Statement from the International Association for Forensic Psychotherapy
By Dr. Estela Welldon
31st October 2014
Forensic psychotherapy creates a bridge between traditional forensic psychiatry and psychology with its main focus on illness and risk, and psychoanalytical psychotherapy that helps to understand the forensic/offender patient. We need to understand not only the crime in detail, but also the individual as a whole person, within his environment.
The aim of forensic psychotherapy is to foster psychodynamic understanding of the offender and contribute to his or her consequent treatment. It does not seek to condone the crime or to excuse the criminal. On the contrary, the object is to help the offender to acknowledge responsibility for his/her acts and thereby helps to protect the offender and society from the perpetration of further crimes.
Taking responsibility and understanding what you did, and why, is more than simply saying you regret it: getting there takes hard work from both patient and therapist(s). Forensic Psychotherapy is a therapeutic discipline that was developed through the amalgamation of forensic psychiatry and psychoanalytic psychotherapy to address the treatment challenges of often unhelpful, punitive and unmitigating responses to criminal behaviour. These reactions are usually born out of a transitory inability to think accompanied by a lack of comprehension of the so-called “irrational” behavior.
Forensic psychotherapy operates with a triadic configuration of patient, therapist and society. It does not seek to condone or excuse the offending behaviour, but enhance the understanding of both the conscious and unconscious motivations underpinning them, thereby saving both the perpetrator and society from further criminal acts, and in the process achieving better management and more cost effective, sustainable treatment of such patients.
Forensic psychotherapy may involve group work, therapeutic communities, family work and work with victims as well as individual offenders, all within an informed and (hopefully) supportive institutional base.
A crucial point about the discipline of forensic psychotherapy is that it requires a team effort using a systemic approach with a wide range of people inescapably involved. Successful treatment rests not only with the specialist psychoanalytical psychotherapist from a number of core professions such as psychiatry, psychology, nursing, social work or creative arts, but also with a team of helpers, including managers, administration and clerical staff who get involved with the patient at all levels and in different settings.
This was the most important, essential factor in the creation of the first course of forensic psychotherapy delivered to students from around the world by the Portman Clinic in association with the British Post Graduate Medical Federation at the University of London. Its emphasis was on the multidisciplinary aspect and different forensic settings from where our students were chosen.
Forensic Therapy was first developed at the Portman Clinic in London in 1931 by a small group of men and women who established the Association for the Scientific Treatment of Delinquency and Crime, whose first chairman was the eminent psychoanalyst Dr Edward Glover.
In 1991, the International Association for Forensic Psychotherapy adopted these values, and sought to bring together professionals from a range of disciplines to enhance the understanding and influence of this approach to the treatment of criminal behaviour.
One of the problems in developing this field is that the offender attacks the outside world (society) through his actions and hence concerns become rarely focused on the internal world of the offender.
Crimes are viewed as directed against individuals and society, which then judges - often punitively. It is unfortunate that the focus of attention most times is placed exclusively on the offence and on the punishment of the offender. Any attempt at psychodynamic understanding of the offender and of the delinquent actions resulting from his own self-destructive internal and compulsive needs is usually equated by society with condoning it. This is an understandable but serious error.
While it is acknowledged that victims may sometimes become perpetrators, this is uncomfortable to face and it is easier to stick to the clarity that victims are innocent and perpetrators are bad. The first group is assumed to be devoid of any negative, hostile feelings and the second group as filled only with hatred. This is a primitive splitting response. Both victims and perpetrators are left without the benefit of a full understanding. A similar stereotype is that women are seen as victims and men as perpetrators. Such challenges to established ways of thinking are, of course, reasoned and rational at one level but the unravelling of such complicated narratives also requires a counter-intuitive approach because the underlying motives may be hidden from conscious awareness.
Forensic Psychotherapy, by entering into and focusing on the mindful world of the offender and victim allows the therapist to create a powerful research setting, or transference relationship, to develop between the psychotherapist and offender-patient. This enables an intense but hopefully safe environment to be fostered in order to explore this mindful/mindless world together.