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Claude Balier brings psychoanalytic thinking into the penal world. The setting of his clinical work, a residential treatment center situated within a jail, has been in operation for 10 years. Patients, young men convicted of violent crimes, are selected from among the prisoners as those showing major psychological disturbances in the prison, and willing to undergo treatment. Without postulating that all criminals
are mental patients or resolving the issue of the limits of pathology, this study focuses primarily on subjects presenting a primitive organization, where splitting, dissociation of impulses, acting out as a defense against psychotic decompensation, omnipotence, and presence of major amounts of excitation are compatible with a certain level of conflict.
Incarceration fulfills several functions: a containment of excitation and acting out, a facilitation of regression and dependency, and a change in symptomatology. As such it operates like a primitive superego. Specifically, and this is a factor where the judicial and the clinical processes join in their effects, containment limits acting out and increases symptom emergence. Incarceration does not in itself create pathology.
A review of the literature, primarily French and American, points to several major psychopathological directions: first, the failure to reach successfully the depressive position, characterized by the presence of primitive defenses—splitting, projective identification, identification with the aggressor, omnipotence; second, taking the failure to negotiate adolescence as the developmental point of departure; third, diagnostic considerations. These cases fall mostly in the realm of narcissistic and severe borderline pathology, where a split between the good and the bad object, together with the lack of differentiation between self and object, leads to the defensive destruction of the object. These patients frequently reach the psychotic range, where the threat of decompensation le