Forensic Psychiatry Quotes

If we do not transform our pain, we will most assuredly transmit it.

The forward to the landmark 1980 DSM III was appropriately modest and acknowledged that this diagnostic system was imprecise. So imprecise that it never should be used for forensic or insurance purposes. As we will see that modesty was tragically short lived.

P252 Habit dooms us all to fight out the battle of life upon the lines of our nurture or our early choice, and to make the best of a pursuit that disagrees, because there is no other for which we are fitted, and it is too late to begin again.

most men consider their rationally selected actions are in fact idiosyncratic responses that have grown strong enough, through repeated use, to overpower other urges and reactions—that have won, in other words, the mental battle for survival.

P198 Describe John Moore’s brother’s death: but at heart I believe now, as I believed then, that it was essentially the result of growing up in a household, and a world, where emotional expression of any kind was at best frowned on and at worst strangled. Unfortunately, I’d stated this opinion during the funeral, and was nearly forced into an asylum as a result.

Do not attempt any of the autoerotic activities described or depicted in this monograph. There is no reason to believe that these activities are pleasurable to the average person, and there is every reason to believe that they may prove fatal.

Remember, psychiatry shouldn’t be over-complicated. Unnecessarily diagnosing always labels but rarely helps the individual. Simplicity is key.

I came to realise that psychiatry is one of the only medical specialties (I would also include general practitioners in this category) where personality and bedside manner were not just a bonus, they were essential.

Offenders tell me that they often find it easier to work with older probation officers than younger ones, who can sometimes present as more rigid and controlling.

metaphor of the dark lamp (as I mentioned in the Introduction) and paid such exquisite attention to language. He described how a patient moves from ‘I don’t know what you’re talking about’ to ‘It wasn’t me’ to ‘It was me, but I was mentally ill at the time’ to ‘I did it when I was mentally ill,’ until they finally land on ‘I did it.’ Cox called this coming to terms

know the words but not the music’ of emotional encounters.

The problem with psychiatry in a forensic setting is that it is based on self-reporting. If you go to a therapist as a private patient, it is presumably because you are unhappy or mentally troubled and therefore have a vested interest in telling that therapist the truth so he or she can help you. If you see a therapist as an offender, your goal is to get out of whatever institution you’ve been placed in and therefore have a vested interest in telling that therapist whatever you have to in order to accomplish your goal. A psychiatrist might hope his patient is getting better; naturally, that will make him feel more effective as a professional and better as a human being. He will want to believe what the subject is telling him and give him a shot back in normal life. But if by doing so, he’s possibly putting the lives of more potential victims at risk, then that’s a price I, for one, am not willing to have us pay.

Guilt is another central aporia leading to limit situations since any human being has to leave options aside while acting in any decision whatsoever. Jaspers refers here not so much to ethical problems we deal with in our ethical committees or in forensic psychiatry but to existential guilt,