Dr Ronald Doctor

This presentation describes some concepts underpinning forensic psychotherapy, including a theory of a triangular dynamic between patient, psychotherapist and society that was developed by Dr Estela Welldon. The talk explores the countertransference in relation to personality disorder, and how challenging this can be for the clinician, arousing such responses as collusion, disbelief and condemnation and also stirring our own sadism via projective identification. He considers how even the most apparently insane violence has meaning inside the mind of the person who commits it. This is explored in relation to two cases in which the violence erupted through a fragile narcissistic structure that had been attempting to hold the self together. This concept of a narcissistic organisation of the mind, which arises when there is a failure of containment in infancy, is discussed as a means of understanding this fracturing of psychic defenses.

Video lecture with captions – 28 mins

The History of Murder – and the Murder of History

In this detailed theoretical and case-based presentation, Dr Ronald Doctor considers the many-faceted but mostly concealed psychological states and experiences underlying the act of murder. In most cases, killing occurs concretely only after it has been committed many times previously in dreams, nightmares and unconscious fantasies that have never become conscious. Before the deed, conscious efforts – sometimes unconscious too – are designed and devoted to keeping the impulse to murder encapsulated to prevent action. Commonly a sudden reversal takes place internally that breaks the murderousness loose from its cordoned-off status. Ronald Doctor proposes that there is always an underlying psychically traumatic and indigestible experience of loss and death. Using clinical material from two patients who suffered severe loss he explains how they sought refuge: the first in psychosis, and the second in a sado-masochistic retreat.

Video presentation with captions – 52 mins

About the Speaker

Dr Ronald Doctor is a Consultant Psychiatrist in Psychotherapy at West London Mental Health NHS Trust, a member of the British Psychoanalytical Society and the British Psychotherapy Foundation. He is a Clinical Lecturer at Imperial College and has edited two books; Dangerous Patients; psychodynamic approach to risk assessment and management, 2003 and Murder; a psychotherapeutic investigation, 2008.