to 10 murder-suicide events each found dead of gunshot wounds, a case of
week. Of those, Texas had 18 cases. Other sta- suspected murder-suicide.
tistics from the VPC include: Union, SC: Problems with money and child
custody seemed to be precipitating factors in
 Male offenders: 94%
this murder-suicide committed by a husband
 Cases involving an intimate partner: 74%
in his 20s.
 Occurred in the home: 75%
New Providence, NJ: An elderly couple was
 Involved a firearm: 92%
found dead in what authorities called a
 Average age difference between offender,
murder-suicide. The husband’s note seemed
primary victim: 6.3 years
to confirm this.
In Iowa, a Midwestern state with a relatively Lakewood, WA: A couple in their 20s was
low crime rate, between 1995 and 2005, 106 found shot to death in an apparent homicide
Iowans killed a partner or spouse in a domestic and suicide. Police said the man had broken
situation. The main factor appeared to be into his ex-girlfriend’s home with a hammer.
a pending breakup. Ninety-six of the killers There was a history of stalking.
were men; about half committed suicide shortly Landenberg, PA: A man who shot and killed
afterward. In Pennsylvania, of 97 homicide his wife and two sons before killing himself
incidents in 2001, 81 of the perpetrators were was said to be suffering from depression.
males and 16 females, 58 of the victims were
All these cases took place in the space of several
shot, and 29 of the perpetrators committed sui-
days. That the stories were typical was confirmed
cide (Pennsylvania Coalition against Domestic
in later checks on www.google.com. As can be
Violence, 2003).
seen from these illustrations, this form of suicide,
To determine the recent frequency of reports
at the national level, I went to www.google. unlike other instances of suicide, is hardly a sol-
com, typed in murder-suicide, pressed itary act. During the 6-month period of the VPC
‘‘search,’’ then went to news in the row above, study, more people died from murder associated
which gives recent news stories for that item. with the suicide—369—than from suicide
Indeed, the frequency was high; there are at itself—293. Children in the family were or-
least two or more reports of these double or tri- phaned, and others were left in a state of despair.
ple murders for each day, and we have to keep As reported by the VPC (2006), the pattern of
in mind that all newspaper headlines are not the murder-suicide is predictable: a male perpe-
recorded on google. So we can conclude that trator, female victim, decision by the woman to
even two of these events per day is an under- leave the man, and a gun. The typical Florida
estimate. My search as of June 10, 2005 pattern (Florida had the largest number at 35
(reported by van Wormer & Bartollas, 2007), of the 2002 total) involved an elderly male care-
yielded the following recent incidents for giver overwhelmed by his inability to care for
that week: an infirmed wife.

4 Brief Treatment and Crisis Intervention
The Dynamics of Murder-Suicide

Types of Murder-Suicide soldier had a record of abusing his wife and
being drunk on duty.
From her Internet search, I delineated five basic  Young Marine Renee Di Li Lorenzo was
patterns and that the driving force for each is shot and killed by her boyfriend who had
different. The basic types are: been discharged earlier from the Marines.
He then turned the shotgun on himself.
 Suicide bombings
 Suicide by cop Some researchers argue that murder is the pri-
 Murder-suicide in the family where mary motive in such cases. Certainly, the urge
murder is primary to kill is the overwhelming factor; the urge can
 Suicide-murder—three types where be described as self-destruction including the
suicide is primary destruction of people who were once loved. Re-
 Altruistic suicide-murder (of the elderly) garding murder and suicide in such cases, it
may not be a case of either-or but of both-and.
In some of situations, such as that of mass ter-
I am introducing the term ‘‘suicide-murder’’
rorism performed by suicide bombers, homi-
to refer to killings, in whichever age group, that
cide is the predominant motive; in other
is suicide-driven. There are several basic types
situations, the motives are a combination of
of suicide-murders. The first is the elderly cou-
murder and suicide; in still others, the key el-
ple situation in which an elderly man kills his
ement apparently is suicide.
frail, usually dying wife and himself. The el-
‘‘Suicide-by-cop’’ is the term used to describe
derly man is old and feeble and does not want
a situation in which a person wants to commit
to go to a nursing home.
suicide and die in a dramatic way, so he (almost
A second type of killing in which the suicide
always a man) threatens an armed police officer
impulse is prominent is the ‘‘mass school or col-
(sometimes with a toy gun) in order to have the
lege shooting,’’ such as has occurred in the
officer pull the trigger on him first. There is no
United States when boys (who had been bul-
homicide here except for the police officer’s
lied) brought guns to school and killed their
killing of the suicide victim.
fellow students and then themselves. Facts per-
As an example of ‘‘murder-suicide in the fam-
taining to the recent case of the largest such
ily,’’ we can consider war veterans such as sol-
massacre on record—the killings of 32 students
diers who have fought in Iraq. These returning
and faculty at Virginia Tech by Seung-Hui Cho,
troops have a high rate of both murder and sui-
fit this category as well. Details from media
cide and sometimes both. A report from Wash-
accounts reveal a history of school victimiza-
ington state sees such events as a risk factor
tion by taunting, a mental disorder, possibly
distinct to the military in which armed men
autism from childhood, stalking women, refer-
are trained to kill, and many later carry the in-
ral by the campus police for suicidal ideation,
visible scars of war. It is impossible to tell
and continual fantasies of extreme violence and
whether the externalized aggression (homicide)
revenge.
or internalized aggression (suicide) is primary.
The third and most common variety of
Consider these two cases from 2003:
suicide-murder is the case of ‘‘intimate violence.’’
 Army Specialist Thomas R. Stroh, 21, From the dozens of cases I have read about from
strangled his wife and son at their Fort news reports, a consistent pattern emerges. The
Lewis home. He later committed suicide by intimate couple is usually in the 20- to 35-year-
driving head-on into a semitruck. The old range. The man is abusive, psychologically

Brief Treatment and Crisis Intervention
VAN WORMER

and/or physically. Obsessed with the woman to Other studies by psychiatrists describe the
the extent that he feels he cannot live without young male perpetrators as intensely jealous
her, he is fiercely jealous and determined to iso- with a history of suicide attempts (see e.g.,
late her. Characteristically, suicidal murderers Shaw & Flynn, 2003). Women who kill their
have little regard for the lives of other people; children and then themselves are almost always
they would be considered, in mental health jar- depressed and highly suicidal.
gon, to be antisocial. So dependent are these Cases of ‘‘elderly suicide,’’ as mentioned
men on their wives or girlfriends that they above, are more often defined by love and hate,
would sooner be dead than to live without but almost always depression based on serious
them. But for them, suicide is hard—they can- health factors in old age. They can be consid-
not get the nerve—so they have to find a way to ered altruistic because the belief is the world
force themselves to do it. I am speculating here is better off without them. The typical scenario
with this scenario, which is that for some they is the wife with late-stage Alzheimer’s cared for
know if they kill another it will be easier than to by an increasingly frail husband who can no
turn the gun on themselves. After committing longer care for her. So instead of going to a nurs-
a homicide, the only way out is suicide. ing home, he takes their lives in his own hands
An alternative scenario is that the urge to kill (see Malphurs, Eisendorfer, & Cohen, 2001).
the source of their obsession is so strong in some
men that if they cannot have these women they
want to end it all for them both. In the intimate- Reducing the Risk
partner situation, the girlfriend/wife makes
a move to leave. Her partner is absolutely dis- The prediction of the duration, intensity, and
traught in the belief that he cannot live without lethality of woman battering are among the
her. This pattern of dangerously obsessive love most critical issues in forensic mental health
often involves a history of stalking. The man and social work. Nevertheless, the courts, men-
decides at some point, if they cannot live to- tal health centers, family counseling centers, in-
gether they can die together, and if he cannot tensive outpatient clinics, day treatment and
have her, no one will. He hates the woman as residential programs, public mental hospitals,
(he thinks) the source of his passion and pain and and private psychiatric facilities rely on clini-
self-destruction. He kills her because he (obses- cians to advise judges in civil commitment
sively) ‘‘loves’’ and wants to possess her. (O.J. and criminal court cases. Based on interviews
Simpson once was quoted in the popular press of family members and friends of 220 female
as saying that if he did kill Nicole, his ex-wife, victims of domestic homicide, compared to
it would have been because he loved her.) a control group of 343 victims of physical vio-
Milton Rosenbaum (1990) of the Department lence, Campbell et al. (2003) found that a com-
of Psychiatry at the University of New Mexico bination of factors increased the likelihood of
compared 12 cases of murder-suicide to 24 cou- intimate partner homicide. The strongest risk
ple homicide cases through interviews with factor that emerged in this study was an abus-
family members and friends. The most striking er’s lack of employment compounded by a lack
finding was that the perpetrators of murder- of education. Significant relationship variables
suicide were depressed and almost all these kill- are separating from an abusive partner and hav-
ers were men, whereas the perpetrators alone of ing a child in the home who is not the partner’s
homicide were not depressed and one-half were biological child. Other factors that can help pre-
women. dict homicide are an abuser’s use of illicit drugs

6 Brief Treatment and Crisis Intervention
The Dynamics of Murder-Suicide

and access to firearms. Threats of use of a weapon ment and crisis intervention begins signifi-
were common in cases where the partner actu- cantly with an assessment of risk to loss of
ally did so. life. Stage 1 provides for an assessment of le-
The discussion in this paper in terms of the thality. Assessment in this model is ongoing
lower rates of domestic homicide and murder- and critical to effective intervention at all
suicide in the United Kingdom has implica- stages, beginning with an assessment of the le-
tions related to the control of weapons. thality and safety issues for the battered
Tightening gun control laws and restricting women. With victims of family violence, it is
the access to firearms by convicted batterers important to assess if the caller is in any current
is a serious step in reducing rates of lethal vi- danger and to consider future safety concerns
olence. A striking fact, as reported by a former in treatment planning and referral. In addition
city attorney of San Diego and head of a do- to determining lethality and the need for emer-
mestic violence unit, and relevant to gun gency intervention, it is crucial to maintain ac-
ownership, is the way in which domestic vio- tive communication with the client, either by
lence offenders use firearms to intimidate and phone or in person, while emergency proce-
threaten their partners, even when the gun is dures are being initiated.
out of sight (Gwinn, 2006). ‘‘In fact,’’ as Gwinn Additional stages as delineated in the Crisis
indicates, based on his personal experience, Intervention Model are (a) establishing rapport
‘‘most common use of a firearm in the home and communication, (b) identifying the major
of a batterer may well be to threaten the female problems, (c) dealing with feelings and provid-
victim’’ (p. 239). Firearm prohibitions involving ing support, (d) exploring possible alternatives,
domestic violence restraining orders, as he fur- (e) formulating an action plan, and (f) follow-up
ther asserts, do make a difference. States that measures.
carefully limit access to guns by individuals un- To plan and conduct a thorough risk assess-
der a restraining order have significantly lower ment, the crisis worker needs to evaluate the
rates of intimate partner homicide than do following issues: (a) the severity of the crisis,
states without these laws. (b) the client’s current emotional state, (c) im-
A further consideration more specifically mediate psychosocial and safety needs, and
relates to prevention of homicide in connection (d) the level of client’s current coping skills
with suicide. Because the suicide rate is much and resources. In the initial contact, assessment
higher among perpetrators of intimate homicide of the client’s past or pre-crisis level of func-
compared to homicide in general, suicidal ide- tioning and coping skills is useful. However,
ation in battering men might be considered past history should not be a focus of assessment
a possible risk factor for murder-suicide. unless related directly to the immediate victim-
Because of imminent threats and danger, it is ization or trauma. The focus of crisis interven-
important to respond quickly to battered tion is on assessing and identifying critical
women and provide immediate crisis interven- areas of intervention, while also recognizing
tion in a systematic manner. To meet this need, the duration and severity of violence and ac-
Roberts (2000) and Roberts and Roberts (2005) knowledging what has happened. Crisis inter-
developed and customized a seven-stage model vention can be the starting point of a longer
for crisis intervention, a model which is a fre- journey that will not end until the woman’s
quently used time-limited intervention model health and life are no longer at risk.
with battered women. Roberts’ (2007) Seven- A safety plan is crucial. The crisis worker
Stage Crisis Intervention Model crisis assess- must help the client look at both the short-term

Brief Treatment and Crisis Intervention
VAN WORMER

and long-range impacts in planning interven- among clients in order to provide the best pos-
tion. Such a plan is designed to ensure the wom- sible safety planning, risk assessments, crisis
an’s safety even if she chooses to remain in intervention, and effective social services. Be-
a threatening situation. The safety plan fore court decisions are made, they should take
involves memorizing relevant phone numbers into account whether or not battered women
of domestic violence and legal services, a coded are at low, moderate, or high risk of continued
statement that can be conveyed to trusted rel- battering; life-threatening injuries; and/or ho-
atives in telephone calls or email messages to micide. All assessments should start with an
signal that help is needed, the storing in an- evaluation of the psychological harm and phys-
other place duplicates of personal records ical injury to the victim and the children in the
and resources that the woman and her children family, the duration and chronicity of violent
might use later in the event of emergency relo- events, and the likelihood of the victim escap-
cation, and finally some thought given to a spe- ing and ending the battering cycle (Roberts &
cific plan of a safe place to which one ultimately Roberts, 2005).
might escape. In knowing such facts about the dynamics of
life-threatening situations that might end in the
death of one or both of the partners, health care
Conclusion practitioners and social workers can be cogni-
zant of the indicators that can serve as a basis
Domestic violence is harmful, destructive of for preventive intervention crisis and, in col-
one’s mental and physical health, and some- laboration with the potential victim of domestic
times fatal. This chapter has focused on cases homicide, the development of a safety plan at
in which domestic violence ends in the death the earliest possible moment.
of one of the parties, most often the woman.
In cases of domestic homicide, the gender dif-
Acknowledgments
ferences are pronounced. The overwhelming
majority of the women who had killed their
Conflict of interest: None declared.
partners and who were serving time in prison
for this act received specific lethal threats in
which the batterer gave every indication that References
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