History of Murder and the Fear of Death;

Ronald Doctor is proposing that the fear of death is a very compelling and potent feeling that may evoke gross conscious and unconscious acting out behaviour, both in the patient and forensic worker/therapist.  The act of murder occurs concretely in most cases when it has been committed many times previously in daydreams, nightmares and sometimes in unconscious fantasy. However before the deed, conscious and unconscious efforts, such as psychosis and sado-masochism are designed to both restoring the patient’s damaged ego and keeping the murder encapsulation from action.  Then something takes place internally, usually the fear of death, which ruptures and breaks loose the murderousness from its cordoned off status and all the energies of the individual becomes devoted to acting out, or indeed, enacting the murderous deed. The aim of this paper and indeed the function of the analytic process, is to follow the chains of associations as manifested and enacted in the transference and counter-transference to construct the narrative of the patient’s history. However when the fear of death occurs in one’s own counter-transference feelings, massive acting out may occur to counter one’s own threat of death. In this paper Ronald will describe clinical vignettes to show the enormous challenges facing the patient and staff in dealing with the fear of annihilation.  

Ronald Doctor is a Consultant Psychiatrist in Medical Psychotherapy and Forensic Psychotherapy at the West London Mental Health NHS Trust and a Psychoanalyst in private practice. Ronald held the roles of Chair of the Association of Psychoanalytical Psychotherapy in the NHS (APP) and Chair of the NHS Liaison Committee of the British Psychoanalytical Society. He is currently on the Board of the International Association for Forensic Psychotherapy (IAFP) and Hon Clinical Lecturer of Imperial College.  He has edited two books: Dangerous Patients: A Psychodynamic Approach to Risk Assessment and Management (2003) and Murder; A Psychotherapeutic Investigation (2008). My most recent publication is: History, murder and the fear of death, International Journal of Applied Psychoanalytical Studies (2015) 12.2 152-160.

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