In this volume contemporary staff describe their thinking and clinical work. Theoretical underpinnings for the understanding of perversion and violence, questions of risk and ethics and the institutional difficulties which emerge in the care of these patients are presented alongside chapters on clinical work, with adults and adolescents, including chapters on paedophilia, the compulsive use of internet pornography and transsexuality. This volume is of relevance to all those working with people with a range of personality disorders and those working with individuals who present with these types of problems in the mental health services and in private practice. The Portman Clinic has been applying a psychoanalytic framework to the understanding and treatment of violent, perverse, criminal and delinquent patients since its foundations in the early 1930’s. All Portman Clinic patients have crossed the boundary from fantasy and impulse to action – action which defies legal and moral boundaries but which also breaches the body boundary of the victims.