What is the psychological impact of prison?

Prison changes people by altering their spatial, temporal, and bodily dimensions; weakening their emotional life; and undermining their identity. What psychological impact does prison have? Does it cause mental disorders? What relationships do inmates have with their environments and themselves? These questions and many others are the focus of a doctoral thesis and new book by Jérôme Englebert, a clinical psychologist and lecturer at the University of Liège.

"Humans become aware of themselves in boundary situations." So wrote Karl Jaspers, a German psychiatrist and philosopher, in a monumental work called General Psychopathology, published in 1913. Jean-Paul Sartre also refers to the notion of humans in a situation in several of his books, particularly Sketch for a Theory of the Emotions, published in 1939.

According to Jérôme Englebert, a clinical psychologist at the Paifve Social Forensic Centre (EDS - a psychiatric prison) and a lecturer at the University of Liège (Department of Psychology and Clinics of Human Systems), it is important to distinguish between the paradigm of "human beings in the laboratory" and that of "human beings in a situation". The first case is useful for studying isolated variables such as short-term memory or visual-spatial attention. But any reflection on clinical psychology and psychopathology requires considering the individual as a whole and as a unique being; in other words, humans must be studied in a particular situation, without removing the variables which define them or their environment.

Incarceration may undoubtedly be considered one of the boundary situations that Karl Jaspers was referring to. Jérôme Englebert therefore chose the context of prisons and social protection to examine fundamental psychological difficulties and psychopathology. His work was the subject of his doctoral thesis(1) and a new book published by Éditions Hermann (Paris): Psychopathologie de l'Homme en Situation: Le Corps du Détenu dans l'Univers Carcéral(2).

According to the psychologist from Liège, different existential coordinates must be taken into account whenever we study human beings. The main ones relate to space, time, and the body, as well as identity and emotion. Along with Michel Foucault and Gilles Deleuze, he believes that the most fundamental issue affecting prisoners is the incarceration of the body. "When we imprison the body, we alter its relationship to space and time," says Jérôme Englebert. "Every inmate has a biased perception of space, time, and his/her own body. His/her imaginary world, psyche, and identity are all affected."

For inmates, there are two time lines that move at different speeds. The first is tied to their daily routine and is extremely repetitive. Prisoners cannot choose when to eat, bathe, sleep, or awaken - their section leader makes those decisions. The second time line relates to the external world, with which the prisoner is completely out of sync.   "I can recall inmates who weren’t aware of the euro or GSM when they were released from prison," says Jérôme Englebert. "This obviously raises the issue of the desocialisation of incarceration."

Prison freedom

The prisoner's notion of space is also profoundly disturbed, partly, but not entirely, because of their confinement. For security reasons, prison cells are all the same. Inmates can put up pictures or posters, but they can't choose their furniture, for example. "We all attempt to set up our own space as we please, just as small territorial animals do," explains Jérôme Englebert. "But prisoners aren't allowed to do this, which can create psychological difficulties."

In some ways, inmates are also disassociated from their own bodies. For security reasons, there are usually no mirrors in prisons, or else they are special mirrors covered in dark film that only show the reflection of a silhouette. "We deprive inmates of the element that forms the basis of our social exchanges and our identity: our own face,” insists the psychologist.

Society has chosen to lock up those who don't respect the rules of society. Jérôme Englebert’s intent is not to comment on this facet of the problem, nor its moral, philosophical, or political components. He is expressing himself purely as a clinical psychologist. In his opinion, and that of Michel Foucault before him, prison is a system that seeks to subjugate individuals, particularly in regards to time, space, and the body. Furthermore, he defines prison as a very pyramidal organisation, with an apex that is never seen... because it doesn't exist. "The inside of the tower is empty", stated Michel Foucault.

"Like capitalism or the Internet, prison is actually a system that has no reality," says Jérôme Englebert. “It's not the prison warden who is at the top of the prison hierarchy, but rather, law and regulations. But what is the law? A disembodied, unattainable entity. When certain severely schizophrenic inmates in social protection centres have demands, they’ll say: ‘I understand how things work, I will address the king’. Then they write to him. Afterwards they try to appeal to God. In short, they keep going higher and higher up the chain."

There is nothing at the top of the pyramid, but for a person subjected to this inalienable system that has no substance, a form of freedom does remain, which the psychologist calls "prison freedom". What is this paradoxical freedom? Jérôme Englebert offers two quotes from Michel Foucault: "Where there is power, there is resistance" and "In this central and centralised humanity, the effect and instrument of complex power relations, bodies and forces subjected by multiple  mechanisms of 'incarceration,' we must hear the distant roar of battle." In other words, faced with a system which seeks to suffocate all subjectivity, the cornerstone of prison freedom is profanation. In his book, Jérôme Englebert writes: "This involves gradually taking back from the system what belongs to human beings; profanation is a restitution of the body, space, time, ... identity.(…) there is freedom hiding in prisons, even if it's hard to see. There is always the possibility of a weak point, in all circumstances, even the most extreme." When confronted with the psychological difficulties or psychiatric pathologies of certain inmates, he considers it essential to talk with them about resistance to the relentless "machinery of subjugation," in order to help them regain a bit of freedom.

Along the same lines, he believes that psychologists practicing in the prison system must not treat their patient as a criminal, but rather a human being. For this individual must be taken as a whole and in the situation. For instance, the level of danger presented by an individual is a very complex phenomenon, since it is always related to a particular moment and context. "Similarly, depending on the moment and the circumstances in which it manifests, a psychopathology may actually be an appropriate response," explains Jérôme Englebert. “In his book Ethology and Psychiatry, Albert Demaret wrote something disturbing about psychopaths: ‘In times of peace, we lock them up; in times of war, we rely on them and decorate them...’ The point is obviously not to minimise atrocious actions, but to insist on the importance of individualised psychological or psychiatric treatment which views the subject as a human being."

Boards on the windows

By perverting the relationship to time, space, and the body, prisons diminish and sometimes even annihilate prisoners’ emotional life. In the prison environment, emotion is viewed as a disorder that may cause security problems.  Consequently, prisons do everything they can to eliminate emotions, which leads some inmates into emotional impasses since emotions cannot be dissociated from our identity and are critical to our psychological well-being. "Often, inmates share their feelings with other inmates or guards who sometimes become their confidants," says Jérôme Englebert. “However, the richness that characterises heterogeneous emotional experiences in the outside world is lost, and this is detrimental to inmates. In the most extreme cases, emotional destruction engenders a sort of psychological death."

In such circumstances, clinical psychologists cannot just serve as "technicians"; they must strive to enable emotional expression. The theory of prison freedom requires psychologists to orient inmates towards this previously-mentioned profanation, towards creative activities that help nourish their emotional lives and allow access to alternative forms of freedom. For example, the psychologist may encourage their patient to try painting or writing.

Incarceration can lead to significant psychological difficulties. However, individuals react in their own way to the prison environment. Some inmates may turn inward and even become more or less paranoid, while others may become depressed. Still others will adopt what is called a "prison identity". The prison courtyard is a very ritualised space where, as everyone knows, there are territorial leaders who "reign," just like in animal societies. They reign over two areas: sexuality, and the attribution and traffic of goods. When young inmates first arrive, they are advised to stay away from the courtyard. “In order to be accepted in the courtyard and occupy a certain social position in this microcosm, some inmates create a prison identity to the detriment of their true identity," explains Jérôme Englebert. “This manifests in two different ways. Inmates who were weak when they arrived may work out for hours every day in order to bulk up. They transform their bodies to meet the criteria of the group they want to fit into."

When they get out of prison, these inmates are frequently more rooted in delinquency - they have more contacts in the milieu, as well as more "debts" and tasks to accomplish. For those who have taken on the prison identity, can prison life become "real life", by substitution? "The desire for freedom is always the strongest desire," says the ULg psychologist. "All prisoners want to get out. However, I knew an inmate who asked to come back to prison after he was released. When he had his own studio apartment, he even put boards on the windows to look like bars. This person's mental state was pretty fragile, but he wasn't mentally ill."

Prison psychoses

In addition to the general disruption in relation to time, there are a number of other factors that can create or increase psychological difficulties in prisons. They have already been well-documented: overcrowding, lack of privacy, violence, racketeering, the obligation to "provide services", drugs, the lack of sexuality, forced homosexuality, the deterioration of some prison buildings, fear of kingpins, bad relationships with some of the prison staff, psychological isolation... These can lead to stress, anxiety, agitation, depression, thoughts of suicide, and "prison psychoses" such as "gate fever", where inmates experience extreme anxiety once the cell door closes.

There are a number of paranoid patients in prison. They are suspicious of everything, and as a result stay confined in their cells most of the time. Though it stands to reason that imprisonment creates severe psychological difficulties, the question remains as to whether prison is responsible for psychopathological conditions. Jérôme Englebert isn't so sure, and warns against ascribing a direct causal relationship. In his book(3) he states: "Saying that an individual's psychotic episode was triggered by their incarceration - whether or not we agree about the existence of prior vulnerability - is a deduction that can only be made after the fact, and thus confirmatory verification can only be retrospective. Following this line of reasoning, we can only identify the cause of the phenomenon (which then becomes an effect) as part of a secondary, and non-predictive time frame.”

In his opinion, any psychotic behaviour, whether chronic or acute, is essentially caused by biological factors (such as genetic vulnerability, among others), environmental factors, and the subject's personal history. In other words, he rejects the notion of linear causation (incarceration - psychopathology) in favour of "circular causation", which involves a number of different factors, including the fact that imprisonment is potentially traumatic and can inhibit harmonious psychological development. The concept of prison psychosis also relates back to a notion dear to Jérôme Englebert: human beings in a situation. Understood in this way, the concept "evokes the situational dimension (imprisonment) of the psychopathological manifestation without negating its intrinsic complexity."

The question of remorse

Many more psychopathologies are exhibited within prison walls than outside of them. Thus, after examining whether prison causes psychiatric psychopathologies, is it worthwhile to consider whether certain psychopathological entities are more likely to lead to criminal activities, and consequently, incarceration. "That may be the case for psychopathologies like psychopathy or perversion, but undoubtedly in a less linear way that we usually think," says Jérôme Englebert.

Jérôme Englebert is certain of one thing: the psychologist must never become a moralist. Certain inmates are ridden with remorse and guilt over the acts they have committed. Is that the most adapted response? "Taking refuge in guilt is not the only way to be constructive from a psychological point of view," states the researcher. "In fact, neurotics always do this. Another adapted response could be for inmates to worry about themselves, their daily lives, and their future - even though sentencing courts, social protection commissions, and all jurisdictions tend to think that inmates should necessarily and primarily commiserate with their victims.”

North American studies by Karl Hanson have shown that neither the success of psychotherapy nor the rate of recidivism were in any way related to the criminal's level of remorse. Bouncing off that idea, Jérôme Englebert throws out a slightly provocative question: ultimately, would we prefer prisoners to redeem themselves, or would we rather they not re-offend once they get out of prison? "I've made a radical choice," he declares.

(1) Jérôme Englebert, Le corps du détenu : études psychopathologique de l'homme en situation, 2012.
(2) Jérôme Englebert, Psychopathologie de l'homme en situation. Le corps du détenus dans l'univers carcéral, Éditions Hermann (Paris), 2013.

(3) Idem.