Frank Lachmann in his excellent volume written from a self-psychological perspective, Transforming Aggression: Psychotherapy with the Difficult-to Treat Patient (2000) speculated that serial killers lie outside the boundary of psychoanalytic understanding. Since the phenomenon is fairly rare, there has not been a great deal of psychoanalytic writing and discussion on this highly disturbed type of person. However, as with the case of the schizophrenias, meaning and comprehensibility do not initially present themselves and understanding is rather hard-won. Although, I have not worked directly with these patients, I have had the experience of doing psychotherapy and consultation with patients who have murdered their own children in a paranoid psychotic state. These patients were quite sane after stabilization with meds and psychosocial structure (state psychiatric hospitalization), and I was therefore able to explore with them the psychological processes leading up to their violence.
It seemed to me that Bion’s concept of the psychotic part of the personality (e.g., projection of intolerable mental pain and parts of the self into another as container for the terror) made a great deal of sense. In working with these and similar patients, I found the psychoanalytic approach of Murray Cox, a forensic psychiatrist at Broadmoor Hospital, UK and Shakespeare scholar as well as an ISPS member who unfortunately died prior to our conference in London in 1997, very helpful. He has an insightful article “On the capacity for being inside enough,” written from a Winnicottian perspective and published in Forensic Psychotherapy and Psychopathology edited by Brett Kahr (2001). Also, the psychoanalytic work of Arthur Hyatt-Williams, forensic psychiatrist at Wormwood Scrubs prison, UK and at Tavistock Clinic, is helpful in seeing the relationship between an unmetabolized “death constellation” and random or planned murder/violence. The former term refers to indigestible, uncontained experience dealing with death or its equivalents, e.g. loss of a loved one or of one’s own health, etc. The latter is ubiquitous, and as Bion pointed out the universal nameless dread and fear of death (Winnicott’s “Fear of breakdown”) is transformed and mitigated by the caregivers’ ability to allow it ingress and then contain it in a good enough way.
Hyatt-William’s (1998) Cruelty, Violence, and Murder: Understanding the Criminal Mind, is a good source for his ideas on understanding and treating these individuals from a contemporary post-Kleinian perspective. Leslie Sohn, another post-Kleinian psychiatrist has written on his experience with individuals who have engaged in seemingly random acts of violence from a psychoanalytic perspective. Herbert Rosenfeld's (1987) concept of "destructive narcissism" has also been helpful in understanding these individuals. This concept refers to an idealization of destructive parts of the self and a cruel hatred of libidinal parts which lead to dependence upon an object and linking functions with others as well as within one's own mind (e.g., being able to bring intrapsychically together one's parents in a creative and fruitful union without excessive feelings of envious destructiveness or feeling totally excluded from such a union).
For Bion, the formation of the non-psychotic part of the personality and the beginning of self-containment and the ability to form and tolerate thought (e.g. the thought of one’s own death) is related to a systems competence (self-and other regulatory capacity as a function of the mother-infant dyad as articulated beautifully in the work of such infant researchers as L. Sander, Beatrice Beebe, Ed Tronick etc.) reflected in the capacity to recognize and experience the absence of an object.
However, in order to be capable of experiencing such a state of absence, there must be a part of the mind capable of containing the anxiety of missing an object. It is the caregiver’s containing capacity that helps the child integrate the equivalents of the “death constellation.” Psychoanalysts have identified in these individuals who kill (perhaps as Semrad believed to avert clinical psychosis), a pervasive sense of inner deadness. As Murray Cox’s patient stated, “I took a life because I needed one.” In regard to attachment theory, this inner deadness could be partially attributed to a striking lack in sustaining resonance from selfobjects. One patient said, “I was so left alone, I wasn’t sure if I was alive or not.” An analysis of the role of attachment processes in serial killers and violent patients has been presented in forensic psychologist J. Reid Meloy’s Violent Attachments (1997).
Brian Koehler, PhD
Faculty, Graduate Divisions, New York University and Long Island University
