I’ve actually been following Sadhbh Walsh’s series on prison in the US, which has generally been excellent, but have not commented there because the whole topic pisses me off too much.
Then I just ran into this over at MSNBC.com. What we’re looking at here, if you can fucking believe it, is a photo of participants in a therapy session;
Here’s the explanatory gloss from MSNBC;
Administrative segregation prisoners take part in a group therapy session at San Quentin state prison in San Quentin, California, on June 8, 2012.
It’s hard to know what to say about this. I’m not one of those New Age woo-woos who thinks that “therapy” is a magic bullet. It can be amazingly powerful, and it can transform lives — that’s true and I’ve seen it happen — but it’s also true that some people are simply in a mental place we don’t understand and cannot reach. I’ve seen that too.
The reasons, if that’s the right word, for why this is happening are a case study in themselves. Sometime around the year 2000 a Federal Court ruled that leaving mentally ill prisoners in their cells without treatment was a violation of the “cruel and unusual” constitutional principle. Prison systems thus had to find ways to comply with what was essentially an order to provide it. Not all prison systems use the approach shown here;
Jeffrey Metzner, a Colorado psychiatrist who has advised the court-appointed special master overseeing mental healthcare in California prisons, said the enclosures offer better security and more freedom of movement than alternatives used in most states, which include handcuffing patients to their chairs or shackling an ankle to the floor. Once the inmates are inside the cage, their handcuffs are removed.
When I first read that, I smelled a rat, because it seemed obvious to me that this is about convenience for the prison staff and not about providing any sense of “freedom” in a therapeutic context. Happily my suspicions were confirmed in the next sentence, where Metzner goes into feel-good euphemism mode in defense of his cages, and tries to mitigate the problem by calling them something else;
Metzner also advised prison officials to refer to the enclosures as therapeutic modules, not cages. “The name is important, because if you call them cages, people inside might feel like animals and respond accordingly,” he said.
Jesus Christ. This man Metzner is a psychiatrist, licensed to prescribe the most powerful psychoactive “medications” on the planet, and he’s talking like a moron. At the very least he seems to be confusing mental illness with stupidity. Does he really think people are going to feel better in a cage because it’s now been renamed a fucking “therapeutic module”? And how does a psychiatrist manage to be so utterly bereft of any sense of just how sinister an approach like that is?
Good thing people in places like this wear name tags, so you can tell who’s staff and who’s an inmate. Because if we had to use behavior as the identifier, we’d be wrong at least as often as right.
“Therapeutic modules”? Appalling.
As you all know, I trained as a psychiatric nurse, mainly on the ‘secure’ wards which held — I’m not supposed to tell people, I had to sign the Official Secrets Act over this — some extremely dangerous criminal psychiatric patients who, had they had enough space in those days, should have been in, and occasionally were, transferred to Broadmoor. These people were there for life, would never be released or discharged, and mostly, knew it very well. Some of their files still had the annotation “Detained during His Majesty’s Pleasure”.
This was some time ago; but even then, the use even of a straitjacket for restraint had been banned. (It was part of the ‘fun’ the trained nurses had with young students, to quietly fish the last one they’d hung onto on the quiet, grab us and tie us into one, so we knew what it felt like. And it is the kind of thing that drives you into a panic, even if you’re not mentally unstable to start with.
I cannot even imagine the use of any kind of restraint. Not handcuffs or shackles; though we did have to use handcuffs if we had to take one of them into hospital for surgery, but more for the anxiety of the ‘ordinary’ nursing staff than anything else.
We had to rely on using injected tranquilisers if there was a very violent episode. (I got quite badly bitten helping to physically restrain a patient in one of those: still got the scar, even. Had to get tetanus injections: a human bite can actually be more infectious than an animal one. Bet you didn’t know that!)
This guy is the kind of psychiatrist who would have been happily at home with . . .Well, Godwin’s Law . . .
“Administrative segregation” is eupho for ‘solitary confinement’, I believe.
So these guys are basically being tortured and driven insane beyond reach by being kept locked up on their own month after month, year after year, and then put in these cages next to each other once a week to try to turn back that that tide for an hour or so. Talk about the large print (they must have access to therapy) giveth while the small print (in cages) taketh away….
I’m assuming San Quentin is not (yet) a private, for-profit prison.
You just know there’s a catalogue somewhere that your up-and-coming prison wardens are leafing through at this very moment, and on page 16 it’s therapeutic modules in seven spring colors and three security levels: strong, extra-strong, and silence of the lambs.
They went out and got the shrink they needed. Who else would go along with that program?
This says a lot about the actual power of courts. In 2000 a federal court hands down what should be a simple and clear order, and this is how it is “implemented.” Maybe in another twelve years another court will rule that this implementation falls a tad short of real compliance, and then California will paint the cages Happy Yellow and Springtime Green. So then in 2036…
Wow, what a flood of memory.
Like Squirrel, I worked in mental hospitals (for a number of years actually): escorted people to their shock sessions, held ‘em down for injections, entertained them in the backs of cabs while the terrified cabdrivers furtively checked the rearview mirror…
Some truly twisted people in the field, especially among the psychiatrists. But my major complaint, to this day, was that most of them were fucking cowards. I could see the fear in their eyes when I went down at 3 AM to make sure a walk-in mental patient didn’t attack them. And the reality was, no matter how crazy a patient was, they almost all knew you shouldn’t do violence to a psychiatrist because the psychiatrist would always get even.
Wow, you know what, I just looked at this photo again this morning when I’m kinda fresh and wide awake, and noticed that the photographer is not actually in the room where this, um, therapy is taking place.
She’s holding the camera up against armored glass (the kind with wire mesh embedded in it)—you can see the mesh even though its been (deliberately) thrown out of focus, and there are some oddball reflections in the lower right hand corner.
Wish I’d noticed that last night, there’s a whole ‘nother dimension to discuss there, but was too wiped-out to notice much of anything subtle at all.
I’m turning wood about 10 hours a day right now to prepare for the big chi-chi Art Show over Labor Day weekend, so by the time I get to reading the news and pondering if there’s anything I want to write about I’m so tired as to be more than a little insensate.
I have a story about working for a (practicing) psychiatrist once who was absolutely the craziest and psychically toxic person I ever met, and it was the only time I ever bailed out on a project before finishing it, but that’s for another day.
Gunny,
Your cynicism is appalling. Here’s this sensitive photographer trying to respect the Sanctity Of What Is Said In Group and gamely reconciling it with The Public’s Right To See Bad People In Cages and you just have to twist it around, don’t you?
Bears repeating:
From Dr. Metzner’s profile (http://www.ncchc.org/CCHP/profile/20-1.html):
Bim:
ECT? We had a form of ‘conscientious objection’ when I was nursing. (I was never happy about it; not so much about what it did when it was applied to patients, but the scale of what the hospital psychiatrist sometimes ordered; and I never really felt it did much anyway.) So I always refused to escort patients to, or apply, ECT.
About some psychiatrists . . .yes; there was one I when I was training, who was very easily freudened. Her assessment sessions with some patients never seemed to last very long before the buzzer called me in. She always wanted a nurse in there with some patients, and we had to keep saying we couldn’t sit in like that, because patient confidentiality applied to them as well.
On one occasion, I couldn’t see her, only the patient — not normally violent, just excitably weird sometimes — sitting perfectly calmly at one end of her office and I got quite panicky myself about what might have happened, and how on earth I was going to explain to the Chief Male Nurse I hadn’t heard anything untoward when I was supposed to be listening very carefully for anything odd. Turned out she was under her desk. She chain smoked; and he had just grabbed her ashtray suddenly and swallowed the entire contents.
Not just psychiatrists either: had to collect an ‘escaped’ patient (admittedly rather heavily built and over 6 foot) once from an (open: they weren’t allowed to lock patients in) police station cell. Guarded by two of the biggest, burliest (and twitchiest) policemen I’ve ever seen.
Supposedly he had a very low IQ, and wasn’t supposed to be able to read. Or count. But he’d hopped over a railing, gone to a public telephone kiosk in the hospital grounds, and called for a taxi from one of the ads in it. Which took him 30 miles to the nearest city, where, of course, he was arrested for not being able to pay. I’ve never forgotten the look on those cops’ faces as I said “Hello George, come to take you home,” and he docilely put his hand in mine like a four year old and we walked out to the hospital car.
We thought afterwards there’d definitely been something very wrong with that IQ test, but the (same) hospital psychiatrist wouldn’t listen to us. And I’ve never trusted any IQ test since. (When I got to uni afterwards, I stunned a psychology student by coming out of one of his IQ tests with an IQ of 71 . . .I knew, by then, how to manipulate them, of course. At least, downwards, anyway. Manipulating them upwards, I found, was rather trickier though.)
(Somewhere, it dawns on Squirrel suddenly, this honestly hadn’t occurred to me in all these years, there must be some peculiarly wide-ranging assessments of the Squirrel IQ stored here and there. . .hope nobody ever puts them together!)
Squirrel:
Yeah, ECT. It was kind of refined by the time I was involved, and there really were some miraculous results – and some terrible results, particularly when the heavy drinkers were zapped, something I took note of – it was like a Hemingway thing – though the psychiatrists weren’t usually that inquisitive or attentive and it never seemed to occur to them that there might be a connection between heavy drinking and severe memory loss following ECT. (Perhaps they didn’t have my wise blood where the drinking life was concerned.)
Honestly, the ECT wasn’t that bad compared to a lot of the shit that went on. But I was a kid and really loved most of the patients, with whom I identified to a startling degree. The work also beat the heal out of manual and low-skilled labor. In some ways, the hospitals were my first exposure to a world beyond the one in which I grew up.
Some of the smartest, most likable people I ever met were mental patients.
Stop the goddamn presses……….
You mean to tell me they’re locking up homicidal crazy people inside maximum security prisons in cages with screens and barriers to protect the people working there from getting piss and shit thrown at them, to administer mandated therapy?
Those people that work there for wages should be happy to risk their life for some half baked mandated law in hope’s that some bat shit crazy murderer sees jesus and tunes into reality.
Maybe the people who mandated it would like to take a crack at the cage free idea.
Talk about shit rollin downhill.
Cochise;
Oooh, just listen to you, eh? Back from a fishing trip to carpet bomb three comment threads with manic enlightenment. I guess I’ll make it easier on myself and deal with all three right here;
Wow, I’d say if a fishing trip made me forget what enormous good fortune it is that I’m not in one of those “therapy modules” myself, I’d wanna give that some thought.
You don’t know that they’re all murderers, or even if any of them are. What they all most certainly are is mentally ill and were not lucky enough to find a way home. Does a few days in Trout Nirvana cause a person to totally lose sight of all that? We’ve known each other a long time, grasshopper, and we both know damn well if the frog had hopped differently just one damn time either one of us could have been in that photo.
I know exactly where I am, and what to expect. As for why do I care, that has something to do with seeing the world as something more meaningful than the disinterested whirling of an electron stew—though it is certainly that as well.
Anyway, it is the numinous duty of all truly sentient beings to expose aesthetic train-wrecks wherever they occur. And let me see if I’ve got this straight — you live out in the middle of a desert, and I live with about 30 miles of gold-medal trout water running right in front of the fucking house here, and you’re recommending that I’m the one who needs a fishing trip?
You’d have been better off just saying it’s not your cup of tea, old bean. That would have the triple merit of being true, of being respectable, and sparing you from sounding like a fucking idiot. And anyway;
Love and murder really do matter,
If can’t do the first
you’ll end up with the latter.
(Damn, I just made that up. It’s fucking good, too.)
Yeah, but you can’t, and neither can I, perhaps because neither of us has had the raw talent, the discipline, and the passion to be that good at anything.
Hey, it’s fine with me if you don’t give a rappy hat’s ass, whatever that is, about anything at all. Really it is. But don’t come here pissing rainbows on the furniture just ‘cos you got emotionally swamped by a trip to Paradise and catching some fish.
I don’t need that shit, and don’t deserve it, either, you little fucker.
Cochise, what Gunny said. Also:
Or are the fish telling you some other tale?
g
I thought it was funny… really…I thought you’d think it was funny…I was wrong. The point was don’t take things, or yourself, so fucking serious….apparently, I missed.
I find no joy beating up on people, places and things…..I thought you knew that.
I think the cages are awful. It is hard to see how any healing can go on in these circumstances.
But then again I hear alot of stories from the social workers in our agencies. We just had to order a panic button for a therapist who sees children, can you believe.
Cochise;
It’s just a matter of style, brother.
The way I write about certain things — the anger, the outrage — is a matter of style. Doesn’t mean I’m personally overwrought by whatever it is. There’s a difference between understanding that something is important and “taking it seriously” and becoming obsessed.
I do tend to agree with Bluthner that we can (and should, more than we do) judge ourselves by the way in which we treat those with the least power, whether they be prisoners, or “primitive” tribespeople who happen to live on top of an oil deposit, or whatever.
And yeah, I do get pissed by bullying, as do you. But that fury doesn’t take over my life. You know that. You can’t work with wood the way I do if you’re angry all the time – you’d lose fingers and other body parts, right? And you can’t make good bread if you’re grumpy either.
Right now though, there are some very unpleasant people with their hands on a lot of power, and they want more of it. They want more of everything – including everyone’s (including yours) retirement funds. I’m guilty of caring about that, and this is my way of letting off some steam about it.
You knew that, too, I think.
Cochise says:
Not really. Know why? A good friend and colleague of mine (he was a near neighbour, and taught me a lot when I was training) was killed in the hospital by the same patient who had once threatened to kill me.
(And terribly ironically he had given me a real dressing-down over because, being young, cocky, and feeling invulnerable of course, I hadn’t treated it with sufficient seriousness and hadn’t taken the proper precautions at the time. Sadly, in just one moment, he suffered just the same lapse of concentration he’d warned me against.)
Some of us did work with that risk every day because we believed (and I at least still do) that people are redeemable. And I don’t mean in any religious sense. But certainly not by dehumanising them and caging them in the name of ‘therapy’.