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.