While Reactive and Disturbed Aggression involve activation of the sympathetic nervous system (heighten arousal), Proactive Aggression differs in that it involves activation of the parasympathetic nervous system (low arousal). This chapter explores violence and aggression designed to achieve a specific goal. The chapter is again introduced by a case study which is used throughout the chapter to illustrate the main points. The dynamics and tactics of predatory aggression are examined with specific guidance offered in responding to service users who deliberately set out to threaten and intimidate. This is followed by looking at how we can assess the danger arising from specific service users and how we can work with them in a safe and skilled way.