"Children who fail to receive sufficient love from others fail to build those reserves of self-love" and mostly feel "numb, empty, and dead," he believes. When there is an absence of self-love in a person the resultant feeling is one of shame. Such feelings can include humiliation, bitterness, and anger. Deep shame often results in the death of the self with a resultant inability to feel anything.

The author believes that overt physical violence is not the only way to kill a child's soul. Words alone are capable of making a child feel and believe that he was worthless and rejected. Violent criminals seem unfeeling because they actually are. Many go to their execution with complete indifference, sometimes with relief. They cannot sympathize with others but neither can they sympathize with themselves. The person who was the receptacle of violence during his early life cannot give to others what he did not first receive. What lies underneath their rage and anger, Gilligan claims, is their early frustrated need to be loved.

Ritualistic murder is an attempt to eliminate the triggered shame by the use of magical thinking. By examining the modus of the murder one can find clues to make sense of senseless killings. The author delves into the lives and behaviors of well known as well as lesser known murderers, including Son of Sam, Starkweather, and others. Even collective violence has symbolism, be believes, as Nazi Germany's violent regime is discussed. Violent incidents recounted in the Bible and in world literature are examined. Dr. Milligan also analyzes the symbolism of shame and violence in myth and world literature.

But what is the trigger of a particular violent action? The author repeatedly writes that "the emotion of shame is the primary or ultimate cause of all violence." The acting out of violence diminishes the intensity of intolerable shame and substitutes in its stead, pride. Dr Gilligan presents a number of case studies from his years as a prison psychiatrist to support this theory.

The battered women's shelter is a relatively new feature in our society. Abusive wives no longer have to tolerate their abuse. Since the shelters were formed there has been a change in the number of husbands killing their wives. Before the shelters the number of spousal murders were about equal, that is, as many husbands were killing wives as wives killing husbands. But now the ratio of husbands killing their spouses has more than doubled! Why did this change occur?

According to Dr. Gilligan, the husbands felt more threatened by possible abandonment because of a secret dependency on their wives. Husbands began acting ". . . the way one would expect if their self-image were that of infants who would die if their mothers left them."

Chapters include "The Symbolism of Punishment," "How to Increase the Rate of Violence and Why" and a discussion on poverty as a cause of violence. In "The Biology of Violence" Gilligan examines the evidence of whether violence is genetic. He concludes that it is not and believes that neither brain lesions nor drugs and alcohol cause violence. However, it seems probable that drugs and alcohol can lower inhibitions in those with repressed anger and shame. The effect of intoxication on behavior is determined by cultural expectations, he writes. I think this would only be applicable to those without or with little repressed hurts.

The author believes that with preexisting psychopathology all of the evidence is not yet available, especially as pertains to violence induced by smoked cocaine which enters the brain directly. In any event, he believes that the illegality of the drug market accounts for far more violence than the pharmacological effects of all drugs.

Thankfully, Dr. Gilligan ignores the present-day media-generated Columbine school massacre non-issues. Rightfully, the effects of violent movies and video games as causes of violence are not considered; nor should they be considered.

The book, which emphasizes the penal system aspects of violence, is well written as far as it goes, but the definitive work on violence from the perspective of early infantile, childhood, birth and intra-uterine traumas has yet to be written. Alice Miller's For Your Own Good has a much greater dramatic and emotional impact on the reader, and comes closest to this goal than any other book I have read.

I believe Dr. Gilligan places too much emphasis on the emotion of shame as a cause of violence. For example, it perhaps may be more typical for an unloved and abused child to have more repressed violent anger than shame. Anger, shame, and desire for revenge against the abuses of one's perpetrator during infancy and childhood all play important roles in these violent act outs.

He also attempts, unsuccessfully, I believe, to justify why the present day Japanese shame-based culture seemingly does not result in more wide-spread violence in that country. He writes that prior to the Second World War, Japan during conquests of its Asian neighbors was as violent as Germany's Third Reich.