Crazy or what?

It seems appropriate in this week of World Mental Health Day that I have been reading The Devil You Know - Stories of Human Cruelty and Compassion by Dr Gwen Adshead, psychiatrist in Broadmoor – a high security mental Hospital about five miles from where we live. Broadmoor houses some of the most dangerous prisoners in the country. There are a few women imates but they are mostly men who have committed the most heinous crimes – murder and serial killing, sex offences and other violent crimes sometimes involving extreme cruelty towards children including murder.

Adshead tells eleven fictionalised accounts based on true stories of patients with whom she has worked and narrates the various strategies she uses. ‘Strategies’ may be the wrong word because it implies some sort of de-personalisation of the men and women she works with whom many of us would see as evil monsters. Her goal is to connect with them in such a way that they can see possibilities for change in their own lives, lives which have been blighted in some cases by one impulsive act under the influence of drink or drugs or their own extreme anger.

She talks about developing ‘a radical kind of empathy’ with them and invites her readers to take a deep dive with her into minds where she maintains criminals’ dark stories hold ‘much enlightenment’. She has developed the skill, it seems, to listen to other people’s stories in a way that allows her to hear and learn from the human being beneath all the distortion of poverty, deprivation and loss which is the background of most of the criminals in her care. Most of them are ‘hard nuts’, highly defended against any sort of therapeutic help. Some of them are highly manipulative. Many are traumatized either by others’ treatment of them or by what they have done. Others have disassociated themselves from what they have done, unwilling to face the pain and guilt. In some cases disassociation means they have forgotten what they have done and are surprised when slowly it comes back to them. Trust of another human being is something they know little or nothing about.

I haven’t finished the book yet! I have to take it slowly because some of the details are gruesome. I am in awe of Adshead’s professional knowledge and skills. She has deep knowledge of forensic psychiatry, of the criminal mind, profound understanding of the roots and nature of violence and of so many other areas of behaviour. It makes the less specialised psychotherapy training that I did feel kind of rudimentary!

And yet the business of listening is familiar and common to both and learning to do it properly is as fascinating to me today as it always was. Radical listening without judgement, unconditional positive regard, curiosity and willingness to learn what it feels like to be in someone else’s skin, deep knowledge about one’s own humanity with its flaws and frailty alongside caution about comparing one’s own humanity to theirs and so much more.  

And beneath it all, Adshead expresses a profound belief that I want to hold on to, however difficult it is  – that if we lose sight of our common humanity as the quality that connects us to even the worst offenders, and those who perpetrate the worst corporate political and humanitarian crimes, there is no way forward for the human race.

In the introduction to Adshead’s book there is a profound quotation from one of Carl Jung’s letters to Sigmund Freud: ‘The reason for evil in the world is that people are not able to tell their stories.’

So much begins with honest storytelling and skilled listening. Some of us are not able to tell our stories because we know we won’t be heard. Others are not able to tell their stories because we are not willing or able to listen to them. It sounds simple, doesn’t it? We may not all have Dr Ahdshead’s skills or gifts but we can learn to listen to each other better. It’s a route to improved mental health for us all.