BehavioralSciencesandtheLawBehav.Sci.Law:333 - PDF document

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,Fair“eld,Victoria3078,Australia.E-mail:paul.mullen@forensicare.vic.gov.auVictorianInstituteofForensicMentalHealth. barrators,whowerethosepersistentcomplainersfomentingquarrelsanddiscordamongtheirneighbours,butsuchlawshavefallenintodisuse(Freckleton,1988).Innineteenthcenturypsychiatrictextsquerulousnessbecameintertwinedwiththemonomaniasandparanoia(Munro,1982;vonKrafft-Ebbing,1879).Thebeha-vioursbywhichquerulousnessisde“nedbecame,inthisdiscourse,totallysub-ordinatedtotheputativementaldisorderssupposedtogiverisetothesebehaviours.Inthelatterhalfofthetwentiethcenturyinterestinthequeruloushaswanedandtheyhaveceasedtoattractprofessionalattentioneitherclinicallyoracademically.Caduff(1995),forexample,documentedathreefolddecreaseintheuseofthediagnosisofquerulousparanoiainSwitzerlandsmentalhealthservicesoverthelast80years.Inpartthedeclineininterestwasbecauseofthedistrustoftheconceptofparanoia(Post,1982),inparttherejectionoftheovertlyjudgementallabels,whichrei“edthosewhoevincedunusuallypersistentcomplainingasneuroticquarrellersorquerulouspsychopaths(Kolle,1931;Schneider,1958;Stalstrom,1980).Inpartitmayhavebeenarecognitionthatthelabelswereobscuringmorethantheyrevealedaboutthiscomplexandmultifacetedbehaviour.Thevirtualdisappearanceofthequerulousfromtheprofessionallandscapecorrespondedtoaperiodwhencomplaintsandgrievanceprocedureswereemergingasacentralmechanismforresolvingcon”ictinsocialsystemswhichincreasinglybasedtheirlegitimacyonanideologyofindividualrights.Ordinarycitizenscapacitytocontestissues,toseekjustice,andeventoclaimredresshascometodependnotprimarilyonthecourtsbutmainlyoncomplaintdepartments,agenciesofaccount-ability,suchasombudsmensof“ces,andcommissionsof,forexample,equalopportunity.Aprivilegedfewcanaffordtogodirectlytothecourts,butformostcomplaintresolutionproceduresaretheirbulwarkagainstthepowerofprivateandpublicagencies.Notsurprisinglyitbecameproblematictodiscussthepathologiesofcomplaints,whichcouldpotentiallystripanindividualoflegitimacyinthenewforawheresomuchofvitalconcerncouldbedecided.Paradoxicallythen,attheverymomentwhenvastnumbersofpeoplewerebeingdrawn,forthe“rsttime,intoamultiplicityofnewcomplaintresolutionprocedures,therewasanexclusionofknowledgeoftheproblemssuchsystemscouldcreateforasmall,vulnerable,butincreasinglysalientgroup.UNUSUALLYPERSISTENTCOMPLAINANTSAgenciesofaccountabilityareawareofasmallgroupofunusuallypersistentcomplainantswhoconsumeaninordinateamountoftimeandorganizationalresourcesinthepursuitofgrievancesthat,inandofthemselves,seem,ifnottrivial,atleastlackinginthecomplexityandimportthatmightjustifysuchlengthyandconcentratedcampaigns(Lester,Wilson,Grif“n,&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.Thisgroupalsotendto“ndthemselveschargedwithcontemptofcourtwhentheirpassionateinvolvementintheircaseresultsinintemperateremarkstothejudge.Attemptstoexcludethesededicatedlitigatorsfromthecourtsoftenfail.Internetsitesnowprovideinformationonhowtocircumventordersdeclaringthemvexatiousaswellasmutualsupportfromlikemindedlitigators.UNUSUALLYPERSISTENTPETITIONERSAthirdtypeofquerulousbehaviourinvolvespursuingaquestforjusticeprimarilythroughpetitioningprominentpeoplesuchaspoliticiansandheadsofstate.Thisgrouptypicallysendvoluminousandrepeatedcommunicationssettingouttheircaseandpleadingfor,ordemanding,help.Likeotherquerulousindividualstheymaygraduallyshiftfromrequeststodemands,fromdemandstorecriminations,andfromrecriminationstothreats.Occasionallysuchindividualsattempttomakedirectcontactwiththepublic“gureonwhomtheyhavebecome“xated.Theycometoregardthepublic“gureeitherastheirsaviourorasthecentralimpedimenttotheirquest.Inrareincidencestheymayattempttoattacktheobjectoftheir“xation.Thoughrare,itisthisgroupwhohavebeenresponsibleformanyoftheattacksonseniorpoliticiansintheWesternworldoverthelast20years.Ourimpressionofthisgroupofthequerulousisthatitcontainsahigherproportionofindividualswithsevereandobviouspsychosis,whichalmostcertainlypreceded,anddrives,theircomplainingandclaiming.Thereisanoverlapwiththevexatiouslitigantsandtheunusuallypersistentcomplainantsinthattheyalsomakecomplaintstovariousagenciesandoccasionallyattempttoinitiatelitigationorcriminalprosecutions.Manyofthelitigantsandcomplainersalsoattemptonoccasiontoexhortsupportfrompublic“gures.Seniorpoliticiansandheadsofstateoftenhaveservicesfordealingwiththeirmountainsofcorrespondence,whichareskilledatrecognizingtheobviouslydisorderedandpotentiallyquerulous.Theytendtorespondwithblandandstandardexpressionofinterestandgeneralgoodwillunderthesignatureoftheprincipal.Theirresponsesareoftentreasuredbytheirrecipientsasclearexpressionsofsupportfortheircause,orworsestillencourageexpectationsoftheprincipal,which,wheninevitablydisappointed,mayprovokecampaignsofharassment.Thosewhodealwiththequerulousbecomeusedtohavingthesestandardlettersfromministersormembersoftheroyalfamilywavedundertheirnosesastheultimateproofofthejusticeofthecause.CLINICALFEATURESVexatiouslitigantsandtheunusuallypersistentcomplainantsandpetitionersareusuallyseeninourcliniconcourtordersfollowingactsofviolenceorthreats.Vexatiouslitigantsandunusuallypersistentcomplainantsandpetitioners3372006JohnWiley&Sons,Ltd.Behav.Sci.Law:333…349(2006)DOI:10.1002/bsl theyhaveusuallylaidwastetothe“nancialandsocialfabricoftheirlives.Theyarelikegamblerswithnowayoutofthedevastationtheyhavewroughtbutthroughareallybigwin.Atissueisnolongerjustmoneyandesteembuttheirveryexistence.Theymayinitiallypresentaseithersuspiciousanddismissive,orasingratiatingandappealingforunderstandingandsupport.Notinfrequentlytheywillarrivedraggingsuitcasesfullofdocumentswhichtheywillattempttohaveyouperuse.Thesepapersoftenappear,at“rstglance,neatlyordered.Thedocumentsarefrequentlygracedwithmultiplemarginaliaandwithwordsandphrasesemphasizedbyunderliningorhighlighterpens,ofteninseveraldifferenthues(seeTable1).Oncloserexaminationtheyareusuallyfoundtoconsistofaconfusingmixtureofcopiesofletters,photocopiesoflegaldecisions,legislationandeveninternationaldeclarationsonhumanrights,togetherwithdocumentssuchascerti“catesofeducationalandotherattainments.Itisnotinfrequentforsuchpatientstoinsistonmakingnotesofanyintervieworrecordingtheinterview,usuallyonaudiotapebutjustoccasionallyonvideo.Inevitablytheywillrequestcopiesofyournotesand,equallyinevitably,onewayoranothertheywilleventuallyobtainthem.TheirspeechmaybemarkedbywhatKraepelin(1904)referredtoasawear-isomediffusenessofconversationandoftenbytheuseofamultiplicityoftechnicalterms,particularlyfromthelegaldiscourse,employedidiosyncratically.Sensitivityandself-referenceisfrequent,withaboutathirdexpressingbeliefsthattheyarethevictimofaconspiracythatspiesuponthemandfrustratesthemateveryPhenomenologically,thequerulouspresentachallenge.Aretheytoberegardedasdeluded?Theycanusuallyadvancetheirideasplausibly,makingapparently Table2.Acaseofquerulousbehaviour:thechangesovera“veyearperiodinthenatureofthegrievance,theagentsheldresponsible,hisstateofmind,andhissocialsituationGrievanceAgentsErrorsinmortgagedocumentsBanksaccountantPotential“nanciallossPlusmanagerActual“nanciallossPlusseniormanagementVictimofmajorfraudandtheftPlusbankingombudsmanSystemwidecorruptionPluslawyersandjudgesAcampaignof“nancialcorruptionthreateningPluswifethenationseconomicstabilityPlusvariouspublicagenciesPluspolicePlusprimeministerPlussecretservicesStateofmindSocialsituationRigid,discontentedman,obsessionaltraitsbutModeratelysuccessfulsmallbusinessman,articulateandambitiousmarried,twochildren,butexperiencingIncreasingly“xatedongrievance“nancialpressuresandmaritalproblemsPursuitofjusticesubordinatesallotherconcernsBusinessbeginstofailasallhisattentionmovesIncreasinglyconvincedheisbeingtogrievancepersecutedandspieduponMarriagebreaksdownHeisamanofdestiny“ghtingforcesofnationalAlienatesfewfriendshehadandinternationalcorruptionLivingaloneVexatiouslitigantsandunusuallypersistentcomplainantsandpetitioners3392006JohnWiley&Sons,Ltd.Behav.Sci.Law:333…349(2006)DOI:10.1002/bsl justpersistencebutatotallydisproportionateinvestmentoftimeandresourcesingrievancesthatgrowsteadilyfromthemundanetothegrandiose,andwhosesettlementrequiresnotjustapology,reparation,and/orcompensationbutretribu-tionandpersonalvindication.Querulousbehaviourisalmostalwaysassociatedwithclaimsofwidesocialsigni“canceforthequestforpersonaljustice.Distinguishingthoseindividualsfromsocialreformerswhoareusingthecomplaintsproceduresorthecivilcourtstopursuetheircampaignsisthereforeofimportance.Socialreformersarepursuingissuesofconcerntogroupsoftheirfellowcitizensandtheyusepersonalexperience,iftheyuseitatall,toinformtheircampaigns.Thesociallyrelevantandthepersonallyrelevantmay,onoccasion,beelided,butneverinamannerinwhichtheidiosyncraticoverwhelmsthewiderpublicinterest.Socialcampaignerstypicallyworkwithandthroughothers.Theirobjectivesarecircum-scribedandobviouslyrelatedtothecoreissuesdrivingthecampaign.Inmostcasestheywillworkfornegotiatedresolutionseveniftheseinvolveadegreeofcompro-miseandfacesavingforauthorities.Querulousbehaviour,incontrast,involvesclaimingwidesocialsigni“canceforidiosyncraticconcerns.Thereisacon”ationofthepersonalwiththesupposedpublicimporttoleavethepersonaldominant.Thoseshowingquerulousbehaviourusuallyhaveproblemsworkingwithothers,typicallydismissingaseriesoflawyers,advocates,and/orclaimsprofessionals,who,notinfrequently,“ndthemselvesthesubjectofsubsequentcomplaints.Querulousbehaviouroftenrevolvesaroundstatedobjectivesthataredif“culttorelatetoanyoftheclaimedcoreissuesofsocialrelevance,anddespite,orpossiblybecauseof,thediffusenatureofthedemands,negotiationandcompromisehavenoplaceintheirquestforjustice.Thecleartheoreticaldichotomybetweensocialcampaigningandquerulousbehaviourisnotalwayssoobviousinpractice.Thosewhosebehaviourisquerulouscanoccasionallygatheraroundthemsmallgroupsoflikemindedsupporters,aprocessnowassistedbytheinternet.Theycanjoinsocialcampaignswheretheirenergiescompensateforatimefortheirpersonalizationofissues.Insomesocialmovementssuchpersonalizationmayevenbeencouraged,thoughusuallythequerulousbyconstantself-referenceeventuallyalienatethemselvesfromthegroup.Thosewhohaveshownquerulousbehaviourinthepastmaytakeonaroleoflayadvocateanduseotherstoadvancetheirownviewofjustice.Suchindividualsarerecognizedasamajorproblemforagenciesofaccountability.Onoccasion,campaignsemergearoundissuesthathaveimmensepersonalimportforallthoseinvolved,andinthesesituationstherisksofquerulousbehavioursuborningaspectsofthegroupsfunctionmaybeconsiderable.Iftherearedoubtsthenthebene“tofthesedoubtsshouldgototheassumptionoflegitimatecampaigning,nottothepresenceofquerulousbehaviour.Whistleblowers,whousuallyclaimtobeexposingnefariousandcorruptpracticesintheirplaceofwork,areaparticularlydif“cultgroupinwhichtoseparatealtruisticfromquerulousbehaviour.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.Querulousbehaviourcommonlyre”ectsbroadlysimilarsetsofattitudesandbeliefs,butinouropinionthesearchforasingleoverarchingexplanationintermsofdelusionaldisorder(paranoia)orofaspeci“cabnormalphenomenaon,suchaovervaluedideas,willatbestbeonlypartiallysuccessful.Kraepelin(1904)favouredthepragmaticapproachofclassifyingthebehaviouraccordingtoarangeofpotentialunderlyingpsychopathologiesfrompersonalitydisordersthroughquerulousparanoiatodementiapraecox,withnormalityanillde“nedpossibility.Jaspers(1923)regardedquerulousnessassimilartojealousy,beingpotentiallytheproductofpathologicalreactions,developments,orprocesses,withagainnormalitybeingafurtheroption.DeClerambault(1942)placedquerulousnessamonghisdisordersofpassionbut,unlikejealousyandlove,wearedealingnotwithanemotionthatdrivesbehaviourbutbehavioursthatre”ectapassionatecommitmenttospeci“cgoals,thepursuitofwhichevokesstrongemotions.VanderHeydt(1952)attemptedatypologyofquerulants,incorporatingtheopportunisticwhowereindividualswithantisocialtraitspursuingpersonaladvantage,theparanoidjusticeseekerdrivenbydelusionalconvictionsspeci“ctotheparticulargrievances,theconjugalcaughtupinthepassionatepursuitofpropertyorparentalrightsfollowingmaritalbreakdown,thequarrelsome,whohadpersonalitytraitsconducivetoprotractedcon”ictwithanyandall,thosewhoseconditionsaresecondarytopsychoticdisorders,notablytheschizophrenias,and“nallyanormalgroup,thenatureofwhichwasleftsomewhatvague.Thisapproachhasappeal,despitecombiningpotentiallyoverlappingtypesbasedoncontext(conjugal),psychopathology(secondaryandparanoid),andmotivation(opportunistic).Querulousnessisdestructivetotheaf”ictedindividualsandtheirfamiliesaswellasdisruptivetoagenciesofaccountabilityandthecourts.Querulousnesssode“nedcanneverbenormalinanidealorstatisticalsense.Querulousnessmaynotbenormalbehaviourbutisitnecessarilyre”ectiveofpsychopathology?Toputthequestiontheotherwayround,couldarelativelynormalindividualbedriventoquerulousnessbythecourts,orbythevariouscomplaintresolutionprocedures?ThiswastheviewarticulatedbyCharlesDickens,whowroteinBleakHouseTheCourtofChancerygivestomoniedmightthemeansabundantlyofwearyingoutthe...sooverthrowingthebrainandbreakingthehearttoleaveitswornoutlunaticineverymadhouse.Thecasesweencounterclinicallywere,priortohavingbecomeenmeshedinthepursuitofgrievances,oftenfunctionalindividuals,withfamiliesandfriendsandwithoutobviousantisocialtraits.Withthebene“tofhindsightcertainvulnerabilitiescanoftenberecognized.Theirpersonalitiesseemedmorefrequentlythanmightbeexpectedtohavebeenmarkedbyobsessionaltraits,self-absorption,andmorethantheusuallevelsofsensitivityandself-reference.Againwithhindsight,therewasVexatiouslitigantsandunusuallypersistentcomplainantsandpetitioners3432006JohnWiley&Sons,Ltd.Behav.Sci.Law:333…349(2006)DOI:10.1002/bsl healthtreatmentoption.Toevaluatetheideasdrivingthequerulousbehaviouracarefulhistoryisneeded,adispassionateexaminationofthedocuments,andanactiveattempttoengagewiththeirideasandclaims.Itistemptingbutinadequatetojustletthetorrentofwords”owoveryou.Theextenttowhichthey,andthosearoundthem,aresufferingasaresultoftheirquerulousnessshouldalsohavesomeweightinmakingadecisionaboutwhethertocompeltreatment.Wecontinuetobeamazedathowbroadourcolleaguesnotionsofnon-delusionaleccentricityseemtobecomewhenconfrontedwiththoseexhibitingquerulousbehaviour.Amongtheexamplesoftheconvictionsthatcolleagueshave“ttedintothenon-delusionalaretheabsoluteconvictionthatoneisowedmillionsofdollarsforanactoftrespass,thatgovernmentswillfallwhenthetruthofonesdentalmismanagementis“nallyacknowledged,thattheUNiskeenlyawaitingtheresultsofonescomplaintagainstalocallawyer,andthattheQueenhasjoinedherselftoonesquestforcompensationfromaninsurancecompany.Eachandeveryassertionisbackedupwithdocumentsinwhicheventhemostimaginativewouldbepressedto“ndaconnectiontowhattheyareclaimedtoprove.Partoftheproblemforclinicians,wesuspect,isconfusingissuesofaetiology,i.e.psychogenesis,withquestionsofdiagnosis,i.e.psychosis.Thisconfusioniscompoundedbythenotionofaparanoidpersonality,whichisoftenevokedinthiscontext.Paranoidmeansnotsuspiciousnessbutsufferingfromparanoia,andimpliesthepresenceofdelusion(s).Itisnotsurprisingthatambiguityhasarisenoveralabeloftenattachedtothosewhoarechronicallysuspiciousbutnotbelievedtobedeluded.Attemptstoavoidconferringlegitimacyaspatientsonthequerulousarealsofedbythewidespread,butwebelieveincorrect,viewoftheuntreatabilityofbothdelusionaldisordersandpersonalitydisorders.RISKOFVIOLENCEAttacksbythequerulousoncourtof“cials,claimsof“cialsandpoliticiansarebynomeansuncommon.Insuchcasestherehasoftenbeenacourseofconductcharacterizedbyincreasinglythreateningandintrusiveactivities,usuallyovermanymonths,which,withthebene“tofhindsight,takesonasinisterimport.Inanumberofcasesofseriousorfatalviolence,ofwhichwehaveknowledge,clearandspeci“cthreatshadbeenissued.Thoseweseeclinicallyconstituteahighlyselectedsampleofpeople,almostallreferredfromthecourtsfollowingconvictionsforthreateningbehaviourorassault.Thispotentiallyprovidesaskewedperspectiveontheviolenceassociatedwithquerulousbehaviour.Inthestudyoftheunusuallypersistentseeninagenciesofaccountability,however,anunexpected“ndingwasthefrequencywithwhichovertandcovertthreatsofviolenceweremadetoclaimsprofessionals(Lesteretal.,2004).Thesethreatswereoften,ineffect,ignored,andtheprofessionals,thoughsometimesfrightenedandstressed,rarelytookanyactivestepstorespondtowrittenorverbalthreats.Noneofthosewhothreatenedof“cialshadbeenprosecuted.Nothreatsweremadebythecontrolgroupinthestudy.Oneofthecharacteristicsofthethreatsbytheunusuallypersistentwasthattheywererarelysimplyexpressiveofintenseemotionbutappearedtobecalculatedattemptstoadvancetheircausebymakingconditionalthreats,Ifyoudonotthen,orIfbynextmonththen.Threatsofsuicide,whichwerealsorelativelyfrequent,tendedtosharethisstructure.Vexatiouslitigantsandunusuallypersistentcomplainantsandpetitioners3452006JohnWiley&Sons,Ltd.Behav.Sci.Law:333…349(2006)DOI:10.1002/bsl Thosewhoarequerulous,orarelikelytobecomequerulous,maybeobviousfromtheoutsetgiventhecharacteristicmannerinwhichtheyoftenadvancetheircase.Obviousthatisifyouknowwhattolookfor.Thisoffersanopportunityforinstitutingaharmminimizationprogramfromtheoutset.Giventhatanyscreeningprocesshasfalsepositives,itisessentialthatanydifferentmethodofdealingwiththepotentiallyquerulantshouldnotdisadvantageanon-querulousindividual.Courtsandagenciesofaccountabilityareadeptatmanagingthedif“cult,theover-emotional,andtheplainawkward.Atypicalstrategyistoassignsuchindividualstoanexperiencedstaffmemberinthehopeofminimisingcrosscommunications,splitting,andcon”ict.Thisworkswiththedif“cultbutnotwiththoseinclinedtoquerulousnesswhocannotbeeffectivelycontainedinthisway,exceptpotentiallybytheagencysmostsenior“gure.Thequerulousplaceunreasonabledemandsandstrainsonanysinglecasemanager.Moreeffectiveislikelytobeagroupwhohavebeentrained,whotakeaspecialinterestinthisarea,andwhoincombinationmanagethepotentiallyquerulous.Mostofthoseinclinedtoquerulousnesswillnotbesurprisedtolearntheirclaimissoimportantandcomplexagroupofexpertsisrequiredtomanagetheissues.Theobjectiveistoassistinresolvingwhatcanberesolvedwithrepeatedandclearemphasisonwhichaspectsoftheclaimareoutsideoftheorganizationsjurisdictionandpowers.Whenwhatcanbedonehasbeendonethecaseneedstobesympatheticallybut“rmlyclosed,albeitideallywiththeopportunityfortheclaimant,whoifquerulouswillremaindissatis“ed,tocomebackoccasionallytodiscussoutstandingissues.Thissystemshouldavoidallowingthequeruloustofocustheirhopesandfrustrationsonanysinglestaffmember.Itshouldremainsympatheticbutclearaboutthelimitsoftheorganization.Anythreatsshouldbetakenseriously.Suchagroupwouldhopefullythroughexperiencedeveloptheknowledgetoimprovethemanagementofquerulousbehaviour,whichcurrentlyisencounteredonlyasatroublesomeraritybymostindividualsworkinginthecomplaintsindustry.Theliteratureonthetherapeuticmanagementofthequerulousisbothsmallandpredominantlydiscouraging.VonDietrich(1968)referstotreatmentasathanklesstaskandvanderHeydt(1952)evenwarnsthatattemptsattherapymayignitebush“resofquerulousness.Winokur(1977)andAstrup(1984)suggestthatthemajorityofthequerulantsintheirstudiesdidnotreceiveanyspeci“ctherapyandtheminoritygivenpharmacotherapyshowednogreatresponse.Incontrast,Ungvari(1993)reportedsuccessfultreatmentusingpimozide.Ourownexperienceisthatrelativelylowdosesofatypicalantipsychoticsarehelpfulthoughtheresponseisslowincoming,oftentakingmonthsbeforethereisobviousimprovement.The“rstproblemisattainingsomesemblanceofatherapeuticalliancewiththepatient.Thisrequiresavoidingbeingcaughtupindiscussionsoftherightsandwrongsoftheirquest.Thefocusshouldbeonthepricetheyandtheirfamilyarepayingforthepursuit.Interestingly,someofthosewhocomeonordersfromthecourtwhichmandatetreatmentwillacceptmedicationandothertherapeuticinterventionsastheywishtomakecleartheyabidebythelaw.Paradoxically,theycanbeultra-compliantpatients.Anumberhavecontinuedvoluntarilyintreatmentaftertheendoftheorder,thoughtheyneveracknowledgeeitherthattheywereinerrororinneedoftreatmentbecauseoftheirquerulousness.Whatchangesistheinvolvementinthequerulousideas,thedegreeofpreoccupation,andthebehaviour,butthecorebeliefthattheywererightneverwavers.QuerulousbehaviourappearstobesustainedbyaVexatiouslitigantsandunusuallypersistentcomplainantsandpetitioners3472006JohnWiley&Sons,Ltd.Behav.Sci.Law:333…349(2006)DOI:10.1002/bsl 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