The place of psychotherapy in forensic settings

Abstract

This article discusses the model of psychoanalytic psychotherapy as modified for use in forensic services (forensic psychotherapy), and its development at the Portman Clinic, London. Within this model the offence is viewed as analogous to a symptom of a neurotic condition and the treatment involves helping the offender to understand the unconscious meaning of the offence. Through forensic psychotherapy the origins and meaning of the violent or perverse behaviour can become explicit, and this awareness and understanding enables the offender to gain control over his or her impulses. Forensic psychotherapy also helps staff teams and forensic organizations to recognize and manage the psychological impact of work with violent and destructive patients. The response of staff teams to violent and perverse patients can mirror their disturbance and requires understanding; the forensic patient communicates destructive and desperate states of mind through mechanisms such as projection and projective identification, and this can be difficult for those who work with them to manage. Re-enactments of disturbance can be prevented through this understanding. Additionally, the article addresses the unique characteristics of female violence and perversion, and its treatment.