Dr Gwen Adshead & Eileen Horne: The Devil You Know

This review is written with thanks to Pigeonhole for the opportunity to read and review The Devil You Know.


Serial homicide. Stalking. Arson. Gang crime. Who are the people behind these acts of terrible violence? What are their stories? And what is it like to sit opposite them?

Dr Gwen Adshead is one of Britain’s leading forensic psychiatrists, and she has spent thirty years providing therapy inside secure hospitals and prisons. Whatever her patient’s crime she aims to help them to better know their minds by helping them to articulate their life experience.

Through a collaboration with co-author Eileen Horne, Adshead brings her work to life in these fascinating, unflinching portraits of individuals who newspaper headlines, TV dramas and crime fiction label ‘monsters’. Case by case, Adshead takes us into the treatment room and reveals these men and women in all their complexity and vulnerability. She sheds new light on the unpredictable nature of the therapeutic process as doctor and patient try to find words for the unspeakable. These are stories of cruelty and despair but also of change and recovery.

In a time of increasing polarisation, in the face of overcrowded prisons and devastating cuts to mental health care, Adshead speaks to our shared humanity and makes the case for compassion over condemnation, empathy over fear. The Devil You Know challenges what we think we know about evil. It is a rare book that has the power to change minds


I am fascinated by life in prison and The Devil You Know allows the reader to get a glimpse into this and other aspects of real life crime. Each chapter focuses on an individual patient and this allows us to see in detail what may have led them to commit their crimes and how they are affected by different aspects of the law, such as confidentiality and duty of care. From the outset, we are asked to consider these people not as “evil” but as human beings with their own thoughts, feelings and life stories. Many have spent time in foster care, are victims of childhood abuse or domestic violence, have addiction issues or mental illness. Whilst this in no way means I condone their crimes, it did mean I was able to think about them in a more compassionate way. 

This is a very honest account of Dr Adshead’s work. She frequently pauses to reflect on her own feelings: some clients make her feel uncomfortable, some evoke her sympathy and some are difficult to get to know. Through this, we can see that even as an experienced practitioner, her human nature shines through and it is really interesting to see how this influences, and sometimes impedes, her work. 

I found The Devil You Know incredibly engaging and I looked forward to every stage. I will be thinking about Dr Adshead and her patients for some time to come.

The Devil You Know is available from Amazon.

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