“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.”
Carine Minne MD
London
Episode 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 the 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 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.
Recommended Readings:
Sohn, L. (1995) Unprovoked Assaults – Making sense of apparently random violence. 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) Towards a unified conception of the origins of sexual and social deviance in young persons. Int. J. Psycho-Anal 10 383-409
Really insightful and interesting listen. It touched me in so many ways and reinforces my belief in forensic psychoanalysis. Thank you
Dr. Minne’s presentation was excellent. She is is remarkable articulate about the complexities of these traumatized individuals. She speaks of them honestly, without narcissistic investment in the sensational content. What a refreshing and inspiring stance to work with patients of ALL levels of disturbance. I worked at a state hospital for the first 3 years of my training (patients that were “not guilty by reason of insanity” ).They have all stayed with me 15 years later- I still refer to them in my mind when working now in an outpatient setting. We are all capable of feeling horror and inflicting horror. Under the right circumstances, we can all be monsters. To be able to tolerate the stories of infants and children, brutalized in their youth, that later grow up to do the best they can, is such an important point- that the acting out is a response to a wish to transform pain. Dr. Minne so articulately brings to light the origins of these human beings that prompts us to reflect on our own lives. How can anyone hear this podcast and not think:
“that could have been me.” ? This is why her work is so meaningful, because it relates to not THEM but to US. She seems to use her personhood, her own humanity as the starting point- the only starting point. In recognizing herself, I suspect the patient can begin to recognize something hidden in himself. That was my impression The man who wanted to kill (slashing the neck) most likely, had somehow observed there was something in her that made it possible for him to say something that might land somewhere. IN my experience, no matter how psychotic, patients can decipher who they can and cannot confide in. I think Dr. Minne is likely a gifted person that has access to enough of her own pain to reach others that society deems too out of reach. These are my impressions.
I work in prison as a counsellor psychotherapist and also manage a team of counsellors. This interview was very interesting to me with my line of work. I think more psychotherapy should be provided in prisons. It is essential to help a person understand what got them to offending and an important in healing them have better relationships and is an integral part their rehabilitation back into society
Would be interesting to talk about war and nationalism with a psychoanalyst, especially considering what we have nowadays…
In connection with war and nationalism you might be interested in the writings of Dr. Vamik Volkan, available on his website.
I was very grateful to hear Dr. Minne describe her work and to hear briefly of the importance of Dr. Sohn in her work. This work is so valuable.
On listening to this interview,I am conscious of the compassionative and heartfelt humanitarian concern which underpins Dr. Minne’s professional practice and life commitment to supporting the deeply traumatised individuals she supports on a daily basis. The interview presents examples of positive change. It also presents important personal and societal challenges. I wish her well.
I enjoyed Dr Minne’s sharing her experiences and her ability to reach these patients, amazing work.
Dr Minne’s talk about her compassionate and insightful psychoanalytic work with violent patients was inspiring and I hope many others will take the opportunity to learn from her wealth of experience in this field. Thanks to her and the IPA for sharing this interview online..
I’m incredibly pleased to have heard Dr Minne speak of her work with these profoundly disturbed and disturbing patients. I’m pleased the IPA is devoting some attention to the work that some do in this area where psychoanalytic thought has so much to offer.
I agree that it is an honour to listen to dr. Minne talking about her work.
Thank you for this interview
Maria Pia Conte