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Peter Aylward has written an instructive, thought-provoking and somewhat controversial book, which describes psychotherapeutic work with patients suffering from very severe personality and borderline disorders.
Drawing on the 15 years he spent working for the Metropolitan Police, mainly in the anti-terrorism branch, and his subsequent career as a psychoanalytic psychotherapist working with patients in Broadmoor Hospital and other secure and clinical units, Aylward presents a theory to explain their violent or self-destructive behaviour. He then uses this theory to suggest detailed explanations for the offences committed by people with whom he has not worked: Ian Huntley, the Soham murderer, Thomas Watt Hamilton, who carried out the Dunblane massacre, and Anders Breivik, who killed 77 people in Norway in July 2011. Cumulatively, the book becomes a powerful therapeutic and political manifesto, appealing to the powers that be to transcend dyadic thinking - good vs. evil, victim vs. perpetrator - enabling the victims in the perpetrators to be recognized, and timely interventions made before the unconsciously pre-programmed enactments of their traumas are visited upon the society which has colluded in shaming and rejecting them.
Many of the chapters in the book began life as presentations to annual conferences of the International Association of Forensic Psychotherapy, given in conjunction with Professor Gerald Wooster, whose wisdom and guidance as a supervisor are gratefully acknowledged (p. x). In some ways, their contents are a curious amalgam. On the one hand, readers will find first-rate clinical insights, especially regarding Aylward's countertransference experiences while working with some of his patients, and also some profoundly significant and useful observations about the ways in which treatment teams can become enmeshed in the dynamics of their patients' internal worlds, and the methods Aylward uses to create a therapeutic milieu which can contain and not be po