The subspecialty of forensic psychotherapy is a relatively young one. However, the tradition of psychotherapeutic approaches to understanding violence and aggression, which underpin much of the theory and practice in this field, has a much longer history.

Working with Violence is a recent addition to the ‘Basic Texts in Counselling and Psychotherapy’ series, aimed at an ‘introductory level’ for students and practitioners across a range of disciplines. The opening chapters – covering basic psychodynamic and analytical ideas and introducing relevant clinical concepts, such as psychosis and personality disorder – achieve this in a concise and readable manner. Yakeley introduces the concept of violence as a form of communication (conscious or unconscious) and the central idea that within every violent individual resides both a perpetrator and a victim. One of the book's greatest strengths is that it sets out to complement, rather than replace or refute, alternative theories of violence. Psychological theories – such as attachment and internalisation of transactional patterns – are integrated with findings from other disciplines, including epidemiology, criminology and forensic psychiatry. In approaching this task the book is well structured, each chapter opening with an up-to-date commentary on the topic in question and using clinical vignettes to good effect in bringing these concepts to life.

One chapter which departs from this format – and offers relatively little from other disciplines to place the material in context – is that which covers the links between violence, sexuality and perversion. This chapter begins with the bold assertion that, ‘Aggression plays an integral part in all sexual activity’, and goes on to explore this assertion in wholly psychoanalytic terms. It was in relation to this chapter that our opinions diverged. We felt it likely that some readers will find the discussion of these powerful, complex (and not uncontroversial) ideas too esoteric, whereas others will find it is in understanding this mode of violence that psychoanalytic ideas are of greatest use.

Irrespective of this caveat, there is much to be learned from this book. The chapter covering ‘violence and society, race and culture’ is particularly good. Here Yakeley provides an excellent account of the multifactorial nature of societal violence, including systemic ideas of the different levels (or layers) of influence over an individual or group in the ‘real world’, along with a discussion of how such influences can be internalised and erupt in extremes of violence. It would have been interesting, perhaps, to see this comprehensive approach further explored in other sections of the book, dealing with the causes of individual, interpersonal violence (in which such ‘external’ factors are also likely to play a significant role).

The later chapters, covering practical issues of managing and working with violent individuals, are similarly pragmatic in tone. The chapter on working in secure forensic settings gives a helpful insight into issues of ‘containment’ and treating the ‘institutional sickness’ of such places (perhaps the real work of the forensic psychotherapist). Likewise, the chapters dedicated to individual and group psychotherapy for violence are pleasingly focused on the practical elements of such work, including an emphasis on awareness of risk and safety.

We would recommend this book as a useful aid for practitioners working in the field of forensic mental health, as well as for psychiatric trainees with an interest in forensic psychiatry or psychotherapy. The concise text and generally practical focus, which places psychoanalytic concepts alongside more mainstream approaches, will help to make sense of the actions of the violent ‘offender-patient’ and assist with the challenge of engaging such individuals in a safe, boundaried and empathic manner.