NCJ Number
168177
Date Published
1997
Length
5 pages
Annotation
This paper discusses the diagnosis and treatability of murderers, with attention to the effect the killing has in the countertransference in assessment and treatment.
Abstract
The discussion focuses on the lessons learned about assessment and treatment in a clinical vignette. Assessment of the patient revealed that he was afraid of re-offending, that he was too afraid to admit it, and that this would be the focus of treatment. Assessment also showed that a relationship based on trust may be possible in time and that he wanted not only to protect himself and other potential child victims but more immediately the therapist. This latter issue raises the dilemma with such patients. To treat them opens up the essential re- enactment that is transference. The therapist can become the dangerous person who risks uncovering the fact that he could kill again and who is therefore at some risk. By not engaging in treatment, the patient has symbolically killed the therapist in the transference, whether it is a presentation of himself, his mother, or another child, at the level it is considered. Had he been able to engage in treatment, with the dangerousness at first projected into the therapist in this way, the task would have been to contain the anxiety until he could come to terms with, and own, this frightening part of himself without having to retaliate against those who initially abused him. The psychoanalytic setting is ideal, in that its stability, security, and opportunity for trust to grow helps contain such anxieties.