Working with Dangerous People: The Psychotherapy of Violence

227 Pages·2004·18.959 MB·\227

by  Jones David (Author)

Working vvith
Dangerous People
The psychotherapy of violence
Edited by
David Jones
Psychoanalytic Psychotherapist
Therapist, Assessment Unit
Grendon Prison
United Kingdom
Forewords by
Christopher Cordess
Psychoanalyst
Emeritus Professor of Forensic Psychiatry
University of Sheffield
and
Terry A Kupers
Psychiatrist
Institute Professor
The Wright Institute
Berkeley, California
Boca Raton London New York
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First published 2004 by Radcliffe Publishing
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Contents
Forewords v
List of contributors xi
Introduction
David Jones 1
Part One: Mainly theory 7
1 The disturbed disruptive
Hans Toch 9
2 Some ethical issues in psychodynamic work with
dangerous people
Mark Morris 15
3 Science, meaning and the scientist-practitioner model of
treatment
Agnes Petocz 25
4 Psychopathy: the dominant paradigm
Mark Morris 43
5 Changing people with programmes
Richard Shuker 55
Part Two: Mainly practice 69
6 Thinking under fire: the prison therapeutic community
as container
Andrew Downie 71
7 Working with the unbearable
Liz McLure 81
8 Responding to injustice: working with angry and violent
clients in a person-centred way
Gillian Proctor 99
9 Violence, sexual offending and sexual abuse: are they
linked? A qualitative research study
Michael Parker 117
iv Contents
10 Murder as an attempt to manage self-disgust
David Jones 131
11 Working at the coalface
Jane Coltman 143
12 The concept of dangerousness and younger people
Celia Taylor 153
13 Where lies the danger? A psychodrama approach
Jinnie Jeffries 165
14 After life imprisonment: the role of the probation service
Catherine Appleton 175
15 Concluding comments: a humane approach to working
with dangerous people
David Jones and Richard Shuker 191
Index 199
Foreword
It is an honour to be asked to write a foreword to this admirable volume which
is in so many ways close to my heart in conception and content.
Contemporary policy responses to increasing violence and a perception of an
increasing prevalence of dangerous people tend towards the increasingly
coercive and authoritarian; for example, escalations of surveillance, expanding
legislation and a mushrooming of the size of the prison population. We have,
indeed, in recent decades in Western societies, moved from a 'Culture of
Welfare' to a 'Culture of Control'.1 Many of us working within the health and
welfare systems related to the criminal justice system consider these policies
to be barren, especially when they ignore or neglect the complex but crucial
issues of institutional and prison culture, treatment and rehabilitation.
Professionals working in these fields increasingly feel over-regulated and
restricted by policies in which they, working at the coal face, frequently
have little faith. Add to this the anxieties for the clinician of being held
responsible - within the culture of blame - for even the least predictable of his
client's actions, and we have the ingredients for a dangerously de-moralised
system.
This book, written by people with an intimate knowledge of prisons and
dangerous prisoners and their mental health and welfare, offers something of
an antidote to the simply coercive and repressive. In the words of the editor, it
offers 'a humane approach to working with dangerous people ... It should be a
basic tenet of psychological work with clients that we are prepared and able to
be in sympathy with them, to have some understanding of their despair'. The
rich source of knowledge and experience of the contributors is that gleaned
largely from working at, or in close association with, the therapeutic com­
munity at Grendon Underwood Prison; the contents have wide and far reach­
ing applicability to all aspects of understanding the anti-social and dangerous
offender.
Forensic psychotherapy - the attempted amelioration of psychological
pathology and criminal behaviour in the criminal offender - always operates
within a triangulated system in which society, represented by its institutions
(e.g. the criminal justice system), has a legitimate and important role, in
addition to the therapist and client dyad.
Actually, as our society becomes more and more preoccupied with risk
assessment and risk management, and third party protection, society's
concerns impinge upon all psychotherapy, even that which appears most
'private and voluntary' - but that is another subject. Psychotherapy, by
its nature, questions the premises upon which beliefs, whether individual,
institutional or societal, are held. Such a questioning is at the heart of the
operation of the therapeutic community. It is a highly commendable feature of
this book that it encourages examination and re-examination of assumptions
vi Foreword
too easily made and taken for granted. So that, whereas it is primarily
concerned with 'the mind of the criminal' (and his behaviour) it also takes
cognizance of 'the criminal of the mind', that is to say those aspects of
ourselves which are potentially anti-social, criminal or neglectful. In this
context, this may be focused down to the potential for abusive or excessively
retaliatory policies or individual behaviour, and in settings of detention the
ever present tendencies towards quite subtle, as well as gross, abuses of power.
Our 'criminal institutions' are every bit in need of assessment and 'treatment'
as the dangerous people held within them, but they are frequently even more
resistant.
Theory - implicit or explicit - and practice are intimately entwined in all
good psychotherapy, as indeed in any criminological endeavour. For heuristic
reasons, as has become traditional, this book is divided into separate theory
and practice parts, but it seems to me that they are especially well integrated. I
particularly enjoyed the philosophically well informed critique by Agnes
Petocz of 'scientism' in psychology and the way in which the 'evidence
based' movement has been applied in a form which is often a concretised
caricature of its progenitor's original intention. Clearly and relatedly, it is of
crucial importance in our subject that we fully participate in the contemporary
rapprochement between the neurosciences and the 'psychotherapies of mean­
ing', rather than allow ourselves to become caught up in furthering that false
divide.
This volume offers a contribution to ways of thinking about dangerous
people and their behaviour, and working with them constructively, respect­
fully and possibly redemptively.
Although there is no chapter dedicated to the subject of training, super­
vision and professional support, these crucial aspects are implicit, and some­
times explicit, throughout the text. I sincerely hope that this book will be read
by all those concerned with offenders in whatever capacity, from clinicians to
politicians, from policy makers to managers. It will well reward their interest
and attention.
Christopher Cordess
Psychoanalyst
Emeritus Professor of Forensic Psychiatry
University of Sheffield
January 2004
Reference
1 Garland D (2001) The Culture of Control. Oxford University Press,
Oxford.
Foreword
I don't believe it is overly optimistic to say we are witnessing the beginning of
a paradigm shift in the field of criminology. The reigning paradigm, the one
that is about to be replaced, involves an ever more punitive approach to
criminal defendants and prisoners. Punish, punish, punish: less sympathy in
the courts, longer sentences, fewer privileges behind bars, less recourse,
tougher parole officers, more parole violations, added prison time. The
singularly punitive approach has had its trial, and, in the minds of many
policy-makers and correctional managers, it has proven a failure. In the period
that began with Robert Martinson's1 1974 'nothing works' proclamation about
efforts at rehabilitation, rehab programs have been dismantled, the prisons
have become massively overcrowded, and harsher punishments have been
instituted at every turn. Meanwhile there is more violence in the prisons, the
crime rate in the community did not fall, but the recidivism rate rose, as did
the proportion of prisoners serving time merely for violating parole. The
punitive approach does not help dangerous people take control of their
aggressive impulses. Today, the big question is, if ever harsher punishments
don't work, what will? Specifically, what is the most effective intervention
with the disruptive and assaultive prisoner?
The story of supermaximum security prisons in the USA is emblematic of
the evolving paradigm shift. Supermaxes (also known as maxi-maxis, control
units, security housing units or SHUs) exploded on the corrections scene a
little over a decade ago. The idea was to curtail the frighteningly high rate of
prison violence by locking assaultive prisoners in their concrete and steel cells
most of 24 hours per day. Of course, there was a certain quieting of the prison
yards for a while, the quarantine effect. But beyond the immediate quieting,
the outcome is not as cheering. For example, there is the problem of 'maxing
out of the SHU'. So many prisoners are relegated to long-term isolated
confinement that a certain number of them reach their fixed release date
prior to finishing their stint in the SHU. They are released into the community
straight out of a cell where they had been isolated and idle for years. Not
surprisingly, some of them return to drugs and alcohol and commit heinous
crimes. What is surprising is that there aren't more who do so. Most ex­
inhabitants of supermaximum isolation cells actually keep to themselves
when they are released from prison, their will to relate to others having
been broken. But when any ex-resident of supermax commits a violent
crime there are headlines and, of course, heated accusations about where the
fault lies.
The 'tough on crime' faction loudly proclaim that the heinous deed is
incontrovertible proof the violent criminal element is incorrigible, and call for
a halt to 'coddling' and the building of even more super-secure prisons where
we can 'lock-'em-up-and-throw-away-the-key'. The other side in the debate,
viii Foreword
prison reformers and progressives among them, just as passionately believe
that the error was to lock prisoners in cold storage in the first place; long-term
isolated confinement causes human breakdown of all kinds, including psy­
chosis, suicide, and in far too many cases, intensification of uncontrollable
violent impulses. To the reformers, the crime spree of an ex-SHU resident
means that the corrections department has failed in its mission to reduce
violence and 'correct' the errant felon. After all, the first principle of inter­
ventions aimed at reducing violence is to make certain that the interventions
themselves do not actually raise the prevalence of violence; and many
commentators are coming to the conclusion that the advent of the super­
maximum security prison has increased rather than decreased the rates of
violence in the prisons and on the streets.
Of course, both sides in this very old debate haul out scientific studies to
bolster their arguments. Often, the two sides utilize the same events and the
same statistics to make very opposite points. An example is the fact that
people who have committed violent acts in the past are more likely than
others to commit violent acts in the future. This well-known correlation can
be used to buffet the argument that they must be locked up for a very long time
and punished severely, or the same correlation can be used to support the
argument that we need to find programs that work to change the deeply
ingrained habits of very assaultive individuals or else we will suffer the
consequences of their repeated acts of violence after they are released from
custody.
Clearly, anyone who steps forward to proclaim a new, less exclusively
punitive paradigm for corrections must first argue that there is scientific
evidence for their approach, that the arguments of their 'tough on crime'
adversaries have indeed proven a failure, and that the interventions and
programs being proposed are effective in managing and rehabilitating assaul­
tive prisoners. If the crime rate has not fallen substantially in the face of the
unprecedented imprisonment binge in the USA in recent decades, then it is
not going to be possible to prevent violent crime by locking up an even greater
proportion of the population. And even political conservatives are realizing the
practical folly of a strategy that relies on ever tougher sentencing: it costs a lot
of money to keep so many people in prison, and even with today's harsher
penalties, most prisoners will eventually be released. Do we want them to
come out of prison broken and embittered by the constant punishments, and
by the many cruelties that inevitably evolve within a culture of punishment?
Meanwhile, class action lawsuits are forcing the states and the federal
government to pay more respect to human and civil rights, and that means
halting the kinds of abuse that regularly crop up in the extremity of super­
maximum confinement. The tide is turning and a growing number of serious
criminologists and policy-makers are asking what alternatives there might be
to ever longer prison sentences. The state of Maryland has announced it will
close its supermaximum facility near Baltimore, and other states are thinking
about following suit.
But there is a problem. The staff will have to talk to the prisoners. Too often
in the supermax setting the officers limit their contact with prisoners to
barking out orders and cussing them as they tell them what will happen to
them if they deign to disobey. In the highly segregated and controlled setting
Foreword ix
that the modern maximum security prison has become, many staff have
forgotten how to talk civilly to a prisoner, how to ask a prisoner how he is
feeling and what are his needs, and how to interact casually with prisoners on
the yard or in the dayroom. One can see the result in almost any maximum
security prison: officers huddled in an office while the prisoners steer clear of
them for fear of being labeled a 'snitch' by their peers if they engage staff in
anything other than brusque exchanges.
As the paradigm shifts from punitive idleness and isolation to an emphasis
on educational and rehabilitative programs, the staff must learn anew to
mingle with prisoners. How will they remain safe doing their work? Which
attitudes and approaches toward prisoners are most conducive to rehabilitative
efforts, especially when the prisoner has a history of violence? In the old days
staff interacted with rowdy prisoners on the maximum security yards. But
many corrections officers and correctional mental health staff have forgotten
how to do that.
By the time a scientific paradigm actually shifts, the founders of the next
and better explanatory theory stand in the wings, ready to point the way
forward. When Heisenberg's uncertainty principle replaced Newton's model,
the group of quantum physicists at work on the new paradigm was already
very sophisticated.
During the heyday of the punishment paradigm and the supermaximum
prison, the staff at Grendon Prison were experimenting with a very different
strategy for managing and rehabilitating assaultive prisoners. This book is
both a collection of essays about their sophisticated, pioneering approach, and
a preview of the new paradigm. Authors of the very varied but always
thoughtful chapters about different aspects of work with very dangerous
people share in common the conviction that mutual respect between ward
and warder is a cardinal prerequisite for altering the behavior of disruptive and
assaultive prisoners. The authors share a preference for horizontal commun­
ications over strictly top-down ones, and thus they view the prisoner as a very
active participant in decisions that affect him or her. The authors prefer
collaborative analysis of the meaning of events to shouting orders. And the
authors deeply ascribe to the principle that more and better communication
between staff and prisoners is required if we are to accomplish any significant
work with very disruptive prisoners.
Grendon Prison has a unique history. As prison managements elsewhere in
the United Kingdom and the USA turned to intensified segregation as the
antidote to uncontrollable prisons, the staff at Grendon remained true to their
plan to run a prison unit for very assaultive prisoners as a therapeutic
community. Groups become the place to talk about the meaning of angry
feelings, and there is significant evidence that the approach works, for example
there is far less physical violence at Grendon than at other prisons of compar­
able security level. The editor has brought together in this eloquent volume
the ideas of various participants in the Grendon experiment, along with others
who have been thinking along similar lines.
And the authors have done something quite admirable: they have reintro­
duced psychoanalytic concepts into the field of forensic mental health - but
not in the idealistic way that August Aichhorn,2 Franz Alexander3 and Erich
Fromm4 did early in the Twentieth Century. Rather, they have incorporated