The process of therapy requires that the therapist become intimate with not only the patient's conscious and unconscious worlds, but with the role of the victim in these worlds. The extreme nature of some of the material will make treatment taxing for the therapist, but the therapist must also act as an agent of healing and change. It is only through a re-examination of the origins of destructiveness and the reworking of its mode of expression that healing can occur. Of utmost importance is the symbolic meaning of the killing. Some issues that should be addressed in this connection are who the victim represents in the patient's early relationships, what experiences within those relationships were being re-enacted, and what particular circumstances provoked such a fatal repetition at the exact time that they did. The discussion of the management and treatment of the murderer focuses on case studies of remanded offenders. Some of the topics discussed are assessment, the patient's forgetting and remembering, treatment, guilt and the importance of punishment, and the hospital setting.