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Other titles in the
Forensic Psychotherapy Monograph Series
Violence:A Public Health Menace and a Public Health Approach
Edited by Sandra L. Bloom
Life within Hidden Walls:Psychotherapy in Prisons
Edited by Jessica Williams Saunders
Forensic Psychotherapy and Psychopathology:
Winnicottian Perspectives
Edited by Brett Kahr
Dangerous Patients: A Psychodynamic Approach to Risk Assessment
and Management
Edited by Ronald Doctor
Anxiety at 35,000 Feet:An Introduction to Clinical Aerospace Psychology
Robert Bor
The Mind of the Paedophile: Psychoanalytic Perspectives
Edited by Charles W. Socarides
Violent Adolescents: Understanding the Destructive Impulse
Lynn Greenwood
Violence in Children: Understanding and Helping Those Who Harm
Rosemary Campher
Murder: A Psychotherapeutic Investigation
Ronald Doctor
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1 Countertransference in
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Forensic Settings
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Edited by
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Foreword by
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1 Forensic Psychotherapy Monograph Series
2 Series Editor Honorary Consultant
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Brett Kahr Estela Welldon
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KARNAC
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First published in 2008 by
Karnac Books Ltd
118 Finchley Road
London NW3 5HT
Arrangement, Introduction © 2008 by John Gordon and
Gabriel Kirtchuk; chapter 1 copyright © 2008 by Anne
Aiyegbusi and Gillian Tuck; chapter 2 copyright © 2008 by
Carine Minne; chapter 3 copyright © 2008 by John Gordon,
Sharman Harding, Claire Miller and Kiriakos Xenitidis;
chapter 4 copyright © 2008 by Michael Mercer; chapter 5
copyright © 2008 by Stanley Ruszczynski; chapter 6 copyright
© 2008 by Gabriel Kirtchuk, David Reiss and John Gordon;
conclusion copyright © 2008 John Gordon and Gabriel
Kirtchuk; Afterword copyright © 2008 by David Armstrong
The rights of the editors and contributors to be identified
as the authors of this work have been asserted in
accordance with §§ 77 and 78 of the Copyright Design
and Patents Act 1988.
All rights reserved. No part of this publication may be
reproduced, stored in a retrieval system, or transmitted,
in any form or by any means, electronic, mechanical,
photocopying, recording, or otherwise, without the prior
written permission of the publisher.
British Library Cataloguing in Publication Data
A C.I.P. for this book is available from the British Library
ISBN13: 978–1–85575–562–8
Edited, designed, and produced by
Florence Production Ltd, Stoodleigh, Devon
www.florenceproduction.co.uk
Printed in Great Britain
www.karnacbooks.com
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122 CONTENTS
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SERIES FOREWORD ix
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Brett Kahr
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4 EDITORS AND CONTRIBUTORS xiii
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R.D. Hinshelwood
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9 Introduction 1
30 John Gordon and Gabriel Kirtchuk
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2 CHAPTER ONE
3 Caring amid victims and perpetrators: trauma and forensic
4 mental health nursing 11
5 Anne Aiyegbusi and Gillian Tuck
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7 CHAPTER TWO
8 The dreaded and dreading patient and therapist 27
922 Carine Minne
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vi CONTENTS
CHAPTER THREE
X-treme group analysis: on the countertransference edge
in inpatient work with forensic patients 41
John Gordon, Sharman Harding, Claire Miller and
Kiriakos Xenitidis
CHAPTER FOUR
Bearable or unbearable? Unconscious communication in
management 63
Michael Mercer
CHAPTER FIVE
Thoughts from consulting in secure settings: do forensic
institutions need psychotherapy? 85
Stanley Ruszczynski
CHAPTER SIX
Interpersonal dynamics in the everyday practice of a
forensic unit 97
Gabriel Kirtchuk, David Reiss and John Gordon
Conclusion:
The role of a psychotherapy department in the large
forensic service 113
John Gordon and Gabriel Kirtchuk
Afterword 137
David Armstrong
REFERENCES 141
INDEX 149
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20111 The case material in this book has been disguised and comprises
1 composites of many individuals with whom the authors have
2 worked. We are very grateful to the patients and colleagues
3 who have shared the difficult and enlightening emotional experiences
4 on which our clinical thinking is based.
5 Extensively revised for this publication, a previous version of
6 Chapter Three originally appeared in Group Analysis 38(3): 409–426
7 and is reprinted by permission of Sage Publications Ltd, © The Group
8 Analytic Society, London, 2005.
9 We would like to thank Kim Bush, Manager of Photography and
30 Permissions at the Solomon R. Guggenheim Foundation; Jessica
1 Casey, Licensing Executive at the Design and Artists Copyright
2 Society (DACS); and the Kandinsky Estate for their support in
3 arranging for the use of Circles on Black (Kreise auf Schwartz), 1921.
4 Finally, Brett Kahr, Editor of the Karnac Forensic Psychotherapy
5 Monograph Series, has helped us with panache at every stage.
6 Muchíssimas gracias, Brett.
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122 SERIES FOREWORD
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9 The Winnicott Clinic of Psychotherapy, London
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20111 Throughout most of human history, our ancestors have done
1 rather poorly when dealing with acts of violence. To cite but
2 one of many shocking examples, let us perhaps recall a case
3 from 1801, of an English boy aged only 13, who was executed by
4 hanging on the gallows at Tyburn. What was his crime? It seems
5 that he had been condemned to die for having stolen a spoon
6 (Westwick, 1940).
7 In most cases, our predecessors have either ignoredmurderous-
8 ness and aggression, as in the case of Graeco-Roman infanticide,
9 which occurred so regularly in the ancient world that it acquired
30 an almost normative status (deMause, 1974; Kahr, 1994); or they
1 have punished murderousness and destruction with retaliatory
2 sadism, a form of unconscious identification with the aggressor. Any
3 history of criminology will readily reveal the cruel punishments
4 inflicted upon prisoners throughout the ages, ranging from beatings
5 and stockades, to more severe forms of torture, culminating in
6 eviscerations, beheadings, or lynchings.
7 Only during the last one hundred years have we begun to develop
8 the capacity to respond more intelligently and more humanely to acts
922 of dangerousness and destruction. Since the advent of psychoanalysis
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