The management of violent behaviour in mentally-disordered patients is increasingly part of the day-to-day work of psychiatrists and mental health professionals, and violence risk assessment has become a huge industry. Whilst the importance of dynamic, as well as actuarial, risk factors is now recognized, a more systematic approach exploring the psychodynamics in the aetiology, assessment, and treatment of violent behaviour is often lacking.  
Violence is an inherently interpersonal or relational act: there is always a victim and a perpetrator, often in the same person. Rooted in disturbed early relationships, trauma and disordered attachments, violence erupts from failures and distortions of mentalizing, and may represent a communication with unconscious meaning. This talk will present a psychodynamic framework for working with violent patients, focusing on the setting and containment, specific therapeutic interventions, and how to use our emotional reactions, or countertransference, in the assessment of risk.