VexatiousLitigantsandUnusuallyPersistentComplainantsandPetitionersFromQuerulousParanoiatoQuerulousBehaviourPaulEMullenMBBSDScandGrantLesterMBBSMMEDQuerulousparanoiawasonceofconsider ID: 209194
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BehavioralSciencesandtheLawBehav.Sci.Law:333 349(2006)Publishedonline16May2006inWileyInterScience(www.interscience.wiley.com).DOI:10.1002/bsl.671 VexatiousLitigantsandUnusuallyPersistentComplainantsandPetitioners:FromQuerulousParanoiatoQuerulousBehaviourPaulE.Mullen,M.B.B.S.,D.Sc.andGrantLesterM.B.B.S.,M.M.E.D.Querulousparanoiawasonceofconsiderableclinicalandacademicinterestinpsychiatry.Overthelast40years,however,ithasvirtuallydisappearedfromtheprofessionallandscape.Thisdeclineoccurredattheverytimethataproliferationofcomplaintorganizationsandagenciesofaccountabilityweredrawingmoreandmorepeopleintoassertingtheirindividualrightsthroughthepursuitofclaimsandgrievances.Querulousbehaviour,asaresult,farfromdeclining,isontheincrease,bringingwithitsufferingforthequerulousanddisruptiontotheorganiza-tionsthroughwhichtheyseektheirvisionofjustice.Thisarticleexaminesquerulousbehaviourinthevex-atiouslitigantandinabnormallypersistentcomplainantsandpetitioners.Thephenomenologicalandnosologicalissuesareoutlinedandtherisksoftheemergenceofthreateningandviolentbehaviourisemphasized.Threatsshouldnotbeignored,foravarietyofreasons.Approachestomanagingquerulousbehaviourinthecourtsandthecomplaintorganizationsarediscussed,togetherwiththeutilityofindividualtherapy.Querulousbehaviourshouldoncemoretakeitsplaceamongthelegitimateconcernsofmentalhealthprofessionals.Thosecaughtupinaqueru-louspursuitoftheirnotionofjusticeareamenabletomanagementthatcanamelioratetheirsufferingandre-ducethedisruptiontheycreate.Copyright2006JohnWiley&Sons,Ltd.2006JohnWiley&Sons,Ltd. Correspondenceto:PaulE.Mullen,M.B.B.S.,D.Sc.,ProfessorofForensicPsychiatry,DepartmentofPsychologicalMedicine,MonashUniversityandVictorianInstituteofForensicMentalHealth,ThomasEmblingHospital,LockedBag10,Faireld,Victoria3078,Australia.E-mail:paul.mullen@forensicare.vic.gov.auVictorianInstituteofForensicMentalHealth. barrators,whowerethosepersistentcomplainersfomentingquarrelsanddiscordamongtheirneighbours,butsuchlawshavefallenintodisuse(Freckleton,1988).Innineteenthcenturypsychiatrictextsquerulousnessbecameintertwinedwiththemonomaniasandparanoia(Munro,1982;vonKrafft-Ebbing,1879).Thebeha-vioursbywhichquerulousnessisdenedbecame,inthisdiscourse,totallysub-ordinatedtotheputativementaldisorderssupposedtogiverisetothesebehaviours.Inthelatterhalfofthetwentiethcenturyinterestinthequeruloushaswanedandtheyhaveceasedtoattractprofessionalattentioneitherclinicallyoracademically.Caduff(1995),forexample,documentedathreefolddecreaseintheuseofthediagnosisofquerulousparanoiainSwitzerlandsmentalhealthservicesoverthelast80years.Inpartthedeclineininterestwasbecauseofthedistrustoftheconceptofparanoia(Post,1982),inparttherejectionoftheovertlyjudgementallabels,whichreiedthosewhoevincedunusuallypersistentcomplainingasneuroticquarrellersorquerulouspsychopaths(Kolle,1931;Schneider,1958;Stalstrom,1980).Inpartitmayhavebeenarecognitionthatthelabelswereobscuringmorethantheyrevealedaboutthiscomplexandmultifacetedbehaviour.Thevirtualdisappearanceofthequerulousfromtheprofessionallandscapecorrespondedtoaperiodwhencomplaintsandgrievanceprocedureswereemergingasacentralmechanismforresolvingconictinsocialsystemswhichincreasinglybasedtheirlegitimacyonanideologyofindividualrights.Ordinarycitizenscapacitytocontestissues,toseekjustice,andeventoclaimredresshascometodependnotprimarilyonthecourtsbutmainlyoncomplaintdepartments,agenciesofaccount-ability,suchasombudsmensofces,andcommissionsof,forexample,equalopportunity.Aprivilegedfewcanaffordtogodirectlytothecourts,butformostcomplaintresolutionproceduresaretheirbulwarkagainstthepowerofprivateandpublicagencies.Notsurprisinglyitbecameproblematictodiscussthepathologiesofcomplaints,whichcouldpotentiallystripanindividualoflegitimacyinthenewforawheresomuchofvitalconcerncouldbedecided.Paradoxicallythen,attheverymomentwhenvastnumbersofpeoplewerebeingdrawn,forthersttime,intoamultiplicityofnewcomplaintresolutionprocedures,therewasanexclusionofknowledgeoftheproblemssuchsystemscouldcreateforasmall,vulnerable,butincreasinglysalientgroup.UNUSUALLYPERSISTENTCOMPLAINANTSAgenciesofaccountabilityareawareofasmallgroupofunusuallypersistentcomplainantswhoconsumeaninordinateamountoftimeandorganizationalresourcesinthepursuitofgrievancesthat,inandofthemselves,seem,ifnottrivial,atleastlackinginthecomplexityandimportthatmightjustifysuchlengthyandconcentratedcampaigns(Lester,Wilson,Grifn,&Mullen,2004).ThevariousagenciesofaccountabilitycontactedinAustraliaestimatedthatsuchunusuallypersistentcomplainantsonlymadeupafractionofonepercentofthosewhopursuedgrievancesbutconsumedbetween15and30%ofallresources.Thosewhostruggletoassistthesecomplainantsarekeenlyawareofthepricebeingpaidforsuchpersistencebythecomplainantsthemselvesintermsoftime,money,andpersonalandsocialfunctioning.Alltoomanylosejobs,friends,andpartnersastheirlivesaretakenoverbythepursuitoftheirvisionofjustice.TheprofessionalswhomanageVexatiouslitigantsandunusuallypersistentcomplainantsandpetitioners3352006JohnWiley&Sons,Ltd.Behav.Sci.Law:333 349(2006)DOI:10.1002/bsl litigantsaredistinguishedfromtheunusuallypersistentcomplainantslargelybypursuingtheirgrievancepredominantlywithinthecourts,thoughtheyusuallyaccessagenciesofaccountabilitytosomeextent.Thosewhousethecourtsextensivelywilloftenappearasunrepresentedlitigants,sometimesbecausetheyhaveexhaustedtheirfundsorthepatienceoflawyers,sometimesbecausetheybelievethatnobodyelsecanbetrustedtoadequatelypresenttheircase.Asunrepresentedlitigantstheycanbeparticularlychallengingtothesmoothfunction-ingofthecourts.Thisgroupalsotendtondthemselveschargedwithcontemptofcourtwhentheirpassionateinvolvementintheircaseresultsinintemperateremarkstothejudge.Attemptstoexcludethesededicatedlitigatorsfromthecourtsoftenfail.Internetsitesnowprovideinformationonhowtocircumventordersdeclaringthemvexatiousaswellasmutualsupportfromlikemindedlitigators.UNUSUALLYPERSISTENTPETITIONERSAthirdtypeofquerulousbehaviourinvolvespursuingaquestforjusticeprimarilythroughpetitioningprominentpeoplesuchaspoliticiansandheadsofstate.Thisgrouptypicallysendvoluminousandrepeatedcommunicationssettingouttheircaseandpleadingfor,ordemanding,help.Likeotherquerulousindividualstheymaygraduallyshiftfromrequeststodemands,fromdemandstorecriminations,andfromrecriminationstothreats.Occasionallysuchindividualsattempttomakedirectcontactwiththepublicgureonwhomtheyhavebecomexated.Theycometoregardthepublicgureeitherastheirsaviourorasthecentralimpedimenttotheirquest.Inrareincidencestheymayattempttoattacktheobjectoftheirxation.Thoughrare,itisthisgroupwhohavebeenresponsibleformanyoftheattacksonseniorpoliticiansintheWesternworldoverthelast20years.Ourimpressionofthisgroupofthequerulousisthatitcontainsahigherproportionofindividualswithsevereandobviouspsychosis,whichalmostcertainlypreceded,anddrives,theircomplainingandclaiming.Thereisanoverlapwiththevexatiouslitigantsandtheunusuallypersistentcomplainantsinthattheyalsomakecomplaintstovariousagenciesandoccasionallyattempttoinitiatelitigationorcriminalprosecutions.Manyofthelitigantsandcomplainersalsoattemptonoccasiontoexhortsupportfrompublicgures.Seniorpoliticiansandheadsofstateoftenhaveservicesfordealingwiththeirmountainsofcorrespondence,whichareskilledatrecognizingtheobviouslydisorderedandpotentiallyquerulous.Theytendtorespondwithblandandstandardexpressionofinterestandgeneralgoodwillunderthesignatureoftheprincipal.Theirresponsesareoftentreasuredbytheirrecipientsasclearexpressionsofsupportfortheircause,orworsestillencourageexpectationsoftheprincipal,which,wheninevitablydisappointed,mayprovokecampaignsofharassment.Thosewhodealwiththequerulousbecomeusedtohavingthesestandardlettersfromministersormembersoftheroyalfamilywavedundertheirnosesastheultimateproofofthejusticeofthecause.CLINICALFEATURESVexatiouslitigantsandtheunusuallypersistentcomplainantsandpetitionersareusuallyseeninourcliniconcourtordersfollowingactsofviolenceorthreats.Vexatiouslitigantsandunusuallypersistentcomplainantsandpetitioners3372006JohnWiley&Sons,Ltd.Behav.Sci.Law:333 349(2006)DOI:10.1002/bsl theyhaveusuallylaidwastetothenancialandsocialfabricoftheirlives.Theyarelikegamblerswithnowayoutofthedevastationtheyhavewroughtbutthroughareallybigwin.Atissueisnolongerjustmoneyandesteembuttheirveryexistence.Theymayinitiallypresentaseithersuspiciousanddismissive,orasingratiatingandappealingforunderstandingandsupport.Notinfrequentlytheywillarrivedraggingsuitcasesfullofdocumentswhichtheywillattempttohaveyouperuse.Thesepapersoftenappear,atrstglance,neatlyordered.Thedocumentsarefrequentlygracedwithmultiplemarginaliaandwithwordsandphrasesemphasizedbyunderliningorhighlighterpens,ofteninseveraldifferenthues(seeTable1).Oncloserexaminationtheyareusuallyfoundtoconsistofaconfusingmixtureofcopiesofletters,photocopiesoflegaldecisions,legislationandeveninternationaldeclarationsonhumanrights,togetherwithdocumentssuchascerticatesofeducationalandotherattainments.Itisnotinfrequentforsuchpatientstoinsistonmakingnotesofanyintervieworrecordingtheinterview,usuallyonaudiotapebutjustoccasionallyonvideo.Inevitablytheywillrequestcopiesofyournotesand,equallyinevitably,onewayoranothertheywilleventuallyobtainthem.TheirspeechmaybemarkedbywhatKraepelin(1904)referredtoasawear-isomediffusenessofconversationandoftenbytheuseofamultiplicityoftechnicalterms,particularlyfromthelegaldiscourse,employedidiosyncratically.Sensitivityandself-referenceisfrequent,withaboutathirdexpressingbeliefsthattheyarethevictimofaconspiracythatspiesuponthemandfrustratesthemateveryPhenomenologically,thequerulouspresentachallenge.Aretheytoberegardedasdeluded?Theycanusuallyadvancetheirideasplausibly,makingapparently Table2.Acaseofquerulousbehaviour:thechangesoveraveyearperiodinthenatureofthegrievance,theagentsheldresponsible,hisstateofmind,andhissocialsituationGrievanceAgentsErrorsinmortgagedocumentsBanksaccountantPotentialnanciallossPlusmanagerActualnanciallossPlusseniormanagementVictimofmajorfraudandtheftPlusbankingombudsmanSystemwidecorruptionPluslawyersandjudgesAcampaignofnancialcorruptionthreateningPluswifethenationseconomicstabilityPlusvariouspublicagenciesPluspolicePlusprimeministerPlussecretservicesStateofmindSocialsituationRigid,discontentedman,obsessionaltraitsbutModeratelysuccessfulsmallbusinessman,articulateandambitiousmarried,twochildren,butexperiencingIncreasinglyxatedongrievancenancialpressuresandmaritalproblemsPursuitofjusticesubordinatesallotherconcernsBusinessbeginstofailasallhisattentionmovesIncreasinglyconvincedheisbeingtogrievancepersecutedandspieduponMarriagebreaksdownHeisamanofdestinyghtingforcesofnationalAlienatesfewfriendshehadandinternationalcorruptionLivingaloneVexatiouslitigantsandunusuallypersistentcomplainantsandpetitioners3392006JohnWiley&Sons,Ltd.Behav.Sci.Law:333 349(2006)DOI:10.1002/bsl justpersistencebutatotallydisproportionateinvestmentoftimeandresourcesingrievancesthatgrowsteadilyfromthemundanetothegrandiose,andwhosesettlementrequiresnotjustapology,reparation,and/orcompensationbutretribu-tionandpersonalvindication.Querulousbehaviourisalmostalwaysassociatedwithclaimsofwidesocialsignicanceforthequestforpersonaljustice.Distinguishingthoseindividualsfromsocialreformerswhoareusingthecomplaintsproceduresorthecivilcourtstopursuetheircampaignsisthereforeofimportance.Socialreformersarepursuingissuesofconcerntogroupsoftheirfellowcitizensandtheyusepersonalexperience,iftheyuseitatall,toinformtheircampaigns.Thesociallyrelevantandthepersonallyrelevantmay,onoccasion,beelided,butneverinamannerinwhichtheidiosyncraticoverwhelmsthewiderpublicinterest.Socialcampaignerstypicallyworkwithandthroughothers.Theirobjectivesarecircum-scribedandobviouslyrelatedtothecoreissuesdrivingthecampaign.Inmostcasestheywillworkfornegotiatedresolutionseveniftheseinvolveadegreeofcompro-miseandfacesavingforauthorities.Querulousbehaviour,incontrast,involvesclaimingwidesocialsignicanceforidiosyncraticconcerns.Thereisaconationofthepersonalwiththesupposedpublicimporttoleavethepersonaldominant.Thoseshowingquerulousbehaviourusuallyhaveproblemsworkingwithothers,typicallydismissingaseriesoflawyers,advocates,and/orclaimsprofessionals,who,notinfrequently,ndthemselvesthesubjectofsubsequentcomplaints.Querulousbehaviouroftenrevolvesaroundstatedobjectivesthataredifculttorelatetoanyoftheclaimedcoreissuesofsocialrelevance,anddespite,orpossiblybecauseof,thediffusenatureofthedemands,negotiationandcompromisehavenoplaceintheirquestforjustice.Thecleartheoreticaldichotomybetweensocialcampaigningandquerulousbehaviourisnotalwayssoobviousinpractice.Thosewhosebehaviourisquerulouscanoccasionallygatheraroundthemsmallgroupsoflikemindedsupporters,aprocessnowassistedbytheinternet.Theycanjoinsocialcampaignswheretheirenergiescompensateforatimefortheirpersonalizationofissues.Insomesocialmovementssuchpersonalizationmayevenbeencouraged,thoughusuallythequerulousbyconstantself-referenceeventuallyalienatethemselvesfromthegroup.Thosewhohaveshownquerulousbehaviourinthepastmaytakeonaroleoflayadvocateanduseotherstoadvancetheirownviewofjustice.Suchindividualsarerecognizedasamajorproblemforagenciesofaccountability.Onoccasion,campaignsemergearoundissuesthathaveimmensepersonalimportforallthoseinvolved,andinthesesituationstherisksofquerulousbehavioursuborningaspectsofthegroupsfunctionmaybeconsiderable.Iftherearedoubtsthenthebenetofthesedoubtsshouldgototheassumptionoflegitimatecampaigning,nottothepresenceofquerulousbehaviour.Whistleblowers,whousuallyclaimtobeexposingnefariousandcorruptpracticesintheirplaceofwork,areaparticularlydifcultgroupinwhichtoseparatealtruisticfromquerulousbehaviour.Thereisnodoubtthaterrorsoccur.In1977inFinlandatelevisionsalesmancontactedthepoliceandtaxauthorities,claimingthatthecompanyheworkedfor,alongwithamajortelevisionmanufacturer,wereinvolvedinlargescaletaxevasionandblackmarketsales.Whengreetedwithdisbeliefheattemptedtopublicizehisrevelations,eventuallybeingdetainedandVexatiouslitigantsandunusuallypersistentcomplainantsandpetitioners3412006JohnWiley&Sons,Ltd.Behav.Sci.Law:333 349(2006)DOI:10.1002/bsl Thelastofthesedistortions,whencombinedwiththeirfocusonretributionandvindication,isparticularlytoxic.Themanagementofthequerulousisassistedbyrepeatedlyclarifying,confronting,andgentlychallengingthesedistortions.NOSOLOGYQuerulousnessdescribesbehavioursinvolvingthepersistentpursuitofapersonalviewofjustice.Querulousbehaviourcommonlyreectsbroadlysimilarsetsofattitudesandbeliefs,butinouropinionthesearchforasingleoverarchingexplanationintermsofdelusionaldisorder(paranoia)orofaspecicabnormalphenomenaon,suchaovervaluedideas,willatbestbeonlypartiallysuccessful.Kraepelin(1904)favouredthepragmaticapproachofclassifyingthebehaviouraccordingtoarangeofpotentialunderlyingpsychopathologiesfrompersonalitydisordersthroughquerulousparanoiatodementiapraecox,withnormalityanilldenedpossibility.Jaspers(1923)regardedquerulousnessassimilartojealousy,beingpotentiallytheproductofpathologicalreactions,developments,orprocesses,withagainnormalitybeingafurtheroption.DeClerambault(1942)placedquerulousnessamonghisdisordersofpassionbut,unlikejealousyandlove,wearedealingnotwithanemotionthatdrivesbehaviourbutbehavioursthatreectapassionatecommitmenttospecicgoals,thepursuitofwhichevokesstrongemotions.VanderHeydt(1952)attemptedatypologyofquerulants,incorporatingtheopportunisticwhowereindividualswithantisocialtraitspursuingpersonaladvantage,theparanoidjusticeseekerdrivenbydelusionalconvictionsspecictotheparticulargrievances,theconjugalcaughtupinthepassionatepursuitofpropertyorparentalrightsfollowingmaritalbreakdown,thequarrelsome,whohadpersonalitytraitsconducivetoprotractedconictwithanyandall,thosewhoseconditionsaresecondarytopsychoticdisorders,notablytheschizophrenias,andnallyanormalgroup,thenatureofwhichwasleftsomewhatvague.Thisapproachhasappeal,despitecombiningpotentiallyoverlappingtypesbasedoncontext(conjugal),psychopathology(secondaryandparanoid),andmotivation(opportunistic).Querulousnessisdestructivetotheafictedindividualsandtheirfamiliesaswellasdisruptivetoagenciesofaccountabilityandthecourts.Querulousnesssodenedcanneverbenormalinanidealorstatisticalsense.Querulousnessmaynotbenormalbehaviourbutisitnecessarilyreectiveofpsychopathology?Toputthequestiontheotherwayround,couldarelativelynormalindividualbedriventoquerulousnessbythecourts,orbythevariouscomplaintresolutionprocedures?ThiswastheviewarticulatedbyCharlesDickens,whowroteinBleakHouseTheCourtofChancerygivestomoniedmightthemeansabundantlyofwearyingoutthe...sooverthrowingthebrainandbreakingthehearttoleaveitswornoutlunaticineverymadhouse.Thecasesweencounterclinicallywere,priortohavingbecomeenmeshedinthepursuitofgrievances,oftenfunctionalindividuals,withfamiliesandfriendsandwithoutobviousantisocialtraits.Withthebenetofhindsightcertainvulnerabilitiescanoftenberecognized.Theirpersonalitiesseemedmorefrequentlythanmightbeexpectedtohavebeenmarkedbyobsessionaltraits,self-absorption,andmorethantheusuallevelsofsensitivityandself-reference.Againwithhindsight,therewasVexatiouslitigantsandunusuallypersistentcomplainantsandpetitioners3432006JohnWiley&Sons,Ltd.Behav.Sci.Law:333 349(2006)DOI:10.1002/bsl healthtreatmentoption.Toevaluatetheideasdrivingthequerulousbehaviouracarefulhistoryisneeded,adispassionateexaminationofthedocuments,andanactiveattempttoengagewiththeirideasandclaims.Itistemptingbutinadequatetojustletthetorrentofwordsowoveryou.Theextenttowhichthey,andthosearoundthem,aresufferingasaresultoftheirquerulousnessshouldalsohavesomeweightinmakingadecisionaboutwhethertocompeltreatment.Wecontinuetobeamazedathowbroadourcolleaguesnotionsofnon-delusionaleccentricityseemtobecomewhenconfrontedwiththoseexhibitingquerulousbehaviour.Amongtheexamplesoftheconvictionsthatcolleagueshavettedintothenon-delusionalaretheabsoluteconvictionthatoneisowedmillionsofdollarsforanactoftrespass,thatgovernmentswillfallwhenthetruthofonesdentalmismanagementisnallyacknowledged,thattheUNiskeenlyawaitingtheresultsofonescomplaintagainstalocallawyer,andthattheQueenhasjoinedherselftoonesquestforcompensationfromaninsurancecompany.Eachandeveryassertionisbackedupwithdocumentsinwhicheventhemostimaginativewouldbepressedtondaconnectiontowhattheyareclaimedtoprove.Partoftheproblemforclinicians,wesuspect,isconfusingissuesofaetiology,i.e.psychogenesis,withquestionsofdiagnosis,i.e.psychosis.Thisconfusioniscompoundedbythenotionofaparanoidpersonality,whichisoftenevokedinthiscontext.Paranoidmeansnotsuspiciousnessbutsufferingfromparanoia,andimpliesthepresenceofdelusion(s).Itisnotsurprisingthatambiguityhasarisenoveralabeloftenattachedtothosewhoarechronicallysuspiciousbutnotbelievedtobedeluded.Attemptstoavoidconferringlegitimacyaspatientsonthequerulousarealsofedbythewidespread,butwebelieveincorrect,viewoftheuntreatabilityofbothdelusionaldisordersandpersonalitydisorders.RISKOFVIOLENCEAttacksbythequerulousoncourtofcials,claimsofcialsandpoliticiansarebynomeansuncommon.Insuchcasestherehasoftenbeenacourseofconductcharacterizedbyincreasinglythreateningandintrusiveactivities,usuallyovermanymonths,which,withthebenetofhindsight,takesonasinisterimport.Inanumberofcasesofseriousorfatalviolence,ofwhichwehaveknowledge,clearandspecicthreatshadbeenissued.Thoseweseeclinicallyconstituteahighlyselectedsampleofpeople,almostallreferredfromthecourtsfollowingconvictionsforthreateningbehaviourorassault.Thispotentiallyprovidesaskewedperspectiveontheviolenceassociatedwithquerulousbehaviour.Inthestudyoftheunusuallypersistentseeninagenciesofaccountability,however,anunexpectedndingwasthefrequencywithwhichovertandcovertthreatsofviolenceweremadetoclaimsprofessionals(Lesteretal.,2004).Thesethreatswereoften,ineffect,ignored,andtheprofessionals,thoughsometimesfrightenedandstressed,rarelytookanyactivestepstorespondtowrittenorverbalthreats.Noneofthosewhothreatenedofcialshadbeenprosecuted.Nothreatsweremadebythecontrolgroupinthestudy.Oneofthecharacteristicsofthethreatsbytheunusuallypersistentwasthattheywererarelysimplyexpressiveofintenseemotionbutappearedtobecalculatedattemptstoadvancetheircausebymakingconditionalthreats,Ifyoudonotthen,orIfbynextmonththen.Threatsofsuicide,whichwerealsorelativelyfrequent,tendedtosharethisstructure.Vexatiouslitigantsandunusuallypersistentcomplainantsandpetitioners3452006JohnWiley&Sons,Ltd.Behav.Sci.Law:333 349(2006)DOI:10.1002/bsl Thosewhoarequerulous,orarelikelytobecomequerulous,maybeobviousfromtheoutsetgiventhecharacteristicmannerinwhichtheyoftenadvancetheircase.Obviousthatisifyouknowwhattolookfor.Thisoffersanopportunityforinstitutingaharmminimizationprogramfromtheoutset.Giventhatanyscreeningprocesshasfalsepositives,itisessentialthatanydifferentmethodofdealingwiththepotentiallyquerulantshouldnotdisadvantageanon-querulousindividual.Courtsandagenciesofaccountabilityareadeptatmanagingthedifcult,theover-emotional,andtheplainawkward.Atypicalstrategyistoassignsuchindividualstoanexperiencedstaffmemberinthehopeofminimisingcrosscommunications,splitting,andconict.Thisworkswiththedifcultbutnotwiththoseinclinedtoquerulousnesswhocannotbeeffectivelycontainedinthisway,exceptpotentiallybytheagencysmostseniorgure.Thequerulousplaceunreasonabledemandsandstrainsonanysinglecasemanager.Moreeffectiveislikelytobeagroupwhohavebeentrained,whotakeaspecialinterestinthisarea,andwhoincombinationmanagethepotentiallyquerulous.Mostofthoseinclinedtoquerulousnesswillnotbesurprisedtolearntheirclaimissoimportantandcomplexagroupofexpertsisrequiredtomanagetheissues.Theobjectiveistoassistinresolvingwhatcanberesolvedwithrepeatedandclearemphasisonwhichaspectsoftheclaimareoutsideoftheorganizationsjurisdictionandpowers.Whenwhatcanbedonehasbeendonethecaseneedstobesympatheticallybutrmlyclosed,albeitideallywiththeopportunityfortheclaimant,whoifquerulouswillremaindissatised,tocomebackoccasionallytodiscussoutstandingissues.Thissystemshouldavoidallowingthequeruloustofocustheirhopesandfrustrationsonanysinglestaffmember.Itshouldremainsympatheticbutclearaboutthelimitsoftheorganization.Anythreatsshouldbetakenseriously.Suchagroupwouldhopefullythroughexperiencedeveloptheknowledgetoimprovethemanagementofquerulousbehaviour,whichcurrentlyisencounteredonlyasatroublesomeraritybymostindividualsworkinginthecomplaintsindustry.Theliteratureonthetherapeuticmanagementofthequerulousisbothsmallandpredominantlydiscouraging.VonDietrich(1968)referstotreatmentasathanklesstaskandvanderHeydt(1952)evenwarnsthatattemptsattherapymayignitebushresofquerulousness.Winokur(1977)andAstrup(1984)suggestthatthemajorityofthequerulantsintheirstudiesdidnotreceiveanyspecictherapyandtheminoritygivenpharmacotherapyshowednogreatresponse.Incontrast,Ungvari(1993)reportedsuccessfultreatmentusingpimozide.Ourownexperienceisthatrelativelylowdosesofatypicalantipsychoticsarehelpfulthoughtheresponseisslowincoming,oftentakingmonthsbeforethereisobviousimprovement.Therstproblemisattainingsomesemblanceofatherapeuticalliancewiththepatient.Thisrequiresavoidingbeingcaughtupindiscussionsoftherightsandwrongsoftheirquest.Thefocusshouldbeonthepricetheyandtheirfamilyarepayingforthepursuit.Interestingly,someofthosewhocomeonordersfromthecourtwhichmandatetreatmentwillacceptmedicationandothertherapeuticinterventionsastheywishtomakecleartheyabidebythelaw.Paradoxically,theycanbeultra-compliantpatients.Anumberhavecontinuedvoluntarilyintreatmentaftertheendoftheorder,thoughtheyneveracknowledgeeitherthattheywereinerrororinneedoftreatmentbecauseoftheirquerulousness.Whatchangesistheinvolvementinthequerulousideas,thedegreeofpreoccupation,andthebehaviour,butthecorebeliefthattheywererightneverwavers.QuerulousbehaviourappearstobesustainedbyaVexatiouslitigantsandunusuallypersistentcomplainantsandpetitioners3472006JohnWiley&Sons,Ltd.Behav.Sci.Law:333 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