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Home , Imprisonment, Prison, Social status

The Psychological Impact of Incarceration: Implications for Post- Adjustment

Craig Haney, University of California-Santa Cruz

This paper was produced for a conference funded by the U.S. Department of and Services on January 30-31, 2002. The views expressed herein are those of the authors, and should not be attributed to the U.S. Department of Health and Human Services, or the Urban Institute, its trustees, or its funders.

The Psychological Impact of Incarceration: Implications for Post-Prison Adjustment

Abstract Moreover, prolonged adaptation to the depriva- tions and frustrations of life inside prison—what This paper examines the unique of psy- are commonly referred to as the “pains of im- chological changes that many are prisonment”—carries a certain psychological forced to undergo in order to survive the prison cost. In this brief paper I will explore some of experience. It argues that, as a result of several those costs, examine their implications for post- trends in American , the personal prison adjustment in the world beyond prison, challenges posed and psychological harms in- and suggest some programmatic and policy- flicted in the course of incarceration have grown oriented approaches to minimizing their poten- over the last several decades in the United tial to undermine or disrupt the transition from States. The trends include increasingly harsh prison to home. policies and conditions of confinement as well as the much discussed de-emphasis on rehabili- One important caveat is important to make tation as a goal of incarceration. As a result, the at the very outset of this paper. Although I ap- ordinary adaptive process of institutionalization proach this topic as a psychologist, and much of or “prisonization” has become extraordinarily my discussion is organized around the themes of prolonged and intense. Among other things, psychological changes and adaptations, I do not these recent changes in prison life mean that mean to suggest or imply that I believe criminal prisoners in general (and some prisoners in par- behavior can or should be equated with mental ticular) face more difficult and problematic tran- illness, that persons who suffer the acute pains sitions as they return to the freeworld. A range of necessarily manifest psycho- of structural and programmatic changes are re- logical disorders or other forms of personal pa- quired to address these issues. Among other thology, that psychotherapy should be the exclu- things, social and psychological programs and sive or even primary tool of prison resources must be made available in the imme- rehabilitation, or that therapeutic interventions diate, short, and long-term. That is, modified are the most important or effective ways to op- prison conditions and practices as well as new timize the transition from prison to home. I am programs are needed as preparation for release, well aware of the excesses that have been com- during transitional periods of or initial re- mitted in the name of correctional psychology in integration, and as long-term services to insure the past, and it is not my to contribute continued successful adjustment. in any way to having them repeated. This paper addresses the psychological im- The paper will be organized around several pact of incarceration and its implications for basic propositions—that have become post-prison freeworld adjustment. Nearly a half- more difficult places in which to adjust and sur- century ago Gresham Sykes wrote that “life in vive over the last several decades; that especially the maximum security prison is depriving or in light of these changes, adaptation to modern frustrating in the extreme,”1 and little has prison life exacts certain psychological costs of changed to alter that view. Indeed, as I will sug- most incarcerated persons; that some groups of gest below, the observation applies with perhaps people are somewhat more vulnerable to the more force now than when Sykes first made it. pains of imprisonment than others; that the psy-

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chological costs and pains of imprisonment can fectively documented—the U.S. rates have con- serve to impede post-prison adjustment; and that sistently been between four and eight times there are a series of things that can be done both those for these other nations.3 in and out of prison to minimize these impedi- ments. Each of these propositions is presented in The combination of overcrowding and the turn below. rapid expansion of prison systems across the country adversely affected living conditions in many prisons, jeopardized safety, com- I. The of the Prisons promised prison management, and greatly lim- ited prisoner access to meaningful programming. Prisoners in the United States and else- The two largest prison systems in the nation— where have always confronted a unique set of California and —provide instructive ex- contingencies and pressures to which they were amples. Over the last 30 years, California’s pris- required to react and adapt in order to survive oner population increased eightfold (from the prison experience. However, over the last roughly 20,000 in the early 1970s to its current several decades —beginning in the early 1970s population of approximately 160,000 prisoners). and continuing to the present time—a combina- Yet there has been no remotely comparable in- tion of forces have transformed the nation’s crease in funds for prisoner services or inmate criminal system and modified the nature programming. In Texas, over just the years be- of imprisonment.2 The challenges prisoners now tween 1992 and 1997, the prisoner population face in order to both survive the prison experi- more than doubled as Texas achieved one of the ence and, eventually, reintegrate into the free- highest incarceration rates in the nation. Nearly world upon release have changed and intensified 70,000 additional prisoners added to the state’s as a result. prison rolls in that brief five-year period alone. Not surprisingly, California and Texas were Among other things, these changes in the among the states to face major lawsuits in the nature of imprisonment have included a series of 1990s over substandard, unconstitutional condi- inter-related, negative trends in American cor- tions of confinement. Federal courts in both rections. Perhaps the most dramatic changes states found that the prison systems had failed to have come about as a result of the unprece- provide adequate treatment services for those dented increases in rate of incarceration, the size prisoners who suffered the most extreme psy- of the U.S. prison population, and the wide- chological effects of confinement in deteriorated spread overcrowding that has occurred as a re- and overcrowded conditions.4 sult. Over the past 25 years, penologists repeat- edly have described U.S. prisons as “in crisis” Paralleling these dramatic increases in in- and have characterized each new level of over- carceration rates and the numbers of persons im- crowding as “unprecedented.” By the start of the prisoned in the United States was an equally 1990s, the United States incarcerated more per- dramatic change in the rationale for prison itself. sons per capita than any other nation in the mod- The nation moved abruptly in the mid-1970s ern world, and it has retained that dubious dis- from a that justified putting people in tinction for nearly every year since. The prison on the basis of the that incarcera- international disparities are most striking when tion would somehow facilitate productive re- the U.S. incarceration rate is contrasted to those entry into the freeworld to one that used impris- of other nations to whom the United States is of- onment merely to inflict pain on wrongdoers ten compared, such as Japan, Netherlands, Aus- (“just deserts”), disable criminal offenders tralia, and the United Kingdom. In the 1990s, as (“incapacitation”), or to keep them far away Marc Mauer and the Sentencing Project have ef- from the rest of society (“containment”). The abandonment of the once-avowed goal of Papers prepared for the "From Prison to Home" Conference (January 30-31, 2002) 78 The Psychological Impact of Incarceration: Implications for Post-Prison Adjustment C. Haney

donment of the once-avowed goal of rehabilita- and the social costs of incarceration becoming tion certainly decreased the perceived need and increasingly concentrated in minority communi- availability of meaningful programming for ties (because of differential enforcement and prisoners as well as social and sentencing policies). services available to them both inside and out- Thus, in the first decade of the 21st century, side the prison. Indeed, it generally reduced con- more people have been subjected to the pains of cern on the part of prison administrations for the imprisonment, for longer periods of time, under overall well-being of prisoners. conditions that threaten greater psychological The abandonment of rehabilitation also re- distress and potential long-term dysfunction, and sulted in an erosion of modestly protective they will be returned to communities that have norms against cruelty toward prisoners. Many already been disadvantaged by a lack of social corrections officials soon became far less in- services and resources. clined to address prison disturbances, tensions between prisoner groups and factions, and disci- plinary infractions in general through ameliora- II. The Psychological Effects of tive techniques aimed at the root causes of con- Incarceration: On the Nature of flict and designed to de-escalate it. The rapid Institutionalization influx of new prisoners, serious shortages in The adaptation to imprisonment is almost staffing and other resources, and the embrace of always difficult and, at times, creates habits of an openly punitive approach to corrections led to thinking and acting that can be dysfunctional in the “de-skilling” of many correctional staff periods of post-prison adjustment. Yet, the psy- members who often resorted to extreme forms of chological effects of incarceration vary from in- prison discipline (such as punitive isolation or dividual to individual and are often reversible. “supermax” confinement) that had especially de- To be sure, then, not everyone who is incarcer- structive effects on prisoners and repressed con- ated is disabled or psychologically harmed by it. flict rather than resolving it. Increased tensions But few people are completely unchanged or un- and higher levels of fear and danger resulted. scathed by the experience. At the very least, The emphasis on the punitive and prison is painful, and incarcerated persons often stigmatizing aspects of incarceration, which has suffer long-term consequences from having been resulted in the further literal and psychological subjected to pain, deprivation, and extremely isolation of prison from the surrounding com- atypical patterns and norms of living and inter- munity, compromised prison visitation programs acting with others. and the already scarce resources that had been The empirical consensus on the most nega- used to maintain ties between prisoners and their tive effects of incarceration is that most people families and the outside world. Support services who have done time in the best-run prisons re- to facilitate the transition from prison to the turn to the freeworld with little or no permanent, freeworld environments to which prisoners were clinically-diagnosable psychological disorders as returned were undermined at precisely the mo- a result.5 Prisons do not, in general, make people ment they needed to be enhanced. Increased sen- “crazy.” However, even researchers who are tence length and a greatly expanded scope of in- openly skeptical about whether the pains of im- carceration resulted in prisoners experiencing prisonment generally translate into psychologi- the psychological strains of imprisonment for cal harm concede that, for at least some people, longer periods of time, many persons being prison can produce negative, long-lasting caught in the web of incarceration who ordinar- change.6 And most people agree that the more ily would not have been (e.g., drug offenders),

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extreme, harsh, dangerous, or otherwise psycho- people first enter prison, of course, they find that logically-taxing the nature of the confinement, being forced to adapt to an often harsh and rigid the greater the number of people who will suffer institutional routine, deprived of privacy and lib- and the deeper the damage that they will incur.7 erty, and subjected to a diminished, stigmatized status and extremely sparse material conditions Rather than concentrate on the most ex- is stressful, unpleasant, and difficult. treme or clinically-diagnosable effects of im- prisonment, however, I prefer to focus on the However, in the course of becoming institu- broader and more subtle psychological changes tionalized, a transformation begins. Persons that occur in the routine course of adapting to gradually become more accustomed to the re- prison life. The term “institutionalization” is strictions that institutional life imposes. The used to describe the process by which inmates various psychological mechanisms that must be are shaped and transformed by the institutional employed to adjust (and, in some harsh and dan- environments in which they live. Sometimes gerous correctional environments, to survive) called “prisonization” when it occurs in correc- become increasingly “natural,” second nature, tional settings, it is the shorthand expression for and, to a degree, internalized. To be sure, the the negative psychological effects of imprison- process of institutionalization can be subtle and ment. The process has been studied extensively difficult to discern as it occurs. Thus, prisoners by sociologists, psychologists, psychiatrists, and do not “choose” do succumb to it or not, and few others, and involves a unique set of psychologi- people who have become institutionalized are cal adaptations that often occur—in varying de- aware that it has happened to them. Fewer still grees—in response to the extraordinary demands consciously decide that they are going to will- of prison life. In general terms, the process of ingly allow the transformation to occur. prisonization involves the incorporation of the The process of institutionalization is facili- norms of prison life into one’s habits of think- tated in cases in which persons enter institutional ing, feeling, and acting. settings at an early age, before they have formed It is important to emphasize that these are the ability and expectation to control their own the natural and normal adaptations made by life choices. Because there is less tension be- prisoners in response to the unnatural and ab- tween the demands of the and the normal conditions of prisoner life. The dysfunc- autonomy of a mature adult, institutionalization tionality of these adaptations is not “pathologi- proceeds more quickly and less problematically cal” in nature (even though, in practical terms, with at least some younger inmates. Moreover, they may be destructive in effect). They are younger inmates have little in the way of already “normal” reactions to a set of pathological con- developed independent judgment, so they have ditions that become problematic when they are little if anything to revert to or rely upon if and taken to extreme lengths, or become chronic and when the institutional structure is removed. And deeply internalized (so that, even though the the longer someone remains in an institution, the conditions of one’s life have changed, many of greater the likelihood that the process will trans- the once-functional but now counterproductive form them. patterns remain). Among other things, the process of institu- Like all processes of gradual change, of tionalization (or “prisonization”) includes some course, this one typically occurs in stages and, or all of the following psychological adapta- all other things being equal, the longer someone tions: is incarcerated the more significant the nature of the institutional transformation. When most

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A. Dependence on institutional structure ent on external constraints that they gradually and contingencies. lose the capacity to rely on internal and self-imposed personal limits to guide their Among other things, penal re- actions and restrain their conduct. If and when quire inmates to relinquish the freedom and this external structure is taken away, severely autonomy to make their own choices and deci- institutionalized persons may find that they no sions and this process requires what is a painful longer know how to do things on their own, or adjustment for most people. Indeed, some peo- how to refrain from doing those things that are ple never adjust to it. Over time, however, pris- ultimately harmful or self- destructive. oners may adjust to the muting of self-initiative and independence that prison requires and be- come increasingly dependent on institutional B. Hypervigilance, interpersonal distrust contingencies that they once resisted. Eventually and suspicion. it may seem more or less natural to be denied In addition, because many prisons are significant control over day-to-day decisions clearly dangerous places from which there is no and, in the final stages of the process, some in- exit or escape, prisoners learn quickly to become mates may come to depend heavily on institu- hypervigilant and ever-alert for signs of threat or tional decisionmakers to make choices for them personal risk. Because the stakes are high, and and to rely on the structure and schedule of the because there are people in their immediate en- institution to organize their daily routine. Al- vironment poised to take advantage of weakness though it rarely occurs to such a degree, some or exploit carelessness or inattention, interper- people do lose the capacity to initiate behavior sonal distrust and suspicion often result. Some on their own and the judgment to make deci- prisoners learn to project a tough veneer sions for themselves. Indeed, in extreme cases, that keeps all others at a distance. Indeed, as one profoundly institutionalized persons may be- prison researcher put it, many prisoners “believe come extremely uncomfortable when and if their that unless an inmate can convincingly project previous freedom and autonomy is returned. an image that conveys the potential for violence, A slightly different aspect of the process he is likely to be dominated and exploited 8 involves the creation of dependency upon the throughout the duration of his .” institution to control one’s behavior. Correc- McCorkle's study of a maximum security tional institutions force inmates to adapt to an Tennessee prison was one of the few that at- elaborate network of typically very clear tempted to quantify the kinds of behavioral boundaries and limits, the consequences for strategies prisoners report employing to survive whose violation can be swift and severe. Prisons dangerous prison environments. He found that impose careful and continuous , and “[f]ear appeared to be shaping the life-styles of are quick to punish (and sometimes to punish many of the men,” that it had led over 40% of severely) infractions of the limiting rules. The prisoners to avoid certain high risk areas of the process of institutionalization in correctional set- prison, and about an equal number of inmates tings may surround inmates so thoroughly with reported spending additional time in their cells external limits, immerse them so deeply in a as a precaution against victimization. At the network of rules and regulations, and accustom same time, almost three-quarters reported that them so completely to such highly visible sys- they had been forced to “get tough” with another tems of constraint that internal controls atrophy prisoner to avoid victimization, and more than a or, in the case of especially young inmates, fail quarter kept a “shank” or other weapon nearby to develop altogether. Thus, institutionalization with which to defend themselves. McCorkle or prisonization renders some people so depend- found that age was the best predictor of the type

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of adaptation a prisoner took, with younger pris- D. Social withdrawal and isolation. oners being more likely to employ aggressive Some prisoners learn to find safety in social avoidance strategies than older ones. invisibility by becoming as inconspicuous and unobtrusively disconnected from others as pos- C. Emotional over-control, alienation, sible. The self-imposed social withdrawal and and psychological distancing. isolation may mean that they retreat deeply into themselves, trust virtually no one, and adjust to Shaping such an outward image requires prison stress by leading isolated lives of quiet emotional responses to be carefully measured. desperation. In extreme cases, especially when Thus, prisoners struggle to control and suppress combined with prisoner apathy and loss of the their own internal emotional reactions to events capacity to initiate behavior on one's own, the around them. Emotional over-control and a gen- pattern closely resembles that of clinical depres- eralized lack of spontaneity may occur as a re- sion. Long-term prisoners are particularly vul- sult. Admissions of vulnerability to persons in- nerable to this form of psychological adaptation. side the immediate prison environment are Indeed, Taylor wrote that the long-term prisoner potentially dangerous because they invite exploi- “shows a flatness of response which resembles tation. As one experienced prison administrator slow, automatic behavior of a very limited kind, once wrote: “Prison is a barely controlled jungle and he is humorless and lethargic.”11 In fact, where the aggressive and the strong will exploit the weak, and the weak are dreadfully aware of Jose-Kampfner has analogized the plight of long-term women prisoners to that of persons it.”9 Some prisoners are forced to become re- who are terminally-ill, whose experience of this markably skilled “self-monitors” who calculate “existential death is unfeeling, being cut off the anticipated effects that every aspect of their from the outside… (and who) adopt this attitude behavior might have on the rest of the prison 12 population, and strive to make such calculations because it helps them cope.” second nature. E. Incorporation of exploitative norms of Prisoners who labor at both an emotional prison culture. and behavioral level to develop a “prison mask” that is unrevealing and impenetrable risk - In addition to obeying the formal rules of ation from themselves and others, may develop the institution, there are also informal rules and emotional flatness that becomes chronic and de- norms that are part of the unwritten but essential bilitating in social interaction and relationships, institutional and inmate culture and code that, at and find that they have created a permanent and some level, must be abided. For some prisoners unbridgeable distance between themselves and this means defending against the dangerousness other people. Many for whom the mask becomes and deprivations of the surrounding environment especially thick and effective in prison find that by embracing all of its informal norms, includ- the disincentive against engaging in open com- ing some of the most exploitative and extreme munication with others that prevails there has values of prison life. Note that prisoners typi- led them to withdrawal from authentic social in- cally are given no alternative culture to which to teractions altogether.10 The alienation and social ascribe or in which to participate. In many insti- distancing from others is a defense not only tutions the lack of meaningful programming has against exploitation but also against the realiza- deprived them of pro-social or positive activities tion that the lack of interpersonal control in the in which to engage while incarcerated. Few immediate prison environment makes emotional prisoners are given access to gainful employ- investments in relationships risky and unpredict- ment where they can obtain meaningful able. skills and earn adequate compensation; those

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who do are assigned to menial tasks that respect and personal space are so inviolate. Yet they perform for only a few hours a day. With these things are often as much a part of the proc- rare exceptions—those very few states that per- ess of prisonization as adapting to the formal mit highly regulated and infrequent conjugal vis- rules that are imposed in the institution, and they its—they are prohibited from sexual contact of are as difficult to relinquish upon release. any kind. Attempts to address many of the basic needs and desires that are the focus of normal F. Diminished sense of self-worth and day-to-day existence in the free world—to rec- personal value. reate, to work, to love—necessarily draws them closer to an illicit prisoner culture that for many Prisoners typically are denied their basic represents the only apparent and meaningful privacy rights, and lose control over mundane way of being. aspects of their existence that most citizens have long taken for granted. They live in small, some- However, as I noted earlier, prisoner culture times extremely cramped and deteriorating frowns on any sign of weakness and vulnerabil- spaces (a 60 square foot cell is roughly the size ity, and discourages the expression of candid of king-size bed), have little or no control over emotions or intimacy. And some prisoners em- the identify of the person with whom they must brace it in a way that promotes a heightened in- share that space (and the intimate contact it re- vestment in one’s reputation for toughness, and quires), often have no choice over when they encourages a stance towards others in which must get up or go to bed, when or what they may even seemingly insignificant insults, affronts, or eat, and on and on. Some feel infantalized and physical violations must be responded to quickly that the degraded conditions under which they and instinctively, sometimes with decisive force. live serve to repeatedly remind them of their In extreme cases, the failure to exploit weakness compromised social status and stigmatized so- is itself a sign of weakness and seen as an invita- cial as prisoners. A diminished sense of tion for exploitation. In men’s prisons it may self-worth and personal value may result. In ex- promote a kind of hypermasculinity in which treme cases of institutionalization, the symbolic force and domination are glorified as essential meaning that can be inferred from this externally components of personal identity. In an environ- imposed substandard treatment and circum- ment characterized by enforced powerlessness stances is internalized; that is, prisoners may and deprivation, men and women prisoners con- come to think of themselves as “the kind of per- front distorted norms of sexuality in which son” who deserves only the degradation and dominance and submission become entangled stigma to which they have been subjected while with and mistaken for the basis of intimate rela- incarcerated. tions.

Of course, embracing these values too fully G. Post-traumatic stress reactions to the can create enormous barriers to meaningful in- pains of imprisonment. terpersonal contact in the free world, preclude For some prisoners, incarceration is so stark seeking appropriate help for one’s problems, and and psychologically painful that it represents a a generalized unwillingness to trust others out of form of traumatic stress severe enough to pro- fear of exploitation. It can also lead to what ap- duce post-traumatic stress reactions once re- pears to be impulsive overreaction, striking out leased. Moreover, we now understand that there at people in response to minimal provocation are certain basic commonalities that characterize that occurs particularly with persons who have the lives of many of the persons who have been not been socialized into the norms of inmate cul- convicted of in our society.13 A “risk fac- ture in which the maintenance of interpersonal

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tors” model helps to explain the complex inter- well enough to sense that something may be play of traumatic childhood events (like , wrong. Eventually, however, when severely in- abusive and neglectful mistreatment, and other stitutionalized persons confront complicated forms of victimization) in the social histories of problems or conflicts, especially in the form of many criminal offenders. As Masten and Gar- unexpected events that cannot be planned for in mezy have noted, the presence of these back- advance, the myriad of challenges that the non- ground risk factors and traumas in childhood in- institutionalized confront in their everyday lives creases the probability that one will encounter a outside the institution may become overwhelm- whole range of problems later in life, including ing. The facade of normality begins to deterio- delinquency and criminality.14 The fact that a rate, and persons may behave in dysfunctional or high percentage of persons presently incarcer- even destructive ways because all of the external ated have experienced childhood trauma means, structure and supports upon which they relied to among other things, that the harsh, punitive, and keep themselves controlled, directed, and bal- uncaring nature of prison life may represent a anced have been removed. kind of “re-truamatization” experience for many of them. That is, some prisoners find exposure to the rigid and unyielding discipline of prison, the III. Special Populations and unwanted proximity to violent encounters and Pains of Prison Life the possibility or of being victimized by Although everyone who enters prison is physical and/or sexual , the need to ne- subjected to many of the above-stated pressures gotiate the dominating intentions of others, the of institutionalization, and prisoners respond in absence of genuine respect and regard for their various ways with varying degrees of psycho- well being in the surrounding environment, and logical change associated with their adaptations, so on all too familiar. Time spent in prison may it is important to note that there are some prison- rekindle not only the memories but the disabling ers who are much more vulnerable to these pres- psychological reactions and consequences of sures and the overall pains of imprisonment than these earlier damaging experiences. others. Either because of their personal charac- The dysfunctional consequences of institu- teristics—in the case of “special needs” prison- tionalization are not always immediately obvi- ers whose special problems are inadequately ad- ous once the institutional structure and proce- dressed by current prison policies15—or because dural imperatives have been removed. This is of the especially harsh conditions of confine- especially true in cases where persons retain a ment to which they are subjected—in the case of minimum of structure wherever they re-enter increasing numbers of “supermax” or solitary free society. Moreover, the most negative con- confinement prisoners16—they are at risk of sequences of institutionalization may first occur making the transition from prison to home with in the form of internal chaos, disorganization, a more significant set of psychological problems stress, and fear. Yet, institutionalization has and challenges to overcome. The plight of sev- taught most people to cover their internal states, eral of these special populations of prisoners is and not to openly or easily reveal intimate feel- briefly discussed below. ings or reactions. So, the outward appearance of normality and adjustment may mask a range of A. Mentally Ill and Developmentally serious problems in adapting to the freeworld. Disabled Prisoners This is particularly true of persons who re- Perhaps not surprisingly, mental illness and turn to the freeworld lacking a network of close, developmental represent the largest personal contacts with people who know them number of among prisoners. For ex-

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ample, a national of prison inmates with mentator has described the vicious cycle into disabilities conducted in 1987 indicated that al- which mentally-ill and developmentally-disabled though less than 1% suffered from visual, mobil- prisoners can fall: ity/orthopedic, hearing, or speech deficits, much The lack of mental health care for the seri- higher percentages suffered from cognitive and ously mentally ill who end up in segregation 17 psychological disabilities. A more recent fol- units has worsened the condition of many low-up study by two of the same authors ob- prisoners incapable of understanding their tained similar results: although less than 1% of condition. This is especially true in cases the prison population suffered visual, mobility, where prisoners are placed in levels of mental health care that are not intense enough, and speech, or hearing deficits, 4.2% were develop- begin to refuse taking their medication. They mentally disabled, 7.2% suffered psychotic dis- then enter a vicious cycle in which their men- orders, and 12% reported “other psychological tal takes over, often causing hostile disorders.”18 It is probably safe to estimate, and aggressive behavior to the point that they then, based on this and other studies,19 that up- break prison rules and end up in segregation units as management problems. Once in puni- wards of as many as 20% of the current prisoner tive housing, this regression can go undetected population nationally suffers from either some for considerable periods of time before they sort of significant mental or psychological dis- again receive more closely monitored mental order or developmental disability. health care. This cycle can, and often does, repeat.20 As my earlier comments about the process of institutionalization implied, the task of nego- tiating key features of the social environment of B. Prisoners in “Supermax” or Solitary imprisonment is far more challenging than it ap- Confinement pears at first. And it is surely far more difficult In addition, there are an increasing number for vulnerable, mentally-ill and developmen- of prisoners who are subjected to the unique and tally-disabled prisoners to accomplish. Incar- more destructive experience of punitive isola- ceration presents particularly difficult adjust- tion, in so-called “supermax” facilities, where ment problems that make prison an especially they are kept under conditions of unprecedented confusing and sometimes dangerous situation for levels of social deprivation for unprecedented them. For mentally-ill and developmentally- lengths of time. This kind of confinement cre- disabled inmates, part of whose defining (but ates its own set of psychological pressures that, often undiagnosed) disability includes difficul- in some instances, uniquely disable prisoners for ties in maintaining close contact with reality, freeworld reintegration.21 Indeed, there are few controlling and conforming one’s emotional and if any forms of imprisonment that produce so behavioral reactions, and generally impaired many indicies of psychological trauma and comprehension and learning, the rule-bound na- symptoms of psychopathology in those persons ture of institutional life may have especially dis- subjected to it. My own review of the literature astrous consequences. Yet, both groups are too suggested these documented negative psycho- often left to their own devices to somehow sur- logical consequences of long-term solitary-like vive in prison and leave without having had any confinement include: an impaired sense of iden- of their unique needs addressed. tity; hypersensitivity to stimuli; cognitive dys- function (confusion, memory loss, ruminations); Combined with the de-emphasis on treat- irritability, , aggression, and/or rage; other- ment that now characterizes our nation’s correc- directed violence, such as stabbings, attacks on tional facilities, these behavior patterns can sig- staff, destruction, and vio- nificantly impact the institutional history of lence; lethargy, helplessness and hopelessness; vulnerable or special needs inmates. One com-

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chronic depression; self- and/or suici- freeworld communities. There is little or no evi- dal ideation, impulses, and behavior; anxiety and dence that prison systems across the country panic attacks; emotional breakdowns; and/or have responded in a meaningful way to these loss of control; hallucinations, psychosis and/or psychological issues, either in the course of con- paranoia; overall deterioration of mental and finement or at the time of release. Over the next physical health.22 decade, the impact of unprecedented levels of incarceration will be felt in communities that Human Rights Watch has suggested that will be expected to receive massive numbers of there are approximately 20,000 prisoners con- ex- who will complete their sentences fined to supermax-type units in the United and return home but also to absorb the high level States.23 Most experts agree that the number of of psychological trauma and disorder that many such units is increasing. In many states the ma- will bring with them. jority of prisoners in these units are serving “in- determinate” terms, which The implications of these psychological ef- means that their entire prison sentence will be fects for parenting and family life can be pro- served in isolation (unless they “debrief” by found. Parents who return from periods of incar- providing incriminating about other ceration still dependent on institutional prisoners). Few states provide any meaningful or structures and routines cannot be expected to ef- effective “decompression” program for prison- fectively organize the lives of their children or ers, which means that many prisoners who have exercise the initiative and autonomous deci- been confined in these supermax units—some sionmaking that parenting requires. Those who for considerable periods of time—are released still suffer the negative effects of a distrusting directly into the community from these extreme and hypervigilant adaptation to prison life will conditions of confinement. find it difficult to promote trust and authenticity within their children. Those who remain emo- tionally over-controlled and alienated from oth- IV. Implications for the Transition ers will experience problems being psychologi- From Prison to Home cally available and nurturant. Tendencies to socially withdraw, remain aloof or seek social The psychological consequences of incar- invisibility could not be more dysfunctional in ceration may represent significant impediments family settings where closeness and interdepen- to post-prison adjustment. They may interfere dency is needed. The continued embrace of with the transition from prison to home, impede many of the most negative aspects of exploita- an ex-convict’s successful re-integration into a tive prisoner culture is likely to doom most so- social network and employment setting, and may cial and intimate relations, as will an inability to compromise an incarcerated parent’s ability to overcome the diminished sense of self-worth resume his or her role with family and children. that prison too often instills. Clearly, the residual The range of effects includes the sometimes sub- effects of the post-traumatic stress of imprison- tle but nonetheless broad-based and potentially ment and the retraumatization experiences that disabling effects of institutionalization the nature of prison life may incur can jeopard- prisonization, the persistent effects of untreated ize the mental health of persons attempting to or exacerbated mental illness, the long-term reintegrate back into the freeworld communities legacies of developmental disabilities that were from which they came. Indeed, there is improperly addressed, or the pathological that incarcerated parents not only themselves consequences of supermax confinement continue to be adversely affected by traumatiz- experienced by a small but growing number of ing risk factors to which they have been ex- prisoners who are released directly from long- posed, but also that the experience of imprison- term isolation into freeworld communities. Papers prepared for the "From Prison to Home" Conference (January 30-31, 2002) 86 The Psychological Impact of Incarceration: Implications for Post-Prison Adjustment C. Haney

ment has done little or nothing to provide them must simultaneously address the adverse prison with the tools to safeguard their children from policies and conditions of confinement that have the same potentially destructive experiences.24 created these special problems, and at the same time provide psychological resources and social The excessive and disproportionate use of services for persons who have been adversely imprisonment over the last several decades also affected by them. Both things must occur if the means that these problems will not only be large successful transition from prison to home is to but concentrated primarily in certain communi- occur on a consistent and effective basis. ties whose residents were selectively targeted for system intervention. Our society There are three areas in which policy inter- is about to absorb the consequences not only of ventions must be concentrated in order to ad- the “rage to punish”25 that was so fully indulged dress these two levels of concern: in the last quarter of the 20th century but also of the “malign neglect”26 that led us to concentrate A. Prison Conditions, Policies, and this rage so heavily on African American men. Procedures Remarkably, as the present decade began, there were more young Black men (between the ages No significant amount of can be of 20-29) under the control of the nation’s made in easing the transition from prison to criminal justice system (including and home until and unless significant changes are parole supervision) than the total number in col- made in the normative structure of American prisons. Specifically: lege.27 Thus, whatever the psychological conse- quences of imprisonment and their implications • The goal of penal harm must give way to for reintegration back into the communities from a clear emphasis on prisoner-oriented re- which prisoners have come, we know that those habilitative services. consequences and implications are about to be • The adverse effects of institutionalization felt in unprecedented ways in these communi- must be minimized by structuring prison ties, by these families, and for these children, life to replicate, as much as possible, life like no others. Not surprisingly, then, one in the world outside prison. A useful heu- scholar has predicted that “imprisonment will ristic to follow is a simple one: “the less become the most significant factor contributing like a prison, and the more like the free- to the dissolution and breakdown of African world, the better.” American families during the decade of the • Prisons that give inmates opportunities to 1990s”28 and another has concluded that exercise pockets of autonomy and per- “[c]rime control policies are a major contributor sonal initiative must be created. to the disruption of the family, the prevalence of • Safe correctional environments that re- single parent families, and children raised with- move the need for hypervigilance and out a father in the ghetto, and the ‘inability of pervasive distrust must be maintained, people to get the still available’ . ”29 ones where prisoners can establish au- thentic selves, and learn the norms of in- terdependence and cooperative trust. V. Policy and Programmatic • A clear and consistent emphasis on Responses to the Adverse Effects maximizing visitation and supporting con- of Incarceration tact with the outside world must be im- plemented, both to minimize the division An intelligent, humane response to these between the norms of prison and those of facts about the implications of contemporary the freeworld, and to discourage dysfunc- prison life must occur on at least two levels. We

Papers prepared for the "From Prison to Home" Conference (January 30-31, 2002) 87 The Psychological Impact of Incarceration: Implications for Post-Prison Adjustment C. Haney

tional social withdrawal that is difficult to some understanding of the ways in which reverse upon release. prison may have changed them, the tools with which to respond to the challenge of • Program rich institutions must be estab- adjustment to the freeworld. lished that give prisoners genuine alterna- tive to exploitative prisoner culture in • The process must begin well in advance which to participate and invest, and the of a prisoner’s release, and take into ac- degraded, stigmatized status of prisoner count all aspects of the transition he or transcended. Prisoners must be given op- she will be expected to make. This means, portunities to engage in meaningful among other things, that all prisoners will activities, to work, and to love while need occupational and vocational training incarcerated. and pre-release assistance in finding gain- ful employment. It also means that pris- • Adequate therapeutic and habilitative re- oners who are expected to resume their sources must be provided to address the as parents will need pre-release as- needs of the large numbers of mentally ill sistance in establishing, strengthening, and developmentally disabled prisoners and/or maintaining ties with their families who are now incarcerated. and children, and whatever other assis- • The increased use of supermax and other tance will be essential for them to func- forms of extremely harsh and psychologi- tion effectively in this role (such as par- cally damaging confinement must be re- enting classes and the like). versed. Strict time limits must be placed • Prisoners who have manifested signs or on the use of punitive isolation that ap- symptoms of mental illness or develop- proximate the much briefer periods of mental disability while incarcerated will such confinement that once characterized need specialized transitional services to American corrections, prisoners must be facilitate their reintegration into the free- screened for special vulnerability to isola- world. These would include, where ap- tion, and carefully monitored so that they propriate, pre-release outpatient treatment can be removed upon the first sign of ad- and habilitation plans. verse reactions. • No prisoner should be released directly out of supermax or solitary confinement B. Transitional Services to Prepare back into the freeworld. Supermax prisons Prisoners for Community Release must provide long periods of decompres- No significant amount of progress can be sion, with adequate time for prisoners to made in easing the transition from prison to be treated for the adverse effects of long- home until and unless significant changes are term isolation and reacquaint themselves made in the way prisoners are prepared to leave with the social norms of the world to which they will return. prison and re-enter the freeworld communities from which they came. Specifically: C. Community-Based Services to Facili- • Prison systems must begin to take the tate and Maintain Reintegration pains of imprisonment and the nature of institutionalization seriously, and provide No significant amount of progress can be all prisoners with effective decompression made in easing the transition from prison to programs in which they are re-acclimated home until and unless significant changes are to the nature and norms of the freeworld. made in the way ex-convicts are treated to in the • Prisoners must be given some insight into freeworld communities from which they came. the changes brought about by their adap- Specifically: tation to prison life. They must be given

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• Clear recognition must be given to the proposition that persons who return home from prison face significant personal, so- cial, and structural challenges that they have neither the ability nor resources to overcome entirely on their own. Post- release success often depends of the na- ture and quality of services and support provided in the community, and here is where the least amount of societal atten- tion and resources are typically directed. This tendency must be reversed. • Gainful employment is perhaps the most critical aspect of post-prison adjustment. The stigma of incarceration and the psy- chological residue of institutionalization require active and prolonged agency in- tervention to transcend. Job training, em- ployment counseling, and employment placement programs must all be seen as essential parts of an effective reintegra- tion plan. • A broadly conceived family systems ap- proach to counseling for ex-convicts and their families and children must be im- plemented in which the long-term prob- lematic consequences of “normal” adapta- tions to prison life are the focus of discussion, rather than traditional models of psychotherapy. • Parole and probation services and agen- cies need to be restored to their original role of assisting with reintegration. Here too the complexity of the transition from prison to home needs to be fully appreci- ated, and parole revocation should only occur after every possible community- based resource and approach has been tried.

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6 1 Gresham Sykes, The Society of Captives: A Study of Among the most unsympathetic of these skeptical a Maximum Security Prison. Princeton: Princeton views is: Bonta, J., and Gendreau, P., “Reexamining University Press (1958), at 63. the Cruel and Unusual of Prison Life,” 2 and Human Behavior, 14, 347 (1990). However, For a more detailed discussion of this issue, see, for even these authors concede that: “physiological and example: Haney, C., “Riding the Punishment Wave: psychological stress responses… were very likely [to On the Origins of Our Devolving Standards of De- occur] under crowded prison conditions”; “[w]hen cency,” Hastings Women’s Law Journal, 9, 27-78 threats to health come from suicide and self- (1998), and Haney, C., & Zimbardo, P., “The Past mutilation, then inmates are clearly at risk”; “[i]n Ca- and Future of U.S. Prison Policy: Twenty-Five Years nadian penitentiaries, the homicide rates are close to After the Stanford Prison Experiment,” American 20 times that of similar-aged males in Canadian soci- Psychologist, 53, 709-727 (1998), and the references ety”; that “a variety of health problems, injuries, and cited therein. selected symptoms of psychological distress were 3 Mauer, M., “Americans Behind bars: A Comparison higher for certain classes of inmates than probation- of International Rates of Incarceration,” in W. Chur- ers, parolees, and, where data existed, for the general chill and J.J. Vander Wall (Eds.), Cages of Steel: The population”; that studies show long-term incarcera- of Imprisonment in the United States (pp. 22- tion to result in “increases in hostility and social in- 37). Washington, D.C.: Maisonneuve Press (1992); troversion… and decreases in self-evaluation and Mauer, M., “The International Use of Incarceration,” evaluations of work and father”; that imprisonment Prison Journal, 75, 113-123 (1995). produced “increases in dependency upon staff for di- rection and social introversion,” a tendency for pris- 4 In California, for example, see: Dohner v. oners to prefer “to cope with their sentences on their McCarthy [United States District Court, Central Dis- own rather than seek the aid of others,” “deteriorating trict of California, 1984-1985; 635 F. Supp. 408 community relationships over time,” and “unique dif- (C.D. Cal. 1985) (examining the effects of over- ficulties” with “family separation issues and voca- crowded conditions in the California Men’s Colony); tional skill training needs”; and that some researchers Coleman v. Wilson, 912 F. Supp. 1282 (N.D. Cal. have speculated that “inmates typically undergo a 1995) (challenge to grossly inadequate mental health ‘behavioral deep freeze’” such that “outside-world services in the throughout the entire state prison sys- behaviors that led the offender into trouble prior to tem). In Texas, see the long-lasting Ruiz litigation in imprisonment remain until release.” Bonta & Gen- which the federal court has monitored and attempted dreau, pp. 353-359. to correct unconstitutional conditions of confinement 7 throughout the state’s sprawling prison system for Again, precisely because they define themselves as more than 20 years now. Current conditions and the skeptical of the proposition that the pains of impris- most recent status of the litigation are described in onment produce many significant negative effects in Ruiz v. Johnson [United States District Court, South- prisoners, Bonta and Gendreau are instructive to ern District of Texas, 37 F. Supp. 2d 855 (S.D. quote. They concede that: there are “signs of pathol- Texas 1999).] ogy for inmates incarcerated in solitary for periods up to a year”; that higher levels of anxiety have been But these two states were not alone. According to the found in inmates after eight weeks in jail than after ACLU's National Prison Project, in 1995 there were one; that increases in psychopathological symptoms fully 33 in the United States under court occur after 72 hours of confinement; and that death order to reduce overcrowding or improve general row prisoners have been found to have “symptoms conditions in at least one of their major prison facili- ranging from paranoia to insomnia,” “increased feel- ties. Nine were operating under court orders that cov- ings of depression and hopelessness,” and feeling ered their entire prison system. National Prison Pro- “powerlessness, fearful of their surroundings, and… ject, Status Report: State Prisons and the Courts emotionally drained.” Bonta & Gendreau, pp. 361- (1995). 362. 5 For a more detailed discussion of these issues, see, 8 Richard McCorkle, “Personal Precautions to Vio- for example: Haney, C., “Psychology and the Limits lence in Prison,” Criminal Justice and Behavior, 19, to Prison Pain: Confronting the Coming Crisis in 160-173 (1992), at 161. Eighth Amendment Law,” Psychology, Public Pol- 9 icy, and Law, 3, 499-588 (1997), and the references Paul Keve, Prison Life and Human Worth. Minnea- cited therein. polis, MN: University of Minnesota Press (1974), at 54.

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10 For example, see Jose-Kampfner, C., “Coming to Clinical Child Psychology (pp. 1-52). : Terms with Existential Death: An Analysis of Plenum (1985), at 3. Women's Adaptation to Life in Prison,” Social Jus- 15 For a more detailed discussion of these issues, see, tice, 17, 110 (1990) and, also, Sapsford, R., “Life for example: Haney, C., & Specter, D., “Vulnerable Sentence Prisoners: Psychological Changes During Offenders and the Law: Treatment Rights in Uncer- Sentence,” British Journal of , 18, 162 tain Legal Times,” in J. Ashford, B. Sales, & W. Reid (1978). (Eds.), Treating Adult and Juvenile Offenders with 11 Taylor, A., “Social Isolation and Imprisonment,” Special Needs (pp. 51-79). Washington, D.C.: , 24, 373 (1961), at p. 373. See, also, American Psychological Association (2001), and the Hanna Levenson, “Multidimensional Locus of Con- references cited therein. trol in Prison Inmates,” Journal of Applied Social 16 See Haney, C., & Lynch, M., “Regulating Prisons Psychology, 5, 342 (1975) who found not surpris- of the Future: The Psychological Consequences of ingly that prisoners who were incarcerated for longer Supermax and Solitary Confinement,” New York periods of time and those who were punished more University Review of Law and Social Change, 23, frequently by being placed in solitary confinement 477-570 (1997), for a discussion of this trend in were more likely to believe that their world was con- American corrections and a description of the nature trolled by “powerful others.” Such beliefs are consis- of these isolated conditions to which an increasing tent with an institutional adaptation that undermines number of prisoners are subjected. autonomy and self-initiative. 17 Veneziano, L., Veneziano, C., & Tribolet, C., The 12 Jose-Kampfner, supra note 10, at 123. special needs of prison inmates with handicaps: An 13 The literature on these issues has grown vast over assessment. Journal of Offender Counseling, Services the last several decades. For representative examples, & Rehabilitation, 12, 61-72 (1987). see: Dutton, D., Hart, S., “Evidence for Long-term, 18 Veneziano, L., & Veneziano, C., Disabled inmates. Specific Effects of Childhood and Neglect on In M. McShane & F. Williams (Eds.), Encyclopedia Criminal Behavior in Men,” International Journal of of American Prisons (pp. 157-161). New York: Gar- Offender Therapy & Comparative Criminology, 36, land (1996). See, also, Long, L., & Sapp, A., Pro- 129-137 (1992); Haney, C., “The Social Context of grams and facilities for physically disabled inmates in Capital : Social Histories and the Logic of state prisons. Journal of Offender Rehabilitation, 18, Capital Mitigation,” 35 Santa Clara Law Review 35, 191-204 (1992). 547-609 (1995); Craig Haney, “Psychological Se- crecy and the Death Penalty: Observations on ‘the 19 For example, according to a Department of Justice Mere Extinguishment of Life,’” Studies in Law, Poli- census of correctional facilities across the country, tics, and Society, 16, 3-69 (1997); Haney, C., “Miti- there were approximately 200,000 mentally ill pris- gation and the Study of Lives: The Roots of Violent oners in the United States in midyear 2000. This rep- Criminality and the Nature of Capital Justice,” in resented approximately 16% of prisoners nationwide. James Acker, Robert Bohm, and Charles Lanier, Bureau of Justice Statistics, Mental Health Treatment America’s Experiment with : Re- in State Prisons, 2000. (NCJ 188215), July, 2001. flections on the Past, Present, and Future of the Ul- 20 Streeter, P., “Incarceration of the mentally ill: timate Penal Sanction (pp. 343-377). Durham, NC: Carolina Academic Press (1997).Huff-Corzine, L., Treatment or warehousing?” Bar Journal, Corzine, J., & Moore, D., “Deadly Connections: Cul- 77, 166 (1998), at p. 167. ture, Poverty, and the Direction of Lethal Violence,” 21 For a more detailed discussion of these issues, see, Social Forces 69, 715-732 (1991); McCord, J., “The for example: Haney, C., & Lynch, M., “Regulating Cycle of Crime and Socialization Practices,” Journal Prisons of the Future: The Psychological Conse- of & Criminology, 82, 211-228 (1991); quences of Supermax and Solitary Confinement,” Sampson, R., and Laub, J. Crime in the Making: New York University Review of Law and Social Pathways and Turning Points Through Life. Cam- Change, 23, 477-570 (1997), and the references cited bridge, MA: Harvard University Press (1993); and therein. Widom, C., “The Cycle of Violence,” Science, 244, 22 160-166 (1989). See Haney & Lynch, supra note 21. 23 14 Masten, A., & Garmezy, N., Risk, Vulnerability Human Rights Watch, Out of Sight: Super- and Protective Factors in Developmental Psychopa- Maximum Security Confinement in the United States. thology. In F. Lahey & A Kazdin (Eds.) Advances in Feburary, 2000.

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24 Greene, S., Haney, C., and Hurtado, A., “Cycles of Pain: Risk Factors in the Lives of Incarcerated Women and Their Children,” Prison Journal, 80, 3- 23 (2000). 25 Lois Forer, A Rage to Punish: The Unintended Consequences of . New York: W. W. Norton (1994). 26 Michael Tonry, Malign Neglect: Race, Crime, and Punishment in America. New York: Oxford Univer- sity Press (1995). 27 Mauer, M. (1990). More Young Black Males under Correctional Control in US than in College. Washington: The Sentencing Project. 28 King, A., “The Impact of Incarceration on African American Families: Implications for Practice,” Fami- lies in Society: The Journal of Contemporary Human Services, 74, 145-153 (1993), p. 145.. 29 Chambliss, W., “Policing the Ghetto : The Politics of Law and Law Enforcement,” Social Problems, 41, 177-194 (1994), p. 183.

Papers prepared for the "From Prison to Home" Conference (January 30-31, 2002) 92 The Psychological Impact of Incarceration: Implications for Post-Prison Adjustment C. Haney