Abstract
This observational article describes three cases of self-cannibalism and cannibalism by patients in a secure setting. These are studies of severe personality disordered patients, each of whom have perpetrated terrible offences, usually on others. In our view, the inner world of the cannibalistic patient is committed to a narcissistic biting grip on his objects and is bent upon appropriating their good aspects. In our practice, we have observed a countertransference enactment that may be characterised as a roadblock to explore the past: to feel, to understand, and to repair. The aim of the perverse pact is to remain in a stuck state to protect the self from any awareness of feelings of depression. This is an enactment of the inherently deathly, inner relationship of the individual perpetrator. We believe it is essential to attempt to open up a space to explore the unthinkable act of cutting and eating flesh in the context of the person’s developmental history. Failure to do so within systems of care sets in motion a repeating cycle of a traumatic victim–victimiser dynamic associated with ever increasing risk.
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