HOW do people come to commit violent and life-threatening acts? Some think such people are innately bad, calling them “monsters” or “e”. It is a view that William Shakespeare encapsulated in The Tempest when Prospero says of Caliban that he is “a born devil, on whose nature nurture can never stick”. But Gwen Adshead doesn’t accept that view. She has spent her career working as a psychotherapist with offenders in prisons and secure psychiatric hospitals, including Broadmoor Hospital, where some of the UK’s most notorious criminals are detained. Rather than seeing violent offenders as being innately evil, she thinks of her patients as survivors of a disaster – where they are the disaster and she is the first responder.
Adshead has published many academic papers and books on criminal mental health. Now, in collaboration with the dramatist Eileen Horne, she has written her first book for a popular audience. It consists of a mosaic of case studies drawn from the many people she has treated over the years. In it, Adshead debunks myths about violent offenders, argues for compassion over condemnation and says that with good mental health care, recovery is possible.
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Rowan Hooper: You called your book The Devil You Know. Are you saying that we are all capable of evil deeds?
Gwen Adshead: That’s very much where we’re coming from. I became interested in this while working as a therapist and listening to what people who’d done terrible things had to say. These offenders were familiar to me. They were not the “monsters” that I’d read about in the newspaper. They often seemed to be people who were sad and disorganised, and frightened as much as frightening.
It is my very firm conviction that we all have the capacity to get into states of mind that we might call evil. It’s better that we understand those aspects of ourselves. In fact, the more we know about our own inner devils, the better able we are to act in ways that might help people and help ourselves.
Which aspects should we be wary of?
The risk factors for violence include very general things, like being young and male, which are not much help, really, in terms of assessment or intervention. But also more specific kinds of risk factors that could be additive. If you add in substance misuse, if you add in some kinds of paranoid mental illness and then if you add in extreme exposure to childhood trauma, without any support, then you can get to a situation where all these risk factors pile in and generate a level of stress.
The last risk factor that unleashes the violence is often something rather specific to the offender. It can be something that the victim does – which is in no way to blame the victim for what happens – but it may be that the victim doesn’t realise that what they’re doing or saying is having a very specific psychological impact on the perpetrator, who then acts violently.
How important is childhood experience in subsequent violent behaviour?
We really have to take childhood adversity seriously, because there’s such a solid evidence base for that now. , for example, found that nearly 50 per cent of prisoners in HMP Parc [a prison for men and young offenders in south Wales] had been exposed to a very high level of childhood adversity, which was about five times what you’d expect compared with the general population.
“These offenders are not the ‘monsters’ we read about in newspapers”
Of course, most victims of trauma will not go on to be violent. It may be that very high levels of childhood adversity – particularly some kinds of adversity, like physical abuse and neglect – can be risk factors for significant violence if they then get combined with substance misuse and serious mental illness or serious mental disorganisation.
What is your take on the role of genetics in violence?
It’s absolutely clear from the research, over and over again, that nature and nurture interact. The interaction of an environment with a genetic vulnerability can then change that gene to express itself in different ways. But we have no genes for violence. Behaviours arise from the human mind and the journey from synaptic activity to the decision to kill somebody is a very long one.
After decades working with violent criminals, what is your view of human nature?
My view is very much that we have the capacity for goodness, and that is something that has to be worked on, as much as the capacity for cruelty has to be managed and minimised. Most offenders, once they’ve done something horrible, are keen to learn from what they’ve done, get themselves into a situation where they’re not going to be a risk again and go out and have the usual things that everybody likes. Which is a roof over their heads, someone to love and something useful to do. And those three things are pretty much important to all human beings, and most violent offenders are not exceptions.
How does your viewpoint differ from that of others?
We’re fighting against a minority, but one with a loud voice, which says, “no, we don’t want to understand, we want to punish and we want to take revenge”. While I completely understand the emotions behind that position, I think that it’s probably not feasible or workable in the long term. It’s in all our interests that people who have offended get some help to become safer, in terms of not only their mental health, but in terms of their risk to others.
What form does your help take?
I see the mind as a coral reef: ancient, layered and mysterious. My method is simple at one level: I start a dialogue with my patients and provide a space for reflection. But dealing non-judgementally and listening compassionately to people who have committed terrible crimes is by no means easy. The aim, through many sessions of therapy, is to discover the idiosyncrasy at the heart of each person’s crime – the particular part of their history and identity that has pushed them into what is often called “e”. I have found that articulating their experience helps many of my patients change and recover. They are able to leave secure psychiatric care and return to prison, and in some cases can be rehabilitated into society.
Media coverage of violent crime might leave people thinking that it is on the rise. Is it?
Every homicide is a tragedy and a disaster, so it’s quite right that every one is brought to public attention, and there’s a proper public mourning and a proper public concern. Nevertheless, homicide is a very rare event, and a quite unusual way for human beings to break the law. A study published in April shows that homicide rates in England and Wales have – at . In fact, in most countries that have organised social democracies, rates of violence have been falling. Even in prison, violent perpetrators are not the norm, constituting only between 20 and 30 per cent of prison inmates.
What motivated you to write your book?
It is an invitation to come and see a world that people don’t often want to look at. The world after the judge has sentenced, after the jail doors have shut, after people have been admitted to a secure setting. I want people to come and see what I see and to learn what I’ve learned. There is real potential for change and rehabilitation.
