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New Horizons in Forensic Psychotherapy

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10 Chapters

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Chapter One: “No Intolerable Persons” or “Lewd Pregnant Women”: Towards a History of Forensic Psychoanalysis

ePub

Brett Kahr

Do you not think that rage is a sickness of the soul?

Claudius Galenus of Pergamon, “The Diagnosis and Treatment of the Affections and Errors Peculiar to Each Person’s Soul”, n.d. (Galen, n.d., p. 258).

Shame and Di∫grace cau∫e mo∫t violent pa∫∫ions, and bitter pangs.

Democritus Junior [Robert Burton], The Anatomy of Melancholy: What it is, with All the Kinds Causes, Symptomes, Prognostickes, & Seuerall Cures of it. In Three Partitions, with their Severall Sections, Members & Sub∫ections, Philosophically, Medicinally, Historically, Opened & Cut Up, 1660, Partition 1, Section 2, Member 3, Sub∫ection 6. (Democritus Junior, 1660, p. 99).

The cruel treatment of the offender patient

Throughout much of history, human beings have treated offenders—vagrants, villains, outlaws, gangsters, hooligans, thugs, crooks, racketeers, or killers—with the utmost sadism, often punishing such people with a viciousness that far exceeded the original crime (Phillips, 1857; Bauman, 1996; Evans, 1996; Lyons, 2003; Hillner, 2015; Swain, n.d.; cf. Shepherd, 2016).

 

Chapter Two: True Falsehoods: Estela Welldon's Paradoxical Insights in Forensic Psychotherapy

ePub

David Millar

Introduction

If the search for happiness is one of the chief sources of unhappiness, then what fate befalls those whose professional quest leads them into unearthing the meaning of sadness, or despair, or fear, or even…perversity? Could the outcome for those who seek the darker truths be an enlightened understanding? Could a close acquaintance with perversion bring a closer insight into decency? Here beginneth my prelude to the work of Estela Welldon, whose most remarkable accomplishment would seem to be the understanding of oppositional states of mind and their paradoxical struggles.

It would be getting rather too close to melodrama to describe her work simply as exploring the “darker side” of human behaviour; but dark and despairing it often is. If you have picked up this book and got as far as this chapter, then you will know an awful lot about Estela Welldon by now. My effort will be to try to describe as best I can what some might regard as the inverted logic in her approach to psychotherapy with criminal offenders and victims of criminal offences. Two significant illustrations may set the scene for what I hope to illustrate further on in this chapter.

 

Chapter Three: Mothers-In-Law: Maternal Function and Child Protection

ePub

Gwen Adshead

Introduction

Estela Welldon is justly renowned for her work on mothers and mothering, and how the mothering role can be both idealised and denigrated, with far-reaching effects for children. Her first book, Mother, Madonna, Whore: The Idealization and Denigration of Motherhood (Welldon, 1988) explicitly challenged psychoanalytic orthodoxy about perversion by arguing that women could develop perverse psychological structures in mind just as men do; and that they use their bodies, and the bodies of the children, to enact their perverse thoughts and desires. Welldon's work also caused a stir because she claimed to have good clinical evidence that motherhood and mothering is not always a state of bliss for women; but motherhood can be a time when affects of fear, distress, and hatred are experienced and also expressed. She articulated the view (and was perhaps the first person to do so) that those women who abused their children were not monsters but, rather, people who experienced unresolved distress arising from their own adverse experience of being cared for as children; and she suggested that professionals and society could and should take maternal distress and rage more seriously.

 

Chapter Four: Brain, Womb, and Will: A Lethal Cocktail or a Grand Affair?

ePub

Ronald Doctor

Introduction

I have known Estela Welldon—pretty well, I think—for twenty-five years, and my immediate response after being asked to write a chapter for this book to celebrate her eightieth birthday and to honour her work is that maybe I don't know her. I thought that researching her work and the influence of her creativity for this Festschrift would hopefully give me the opportunity to get to know her.

My earliest memory of her is shockingly intense and vivid. Sitting across an interview table, she asked me this very confrontational question: “What would you do if a perverse patient gave you a gift?” After looking perplexed and dumbfounded, she both gave me the answer and, to my great surprise, the job for which I was being interviewed. She explained that you would neither accept nor reject the patient's offerings but leave the gift on the table for discussion. She told me that I should try to listen to the patient and understand the meaning of the gift and whether this was possibly a seductive collusion or a real offering of gratitude. This incident offers some idea of what it felt like to tumble into the slipstream of Welldon's very considerable personality—a personality that, it turns out, was quite breathlessly maintained throughout her three-decade tenure at the Portman Clinic and beyond. The woman who enlivened any encounter, who addressed her friends and professional colleagues in exactly the same way: at all times affectionate, intellectual, loyal, free-associative, and, at least occasionally, vulnerable. The effect is oddly appealing, and whatever you happen to feel about her work, deeply impressive.

 

Chapter Five: Just a Normal Day: From Prodrome to Index Offence and Beyond

ePub

Gill McGauley

Introduction

In listening to how patients talk about their index offences, I have been struck by similarities in some of their narrative accounts. A day that culminated in a catastrophic act of interpersonal violence has been described as starting as just a “normal day”. Immediately after committing their attack on another person, some individuals report feeling “better” and of experiencing an incredible sense of relief and calmness. What are these patients feeling better from, especially if the day began as just another normal day in the mind of the patient? Within the treatment setting of forensic psychotherapy it emerges that, just as with physical diseases, the offence often has a prodromal period: a time when the disease process has begun, but it is not yet clinically manifest.

In this chapter I discuss how the index offence is conceptualised in forensic psychotherapy and consider the significance of its prodrome with reference to a particular group of forensic patients—namely, those with a diagnosis of personality disorder. I also discuss how one particular mental process, that of mentalization and its failure, relates to the index offence in these patients.

 

Chapter Six: The Female Body as Torturer: Malignant Bonding and its Manifestations in Perverse Partnerships

ePub

Anna Motz

Introduction

In her seminal work on female perversion, Welldon (1988) introduced the notion of maternal perversion and described the narcissistic use of children to extend a woman's own maltreatment of her body, as well as the intergenerational pattern of abuse and cruelty. She challenged the assumption that a phallus was an essential prerequisite of perversion and shocked clinicians with her startling and unsettling discoveries about the potential for mothers to use their own bodies and those of their children in the service of perverse activity. Welldon (1988, 2011) offered an extensive description of the characteristics of female perversion in both her early work and her later work. As she wrote,

I believe that a fitting term for my female patients’ specific predicaments in relation to their bodies and babies could be “the body as the torturer”. This would signal the compulsive urges these women experience towards their bodies unconsciously making them function as the effective torture tool in becoming victimizers to themselves and to their babies. [Welldon, 2011, p. 38]

 

Chapter Seven: Working with Gangs and Within Gang Culture: A Pilot for Changing the Game

ePub

Carine Minne and Paul Kassman

Introduction

The work described in this chapter is a new project based on the piloting of “Changing the Game”, a group therapeutic intervention conceived by Paul Kassman and developed together with Carine Minne, designed specifically for gang members. Despite coming from different professional backgrounds, we came together to trial the project, which adapts therapeutic approaches to address the particular needs and challenges presented by gang members. In this chapter, after a brief overview of the history of gangs, we describe setting up the pilot gangs’ group therapy and discuss what emerged from it and what we learned from gang members, as well as think about plans for the future. Dr Estela Welldon would appreciate this unusual combination of a clinician and a sociologist getting “married” and deciding to try to make a therapeutic “baby” in this closed world of gangs, using group therapy principles.

Over the last decade, gangs have increasingly emerged as a more visible issue in English inner cities. Since 2005, gang culture has been attributed as a key factor behind the wave of “postcode” wars and serious gun and knife crimes, which have afflicted inner cities and spilled over into the criminal justice system. In 2008, twenty-eight teenagers were killed in London, with this figure rising to thirty teenage fatalities the following year. Many will remember the regularity of news reports about those teenage victims, as well as the questions that politicians, sociologists, and journalists began to ask about how best to understand this emerging gang culture and how to explain the resulting levels of associated violence. Gangs have remained embedded in the public and political consciousness as well as within the inner-city communities. After the 2011 riots affecting major towns across England that followed the police shooting of Mark Duggan, the political response was to blame gangs and gang culture for public disorder. Indeed, Iain Duncan Smith, at that time Secretary of State for Work and Pensions and head of the Centre for Social Justice, said that, “Gangs are firstly the products of social breakdown, and they are also the drivers of perpetual social breakdown in these communities” (quoted in Wintour and Lewis, 2011). One question raised by this response is whether there is a sense of moral panic, leading to gangs being a useful label for society's ails?

 

Chapter Eight: Extraordinary Therapy: On Splitting, Kindness, and Handicapping Mothers

ePub

Alan Corbett

Estela Welldon's influence spreads far beyond the forensic field, and in this chapter, I examine the impact she has had upon the birth and development of a relatively new specialism—namely, psychoanalytic psychotherapy for patients with intellectual disabilities: a body of work known, increasingly, as forensic disability psychotherapy. To apply psychoanalytic understanding not only to the sexual offender, but also to the sexual offender who has an intellectual disability is an audacious act and perhaps one that could only flourish under the remarkable influence of a visionary thinker and practitioner.

The grandparents of psychoanalysis all tend to be extraordinary, to varying degrees. And in trying to make sense of Estela Welldon's role as one of the grandparents of forensic disability psychotherapy, I have found myself wondering whether her unique qualities of clinical bravery and radical thinking, which she personifies, are actually the essential components of being a forensic psychotherapist or, indeed of being a disability psychotherapist.

 

Chapter Nine: Responses to Trauma, Enactments of Trauma: The Psychodynamics of an Intellectually Disabled Family

ePub

Richard Curen

Introduction

The forensic field is one that covers a multitude of sins. Due to the structures of the criminal justice and mental health systems, and to the way in which these systems often fail spectacularly to act, the forensic patient with intellectual disabilities rarely fits neatly into the frame. Fortunately, over the last twenty-five years forensic psychotherapy has emerged as a discipline that provides us with critical tools and with profound new ways of understanding perversion, offending, and complex psychopathologies. And under the tutelage and guiding force of Estela Welldon and her pioneering work, the efforts of clinicians engaged at the margins, especially those treating people with intellectual disabilities, have become more possible, and the lives of such patients and their families have, as a result, been vastly improved.

I work at a voluntary sector organisation called Respond. Based in Central London, it provides assessment and treatment for young people and adults with intellectual disabilities or autism who have committed sexual, as well as other, offences. I have worked at Respond since 2002, and my colleagues and I are grateful that Welldon's groundbreaking theories have become a veritable cornerstone in the application and thinking that underpins the organisation's approach to perversion, trauma, and violence.

 

Chapter Ten: Committing Crimes without Breaking the Law: Unconscious Sadism in the “Non-Forensic” Patient

ePub

Brett Kahr

The sub-clinical forensic perpetrator

In 1969, Peter Sutcliffe, a twenty-three-year-old sometime grave-digger from the market town of Bingley in the West Riding of Yorkshire, attacked a female prostitute by hitting her on the head with a stone wrapped in a sock. The victim did not press charges; consequently, Sutcliffe remained at liberty. In 1975, some six years later, Sutcliffe attacked another woman, assaulting her with a hammer and slashing her stomach with a knife. Over the next five years, Sutcliffe perpetrated many more offences, which became increasingly violent in nature and resulted in the murder of many innocent women, whom he bludgeoned with hammers and skewered with screwdrivers (Burn, 1984). Regrettably, this extremely dangerous man would not be apprehended until 1981, more than a decade after his first detected offence; and eventually, having served several years in Her Majesty's Prison Parkhurst on the Isle of Wight, he would in 1984 be transferred to the high-security Broadmoor Hospital, where he remains to this day.

 

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