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This book on psychotherapeutic approaches to people who have murdered is a sequel to ‘Dangerous Patients: A Psychodynamic Approach to Risk Assessment and Management
of Dangerous Patients' (Doctor 2003). The present volume contains six essays from therapists and analysts working in the field of forensic psychotherapy. In his foreword Doctor considers that murders need to be understood from the perspective of the primary relationship with the mother and the Oedipus complex. In the murderer's mind there is at least one other besides the murdered person, as is also suggested by Perelberg (1999).
A particularly gripping essay written by Motz describes women who kill their children. Against a background of deprivation, neglect and cruelty, pregnancy becomes a surrogate solution to emptiness with the development of a renewed sense of feeling wanted. The loving baby is not an individual in its own right but a narcissistic extension of the mother's body. This unconsciously fantasized solution is challenged when the baby's needs are perceived as the betraying and abandoning mother, causing frustration and leading to a murderous attack.
McAlister, a member of the Society of Analytical Psychology, writes beautifully about her work with a paranoid man and clarifies that forensic psychotherapy differs from analysis in that its inevitable focus is the index offence, the patient's criminal act for which sentence was passed. The story of the murder provides a reflection of her patient's internal objects. She is concerned with powerful projective identifications which reduce the patients' minds to significant concreteness and she connects her thinking to Bion's concept of lack of maternal reverie (-K), a failure of containment of extreme anxieties and nameless dread.
Lucas presents a fascinating case of a patient who keeps his internal bad objects buried and hidden and projects a picture of idealized goodness. The team treating this patient thought he was a good man. This defence mech