The Devil You Know: Encounters in Forensic Psychiatry

by Gwen Adshead

The title comes from the Latin proverb which suggests that the devils we know are less risky than the ones we don’t.

prefer to think of the mind as a coral reef: ancient, layered, and mysterious, not without shadows and risk but containing a nourishing diversity; it might appear chaotic, but it is a complex and structured ecosystem, endlessly fascinating and essential to human life.

revenge is a basic human impulse, a kind of wild justice that keeps us stuck in our fear and anger, mirroring the very cruelty we claim to abhor. This can be painful; there is wisdom in that popular notion that hating someone else is like taking poison and waiting for them to die.

the violent offender is perceived only as a predator. This person who was once a child like any of us, with shared ideas of joy and sorrow, is drowned in polarity and the public noise of condemnation.

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

Sometimes people are unlikeable because they don’t like themselves, a truism that extends well beyond forensic settings.

I would learn many times over as my career went on that it is always a greater act of compassion to empathize with someone you don’t like.

“All I wanted was to be beautiful.”

But you can’t go back. You can never go back. Never ever, not ever.”

good things happen to good people and bad things happen to bad people. This “just deserts” way of thinking is still prevalent today. It may even explain why some victims become perpetrators, a recurrent theme in forensic work, as we’ve seen.

“The greatest misery in adverse fortune is once to have been happy.”

Within these walls, sorrow, grief, and forgiveness were well understood.

The urgent challenge is to take a hard look at our priorities and prejudices in a justice system and a society where only a few women like Zahra will get the help they need, and only when they literally or metaphorically set themselves on fire.

suicide, the act that stops all conversation.

shame is a powerful motivator of violence, including violence directed at the self.

Shame is such a soul-eating emotion.

The first casualty of obsession or addiction is truth, when people succumb to the dangerous fantasy that they can walk away anytime.

How can you give anyone what you never had?”