Abstract
This book is a series of essays by those working in the field of forensic psychotherapy, collected by Brett Kahr. I, as the reviewer, am a medical psychotherapist and forensic psychiatrist. I am interested in group analysis, and have been a member of the ‘Creating Large Groups in Organisations and Society’ workshops run by Teresa Von Sommaruga Howard for a number of years.
The book is described as a ‘festschrift’ which (I needed to look this up) is ‘a collection of writings published in honour of a scholar’. The book was clearly a labour of love for the authors, and written as a surprise for Estela Welldon’s 80th birthday.
I was initially a bit cynical about the idea of a festschrift. I did not know whether the dedications to, and anecdotes about, the scholar would add anything to the intellectual endeavour, and whether it would be like being on the outside of a party that I wasn’t quite invited to. I baulked a bit seeing that the first 14 pages were devoted solely to the relationship between the author and the scholar. I was proved wrong and actually really enjoyed this first section. It was entertaining, heartfelt and very funny. The authors all weave anecdotes and reflections on their relationship with Estela in their chapters, and it adds a real dimension of humanity to the book. As a forensic psychotherapist relatively early on in my career, it was interesting to notice my own mixed responses to this humanity; both feeling inspired and enriched by how the authors have paved the way for those following on behind them, as well as noticing petty jealousy and envy of their camaraderie and glittering careers in a better functioning health service. It was an interesting exercise in itself reflecting on the perilous yet hugely significant relationships that we have with our teachers and mentors. I have learnt from a number of the authors in this book, and it is clear they have strived to give to others what Estela has given to them, through both their teaching and this writing. It made me think of my own role as an educator, and the role of teaching and nurturing those behind, alongside, and even in front of us, as being as vital to the work as the clinical encounters themselves. This book helped something click for me about the concurrent work that we have to do as psychotherapists, particularly forensic psychotherapists, to survive both internally and externally in systems which may be desperately trying to annihilate someone responsible for the badness associated with thinking and feeling. No, I would not recommend skipping the first 14 pages.
So, to the book itself. Aside from thought provoking, relational musings, what else does it hold? It’s really fun, interesting and varied. I defy anyone to read it and not find a chapter that holds their interest. I imagine most people will read it and find a number of paragraphs that they choose to photograph and send to a friend or colleague. The chapters are all different, and between them hold a mixture of clinical material, theory and application.
Chapter one is written by Brett Kahr and covers the history of forensic psychotherapy. My jaw dropped when I saw that this includes a whopping 27 pages of references. I cannot imagine how much time and effort has gone into collating and synthesizing all of this information, as well as giving it enough background to be human and fascinating. The paragraph about the work of Dr jur. Géza Dukes and his fellow psychoanalysts’ efforts to rescue him from a concentration camp was devastating. I was fascinated to read about Marie Bonaparte spending hours at a time interviewing dangerous criminals in prison. It was notable how few women made it into the early days of forensic psychotherapy, although I was glad that a number of paragraphs were dedicated to the contribution of littérateurs in our understanding of the psychodynamics of criminality. I particularly enjoyed Kahr’s observations about the remarkable work of Mary Shelley and her understanding of humanity and violence which is reflected in Frankenstein. This chapter mainly focuses on individuals who have committed crime, rather than the systems and structures around them.
The next chapter by David Millar eases us into the clinical aspects of forensic work. This is a beautifully written case study and brings alive ideas about shame and projective identification. It is moving and made me shed a few tears, and ends on a hopeful note. Spoiler: this is one of the easier chapters to read from an emotional perspective, don’t expect Anna Motz in Chapter Six to be as gentle with the reader.
Chapter three takes us to women, written by one of the four female contributors to this book, Gwen Adshead. She succinctly takes the reader through the attachment theory needed and gives us a clear understanding of perversion. She places this all in the context of women, particularly mothers. I felt that this chapter really started to bring in the interaction between society and offenders, in this instance highlighting the neglect of mothers who abuse their children and thinking about why that might be happening from a psychodynamic perspective.
Next up we have Ronald Doctor and the gun on the table. The question being, is it Schrodinger’s or Chekhov’s gun? No spoilers for this chapter I’m afraid. However, I will tell you that there is a really interesting discussion on the role of wider society in the provision of containment, particularly when working with forensic patients. It made me think about the practicalities of this dangerous work and the back up that might be needed from the system.
Chapter five is the one that those interested in risk have been waiting for — the index offence, how we conceptualize it, and whether we can predict it. This chapter brings in the concept of mentalizing, and the late Gill McGauley, like all the authors in this book, introduces us clearly and succinctly to the aspects of this concept that we need, before applying this to the clinical material. As a forensic psychiatrist, I absolutely loved this chapter. It provides a really clear structure for starting to think about and trying to understand what might be underlying an index offence. I know I shall read and refer back to this chapter many times.
As I mentioned earlier, the next chapter authored by Anna Motz is not for the faint hearted. I found this chapter virtually unreadable with an unflinching, merciless narrative about sadomasochism illustrated by the case of Victoria Climbié. This chapter neatly brings our attention to professionals not seeing what they don’t want to see, and was starkly illustrated with my wish to move onto the next chapter. Alongside the unbearable clinical material, Motz holds the reader captivated by sharing her insights about toxic couples and malignant bonding. I imagine group analysts will be particularly interested by the material in this chapter, as it explores the impact of forming a couple, and how in these cases the individuals come together to validate and enable each other to commit horrific crimes.
The themes of neglect and the criminal justice system, had started to make me hungry for more of a commentary on race, which had certainly been very much on my mind reading Motz’s chapter about Victoria Climbié, a child from the Ivory Coast. I was therefore pleased to read Carine Minne and Paul Kassman’s chapter on working with gangs. This chapter offers a fascinating insight into the world of gangs, running alongside a social commentary about the impact of racism. I really enjoyed reading about the work that the authors had done in prisons with gang members. The authors in this book ‘do stuff’ as well as thinking and theorizing, and I like that.
The book then takes the themes of neglect into the world of ‘forensic disability psychotherapy’. Alan Corbett explores and challenges the neglect of this group from the psychotherapy community, and hypothesizes that the traditional idea that learning disability is a contra-indication for psychotherapy reflects unconscious splitting. His ideas about the impact on the family unit, and the trauma to the parents through the birth of the disabled child, including the ‘twin phantasy’, were illuminating and inspired me to think about this work in a different way. Richard Curren provides a complex and multigenerational case history, which pairs exceptionally well with Corbett’s chapter. It definitely shifted my rather primitive ideas about this type of work. I’m really glad that this book gave such a focus to forensic disability psychotherapy, rather than placing it in a separate book. I was also interested to hear about Estela Welldon’s own career in this field which I had not until this point been aware of.
The final chapter focusses on sub-clinical forensic psychotherapy, ‘committing crimes without breaking the law’. I experienced mixed feelings whilst reading this chapter. I felt somewhat disturbed by the uncomfortable mirror held up to my own ‘forensic-ness’ and privilege. The chapter includes some unsettling case material about individuals’ actions which have resulted in the death of another without breaking any laws. I think those interested in groups will be interested in how this chapter pulls together ideas about what ‘counts’ as forensic in society, or what we consider to be of forensic relevance as clinicians. It made me think about how issues in society can be reflected in the forensic system, either in the forms of persecution or neglect.
Overall this book is fantastic. It’s really readable and there is a lot to learn from it. I think that it could be enjoyed by a range of people including those who are already experienced and familiar with forensic psychotherapy and those who are wishing to start out and learn more. Where technical concepts are used, they are brought in succinctly and relevantly. The descriptions are clear enough to suit someone new to the ideas but concise enough not to bore those who might be familiar with the terms, and help to clarify the author’s use of these terms and their relevance to the clinical material. The balance of case material and theory is great and examples are vividly written and well chosen. I also enjoyed the gestalt; the chapters brought together as a whole and the themes running through them provided a sociological perspective which I found illuminating. The relationship between the authors and Estela Welldon adds another dimension of interest and you can really tell the effort that the authors have put into this as a result of their relationship which adds a shine and gloss to the book, polished off by the visually appealing imagery on the front cover.
It helped connect me to both why I absolutely love doing this work, and also how hard it is. I would recommend this book.
