Managing the unmanageable: psychotherapy in Grendon Prison.

This paper provides an account of some of the organizational and dynamics issues that emerge in a setting that contains and provides psychotherapy to 230 severely personality-disordered and dangerous men. It proposes that in addition to their strategic managerial role, the senior team have an additional task to provide psychodynamic containment for the clinical work of the organization by tracing the journey of dynamics on the clinical factory floor up the organizational structure to the senior team. A conceptualization of this work is proposed, and some implications discussed.