Prisoners and Psychological Trauma
by Masha Bennett www.practicalhappiness.co.uk
Psychological trauma occurs when a person experiences a traumatic event, which usually involves a threat (or perceived threat) of death or serious injury to themselves or others. The common emotions the individual may feel in these circumstances involve fear, helplessness, shock or horror.
Traumatic experiences could include: road traffic accident, natural disaster, rape, assault, robbery, childhood abuse, combat situations, domestic violence, terrorist attack, torture, diagnosis of a terminal illness, traumatic bereavement and others.
Some people can feel traumatised following events that do not directly threaten life but are nevertheless shocking and deeply upsetting, for example, being made redundant, finding out that their partner is having an affair, having their home re-possessed, losing a beloved pet, being bullied, humiliated, criticised or blamed. Whist these events may not satisfy the “official criteria” for trauma, it is important to acknowledge that they could have a profound and lasting effect on our lives and that sometimes we may need help to deal with these “mini-traumas” – especially if we experience a number of these in our lifetime.
In the context of criminal justice, being arrested, charged, put on trial, incarcerated are potentially traumatic experiences that could exacerbate any existing trauma-related condition. Prisoner’s family members can be left traumatised directly or indirectly. Many prison staff are affected by incidents such as suicide attempts, assaults and other events that are not an uncommon part of prison life.
Post-traumatic Stress Disorder (PTSD) is diagnosed if the person who has experienced the traumatic event, continues to suffer the following symptoms after a month or longer after the event:
(a) Intrusive thoughts, flashbacks or nightmares, where the traumatic event is re-experienced; sometimes re-enacting the traumatic situation.
(b) Avoidance of people, situations or things that might bring on their intrusive symptoms (this may include self-medicating with alcohol or drugs in order to numb the feelings)
(c) Hyperarousal – physiological signs of increased emotional arousal, hypervigilance (constantly looking out for danger), increased anxiety or irritability, increased startle response.
An article by Claudia Baker, PTSD and Criminal Behaviour, quotes figures from research (presumably conducted in the US), indicating that among incarcerated populations PTSD has been found in approximately 48% of females and 30% of male prisoners, which does not surprise me (in fact I am guessing that these figures may be under-estimated). On the other hand, a review of literature by UK psychologists Goff et al. in 2007 quotes figures of between 4 and 21% PTSD in prison population – which to me seems to be an unrealistically low estimate, though the authors do acknowledge that women are disproportionately affected.
If my own experience of working with prisoners and hearing their life stories is represetnative, a very significant proportion of them have suffered not just a single traumatic event, but multiple, often chronic trauma, typically going back to childhood, and whilst it is important to acknowledge that traumatic experiences in themselves would not necessarily lead all sufferers to break the law, Claudia Baker’s article gives some examples of circumstances when trauma can be directly or indirectly linked to a criminal offence.
Effective treatment for trauma and post-traumatic stress is rarely available in prisons, and incarceration itself will often exacerbate the distressing symptoms. Current research evidence favours treatments such as CBT (Cognitive Behaviour Therapy) and EMDR (Eye Movement Desensitisation & Reprocessing), and evidence is also building up supporting the use of approaches such as EFT (Emotional Freedom Techniques), creative therapies (art, music, sandplay, writing, drama therapy), body-oriented psychotherapies (e.g. Sensorimotor therapy, Somatic Experiencing) and certain forms of hypnotherapy. In my clinical experience, each individual is unique and requires a unique approach, with no single technique or therapy being a solution for all.
Masha Bennett is a UKCP registered psychotherapist and a trainer of EFT (Emotional Freedom Techniques). She has worked for a number of years within the criminal justice system, including running a drug rehabilitation programme in a women’s prison, and currently combines work in the UK National Health Service with her private therapy and training practice. Masha teaches EFT, trauma awareness and self-help tools to professionals and general public across 10 countries in Europe, Asia and Middle East. Her website is www.practicalhappiness.co.uk.
Some sources of information and support
Combat Stress (UK)
The Long Boat Home – directory of UK therapists offering reduced-cost treatment to ex-servicemen and women
Gift From Within – International organisations for victims of trauma and victimisation