The Devil You Know: Stories of Human Cruelty and Compassion


Dr Gwen Adshead and Eileen Horne


£16.99, Faber & Faber



Plenty of books have been written by doctors about the challenges of working in the NHS. There is quite rightly much admiration for healthcare professionals working in difficult conditions. Their professional lives are dramatic and exciting. Apart from a few barristers and their celebrity clients there are, however, fewer books written by lawyers with clients’ casebooks. 


Dr Adshead, a forensic psychiatrist and psychotherapist, sets out case histories of various patients who have committed often awful, violent crimes. The author, who has worked at Broadmoor Hospital, prisons and in the community with very challenging patients, tells the case histories of people who society would often regard as ‘monsters’. We are taken into the treatment rooms and on to the wards. The case histories describe some of the issues involved and therapies available. This book is mainly about talking therapy but the mainstay of treatment for most patients is still medication.

The author gives an excellent impression of what it is like to work in a special hospital. You can almost hear the jangling keys and slamming doors. It also raises interesting questions about how we regard serious offenders, why they commit crimes – and if we understand this, can we care better for people who are unwell. Crimes of violence among mentally ill people are a minority.

There is much in here of interest for the practitioner who has clients in the criminal legal system. This book also challenges how we perceive anyone affected by severe mental disorder. As the author states, we can but hope that services improve for everyone. There is an urgent need for more understanding of serious offending.

David Pickup is a partner at Pickup & Scott Solicitors, Aylesbury

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