Understanding the religious ideation of forensically committed patients.

Abstract

Clinicians working with forensically committed, mentally ill patients are often confronted with a wide variety of religious ideation. This article is designed to help clinicians think therapeutically and psychoanalytically about such material, with a focus on understanding the latent meanings of religious ideation and its relationship to forensic or precursor issues. Case material and conceptualizations are offered to enhance an understanding of the following functions of religious ideation: (a) religious delusions as motivations for violence; (b) religious distortions as justifications for violence; (c) religious ideas as expressions of intrapsychic dynamics; and (d) authentic religious beliefs as defenses and resources. It is suggested that working directly with religious material can be an avenue to deeper understanding of the patient's psychic life and thus a path toward therapeutic growth and change.

Murder and psychosis: Neuropsychological profiles of homicide offenders with schizophrenia

“…For the supplementary analyses, the sample was divided according to the presence or absence of God/Satan/demon‐themed psychotic content (Silva et al, ; Kunst, ), as nine (36%) of our sample had such symptoms compared with a figure established in a large nonoffender sample with psychosis of 6% (Atallah et al, ). We compared our God/Satan/demon (GSD) and non‐God/Satan/demon (NGSD; n = 16) groups on neurocognitive test performance, psychopathy scores, and clinical and criminological variables.…”

“…Of these risk factors, psychosis, generally, has been associated with a 49–68% increased risk for violence (Douglas et al, ). Specific psychotic symptoms, including persecutory delusions (Bjørkly, ), threat control/override symptoms (Link et al, ), specific command hallucinations (Bjørkly, ; Shawyer et al, ) and Satan/antichrist/demon‐ or God‐themed delusions (Silva et al, ; Kunst, ) are thought to contribute to violence by people with schizophrenia. Despite this large body of literature, there is still controversy over links between schizophrenia and violence because of concerns they stigmatise the mentally ill.…”

Excessive violence and psychotic symptomatology among homicide offenders with schizophrenia

“…Krakowski et al, 1999;Joyal et al, 2004, for a review see Bjorkly, 2002a), passivity delusions (Taylor, 1999), 'threat/controloverride' symptoms (Swanson et al, 1996;Link et al, 1998;Hodgins et al, 2003), religious delusions or ideation (e.g. Maas et al, 1984;Kunst, 1999), and delusional misidentifi cation syndromes (e.g. Silva et al, 1996).…”