What drives someone to commit acts of terrible violence? Drawing on thirty years of experience providing therapy to individuals in prisons and secure hospitals who have committed serious offenses, Dr. Gwen Adshead offers fresh and surprising insights into violence and the human mind. In collaboration with coauthor Eileen Horne, she brings her extraordinary career to life through a series of unflinching portraits. Alongside doctor and patient, readers witness what human cruelty—ranging from serial homicide to stalking, arson, and sexual offenses—means to perpetrators, experiencing firsthand how minds can transform when those often labeled as “evil” take responsibility for their life stories and come to understand themselves. With outcomes spanning hope to despair, denial to recovery, these men and women are revealed in all their complexity and shared humanity. In an era of mass incarceration, deep cuts to mental health care, and extreme social divisions, this book makes a compelling case for compassion over condemnation.