Psychologist Terry Kupers has spent many years working with prisoners in solitary confinement. We discuss the impact of isolation on the mind, and how to cope with it.
What would you say are some of the biggest conclusions from your work?
When I first started touring these places, I found some of the worst cases of psychosis and depression I had ever seen in my entire career. Even if people did not have a serious mental illness, they were damaged in less obvious ways. Anxiety was pervasive. The thinking process was distorted, and often it meant paranoia. There were big memory problems. Despair was very widespread, people became depressed, and suicide occurred incredibly often. The suicide rate in prison is approximately twice what it is in the community at large, and 50% of successful suicides in American prisons occur among the three, or five, or 7%, of the prisoners who are in solitary confinement.
Prisons are also a window into our race dynamics in this country. Almost 50% of prisoners are African American and another 20 to 30% are Latinos. At every step along the way in the criminal justice process there is discrimination by race. Black Americans are more likely stopped by the police and frisked; when they are stopped, they are more likely arrested. Whereas a white counterpart might be released to their own recognizance at home, a black individual is going to be taken to jail. In court they are going to get a more severe sentence, and then in prison a greater proportion of them are going to end up in solitary confinement.
Are you able to get a truthful perspective of a prisoner’s struggle?
Typically, I get a very clear picture of what happens for them – I am an expert for their attorney. There is a kind of trust and honesty that develops that does not with the prison psychiatrist. In prison there is a lot of stigma about having emotional problems, or having a mental illness, or being suicidal. Prisoners think that if they tell something to mental health staff, the officers will learn about it; or they think other prisoners will see that they are getting mental health treatment and then they will be stigmatized. There is instant relief when I come in, because the prisoner understands the confidentiality of our interaction and they also know which side I am on in the lawsuit that they are involved in. There’s an immediate trust.
Could you describe one case that has impacted you in one of your hundreds, if not thousands of interactions with prisoners over the years?
I have had well over a thousand interviews with prisoners. I will give you an example. I met a black man who was about 40, and had been in solitary for nine or ten years. I asked him what happened, and he said, well, I broke a rule, I admit it – I was someplace I was not supposed to be, and they punished me with a term in solitary. The original term was six months, and there he was a decade later. Now, this is a very stable, intelligent man. He is not seriously mentally ill, but when you are in solitary, your anger builds up. You do not know why your anger is building up, but you keep getting angrier, and angrier, and then one day it has to happen. You just blow up, and then they write you a ticket for a longer term in solitary. That had happened to him over and over again. Here is this man who is in solitary for nine or ten years. He has not really done much wrong, and yet he is stuck in solitary – he thinks for the rest of his life. I should mention that maybe 70, 80% of the prisoners in solitary that I have interviewed have told me that exact thing about mounting anger.
I think that feeling of the unknown, of being trapped there and not knowing how long it will last, could drive someone to the point of insanity. Obviously, on an extremely small scale, we have no idea when the quarantine is going to end.
I want to make a distinction: solitary confinement in prison is a whole other magnitude of damage, psychologically. The prisoner has absolutely no control over his life. A lot of prisoners die because they are beaten to death by officers.
They die from being beaten by the officers?
Yes, I have come across many cases of that – it is often because they stand up for themselves. In prison you are supposed to be compliant, and the officers demand total control over the prisoners. The extremity is just a whole other order of magnitude that we are not experiencing out here.
Having said that, sheltering in place is a form of isolation that has a lot of potentially negative effects. Prisoners work out ways to survive their isolation, and we could look at what they do and learn something. I think in order to do well during this current crisis people have to be disciplined. The usual markers of our daily life are gone. We do not have to get to work at nine in the morning; we do not have our workmates to relate to around cooperative tasks. Therefore, we have to create a structure for ourselves which gives meaning to our lives, but also marks the daily rhythm. If we do not organize our day, what happens is a kind of disorientation. The prisoner in solitary confinement works out ways to counter that. They keep a chart of as the days go by, they know the date, because often there is no clock and there is no calendar allowed in solitary confinement.
I loved how a lot of your research mentions intimate relationships. Just how important are they?
A symptom of depression is seeking isolation. What we do in psychiatry is try to counter the tendency towards isolation in order to treat the depression. Human beings are basically social animals: we get our sense of reality by talking to each other. Depriving people of social connection creates a situation that is not hospitable to human beings – which is what happens extremely in solitary confinement, in prison, and to a much lesser degree in shelter in place. We want to encourage all social activity. We do not need to be socially distant – we have ways on the outside in the community to maintain our social connection with others. I think people need reminders that it is important to use them. A Zoom conference is not the same as an in-person interaction, but it is better than nothing. It keeps us socially connected. That is what is missing in prison, and it is why so many suicides occur among people in solitary confinement.
What do you mean by a need for “agency”?
One of the elements of a good relationship is mutuality, caring, empathy, that kind of thing – that creates an attachment pattern where both parties have agency. It starts with the relationship between mother and child. For instance, a baby can cry when it is hungry or has a wet diaper, and the mother responds. That starts to build in the infant a sense that their actions cause effects in the world – they can get mom to notice their needs and take care of them. Now, when you take that into the prison situation, the prisoner in solitary confinement has no social connection. They are socially isolated, and they also have no or very little agency. They do not control anything in their life: they cannot make plans, they cannot really envision a future. That causes a great amount of psychological damage.
What we are also looking for is mutuality in relationships, all relationships. Mutuality is respecting the other person’s autonomy and individuality and bringing out the best in them. That is not going on in our prison system, but it is also not going on for many people on the outside. Domestic violence is rising during this crisis. Take a couple who had tenuous mutuality – that is, there is an average of peace, but every once in a while there is an outbreak of domestic violence in everyday life. Now, these two people are forced to stay within the walls of their home 24-hours a day, day after day: suddenly the prevalence of domestic violence goes up. Typically, the dominator has been dominated in the past and abused, and then they take it out on someone who they have power over.
Can this kind of trauma play a role in ending up in prison in the first place?
Trauma is one of the most pervasive background factors in the prison system. Prisoners as a group are probably the most traumatized group of people that I know of. Prisoners have had a history of physical and sexual abuse as children, of domestic violence as adults, of the crime on the street where they have been victimized. They go into prison and they are dominated by the staff – they are not permitted any kind of agency. They are told they have to follow the rules, and will be punished harshly if they do not. Essentially, prison retraumatizes the person who has already had a lot of traumas in their life.
I think this is a perfect point at which to dive into the concept of attribution and the attribution error. What is meant by that?
I mentioned that practically 50% of prisoners in the United States are African Americans. What is the cause of that? One way to think about it is that there is something inherent in African American people that makes them prone to break laws. That is called racism. In reality, there is something very biased and discriminatory in our entire social system, but particularly the criminal justice system, which lands people of color behind bars. The police treat African Americans, particularly low income African Americans, much more harshly – as will the courts. It is not because of a difference in their attributes, it is because of racism in our system. That is what an attribution error is.
So 50% of prisoners are African American – is it another 20% that are Latino or Native American?
I would say 25, 30. Native Americans are a very small percentage of the prison population – however there is a disproportionate percentage of the Native American population that is in prison. So, while they are a small percentage of the prisoners, it is a huge percentage of that community.