ABSTRACT

This chapter focuses on Alex (not their real name), distressed by a misalliance of gender-identity, and sex assigned at birth, who struggled with gender dysphoria and suicidal ideation, whilst serving a life sentence for the murder of men, and receiving inpatient treatment for personality disorder in a high security forensic hospital. Alex had engaged in radically open dialectical behavioural therapy, for over-controlled violent offending in personality disorders, before being directly referred for forensic sandplay therapy, the focus of this chapter; both of which, were the first of their kind, innovative approaches in the high-secure setting.