Correctional and Forensic Mental Health Delivery: A Bi-directional Process

by Joseph A. Grillo, Psy.D., Licensed Clinical and Forensic Psychologist

Death and Rebirth


Butterflies HatchingOver the years of providing clinical services to those involved with the legal system, I have had the benefit of learning a great deal from my experiences. I believe that, prior to working "behind the wall,” I took many of the simple things in life for granted. In fact, I did not even pay attention to everyday activities in which I was engaged.


As I began to work on my theoretical treatment paradigm for working with incarcerated individuals, one factor that became prominent was the "death and rebirth” process associated with the incarceration experience. Specifically, I noticed that, in order to be successful when entering the prison system, many had to undergo a metamorphosis - shedding many aspects of the "old self” and becoming a new "incarcerated self.” Woe to the person that was unable to do this successfully, letting "the time do them, rather than they doing the time.”


During the period of incarceration, I noticed that those who successfully adjusted also were able to appreciate the "smaller things” in life. Please note that I say this independent of their economic status prior to their entry to the system. Rather, those that were able to adapt to their situation and see the positive rather than the negative had better overall adjustment. Also, a "here and now” focus was prominent. Specifically, you did not see many calendars hanging up in the cells. Rather, you would hear statements about the lunch meal being discussed immediately after breakfast, even if the meals were not particularly pleasant. The concept of time, as a subjective experience, began to shrink. I refer to this as "temporal distortion” in my workshops.


I also noticed that there were those that focused less having on material goods than they did "on the outside.” Those who did otherwise tended to bother others, because it was believed to be rooted in fantasy rather than the reality of their bleak existence. Those that boasted or fantasized too loudly were seen as "mouthy” and were quickly "tuned up” or "dealt with” by unhappy visitors. The material focus was based more on survival, such as stamps, food, and other necessities. Interestingly, the levels of anxiety and depression related to prison entry began to lessen over time as prison adjustment "settled in.”


The pattern of "death and rebirth” appears again upon release, in my opinion. Here, the "inmate” is charged with leaving the prison cell to go to the outside world. I found that the level of angst increased once again, this time being directly related, to some degree, to the time that they spent behind the wall (what some call "institutionalization). Now, the person becomes "anxious” or uncomfortable about returning "home,” or to what they believe was "home.”When I speak to those who have returned, some speak of an odd experience of feeling caught between worlds (prison and home) where they feel more comfortable in prison than on the outside.


This, they report, is a very problematic experience for them. When explained as a death and rebirth process, however, my experience has been that it lessens the blow. Interestingly, over time, many go back to their way of seeing the world prior to incarceration (level of materialism, etc.) and do not like to reflect on their experience of "captivity” since it is viewed as all negative.



Personal Evolution


I believe that a bidirectional view can help identify something positive or therapeutic in the incarceration experience. As with all painful experiences, at some point, the individual must come to terms with the fact that it happened. In this case, the person was incarcerated. Yet, is it possible that something could come from this that would not destroy them, but, rather, make them stronger? I was always taught that the best revenge is living well! While struggling with developing a treatment model behind the wall, I reflected upon the changes that I experienced while working there.


In the supermax environment, I came to appreciate, as many staff members also note, the fact that "I leave at the end of the day.” How wonderful it was to be able to look up at the sky and not wish, as many inmates told me, to be "one of those birds so I could fly away” from there. I came to appreciate the fact that I could wake up in the middle of the night and make a sandwich, or just get into my car and drive to another state at 3:00 in the morning without asking anyone! My family did not look at me cross because of my past behaviors or not trust me to be alone with their children. I was free. I started to appreciate every day, being with my family, and having a wonderful career helping others.


This is what working with incarcerated folks has afforded me. I now deliver services to those that are being released, as well as those that are entering prisons or jails. Additionally, my views of "pain and suffering” and what humans can actually endure has become part of my outpatient practice, workshops, and writings. It is my hope that other Correctional Mental Health professionals can view their work in a positive manner, and not become stuck in the negativity that can be a part of any system. Rather, as we try to tell those that are behind the wall, "you have to do the time, but don't let the time do you.”


I think that viewing our work in this manner can help us avoid burnout to some degree.

Don't forget to check out Dr. Grillo's workshops at the 2012 MHCC Conference.

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