Book Reviews

Psychic assaults and frightened clinicians: Countertransference in forensic settings

John Gordon and Gabriel Kirtchuk ., Forensic Psychotherapy Monograph Series, editor Brett Kahr, London, Karnac Books, 2008, 152 pp., £19.99 (paperback)

There are these two young fish swimming along, and they happen to meet an older fish swimming the other way, who nods at them and says, ‘Morning, boys, how's the water?’. And the two young fish swim on for a bit, and then eventually one of them looks over at the other and goes, ‘What the hell is water?’. Written by David Foster Wallace (2005), this fish story was quoted by Priscilla Roth at a recent psychoanalytic conference (2008). She used it to describe how we can be totally unaware of the shared emotional element in which we are swimming with our patients.

When the fish are at the bottom of a boat, flapping and gasping for air, having been caught by the fisherman, then they know what water is. This comment was made by John Steiner (2008) at the same conference, considering the challenge to the patient of being out of their necessary defensive element as analogous to being a fish out of water. Being caught is the legal reason that the forensic patient becomes a forensic patient. The contaminated water in which they swim predates the sterile hook called the ‘index offence’ on which they were caught. The developmental beginnings of the criminal act remain a pathological buoyancy, nameless, silent and pervasive.

This book is clear about the nature of the water in which the forensic patient and the professionals who work with them swim. It is also clear that in these murky polluted depths people are reluctant to look at what is in the water in which they are swimming. To extend the water analogy, the forensic institution in which they are incarcerated is like a river made toxic by the poisoned chemicals of psychosis, personality disorder, trauma, perversion, an ever-present risk of violence and the obliteration of the oxygen of meaning.