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I would like to express my appreciation of the article ‘AIDS and the unconscious: psychodynamic group work with incarcerated youths’ which appeared in Vol. 23 No. 3, December 1997. It is an excellent account of exciting and innovative work in a much needed area. Though from the other side of the globe it is in tune with increased concern and activity in this locality with the same patient population, viz for example the Bulletin of the ACP of the same month which contains several very useful contributions from child psychotherapists working in relation to legal systems, and also the planned ACP Scientific Meeting on January entitled ‘Loss and Delinquency: Two Adolescents’ Experiences of Prison as an External Container for Psychic Pain’, speaker Debbie Hindle.
As psychoanalytic psychotherapists move away from the protected environment of the private or clinic based consulting room the threats to our professional identity and integrity grow stronger. We are very much in need of demonstrable evidence of the value of our work. Recently I was asked to review a set of three new books by psychologists on work with juvenile sex offenders, none of which gave any regard to ‘psychodynamic theory’. But experience shows that cognitive-behavioural treatment strategies, while providing structure, containment and perhaps above all, rationality for the therapists, may very likely fail to engage with the unconsciously determined (and they are determined!) forces that work toward the destructiveness of these young people. However, the most effective ‘CBT’ therapists that I know seem to have an intuitive grasp of defensive processes such as resistance, splitting and projection and an awareness of the emotional needs for these. These therapists though not officially ‘psychoanalytic’ will also tolerate and use re-enactments of trauma within a transference relationship. They may not interpret such processes as such but do allow, I believe, therapeutic internal change to take place at an em