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The Contribution of Dynamic Psychotherapy to Forensic Psychiatry and Vice Versa^*

Broadmoor Hospital

^* This is a summary, the complete text, with illustrative examples, quotations and bibliography, is to be published elsewhere.

Forensic psychiatry offers dynamic psychotherapy: (a) Specialized expertise in working at that threshold over which Fantasy crosses into Fact. By any standards, a clinical concern of the highest priority. (b) Experience in which conventional aspects of training, such as timing and texturing of interventions, are reinforced. There is also the wider issue of whether the therapist can tolerate the patient's feelings. (c) The reminder of the nagging question ‘Never mind all these elaborate formulations ... will he do it again?’

Dynamic psychotherapy offers forensic psychiatry: (a) Specialized expertise in reaching, unearthing, and hopefully changing, unconscious factors which are inaccessible to introspection. (b) Dynamic assessment of the patient, with special reference to endopsychic factors. Therapy and assessment are interwoven. (c) Particular supportive skills for patients who need ‘a holding environment’ in a ‘holding environment’, without limit of time.