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Abstract
As long as things go well with a man, his conscience is lenient and lets the ego do all sorts of things; but when misfortune befalls him, he searches his soul, acknowledges his sinfulness, heightens the demands of his conscience, imposes abstinences on himself and punishes himself with penances. (Freud, 1930)
When psychiatric patients report their own crimes, authentic confessions can easily be attributed to deviant thinking and mistakenly identified as ‘false confessions’. Four examples of pseudo-false confessions of violent crimes are described. Their relationships to specific psychopathological syndromes, and to counter-transference reactions to violent patients, are discussed. Guidelines are offered to clinicians to help them distinguish true confessions from false ones. Ethical and legal issues are reviewed.