ABSTRACT
A prison provides a firm, external containment barrier against escape in a physical sense. In therapy, one comes across problems arising in the patient or in the psychotherapist or psychoanalyst arising from within themselves. Treatment management needs to include psychotherapy, which will usually involve supervision or regular consultation with colleagues. Two of Melanie Klein's discoveries are helpful in understanding what happens in intolerable states of mind, in countertransference terms. The psychotherapist may act out what has been put into him. A manifestation of countertransference is an opting out on the part of the psychotherapist via a state of bewilderment, excessive anxiety, or, sometimes, disappointment leading to therapeutic nihilism. Among such feelings can sometimes be one of dislike for a prisoner or violent patient because the crime he or she has committed touches on a specific area of sensitivity for the therapist, a sort of Achilles' heel.
