Forensic Psychotherapy and Psychopathology, edited by Brett Kahr,  Karnac Books, London and New York, 2001,  147 pp.

My initial response was to dismiss this tome with the notation that “forensic psychotherapy” is an oxymoron. However, I felt that the readers deserved a little more intensive assessment of the volume. Suddenly it struck me that this book is much like seriously flawed patients who are referred to us, raising the specter as to whether there is anything that our efforts have to offer. We usually don't abandon such patients but look to see assets they possess and what we can possibly help them to achieve.

With this in mind, I first note that I have a modicum of expertise in forensic psychiatry (having somehow successfully negotiated the boards) but know very little about the work of the Winnicottians.

Recently there has been a spate of court orders for jail/prisons to provide medical, including psychiatric, treatment and most political entities have begrudgingly anted up the minimum to get the feds off their backs.

The actual word “treatment” of those in these institutions is illustrated by two experiences. Recently I reviewed the chart of a man, probably schizophrenic, who was in a state prison for a number of violent offenses and the sale of drugs. He was on antipsychotic medication and the chart noted visits to “anger counseling” groups where a form apparently was filled out by someone who attested to the individual's attendance at such activities as viewing a video. I also had an occasion to have a conversation with a bright, young psychiatrist who was heading up one of the few mental health treatment teams at state penal institutions. He appeared to be overwhelmed With the scope of his job. As far as psychotherapy was concerned be said that if the psychiatrists want to do it they can. The intimation was that very little, if any, attempt at psychotherapy in the institution has made. I also got the distinct impression that this man had lost much of his enthusiasm and talked of finding other, more interesting, fields.

I readily acknowledge fascination with many of the Win