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What We Fear Most: Reflections on a Life in Forensic Psychiatry
LONGLISTED FOR THE CWA'S ALCS GOLD DAGGER FOR NON-FICTION AWARD
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'Poignant, funny, engrossing' - Jo Brand
'A sensitive and immersive voyage through the career of a forensic psychiatrist' - Kerry Daynes
'a beautifully balanced and compassionately written memoir... This is a fascinating account of a fascinating journey' - Dr Richard Shepherd
Meet Dr Ben Cave. For over thirty years he has worked in prisons and secure hospitals diagnosing and treating some of the most troubled men and women in society. A lifetime of care takes us from delusional disorders to schizophrenia, steroid abuse to drug dependency, personality disorders to paedophilia, and depression so severe a mother can kill her own baby.
These are the human stories behind the headlines. The reality of a life spent working with patients with the severest mental health disorders. The tragic and often frightening truth about what happens behind closed doors.
Dr Ben Cave takes us on a journey to the heart of this highly emotive environment, putting himself under the microscope as well as his patients. In the process, he allows us to share what they have taught each other, and how it has changed them. To share the psychological battle scars that come with a career on the frontline of our health service. To learn about the brilliant mental health nurses for whom physical injury and verbal abuse are a daily hazard. To learn about ourselves, and what we fear most.
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Thoughtful, revealing, often haunting and always enlightening, if you liked Unnatural Causes by Dr Richard Shepherd , Do No Harm by Henry Marsh and This is Going to Hurt by Adam Kay this book is for you.
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'Poignant, funny, engrossing' - Jo Brand
'A sensitive and immersive voyage through the career of a forensic psychiatrist' - Kerry Daynes
'a beautifully balanced and compassionately written memoir... This is a fascinating account of a fascinating journey' - Dr Richard Shepherd
Meet Dr Ben Cave. For over thirty years he has worked in prisons and secure hospitals diagnosing and treating some of the most troubled men and women in society. A lifetime of care takes us from delusional disorders to schizophrenia, steroid abuse to drug dependency, personality disorders to paedophilia, and depression so severe a mother can kill her own baby.
These are the human stories behind the headlines. The reality of a life spent working with patients with the severest mental health disorders. The tragic and often frightening truth about what happens behind closed doors.
Dr Ben Cave takes us on a journey to the heart of this highly emotive environment, putting himself under the microscope as well as his patients. In the process, he allows us to share what they have taught each other, and how it has changed them. To share the psychological battle scars that come with a career on the frontline of our health service. To learn about the brilliant mental health nurses for whom physical injury and verbal abuse are a daily hazard. To learn about ourselves, and what we fear most.
------
Thoughtful, revealing, often haunting and always enlightening, if you liked Unnatural Causes by Dr Richard Shepherd , Do No Harm by Henry Marsh and This is Going to Hurt by Adam Kay this book is for you.
358 pages, Kindle Edition
First published July 7, 2022
141 people are currently reading
2663 people want to read
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July 10, 2023Don't we all know people like this: "I knew from bitter experience that she had a hearing problem of the kind that renders the sufferer unable to hear a ringing phone even at close range, whilst preserving the ability to engage in a normal conversation with her friends in the office." The author is talking about a doctors' receptionist.
And there's the opposite too. You are standing patiently waiting to talk to a representative but they are on the phone. They say hello to you and the phone goes again and the client on the phone is more important than the one in front of them. Mega-frustrating. Or the Indian call centres where there are five minutes between each response and you suspect they are chatting to other people in the office.
And there's the opposite too. You are standing patiently waiting to talk to a representative but they are on the phone. They say hello to you and the phone goes again and the client on the phone is more important than the one in front of them. Mega-frustrating. Or the Indian call centres where there are five minutes between each response and you suspect they are chatting to other people in the office.
May 18, 2024
”We don't have all the answers about the biological causes of mental illness, and in some ways we are still scratching at the surface, but we do know that social and environmental factors are at least as important, and never more so than in childhood.
The child really is the father of the man, and mother to us all.”
What We Fear Most is a fascinating deep-dive into the world of forensic psychology, and all its complexities.
A Psychiatrist’s Journey into the Heart of Madness; the psychiatrist in question is Dr. Ben Cave. It touches on his own life story growing up and then through his thirty year career in psychology. From the delusional, the psychotic, the schizophrenic; this is an honest look on how mental illness can affect each individual person and case. Also there are some stories of drug-induced psychosis, and how that differs from schizophrenia, but how they can be interlinked. Like a person with schizophrenia could become drug-dependent.
Dr. Ben Cave openly and honestly puts himself under the microscope as well as his patients. He explains how they have learnt from each other and how it has changed them all. There are some very dark real-life cases detailed here, so proceed with caution if such topics are heavy for you (self harm, suicide, infant death etc).
He also praises the brilliant mental health nurses for whom physical injury and verbal abuse are a daily part of the job, but the ones he has worked with are always exceptional with the patients. They truly are the back bone of every story told here.
This book is also a journey to learn about ourselves, the inner workings of the human-mind, and what we fear the most.
5 stars
The child really is the father of the man, and mother to us all.”
What We Fear Most is a fascinating deep-dive into the world of forensic psychology, and all its complexities.
A Psychiatrist’s Journey into the Heart of Madness; the psychiatrist in question is Dr. Ben Cave. It touches on his own life story growing up and then through his thirty year career in psychology. From the delusional, the psychotic, the schizophrenic; this is an honest look on how mental illness can affect each individual person and case. Also there are some stories of drug-induced psychosis, and how that differs from schizophrenia, but how they can be interlinked. Like a person with schizophrenia could become drug-dependent.
Dr. Ben Cave openly and honestly puts himself under the microscope as well as his patients. He explains how they have learnt from each other and how it has changed them all. There are some very dark real-life cases detailed here, so proceed with caution if such topics are heavy for you (self harm, suicide, infant death etc).
He also praises the brilliant mental health nurses for whom physical injury and verbal abuse are a daily part of the job, but the ones he has worked with are always exceptional with the patients. They truly are the back bone of every story told here.
This book is also a journey to learn about ourselves, the inner workings of the human-mind, and what we fear the most.
5 stars
February 26, 2023
Looking at the cover art, I thought this book would have a much more serious tone than it did. Forensic psychiatry is a mysterious area of medicine at the best of times, so I was intrigued to learn about some real patient stories and how the system works to support them.
The author writes with a hefty dose of dark humour, as do many of the other kinds of books of this genre. The main issue I found was that the style, editing, or both, felt disjointed and didn’t flow particularly well. I noticed that at multiple points, I was reading one account then the author would go off on a tangent and describe an all together different time and event. This made it somewhat difficult to follow, especially as I was just getting engrossed in the story at hand.
That being said, I otherwise enjoyed this book and thought it was a powerful depiction of mental health and how and why it fails to flourish. There are lots of references to drug abuse, childhood trauma and addictions that seem to tie many of the offender stories closely together.
A recommended read if you can keep up with the to-ing and fro-ing formatting!
The author writes with a hefty dose of dark humour, as do many of the other kinds of books of this genre. The main issue I found was that the style, editing, or both, felt disjointed and didn’t flow particularly well. I noticed that at multiple points, I was reading one account then the author would go off on a tangent and describe an all together different time and event. This made it somewhat difficult to follow, especially as I was just getting engrossed in the story at hand.
That being said, I otherwise enjoyed this book and thought it was a powerful depiction of mental health and how and why it fails to flourish. There are lots of references to drug abuse, childhood trauma and addictions that seem to tie many of the offender stories closely together.
A recommended read if you can keep up with the to-ing and fro-ing formatting!
June 15, 2024
What We Fear Most: Reflections on a Life in Forensic Psychiatry was a fascinating delve into forensic psychiatry, a subject that I could read about all day. I've had an interest in it for many, many years, so it's no wonder this book piqued my curiosity.
We follow Dr Ben Cave, as he tells us snippets about his own personal life, as well as his thirty year career in psychiatry. Mental illness is something that affects us all at some point in our lives, and I think it's really important to be aware and to stay informed.
This book deals with schizophrenia, psychosis, as well as drug-induced psychosis and many more mental health illnesses. I must admit, some of this made for difficult and sometimes grim reading, and I couldn't help but feel for these patients and families that have endured so much. I find it devastating that a young person can be happily living life one day, and the next, they begin suffering from early symptoms of schizophrenia, something that will ultimately rule their lives, cause them to kill their child, and then themselves. I feel thankful that we have advanced procedures and medicine, but situations like that are never straightforward, and are heartbreaking to read about.
This book is written with a lot of dark humour which I've experienced before with this genre, this is fine of course, but a couple of times I did notice how Cave went off talking about something random when he was midflow with something else. This was a little tiresome and frustrating as I was rather invested in what I was reading.
I enjoyed this book overall, and I am always admirable of people that dedicate themselves to the the field of mental health.
We follow Dr Ben Cave, as he tells us snippets about his own personal life, as well as his thirty year career in psychiatry. Mental illness is something that affects us all at some point in our lives, and I think it's really important to be aware and to stay informed.
This book deals with schizophrenia, psychosis, as well as drug-induced psychosis and many more mental health illnesses. I must admit, some of this made for difficult and sometimes grim reading, and I couldn't help but feel for these patients and families that have endured so much. I find it devastating that a young person can be happily living life one day, and the next, they begin suffering from early symptoms of schizophrenia, something that will ultimately rule their lives, cause them to kill their child, and then themselves. I feel thankful that we have advanced procedures and medicine, but situations like that are never straightforward, and are heartbreaking to read about.
This book is written with a lot of dark humour which I've experienced before with this genre, this is fine of course, but a couple of times I did notice how Cave went off talking about something random when he was midflow with something else. This was a little tiresome and frustrating as I was rather invested in what I was reading.
I enjoyed this book overall, and I am always admirable of people that dedicate themselves to the the field of mental health.
July 8, 2023
I absolutely loved this book - an open, honest (dare I say) amusing book about the most extreme forms of mental health or perhaps just bad behaviour (or a bit of both). I usually add a spoiler at this stage and say that I'm a medic but in the most different speciality you could imagine and yet I found lots of reassuring familiarities in the book - team work, reliability on working with the same members in the team to keep one another safe and our patients safe. The other thing that saddened me was how we all, whatever our subspecialty, end up 'wasting' our time because the way the 'system' is run just doesn't work. For Dr Cave it was prison v secure hospital and the differences in how you could (or couldn't) treat patients in those two units. I won't even start by listing how my speciality in the NHS doesn't work! As ever with my reviews - they never do the book justice - but this really was fantastic and I can't recommend it highly enough.
September 9, 2023
This book is a memoir from Dr Ben Cave, who works as a prison psychiatrist, community psychiatrist and as a consultant in medium, low-secure and general mental health units.
I listened to the abridged version of this on BBC sounds. I think I should have read the whole book as it was great. It was insightful, moving, shocking, deeply personal, sometimes depressing, and yet it also possessed of some flashes of humour that made me laugh. Cave’s emotion-packed rollercoaster ride teaches us much about ourselves… and what we really fear the most.
I listened to the abridged version of this on BBC sounds. I think I should have read the whole book as it was great. It was insightful, moving, shocking, deeply personal, sometimes depressing, and yet it also possessed of some flashes of humour that made me laugh. Cave’s emotion-packed rollercoaster ride teaches us much about ourselves… and what we really fear the most.
August 12, 2022
Wow! What a book! I took my time to read (study) this book because I wanted to get into the heart of the message. I wanted to understand and view Mental Illness through the eyes of the psychiatrist and through the eyes of an everyday citizen. The stories here, expertly written by Dr. Ben Cave, are insightful and eye-opening. Not to talk of the free Medical, Psychiatry and Law classes included. LOL!
I must say, it takes a lot to be able to recount all the experiences and put them down in writing. Some traumatic, even to the writer! There are some stories that are quite dark, that sometimes it takes a few days for me to come back to the book after finishing the chapter. However, the humour with which he delivers the stories are next to none! Even the chapter titles are humorous! LOL!!! I suppose it is this unique sense of humour that carried him through his career.
I cannot recommend this book highly enough. For those that want to know more about mental illness and how it affects our society, for those that want to appreciate the impeccable work that nurses do everyday, for those that love medical drama (and humour) ... or for those that are just curious, pick up a copy, you will not be disappointed.
I must say, it takes a lot to be able to recount all the experiences and put them down in writing. Some traumatic, even to the writer! There are some stories that are quite dark, that sometimes it takes a few days for me to come back to the book after finishing the chapter. However, the humour with which he delivers the stories are next to none! Even the chapter titles are humorous! LOL!!! I suppose it is this unique sense of humour that carried him through his career.
I cannot recommend this book highly enough. For those that want to know more about mental illness and how it affects our society, for those that want to appreciate the impeccable work that nurses do everyday, for those that love medical drama (and humour) ... or for those that are just curious, pick up a copy, you will not be disappointed.
July 17, 2023
The writer is reflecting on their past experiences as they pack up their office preparing to leave their last job - there are some genuinely interesting and heartbreaking case studies, but overall I found the writing disjointed and hard to follow. I understand that forensic psychiatrists are always going to work with extremes, but I was hoping for a bit more nuance than schizophrenic = dangerous, and generally a bit more depth and insight. Definitely personal preference but I just didn’t ‘get on’ with the narrator.
September 9, 2023
I have only read a handful of books that were so incredible, inspiring, and impactful that they will be etched into my mind forever. I knew that this was one of them when I started writing my good reads review in my notes app after only having read 10%.
This book was written so beautifully and skillfully that I actually thought to myself “this might be a ghost writer because how can a psychiatrist be this talented of an author!?” As a mental health practitioner and aspiring clinical psychologist, I have read a substantial amount of mental health literature and What We Fear Most has now topped my list of recommended readings. It is deeply profound, enthralling, vulnerable and touching, whilst also being highly educational, funny, and reflective.
I laughed, I cried, I learned and I finished it feeling a renewed sense of motivation in my career. What more could you ask for from a book?
Dr. Ben Cave is a true inspiration and he gives me faith that there are doctors out there fighting the good fight and advocating for a better mental health system (both in hospitals and prisons) in the UK.
This book was written so beautifully and skillfully that I actually thought to myself “this might be a ghost writer because how can a psychiatrist be this talented of an author!?” As a mental health practitioner and aspiring clinical psychologist, I have read a substantial amount of mental health literature and What We Fear Most has now topped my list of recommended readings. It is deeply profound, enthralling, vulnerable and touching, whilst also being highly educational, funny, and reflective.
I laughed, I cried, I learned and I finished it feeling a renewed sense of motivation in my career. What more could you ask for from a book?
Dr. Ben Cave is a true inspiration and he gives me faith that there are doctors out there fighting the good fight and advocating for a better mental health system (both in hospitals and prisons) in the UK.
September 1, 2023
A fascinating glimpse into this complex world.
February 16, 2025
Brilliant memoir by a very talented forensic psychiatrist set in both high secure psychiatric hospitals and prison. Having worked in mental health some of the story themes were familiar but his compassionate and thought provoking style of writing gave me a renewed passion for psychiatry. Mental health is a topic that I will never be bored of and always welcome the opportunity to learn more.
June 5, 2024
Listened on audiobook
A fascinating and easy to follow insight into psychiatric medicine. The more complicated terminology is explained very well and each case is different and interesting. High recommend.
A fascinating and easy to follow insight into psychiatric medicine. The more complicated terminology is explained very well and each case is different and interesting. High recommend.
July 14, 2022
This book was given to me by a family friend on the 8th of July, and by morning of the 10th, I had finished reading. I just couldn’t put it down. Now, I’m planning to give this book to everyone this Christmas - it is just so good!
I have been working in healthcare for 8 years, and as a Neuroscience student interested in behaviour, I feel I have gained great insights into mental health and human behaviour from this book. It is the first time, I realised simply treating a problem doesn’t always solve the problem and this field is definitely quite complex therefore more teaching and research is definitely necessary. And thank you Dr Cave for highlighting what nurses go through and how due to lack of support we lose some amazing nurses. I come from a South East Asian background myself and the chapter ‘The best curry in the world’ chapter brought tears to my eyes especially the end.
All in all - an amazing book. Fascinating, Capitative, Inspirational, and oh plenty of humour! Look forward to your future accounts/books/insights 🙌🏽
I have been working in healthcare for 8 years, and as a Neuroscience student interested in behaviour, I feel I have gained great insights into mental health and human behaviour from this book. It is the first time, I realised simply treating a problem doesn’t always solve the problem and this field is definitely quite complex therefore more teaching and research is definitely necessary. And thank you Dr Cave for highlighting what nurses go through and how due to lack of support we lose some amazing nurses. I come from a South East Asian background myself and the chapter ‘The best curry in the world’ chapter brought tears to my eyes especially the end.
All in all - an amazing book. Fascinating, Capitative, Inspirational, and oh plenty of humour! Look forward to your future accounts/books/insights 🙌🏽
Read
November 20, 2022A memoir by a forensic psychiatrist of his life and work, beautifully written and elegiac. It's harrowing, full of stories of violent offenders and awful murders, assaults, sexual offences, but also funny and even heartwarming in places. The author is a wry narrator, very well aware of his own failings, which is what makes it a good story as well as a factual account.
April 6, 2023
4 stars for content, 3 stars for the delivery/style.
July 17, 2022
Not the easiest read, but a compelling insight into forensic psychiatry over the last 20 plus years through the eyes of the author. Equally sad, funny and horrific, you get a sense of two overburdened systems with professionals giving their all to prevent further damage to both the patient and / or future victims in both the penal and healthcare arenas. You get insight into the personal toll on the doctors and nurses - physical and emotional.
The book has challenged my views and what is right for society may not be for those being treated. I’d certainly recommend this book and I will pre-order the follow up.
The book has challenged my views and what is right for society may not be for those being treated. I’d certainly recommend this book and I will pre-order the follow up.
September 13, 2024
3.25
This was a powerful & intense read of a number of patients from the world of forensic psychiatry, and I really felt this was done with a sympathetic insight: the author consistently reminded me of the point of "just because someone does a bad thing, it doesn't make them a bad person". What I struggled with was the erratic structure which switched between personal anecdotes & professional stories - I often found
that these anecdotes had little reference to the patient that was being discussed. Overall though, a good read!
This was a powerful & intense read of a number of patients from the world of forensic psychiatry, and I really felt this was done with a sympathetic insight: the author consistently reminded me of the point of "just because someone does a bad thing, it doesn't make them a bad person". What I struggled with was the erratic structure which switched between personal anecdotes & professional stories - I often found
that these anecdotes had little reference to the patient that was being discussed. Overall though, a good read!
January 5, 2025
A memoir of sorts from a UK forensic psychiatrist during his time working in prison/general hospitals & community mental health.Does not shy away from sensitive topics such as rape,murder & abuse but does not glorify or sensationalise them.
This book does not require medical knowledge to be understood & has a dark humour to it which is almost a necessity working within these fields.
Through the various cases/stories in the book given to the reader, the author examines his own bias/experiences and how they helped mould him throughout his career.
The stories in the book are very non linear to protect the anonymity of the people involved so easy to pick up & put down when you have spare time to read.
This book does not require medical knowledge to be understood & has a dark humour to it which is almost a necessity working within these fields.
Through the various cases/stories in the book given to the reader, the author examines his own bias/experiences and how they helped mould him throughout his career.
The stories in the book are very non linear to protect the anonymity of the people involved so easy to pick up & put down when you have spare time to read.
February 16, 2025
Written under the pen name Dr Ben Cave, "What We Fear Most" is an inspiring account of a 25-year career in prisons and secure hospitals, where he dedicated himself to the treatment of acutely unwell patients facing challenges such as schizophrenia, steroid abuse, personality disorders, and psychosis.
Dr Cave's talent for humanising mental illness makes "What We Fear Most" unique. He challenges stereotypes and cultivates compassion and empathy. His honest reflections and thought-provoking insights encourage readers to face their own fears and misconceptions about mental health.
This approach sparks meaningful conversations and promotes greater understanding.
With his extensive experience as a psychiatrist, Dr. Cave joyfully explores the fascinating complexities of the human mind, bringing empathy, wisdom, and thoughtful insight to every interaction.
This book is engaging and informative. It is written with compassion, empathy, humour, and a deep understanding of mental health issues, hopefully educating those who may not realise these issues can be.
Easy to read and compelling, it provides a glimpse into the life of a psychiatrist.
January 9, 2026
An excellent memoir, which is engrossing for both the right and wrong reasons. I really know very little about forensic psychiatry, outside of a selection of buzzwords, ideas and key phrases, and even I was able to keep up with Ben Cave's reflections.
There is a distinctly human element in the way this is written, perhaps unsurprisingly, but not once does it come off as robotic, cold, careless. Instead there are genuine moments of anger, joy, regret and heartbreak, and the writing style is enjoyable and engaging.
Some of the subject matter is a little troubling and if you have a weak stomach some of the chapters will likely make you queasy (you will know which one I am referring to when you reach it) but these minor horrors aside, this was a highly enjoyable and professional work.
8/10, a great way to start off my reading of 2026.
There is a distinctly human element in the way this is written, perhaps unsurprisingly, but not once does it come off as robotic, cold, careless. Instead there are genuine moments of anger, joy, regret and heartbreak, and the writing style is enjoyable and engaging.
Some of the subject matter is a little troubling and if you have a weak stomach some of the chapters will likely make you queasy (you will know which one I am referring to when you reach it) but these minor horrors aside, this was a highly enjoyable and professional work.
8/10, a great way to start off my reading of 2026.
November 18, 2022
Ive read a few of these ´Dr shares his experiences’ books now, especially in the field of forensic medicine. It’s the crime writer in me. This is definitely up there with the best. Well written and terrifying in its honesty it does, in the less serious criminal cases, bring up that horrible feeling ´there but for the grace of god…´Mental illness is serious illness. In some cases here, terminal. It needs more resources and this is a call for those in its examples, not by preaching.
September 10, 2023
Exactly what I wanted this book to be; and much, much more.
Packed with real-life case studies as well as factual information, this book was thought provoking and interesting and I genuinely feel like I learnt a lot.
I now have even more respect for those that work in the field of psychiatry.
Packed with real-life case studies as well as factual information, this book was thought provoking and interesting and I genuinely feel like I learnt a lot.
I now have even more respect for those that work in the field of psychiatry.
September 27, 2023
Head in the sand
It always amazes me whenever I read a book about professionals who serve the public, whether they be police, fire service, doctors, nurses to name a few, it's a thankless job, something we don't value enough until we need their help and I can understand why people want to leave
This book is amazing it gives you an insight into what is a difficult and demanding job and I praise you for the work you have done, you would have changed people's lives and inspired others, thank you for sharing your life experience with us
It always amazes me whenever I read a book about professionals who serve the public, whether they be police, fire service, doctors, nurses to name a few, it's a thankless job, something we don't value enough until we need their help and I can understand why people want to leave
This book is amazing it gives you an insight into what is a difficult and demanding job and I praise you for the work you have done, you would have changed people's lives and inspired others, thank you for sharing your life experience with us
March 25, 2024
interesting and thought provoking read
I have loved this book. The author carefully discusses the issues in psychiatry without making the subject too heavy. It is by no means a “light” read but it also doesn’t leave you in tears, often.
I’d recommend to those who enjoy real life stories of interesting people/careers.
I have loved this book. The author carefully discusses the issues in psychiatry without making the subject too heavy. It is by no means a “light” read but it also doesn’t leave you in tears, often.
I’d recommend to those who enjoy real life stories of interesting people/careers.
August 30, 2022
This is one of the best books by far I have read this year.
An in depth look at Forensic Psychiatry, some of it is hard to read, to try and understand and put yourself in different situations but it's truly worth it.
Highly recommended
An in depth look at Forensic Psychiatry, some of it is hard to read, to try and understand and put yourself in different situations but it's truly worth it.
Highly recommended
July 14, 2023
A really interesting listen!
March 14, 2024
Philosophical, eye opening, haunting (in a good way)
January 25, 2026
This was amazing and absolutely fascinating. It really opened my eyes to psychiatry in general. It is written very cleverly, it doesn't read like non-fiction. I found it incredibly impactful to hear everyone's story in the book.
October 7, 2022
Wonderful. It’s a subject I’m interested in, and the book didn’t disappoint. Ben Cave’s career journey became my journey through the various facets of mental health disorders and their treatments. Witty and entertaining throughout. I don’t think I’ve enjoyed a book so much in ages! Thanks Ben Cave… write some more!
September 3, 2023
Could barely put this book down! You know what it's like sometimes, right? - *just one more chapter*... I've worked in the criminal justice system and in mental health so none of this stuff is new to me, but Cave brings each patient on the page to life and has a conversational style of writing that made me continually want more!
Displaying 1 - 30 of 101 reviews