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Psychoanalysis On and Off the Couch

Oct 13, 2019

“Psychoanalysis has so much to offer a particular patient population that really doesn't have sufficient access to our psychoanalytic work and applications. It is a terrible pity because so many of them really benefit from it directly and there is so much benefit for society in general.”


Description: Harvey Schwartz welcomes Dr. Carine Minne who is a Psychoanalyst at the British Society and a Fellow of the Royal College of Psychiatrists. She trained as a forensic psychiatrist and psychotherapist, bringing these specialties together in her posting as Consultant Psychiatrist at the Portman Clinic, (Tavistock & Portman NHS F Trust) and Broadmoor Hospital (West London NHS Trust). She is President of the International Association for Forensic Psychotherapy and chairs the IPA community committee on Violence. Her focus for the last 25 years has been mainly on providing psychoanalytic treatments for patients who have acted violently or are troubled by sexual perversions. Many of her patients are in secure settings, psychiatric hospitals or prisons where psychoanalytically informed supervisions are provided to staff, given the strength of the reactions such patients or prisoners can provoke in those caring for them. Long term in-depth work is an important part of the overall treatment for such multiply traumatized people, given their background histories, the offenses they commit, and their discovery during treatment of being mentally disordered. Strong resistance to this work is regularly encountered, particularly by the general public that can mistake understanding with condoning. However, providing psychoanalytic approaches within relevant mental health and criminal justice organizations is often appreciated.


Key takeaways:

[4:00] Allowing primitive states of mind to emerge while benefiting patients who have committed crimes.

[5:53] Terms that contribute to dehumanizing mentally disordered offenders (MDO).

[6:26] What these patients have in common.

[8:40] The setting of these psychoanalytic interventions.

[8:17] The treatment should fit the crime, not punishment.

[10:35] Dealing with the therapist’s repugnancy towards the crimes that were committed.

[13:36] Being a woman treating male and female MDOs.

[14:45] Being an Irish woman in English psychiatric prisons.

[16:20] Dr. Minne talks about the feeling that “her mind was taken over” by her patients.

[16:56] The case of the man who killed his mother.

[21:15] Long term work, a form of psycho-dialysis which is very cost-effective.

[23:25] Why have these patients acted out the murder as opposed to imagining it?

[25:16] Biology's role in MDO.

[26:38] You can treat patients but can't cure them.

[27:05] The use of medication.

[28:03] What brought Dr. Minne to this work.

[32:15] Psychoanalytic training enriching Dr. Minne’s psychiatric background.


Mentioned in this episode:

IPA Off the Couch


Recommended Readings:

Sohn, L. (1995) UnprovokedAssaults - Makingsenseofapparentlyrandomviolence. Int. J. Psycho-Anal 76 565-575


Hyatt-Williams, Arthur (1998) Cruelty, Violence and Murder. P. Williams (Ed) London Karnac Books


Winnicott, D. W. (1956) The Antisocial Tendency. In D. W. Winnicott's Collected Papers: Through Paediatrics to Psychoanalysis. London: Tavistock Publications, 1958. Reprinted 1991, London, Karnac Books


Limentani, A. (1984) Towardsaunifiedconceptionoftheoriginsofsexualandsocialdevianceinyoungpersons. Int. J. Psycho-Anal 10 383-409