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In the management of patients who are violent or antisocial in their behaviour, attention to safety is a priority. Physical interventions which are required to provide safety have the effect of altering the dynamics between patients and nurses, with forces towards regression in both. The nurses have to stay alert to potential danger so that they can intervene quickly when necessary. This can alter their responses to patients towards a parental approach, one which has been recognised as a problem in institutions. In regression, the patients have the opportunity for affectionate relationships otherwise denied. Unless a space for reflection is available, many patients who could otherwise benefit from psychological intervention are trapped in regression. This space is provided by the work of the multidisciplinary team. An interpretative intervention is described, one in which the patients were alerted to a potential external reality of a concerned object. The patients’ responses showed a capacity for psychological mindedness which had been obscured by behaviour. In a setting with limited resources, a psychoanalytically informed approach proved to have major therapeutic impact.