The internal world of a murderer can be a complex area, characterized by pain, anger
and separation. The pain of the knowledge of what has been done and the separation
from this and other feelings threaten to overwhelm and annihilate the ego. The
murderer has committed the ultimate crime and is in receipt of the opprobrium of
society and, often, of themselves. The author looks at this phenomenon, illustrating
it with clinical vignettes and considers the parallel process that can occur in
therapists and staff groups. The consequences for staff dynamics are discussed.
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