Based on learning from the Dangerous and Severe Personality Disorder (DSPD) programme, the UK government is developing new services for the assessment and treatment of individuals with severe personality disorder who have committed serious offences such as murder, arson and rape. These offenders will largely be managed within the criminal justice system, with overall responsibility being taken by probation officers. Psychodynamic approaches have not been incorporated into these developments, apart from some supervision and reflective practice being offered to staff. This paper describes how one of the original medium secure DSPD units, based in the NHS, has adapted the psychoanalytic approach within its therapy programme. These adaptations are illustrated through a consideration of several patients who have committed parricide – the killing of a parent.