Am J Psychiatry 1977; 134:553-555
Copyright © 1977 by American Psychiatric Association
Voluntary and involuntary treatment of aggressive patients
DJ Madden
The author describes his experiences in treating violent patients in group
therapy. Problems include the divergent goals of therapist, patient, and
society; the environmental limitations on incarcerated patients;
countertransference issues; and magical expectations on the part of
patients. Therapeutic goals must be somewhat limited with patients who are
forced into therapy. It may be dangerous to "open up" such patients,
especially when they face lengthy prison terms. The author suggests that
distancing tactics be avoided with violent patients, who need to encounter
another person who has dealt successfully with hatred, fear, and
limitations.
