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From Trauma to Harming Others. Therapeutic Work with Delinquent, Violent and Sexually Harmful Children and Young People presents a collection of papers written by three generations of clinicians who have worked at the Portman Clinic in London. The book brings together a wide scope of psychoanalytic theories and clinical examples in order to explore the link between relational trauma and harmful enactments by children and young people. In the era of diagnostically driven commissioning of mental health services and of radicalisation and polarisation of public opinion about any topic concerning individual and group welfare, I find this publication to be of particular importance. It offers a layered, empathic and thought-provoking analysis of different types of aggressive behaviours – from outright violence to sexual perversions, as well as of the way therapeutic interventions are applied with this group of patients at the Portman Clinic.
A child acting violently or in a sexually harmful way is bound to trigger a strong emotional response in others. Even more so if the acts are committed in a cold-blooded, calculated manner, with no trace of guilt or remorse. The most common reaction is to reprimand and punish, to ‘put the fear back into the young person who produced it’ (p. xv). The exact opposite response is also not rare – to describe young perpetrators as victims only. This false dichotomy is probably familiar to anyone who has worked with people who have committed offences. What the book does very well, throughout, is to depict a much more complex, multi-layered reality – the victim and perpetrator reside in the same individual, alongside sometimes hard to discover positive characteristics and the capacity to grow and develop.
The book has several further strengths. The first one is that it brings together a wide range of theoretical ideas, which are interwoven with clinical examples throughout. Object relations and psychosexual development theories seem particularly