Psychosis tends to be an experience that socially isolates the sufferer and generates fear and distance in others. This is likely intensified when this presentation is combined with offending. In this chapter, using case examples we describe the possible pathway to psychosis through trauma and the links to violence.

We illustrate the function and method in “madness”, clear evidence for the need to understand, and make sense of, what is being communicated through delusional and/or psychotic experience, and the importance of looking beyond diagnostic frameworks. In doing so, we can explore the function of hypervigilance, the parallels with childhood experience, and the efforts to avoid further victimisation.