ABSTRACT
While therapists tend to think of psychotherapy as primarily a talking treatment, there is a growing evidence base for its more creative methodologies in the forensic world, including art therapies. Working with forensic patients with severe disabilities requires a close attunement to the symbolic level of communication. When the severity of a disability reduces the possibility of clear verbal communication, meaning should be viewed as the negotiated outcome of interactions, always involving inference, but remaining at heart an intersubjective process. When working with severe disability, the countertransference becomes the primary map with which therapists navigate the patient's internal world. It is far from rare for the forensic disability patient to quickly become attuned to any trace of revulsion or fear in their therapist. While not exclusive to the domain of severe disability, the erotic transference can have a particular potency when working without words, given the forensic patient's struggle to view others as anything other than sexual objects.
