"I suddenly had a voice" : a qualitative study of patient experiences of violence and treatment in a Dangerous and Severe Personality Disorder (DSPD) unit.

Narratives give direction, purpose and meaning to people’s lives and are a key component in the development of personality. In forensic psychology, violent offending is most often presented as a set of enduring dispositional traits. It is argued, however, that an analysis of narratives may also offer useful insights into what sustains offending and what might lead to change. This review examines the literature on adult offender narratives and their function within correctional cultures and society. It suggests that practitioners may wish to consider incorporating features of what an offender is trying to achieve through their narratives into existing programmes of rehabilitation to ensure future gains are sustained. The implications of this are discussed. This study investigates the personal accounts of patients in a UK Dangerous and Severe Personality Disorder (DSPD) Unit who are engaging in treatment to help them manage their violent / offending behaviour. Ten participants were interviewed and their interviews were analysed using Interpretive Phenomenological Analysis (IPA). Four master themes surfaced: “A dog eat dog world” shows how violence became a legitimate response to early, abusive environments; “No-one really saw that side of me” explores how alterative ways of behaviour were deterred and difficult to relinquish; “Finding a voice” describes participants’ experiences of change and what they see as important components of it; and ‘Fears for the future’ considers the difficulties that still lie ahead. As the DSPD pilot ends, how these experiences might help augment existing clinical treatment programmes are discussed.