Although psychoanalysis has been preoccupied with the nature of aggression and destructiveness since Freud, until recently very little has been written about the psychoanalytic understanding of actual violence. Similarly, although most psychoanalysts and psychotherapists are familiar with the murderousness and violent fantasies in the patients they see in their clinical practice, few will see patients who act on their fantasies to become violent. In the last two decades, however, there has been increased interest in the psychoanalytic understanding and treatment of violent and delinquent patients, patients with a history of criminality and those who enact sexual violence and other perversions in which violence is inherent. This parallels the increasing interest in psychoanalytically informed treatments for people with severe character pathology, such as those patients diagnosed with borderline or antisocial personality disorders who constitute an increasing proportion of the patient population referred to psychiatrists and therapists for help.
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