Bearing and not bearing unbearable realities: The limits of understanding.

Morgan, David (2011) Bearing and not bearing unbearable realities: The limits of understanding. In: Containment in the community: Supportive frameworks for thinking about antisocial behaviour and mental health. Portman Papers . Karnac, London, pp. 69-86. ISBN 9781855758483 Full text available

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Abstract/Book Review

A famous dictum of Freud's was that bad men do what good men dream. The difficulty for staff working with forensic and psychotic patients is that they are working with patients who confront them with their own worst anxieties. They are being asked to manage the most extreme form of concrete thinking—murder and violence to the self, as in some psychotic patients, or murder and violence toward others, as in forensic work. Even in specialist services such as medium secure units, staff on inpatient wards are often not equipped to manage the extremely difficult task of understanding patients' concrete behaviours in symbolic terms. This is not a criticism of the staff, but an acknowledgement of the nature of the patients they work with. Constant exposure to the patients' very concrete modes of thinking inevitably erodes the staff's own capacity to reflect, often leading to "mindless", institutionalized responses that may recreate the patients' very early deprived relationships. In this chapter, I describe my experience of applying a psychoanalytic perspective to such patients, seen in both institutional settings and in my private practice, and how such an approach might begin to translate patients' concrete enactment to often painful and terrifying thinking.

Item Type: Book Section
Subjects: Criminology > Forensic Psychotherapy
Department/People: Adult and Forensic Services
Depositing User: Ms Linda Dolben
Date Deposited: 31 Oct 2013 18:59
Last Modified: 09 Feb 2016 10:28
URI: http://repository.tavistockandportman.ac.uk/id/eprint/504

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