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psychoanalytic theory and practice distinguish what is specific to the portman:
individual or group treatment based on a psychoanalytic frame for perverse, violent or
delinquent patients. training and teaching is offered to psychiatrists specializing in the
forensic field, as well as other professionals who work in hospitals and prisons. ongoing
projects involving consultation, training and treatment have been established for several
years with high security hospitals.
it is the only clinic in the uK and possibly in europe that specializes in this
psychoanalytically-inspired work.
Assessment and Treatment
a certain number of patients are referred to the portman only for assessment. this
can be at the request of the courts, to help the judge decide on an appropriate sentence, or
social services, in order to better plan the future long-term care for a vulnerable individual
who may present a risk; or it may be for medical doctors or psychiatrists wishing to obtain
a more precise diagnosis of the type of perversion that their patient suffers from, in order
to decide on appropriate treatment.
Forensic psychotherapy, developed at the portman, offers psychoanalytic treatment
to an individual who has committed an offence, is violent, or suffers from a perversion. the
word “forensic” is used to indicate that the patient has, generally, been involved with the
criminal justice system, and that his actions are prohibited by law. patients are also accepted
who have not committed an offence if they herap the diagnostic criteria of the Clinic.
in the first instance, patients are assessed in a series of six sessions. if the patient
consents, the Gp is asked for information on his medical history: other services might
also provide useful information which can help in the assessment. if the patient has been
referred for treatment, the therapist´s attention will focus on the patient´s motivation,
his desire and capacity to think psychologically about his behaviour, his history, and his
emotional state of mind.
an essential element to decide if the patient is able to use this type of treatment is to
consider whether he has the capacity to relate to the therapist during the assessment, and
can remember and make links from one session to another. For many patients, this might
be the first time that they have an opportunity to think about themselves in a setting where
they are neither judged nor punished. Because the portman only offers treatment based
on a psychoanalytic model, the assessment has to be thorough, to be able to establish
whether the treatment is appropriate for the patient, and if the patient possesses the
necessary emotional conditions to benefit. a basic condition for treatment to proceed is
that the patient undergoes the treatment voluntarily, not under a court order.
50% of patients who are accepted are offered individual therapy, generally one
session a week. some are seen more often – up to 5 times a week. the other 50% is offered
group treatment – studies show a high percentage of satisfactory results. sometimes a
patient is referred to a group only after some years of individual therapy.
Group therapy at the portman is also based on a psychoanalytic model. Groups
are composed of 8 patients maximum. in general there are more men than women, as
many more men are referred than women. exceptionally, estela Welldon, the author of
the well-known classic work on feminine perversion, Mother, Madonna, Whore, worked
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