chapter  115
8 Pages

Interpersonal Dynamics In Forensic Psychiatry

WithGabriel Kirtchuk, David Reiss, Lakshmiramana Alla

Functional relationships are developmental, creative, and predominantly pleasant. Dysfunctional relationships are a source of discomfort and distress. In the forensic population the intensity of the latter may be extreme, and from it is produced what we call the index offense, which can have devastating consequences, for both the victim and the perpetrator. The ability to develop and maintain effective relationships with others is central to our satisfactory functioning as human beings; however, many patients are impaired in this aspect of their functioning. These difficulties are not restricted to those formally diagnosed with personality disorder but may be present in those whose mental disorder has been apparently successfully treated. Although more subtle than at the time of the index offense, the dynamics may adversely, and sometimes for a prolonged period, affect the therapeutic nature of the relationship with staff. Members of the therapeutic team are often unaware of their own responses that have often been provoked by the patient’s distorted relationship patterns, based mostly on adverse earlier life experiences.