Affiliated member of the WPA – World Psychiatric Association

Abstract Harding, Duncan; Chan, Christine; Doctor, Ronald

The Knife Examined – A social and psychoanalytic discourse on the rising rates of knife-related crimes committed by adolescents in London, UK

In the year ending March 2018, there were around 40,100 offences involving a knife or bladed article in England and Wales, with around 14,700 in London – the highest number over the last 10 years. ‘Juveniles’ aged 10-17 were the offenders in 21% of the 21,044 cases in which court disposals were issued for possession of a knife or an offensive weapon.

In this workshop, we discuss the London knife-crime epidemic from the dual perspectives of Psychiatry and Psychoanalysis. In particular, we consider how an act of violence involving knives affects its ‘victims’, and how the nature of its invasion into these clinicians’ psyche may influence their clinical practice. We examine from psychoanalytic perspectives, how violence involving knives can be seen as distinct and different from that involving the use of other weapons. The anatomy of a knife typically consists of a handle and a blade – the blade being the penetrating object. The victim is required to be within arm’s length for the act to take place, which is viscerally felt by both as a violently penetrative act into the victim. In this way, there is a libidinization and excitement involving a violent phallic object that is akin to that involved in sexual perversions.

We consider how these theoretical constructs may help us with facets of care for this group of young offenders amidst wider factors in society’s response. We also examine how they may influence our views on ‘offender’ autonomy and responsibility, and how our responses can become split between the ‘compassionate’, which views the adolescent as a victim of trauma, and the ‘punitive’, which views the adolescent as a dangerous criminal to be locked away.

Dr C. Chan, West London Mental Health Trust, is a Specialty Trainee in Psychotherapy and General Adult Psychiatry in West London Mental Health Trust. She has worked in a range of acute mental health services across London with a particular interest in the treatment of Personality Disorders, a subject she has also lectured in. She previously organised a conference around the role of the psychiatrist in wider socio-political conflicts. She has also published primary research on psychological wellbeing and is passionate about supporting the wellbeing of doctors through frameworks such as Balint groups and peer mentorship.

Dr D. Harding, South London and Maudsley NHS Foundation Trust, is an NHS consultant in child and adolescent forensic psychiatry, and is currently the clinical lead for two specialist adolescent forensic services at the Maudsley Hospital: South London Forensic CAMHS and the Forensic Medico-Legal service for Young People.  Dr Harding has appeared as an expert witness at the Old Bailey, providing his opinion on a range of serious crime issues such as homicide, rape and terrorism. He has worked at Broadmoor Hospital and in a variety of other forensic settings including prison, medium-secure and in the community. He is a visiting lecturer at King’s College London with a research interest in criminal psychopathy, and is principal investigator for two active research projects on the NIHR portfolio. He has published two books with Oxford University Press, the Deconstruction series, the first of which was shortlisted for book of the year at the BMA Medical Book Awards 2015.

Dr R. Doctor, West London Mental Health Trust, is a Consultant Psychiatrist in Medical Psychotherapy and Forensic Psychotherapy, West London Mental Health NHS Trust, a Fellow of the British Psychoanalytical Society, member of the IPA committee of Psychoanalysis and Law, board member of the International Association for Forensic Psychotherapy, and Hon. Clinical Lecturer, Imperial College, London.  He has edited two books: Dangerous Patients: A Psychodynamic Approach to Risk Assessment and Management (2003) and Murder; a Psychotherapeutic Investigation (2008) and published History, murder and the fear of death, International Journal of Applied Psychoanalytical Studies (2015) 12.2 152-160.


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