ABSTRACT
The perplexing or shocking behaviours that can lead patients, psychotic or otherwise, to be treated in secure settings under the care of forensic psychiatry teams may have contributed to those clinical teams in particular incorporating a psychoanalytic approach. Another reason for this might be that a psychoanalytic approach is considered helpful with those patients suffering from personality disorders for whom the “ordinary” psychiatric management does not seem to suffice. In this chapter, I will first describe in a general way how clinical psychiatric teams in high secure hospital settings approach the problem of patients who have been violent. I will then give examples of “dangerous” patients who have been treated with psychoanalytic psychotherapy and show how this approach can contribute to understanding their difficulties and violent propensities, adding an important aspect to their management.
