The secluded minds of violent patients

In this paper, I will present two violent patients suffering from severe Personality Disorders, illustrating the changes that can arise during the course of several years' psychoanalytic treatment in high security hospital. Progress was monitored using the Operationalised Psychodynamic Diagnostics (OPD) system. The clinical presentations will indicate how secluded these patients' minds are to themselves and to those involved in their care. The psychoanalytic treatment, as one part of the overall treatment, is described to show how the secluded parts of the patients'' minds can be approached, including references to the regular regressions that arise, provoked by ‘getting better’.