Unconscious fantasies: from the couch to the court.
H. Bloom and G. A. Awad,
Bull. Amer. Acad. Psychiatry & the Law
19(2): 119-30, 1991.
No single unifying theory exists that explains the plethora of behaviors that bring individuals before
the courts on a daily basis. No biological, social, or familial model for criminal behavior is without
limitations, or exempt from controversy and criticism. We suggest, however, that it is appropriate,
and often necessary, for the psychiatric expert to advance lucid, intelligible, and simplified
psychodynamic formulation, either alone or in conjunction with another explanatory model of
criminal behavior, to assist the court in its understanding and disposition of a given case. In some
cases, apparent criminal behaviors result when unconscious motivating factors, particularly
unconscious fantasies, find expression in conscious life. In this article, we consider the etiologic role
of unconscious fantasy in certain seemingly inexplicable criminal behaviors. The concept of
unconscious fantasy is explained and a detailed case description and formulation are provided in
order to illustrate the central role of unconscious fantasy in some of these behaviors.
Recommendations are offered for the manner in which psychodynamic formulation should be
presented in reports and in courtroom testimony through reference to the author's experience.