Let the treatment fit the crime: forensic group psychotherapy *

Ím deeply indebted to the Group-Analytic Society for inviting me to be this year’s Foulkes Lecturer. It is a great honour, and it acknowledges my work with groups. I am first and foremost a clinician. For over thirty years I have spent my professional career trying to find a treatment that fits the problems of patients in the field of forensic psychotherapy. In preparation for this lecture, I read again some of Foulkes’s work and his autobiographical notes and I recognised some of my own sense of discovery and excitement in my efforts to apply group analysis to patients with social and sexual disturbances. For example, Foulkes wrote:

I forged my method and technique through trial and error, but above all by thinking about my experiences, as I still do. The practice of group analytic psychotherapy (in the change of human altogether) is the experimental situation in which theories are continuously 4put to the test of observation and are reformulated and revised (1969, p. 204).

Indeed, my own failures slowly began to emerge as successes when I was able to allow my patients to become my teachers and my colleagues my fellow students in dealing with difficult predicaments involving serious risks to others and themselves. Foulkes developed further his group-analytic experience in responding to the need to work at Northfield with a heterogeneous group of men who had become psychologically unable to continue with warfare, which society required of them during the Second World War. In talking about this experience he said:

Thus for me what could have been a frustrating time of trying to cure partly unwilling people in much too short a time and under altogether not very favourable conditions, became a fascinating and arresting period (1969, p. 204).

Thus, from the very beginning, group analysis was both art and science and it was applied in a social context. And it is this mixture of theory born from a pragmatic approach that has inspired my long journey in applying group analysis to those patients who present with social and sexual deviancy. Early in my career I was personally influenced by the teaching of Karl Menninger who believed that punishment neither helps the criminal nor protects society. As early as 1930 Menninger wrote that “the great joke” is that in every prison “the considerable majority of all prisoners are there for the second, third, sixth, or 20th time”. Nor does punishment deter others: it is an old story that in the crowds gathered to watch the hanging of pickpockets in England many had their pockets picked while they watched. Menninger said that regardless of its futility and expense, punishing criminals gratifies, comforts, and even delights the general public: “sadistic attacks in the name of righteousness” deal with the public’s unconscious guilt. I was fortunate to train at the Henderson Hospital which gave me a renewed sense of trust that a therapeutic place can exist for the benefit of the patients and not the staff. Stuart Whiteley of the Group-Analytic Society was Medical Director during the latter part of my time there.