How many eyes do you have? Asks ex-forensic psychologist

badFor decades, the psychological assessment and treatment of offenders has run on invalid and untested programmes. In his book, Bad Psychology, Robert A. Forde exposes the current ineffectiveness of forensic psychology that has for too long been maintained by individual and commercial vested interests, resulting in dangerous prisoners being released on parole, and low risk prisoners being denied it, wasting enormous amounts of public money. Robert A. Forde is a retired consultant forensic psychologist and prison psychologist.

How many eyes do you have?

I’m betting the answer to that question is no more than two. However, there is a traditional joke that psychologists have a “third eye” which enables them to see into people’s minds. Pretty obviously, they don’t. Perhaps less obviously, this means that they only have the same powers of observation as anyone else. Much of my recent writing in psychology has examined the implications of this simple statement.

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Professional and Therapeutic Boundaries in Forensic Mental Health Practice

By Dr. Anne Aiyegbusi and Gillian Kelly, editors of the new volume in the Forensic Focus Series, Professional and Therapeutic Boundaries in Forensic Mental Health Practice.

Photo: Dr. Anne Aiyegbusi (left) and Gillian Kelly.

The word ‘boundaries’ is used a lot in forensic mental health practice. This is not surprising given that by definition the offender populations who constitute the client groups in forensic services have breached boundaries in serious ways. It is also clear that forensic populations include a large percentage of people who have also had their personal and bodily boundaries breached in traumatic ways during their early development.

When groups of people with these backgrounds are locked up together in secure settings where they feel disempowered, restricted and themselves to be victims of the system, the task professionals have of establishing and maintaining safe boundaries is a challenging one. Although there is little research evidence available, a picture emerges from clinical practice that suggests there are complex gender issues at play with regard to boundary violations in forensic settings. Indeed, if we turn to newspaper reporting in the United Kingdom we will find that there are regular stories of female staff accused of sexual relationships with male patients in secure services.

A complicating factor that emerges in forensic services is that clients have a combination of vulnerability and risk. Clients may be vulnerable to being abused and at risk of abusing. Sometimes it is not easy to separate vulnerability from risk, especially when clients are high profile or severe offenders. Working with this combination and maintaining balance is a particularly delicate task.

This book provides detailed accounts of therapeutic practice in all forensic settings, explaining exactly how clinicians from a range of different disciplines work with complex boundary phenomena in the context of nursing, psychotherapy, arts therapies, family therapy and psychology. Importantly, the perspectives of victims and perpetrators of professional boundary violations in psychological therapies are included in this book which provides an insight into the impact of professional corruption on clients who enter into therapy to recover but end up being used by their therapists. The perspective of perpetrators is included by reference to a service in the USA specifically for boundary violating professionals.

This book is important because establishing and maintaining professional and therapeutic boundaries in forensic mental health practice is crucial and yet shockingly there is little available literature to support clinicians in the complex task they have. In particular, there is a complete absence of guidance which elucidates the reality of day to day clinical work with its difficult balancing acts, slippery concepts, confrontation with offence paralleling  behaviours and being tested, pushed and pulled out of professional role.

This book is a valuable resource for clinicians of all disciplines and grades who practice on the front line of forensic practice because it clarifies that they are not alone in facing the boundary challenges inherent in this work. The key roles played by supervision and reflective practice are emphasised throughout the book. Training in boundaries work is also referred to. These are the tools that enable effective clinical work which is important information for managers and academics organising services and providing education for front line workers in order that they ensure their products are sufficiently robust.

The Therapeutic Milieu Under Fire

By John Adlam, Anne Aiyegbusi, Pam Kleinot, Anna Motz and Christopher Scanlon, editors of the new volume, The Therapeutic Milieu Under Fire.

What therapy can be offered to people with forensic histories and how might it work? What can we learn about the minds of offenders from observing our own reactions to working with them? How do teams working with dangerous and disturbed people survive? How can organisations themselves become perverse and abusive, and how is it possible to prevent this through reflective practice and team development?

In The Therapeutic Milieu Under Fire, we explore these and other essential questions in forensic work in organisations and institutions. We work with highly complex, disturbed, dangerous and endangered people; trying to keep their thinking alive despite conscious and unconscious assaults on the therapeutic relationships and on the milieu itself.

This book is based on a series of seminars organised by practitioners that promoted psycho-social enquiry into the nature of forensic systems of care and the qualities of their relationship to the excluded outsider.

This book also reflects on this particular historical moment and it movingly describes the impact of the lethal attacks that have been carried out against organisations and institutions that were dedicated to providing care for some of our most vulnerable fellow citizens. It argues powerfully that it can be a false economy to ignore the wealth of accumulated practice-based evidence and to offer, by contrast, so-called evidence-based, technical-rational packages of treatment under the guise of improving access to psychological therapies.

This volume is in the form of a series of psycho-social and ‘groupish’ associations to the theme of the therapeutic milieu under fire. The approach is trans-disciplinary and it offers spaces for conversations between service-users, nurses, social therapists, project workers, housing support workers, probation officers, psychiatrists, social workers, group analysts, psychologists, psychotherapists, managers, civil servants, educators, researchers and the general public (among others) about the changing and complex relationship between troubled individuals and their troubling social, organisational and institutional context.

The contributors all work on the ‘frontline’ in one way or another, many working with marginalised and excluded outsiders at the edges of our exclusive society. This book explores the ways in which these outsiders are offended against and how, in turn, they offend against others, within systems designed both to care for and to contain them. What is the task of the professional caring for a mentally disordered offender? How can they offer security without custody, or care without collusion or detachment? When does ‘care’ become a perversion of ‘control’? Why is thought replaced with action and why might it be so hard for the milieu to replace action with thought? These are some of the central questions that were debated in our one-day seminars, and whose dynamics are explored in this text.

In presenting this range of papers, and the multiple complexities that these authors explore, we hope to enable the reader to come to a better understanding of the ways in which the therapeutic milieu comes under fire from without and within, so that we can think together about how to remain thoughtful and committed to the task while anticipating and responding to these inevitable attacks.

Thinking under fire is essential in this work, and so too is reconstructing our internal and external milieu. The systems-psychodynamic thinking of the International Association for Forensic Psychotherapy and the therapeutic community model combine in contemporary practice to give us a model of the conscious and unconscious processes that inform criminal acting out or the expression of personality disorder: a model that helps us to make sense both of the violence in the patients and the violence in the societal response.

Copyright © Jessica Kingsley Publishers 2012.

Inmate to Artist: Jeanette Purkis’ Misadventures with Asperger Syndrome

Jeanette Purkis is a successful artist and business owner who has Asperger Syndrome. Jeanette recently featured in a documentary entitled “Alone in a Crowded Room” which seeks to answer the question: What happens to autistic children when they grow up?

Here, Jeanette – author of Finding a Different Kind of Normal: Misadventures with Asperger Syndrome – remembers her turbulant but triumphant transformation from prison inmate to artist, and how she came to appreciate the many gifts that come with Asperger Syndrome.

‘A Case of Ex’

When I was in my twenties I was a very different person to who I am today: I was a prisoner, a criminal and a drug user, a disturbed, inconsequential waif who wandered through life offering joints to passers-by and wondering why this was frowned upon. My twenty-something self was at home in prison in the company of women that my thirty-something, respectable self would not dare to even look at. I was diagnosed with Asperger syndrome in prison and hated and rejected the diagnosis as it seemed to me to be a diagnosis of ‘geek.’

At twenty-five, I decided to say farewell to the life of crime, drugs and having little control and even less desire for it. On 5th February 2000, I was released from lawful custody. At this point, as far as I was concerned, empathy was something that other people practiced and ethics was a foreign concept. However, around early January I’d decided that a new millennium should mean a new life and was determined to avoid returning to prison, but I had little idea of how a positive life could be achieved.

I was lucky enough to have gained a misdiagnosis of borderline personality disorder somewhere along the line and this lead to my attending a live-in therapy program for people with that condition. While misdiagnoses are usually not the best recipe for recovery, in my case it was actually a bit of a blessing, for the course was filled with rules and structure, and every time I did something well I was rewarded. The staff at the program seemed to trust me and, after six months I left, filled with new-found self-esteem and confidence and wanting to succeed in life.

I spent the next few years doing the supposedly impossible – through logical deduction and intellect I learned empathy and I learned ethics. Far from feeling alienated by society, I wanted to make the most of life and give something back to the world that I had taken so much from. I lived in terror of meeting former criminal acquaintances – I would cross the street if I saw someone who looked remotely familiar and a little bit dodgy. In fact, I bade farewell to all my friends – I was quite lonely for some time, but I was a lonely, ethical and drug-free person who had some ambition for the future.

I changed my entire outlook on life, overcompensating a little by being conspicuously honest and avoiding any situations which may lead to difficulties of a legal or ethical nature. I lived in a variety of accommodation over the years: a group house for people with mental illness, which taught me about tolerance and patience; a two bedroom flat by myself, which taught me about self-reliance and appreciation for my own company; and a one-bedroom flat in a huge block owned by the Office of Housing (similar to an English council flat), which taught me that poverty is not an edifying state to be in.

I attended university for six years, graduating from Bachelors to Honours and then achieving a Master of Fine Arts, loving the intellectual rigour and appreciating how far I’d come in a few short years. I became known in the Melbourne contemporary art scene and had many exhibitions, including one at the prestigious Australian Centre for Contemporary Art. I wrote a book about my experiences at the age of 30, which drew a great deal of comment from older people who were amazed that a person that young had enough experience to write an autobiography.

At the end of my Masters degree, I started work as a civil servant and moved to the Australian capital, Canberra, thus escaping poverty and starting on the path towards financial independence. Eighteen months later, I bought my own one bedroom flat, where I was surrounded (mainly) by other civil servants also living in their first property purchase, rather than drunk unemployed people as had been the case in the Office of Housing flat.

And along the way I gained many good friends and won back the respect of my family. When I was young, I had no self-esteem and figured the difficulties my Asperger’s caused made it impossible for me to achieve anything. I gave up on myself and the world. Now that I am older, I realise that Asperger’s is probably the main reason that I have been able to achieve so much. I have little or no emotional memory, meaning that I can ‘move on’ after horrific past experiences; I am focused and determined, almost to the point of obsession – if I want something, that something generally happens; I am organised and thorough, meaning that life at university and particularly in the civil service, is easier for me than for many other people; and I have a rigorous intellect, which means I can understand social situations using logic, as I taught myself ethics by applying how others’ actions would make me feel and turning it back on other people.

While Asperger’s can cause a person difficulties, it also comes with many amazing gifts which in my case have certainly helped to set me up for a wonderful and successful future.

Copyright © Jessica Kingsley Publishers 2010.