ABSTRACT
This chapter focuses on those patients who are contained in institutions such as prisons and medium- and high-secure hospitals. Forensic patients, by definition, also invade, corrupt, attack and damage the institutions which hold them. In ordinary development, the early, unintegrated experiences and states of the infant’s body and mind are gradually processed and integrated as a result of the receptive and containing relationships with primary carers. Patients in a high-security setting, usually because of the nature of their developmental history and experiences, are likely to have a very disordered reaction to care. Staff in high-security settings work with a range of patients who are likely to be all of the above: violent, sexually perverse and personality disordered. Without the opportunity to reflect on these inevitable and very difficult experiences, the staff working in forensic institutions are destined to repeat the early corrupt, mindless and depriving experiences that most forensic patients had in their beginnings.
