"When I sat down to read this book, I decided to fasten my seat-belt. There are people so desperate that they are willing to commit terrible crimes to get their message across, and there are carers so assaulted that they must put safety before care. Not a book to read before bedtime you might say. However I'm not sure that this is setting the scene correctly, because, when I read it, in addition to the psychopathology of desperation, there is the capacity to reflect on it, and to give despair the meaning it should have, and to do so with a greatly reassuring power."--From the Foreword by Bob Hinshelwood, Member of the British Psychoanalytic Society, Fellow of the Royal College of Psychiatrists and Professor in the Centre for Psychoanalytic Studies, University of Essex, UK "[The book] may stand as an unusually bold and uncompromising example of psychodynamically informed action research and the contribution this can offer, drawing on the intelligence afforded by emotional experience, to the restoring of both meaning and agency. Viewed in this way, the book both speaks to and has a relevance for practitioners, managers and consultants well beyond the boundaries of just one signal enterprise."--From the Afterword by David Armstrong, Principal Consultant at the Tavistock Consultancy Service, the Tavistock and Portman NHS Foundation Trust

In clinical work, an awareness of patients' subjective experiences, particularly their perceptions of interpersonal relationships, is indispensable. The aim of this book is to improve care and treatment planning by describing a structured approach to eliciting patients' core relationship patterns. These patterns consist of the roles and scenarios into which they repeatedly cast themselves and others with whom they interact. Maladaptive patterns, in which vicious cycles and self-fulfilling prophecies of misperception, misunderstanding or provocation escalate, cause pain and havoc in personal relationships and can adversely affect both professionals' decisions and the overall delivery of treatment. This book shows how to use vital information that is often not made available to treatment teams in order to understand such potential pitfalls rather than succumb to them.

...a fascinating read for mental health workers regardless of their own theoretical background. Working with disturbed and disturbing individuals in secure settings produces strong feelings, and working with those feelings is undoubtedly an essential part of providing care effectively. This book is likely to challenge readers' understandings of their own actions and reactions.' (Dr Neil Brimblecombe, Director of Mental Health Nursing, Department of Health, and Nurse Director, Tavistock and Portman NHS Trust.)

In clinical work, an awareness of patients' subjective experiences, particularly their perceptions of interpersonal relationships, is indispensable. The aim of this book is to improve care and treatment planning by describing a structured approach to eliciting patients' core relationship patterns. These patterns consist of the roles and scenarios into which they repeatedly cast themselves and others with whom they interact. Maladaptive patterns, in which vicious cycles and self-fulfilling prophecies of misperception, misunderstanding or provocation escalate, cause pain and havoc in personal relationships and can adversely affect both professionals' decisions and the overall delivery of treatment. This book shows how to use vital information that is often not made available to treatment teams in order to understand such potential pitfalls rather than succumb to them.