prison psych

“I can think of one thing that is worse than being sick and in the prison ward here at the hospital. Being well and at Riker’s.” – CPE supervisor

“The midnight shift here on the prison ward is way better than working during the day at the 23-hour lock-up on the island.” – NYC corrections officer

“I would rather try to kill myself than have to go back to Riker’s.” – prison ward psych patient

Working at the prison psych ward this summer has confirmed for me just how bad Riker’s Island is. And the prison psych ward at Bellevue Hospital, where I am interning this summer as a chaplain, is pretty damn bad.

Almost every day I go through airport-like security to reach the floor. Armed corrections officers abound. Often there are folks in the hideous orange jumpsuits, and in leg chains and handcuffs, and the lucky ones shuffle towards an elevator that will get them to their transportation to court, to Riker’s, upstate to Sing-Sing. The less fortunate are pushed in hospital beds. I wait for one mechanized gate, with its once-white, peeling paint, to slowly slide open. I enter a holding area and wait for it to close. At the end of the hallway, another officer unlocks a door. I enter and wait for her to lock it again. She walks to another white metal gate, with yet another officer sitting on the other side, and opens it. I am finally on one of two prison psych wards.

bellevue hospital gate; photo by salem pearce

bellevue hospital gate; photo by salem pearce

I walk past men — they are all men, and the vast majority men of color — in faded blue scrub tops and gray sweatpants. Milling around the hall. Walking deliberately around the hall, because some days that’s all the exercise they can get. Shouting in the hall. About using the telephone. About getting a clean shirt. About talking to a doctor. About . . . something unintelligible. Sleeping in their rooms. Using the bathrooms that abut the halls with huge picture windows.

There are tons of corrections officers here, too, as many as there are patients. During my first visit to the floor, the chief psychiatrist warns me, “They are not here for your protection.” They sit in chairs, as do staff who are assigned to the patients under “constant watch.” There is a lot of sitting. There is nowhere to go.

I check in at the nurse’s station: Is there any patient I need to avoid today? I walk around the hall — only the main hall; the second hall, ironically with absolutely no corrections officers, is too dangerous — and ask if anyone wants to talk to the chaplain. Sometimes I knock on doors, where there are two to three patients per room. I usually don’t have to walk long to get a taker.

We walk to an interview room. The patient enters first and sits on the opposite side of the table; I am closest to the door. If he is under constant watch, the staff member sits outside. And then the patient and I talk.

Some of them have committed the kinds of crimes that you read about in the Post: Man tries to kill girlfriend and then himself. Man takes [unusual weapon] to co-workers. Man assaults officers on the subway during rush hour. But some of them are simply folks with mental illness whose behavior has been criminalized. Man shouts in an unruly manner on street. Man violates probation. Man pandhandles. And yet others are the result of decompensation in isolation, or not, on Riker’s.

What I have been struck by most is the detail of care afforded patients by the system — and its simultaneous profound inhumaneness.

Several mornings a week I attend a meeting of the unit’s principle staff: psychiatrists, psychiatry interns, social workers, social work interns, nurses, and clerks. The meeting starts with a report from the head night watch clerk. He goes through what happened with each patient the night before in minute detail. Who got what medications, who refused medication, who slept when, who was awake when, who ate what, who was in what mood.

Then they go over new admissions. They discuss discharges (which always means back into some part of the criminal justice system). And then one of the doctors presents presents her patients in detail. She talks about medications, psychological state, progress. The social worker adds information about the criminal case, family, records at Riker’s or other institutions, contact with lawyer. (A different doctor will go the next day.) Then the daily lists are created collaboratively: Who is at what “level” (and therefore has more or fewer privileges); who can get a haircut; who is going to court; who can attend groups. The information is mostly in these professionals’ heads: They are very familiar with their charges. And everyone refers to each as “Mr. So-and-so.”

There are groups: art therapy, music therapy, spirituality, community meetings. I run what’s called a “Healing Circle” once a week. Almost every day there is recreation on the roof. General freedom of movement on the unit. Three meals a day, plus snacks. Several televisions.

And yet.

There are no personal possessions, which is helpful since the patients are (inexplicably, to me) moved almost every day. The lists created include who needs to be forced to shower. The walls echo with clinical phrases like, “irritable upon approach”; “responds to redirection”; “sexually preoccupied”; “displays suicidal ideation”; “exhibits disorganized thinking.” The view of the East River is almost completely obscured behind feet of thick wire screens. There is an almost uniform schedule for their movement through the criminal justice system (“Arraignment on Wednesday means a court date on Monday”). Most of the men can’t tell you why they were arrested, much less how they ended up on a prison psych ward. Very few of them will ever experience life outside of an institution.

Adding to the feeling that these men are utterly lost to us is the fact that they almost all have the most common American names. Johnson, Smith, Brown, Williams. John, Michael, Jeffrey, Kevin. Pick a combination, and they’re probably there.

And then the most crushingly heartbreaking of all: Occasionally there is a patient called simply “Unknown Male.”

We know so much and yet virtually nothing about them.

I don’t doubt the motivations of the staff of the unit. I’ve never heard anyone speak about the men under their care with anything but respect and sympathy (okay, sometimes tinged with frustration, but I think that’s reasonable). But the truth is that this care can only go so far. It inevitably runs up against the fundamental philosophy of a system of mass incarceration: that it is acceptable, even preferable, to put certain human beings in cages. The cages in prison psych encompass the entire unit, instead of individual cells, but that doesn’t make them any less inhumane. And all the pastoral care in the world isn’t going to change that.

guest post: ableism in kedoshim

july4My first guest post: a d’var Torah by the awesome Emily Fishman!

The oft-quoted Leviticus 19:18, “וְאָהַבְתָּ לְרֵעֲךָ כָּמוֹךָ– love thy neighbor as thyself,” literarily comes to summarize a list of how to set up your world to be a just one, where the vulnerable are protected and the powerful have their privilege checked.

One of the specifics in the section is לֹא-תְקַלֵּל חֵרֵשׁ–וְלִפְנֵי עִוֵּר, לֹא תִתֵּן מִכְשֹׁל, “Do not curse the deaf nor put a stumbling-block before the blind,” verse 14. This verse, especially the bit about the stumbling block and the blind, is quote frequently in halakhic literature as a shorthand for entrapment, luring someone into sin. For example, an adult is forbidden to hit their parent, that is a matter of law. The parent, though, should not hit their adult child lest the child be tempted to hit back — that is a matter of lifnei iver. Another example: A nazirite is not allowed to drink wine. Therefore you are not allowed to offer wine to a nazirite because of lifnei iver.

By contrast, veahavta lereiacha kamocha is hardly heard in legal discourse, outside of a few citations by the Rambam. And I can imagine how helpful it could be! Don’t hit anyone — because love they neighbor as thyself. Don’t overcharge in business — because love they neighbor as thyself. Don’t throw loud parties at 3am — because love thy neighbor as thyself.

But no, it’s the bit about the blind person that gets dragged out time and time again.

In interpreting biblical verses, giants in the tradition, such as Rashi and Rambam, pull on the Talmud’s statement, “Ein mikra yotzei midei pshuto” (Shabbat, yevamot) — a verse’s interpretation may not contradict its plain meaning. Though it isn’t universally applied, let’s try it here.

What is the literal meaning of lifnei iver? The halakhic implications of not putting stumbling blocks in front of the blind would surely include tucking your backpack under your chair rather than leaving it in the aisle at the library. Making sure that all announcements posted on the bulletin board are also conveyed auditorily. Taping down the edges of rugs so they don’t get folded and become tripping hazards.

Using lifnei iver to name a category of situations where a person is drawn to forbidden acts not only obscures the simple meaning of the verse, it also subliminally erodes the esteem in which we hold blind people. They lose their agency, becoming faceless victims to circumstance, led into horrible situations because they can’t control their own environments.

We have a similar problem in English. We say that someone is “deaf to the cries of those in need” or “blind to the plight of people.” What we actually mean is “willfully ignorant.” We use “schizophrenic” to describe an incoherent argument and “obsessive-compulsive” to describe our coworker’s tidily organized desk.

But this leaves us open to harming others in our inarticulate use of language. How would it feel to be a deaf person and have your identity constantly used to mean “ignorant”? How would it feel to be struggling with anxious repetitive behavior that caused clinically significant impairment and have your diagnosis dismissed as behavior typical of precise or controlling personality types?

Perhaps we are drawn to expansive readings of lifnei iver because we convince ourselves that we would never be so careless as to place an actual barrier in front of an actual blind person. And it feels daunting to try to shift our language around any of these issues. There are too many people asking too many things of us. And maybe I don’t understand why they are asking me to change my language from an intellectual or emotional perspective.

How would the halakhic category of caring for each other’s vulnerabilities be different if we framed it as Veahavta lereiacha kamocha instead of lifei iver? If we came from an angle of thinking through and asking how we can be of service to another human like ourselves, rather than taking a patronizing tack and assuming we know how to best serve a person who is unlike us?

Veahavta lereiacha kamocha relationships are admittedly harder than lifnei iver relationships. It requires us to learn about each other’s experiences, act with compassion and humility, give benefit of the doubt, and trust that everyone else is doing the same. But what we stand to gain is a life where we learn about each other’s experiences and community characterized by compassion, humility, trust, and second chances.

Kamocha means that the person in question is fundamentally like me, relatable. It pushes against our instinct to view ourselves as separate from each other. Kamocha encourages us to see difference as incidental rather than fundamental. This solidarity lends itself to compassion. Problematically, the lifnei iver frame puts me in a place of approaching an “other” who is fundamentally different from me. On the other hand, the veahavta lereiacha kamocha tack lends itself to broadly defining who we mean when we say “us” and using language to both reflect and encourage inclusive notions of community.

In the mindset of lifnei iver, if I don’t understand the utility of putting effort into changing language, then it isn’t incumbent upon me to try. I don’t have evidence leading me to believe that what I do is going to trip them up. Additionally, I have no responsibility to be proactive, to think about and ask about other people’s needs. If I just care about avoiding stumbling blocks, then I am only responsible for the harm I do through action, but not the harm I do through inaction

But if we work the same situation from a frame of veahavta lereiacha kamocha, we come to a very different conclusion. A human being has told me that they want me to change my language around a particular topic — gender, mental illness, disability, race, income, whatever. They seem to have a real stake in the issue. Veahavta lereiacha kamocha does not invite me to weigh whether I think this language should or shouldn’t matter to them or whether it will or won’t radically change society.  It invites me simply to respect another human’s stated experience and join them in creating the world they wish to live in.

the light gets in

Ring the bells that still can ring
Forget your perfect offering
There is a crack in everything
That’s how the light gets in. (Leonard Cohen)

As I’ve mentioned several times in this space, my first year of rabbinical school was really difficult for me, for a number of reasons. For one, everything was new: We moved to a new city so that I could start a graduate program in an area I’d never done academic study before after being out of school for more than 10 years. Plus I was being asked to make myself vulnerable on a daily basis with people I didn’t know at all — and to think about some of the most profound questions that we ask ourselves as human beings. Then, add all of this to the fact that the people I was with eight hours a day (my first-year cohort) had a fair amount of trouble trusting each other and meshing as group.

I started seeing a therapist here in December of 2012, just a few months into my first year of school. I know it was a good idea in a general way — if I’m going to be in a pastoral role, I need to have dealt with my own issues so that I’m not holding my own pain while holding others’ — but what motivated me to seek help then was an explosive incident in class. My intense reaction to the discussion took me by surprise (and, if I’m being honest, embarrassed me, too).

I completely lucked out in my “search” for a therapist in the area: I visited just one woman, who had been recommended to me, and I felt like it was a good fit immediately. I’ve been seeing her ever since.

I’ve been in therapy on and off since college when I first started seeing someone in the university’s health services department. I didn’t go regularly until I lived in D.C. and I needed support for my volunteer work at the rape crisis center. I now go once a week, and I feel like I need every hour.

everything is broken (source: moshe giventhal)

everything is broken (source: moshe giventhal)

Sometimes it’s frustrating to think about how many years I’ve been working on my issues, for indeed, I am still dealing with a lot of the stuff that I first started talking about in college. There’s a part of me that wants to just be done with it and move on. But I also know that’s not really how it works. I do hope, however, that my need for help will someday not feel as urgent as it does now. Right now, I at times feel broken beyond repair. I wonder if I’ll ever feel whole, or anything like it.

There are definitely bright spots, though. I know how absolutely privileged I am to even be able to see a therapist, let alone be free to find a good fit and not have the choice be limited by insurance. (My insurance does cover part of the cost, but I’m reimbursed at the out-of-network provider rate, and paying for part of expensive is still expensive.) I also am beyond grateful to my husband, who also recognizes how important this is for me and has agreed to prioritize the expense. I am also fortunate to have been able to find medication that very effectively helps with my depression. Most of the time, I feel “normal” — or more accurately, I feel like myself. And that is a relief.

This is not to say, however, that I don’t have times when I feel depressed, when I can’t do much of anything. It doesn’t happen a lot, but when it does, I feel helpless. I have a hard time accessing my own strength and resources that I know theoretically that I have. (For a good illustration of how depression works, see these posts from Hyperbole and a Half: Adventures in Depression and Depression Part Two.) All I can do most of the time is wait for it to pass, which it usually does within a couple of days (which relatively short period of time I am extremely grateful for — though it doesn’t always feel “short”). I wake up one day feeling better, and I pick myself up and go back to my life.

I write this because I think sharing my story, my journey with mental illness, is an important part of destigmatizing it and destigmatizing seeking help for it. I write this for myself, too: I can’t always convince myself of the fact that my depression is not a moral failing on my part, even though I know intellectually that it is so. It’s chemical, and it’s genetic (several members of my family also have experience with depression). I continue to work on accepting the fact that I will probably struggle with this my whole life — and that I’ll be on medication for the rest of my life. And some days that feels more acceptable and manageable than others.

a world apart

This week I was assigned Cristina Rathbone’s A World Apart: Women, Prison, and Life Behind Bars as part of my Foundations of Prison Ministry class. I was only required to read parts, but I ended up tearing through the whole thing. It helped that I had a snow day on Tuesday.

The book hits close to home (it looks like I’m calling Boston home now!) because the author lives in Jamaica Plain, a neighborhood just a few miles away from mine. Plus, the subjects of the book are women incarcerated at nearby MCI-Framingham, a women’s prison, where I mentor an inmate who is in Boston University’s College Behind Bars program. I visit her as part of an interfaith initiative between Hebrew College and Andover Newton Theological Seminary, the CIRCLE Prison Justice and Ministry Program.

Rathbone’s relationships with the five women whose stories constitute the majority of the book developed over five years — and were only the result of years of initial litigation for access to the prison. As she notes at the outset, she has just about only been in MCI-Framingham’s visiting room. But despite the considerable efforts of the powerful Massachusetts Department of Corrections to keep her out, Rathbone presents a comprehensive picture of life on the inside (in so far as any outsider can tell, I suppose).

The importance of the book lies in the fact that, Rathbone notes, “women behind bars are startlingly unlike their more violent male counterparts. Predominantly incarcerated for nonviolent, drug-related offenses, they are frequently mere accessories to their crimes: girlfriends, wives, or lovers of drug dealers, even leaseholders of apartments in which drugs are stashed. Almost all have serious drug problems themselves, and about half are victims of domestic abuse.” It stands to reason that life inside a women’s prison would be different, too.

If the stereotypical male experience in prison is working out, illegal procurement of weapons and drugs, physical violence, and trying to escape, the stereotypical female experience is eating junk food, illegal procurement of underwear and personal hygiene products, gossiping, and trying to see children. But sex is the great unifier: It turns out that almost everyone, in both environments, sleeps with a fellow inmate or a guard.

The book alternates between the stories of a handful of women and the history of women’s incarceration in the U.S. I found the latter only of passing interest, in part because how little effect the past has had on the trajectory of how women now fare in the criminal justice system. The first women’s prison, Mount Pleasant, opened in 1838 on the grounds of the infamous Sing Sing prison, and it was closed in 1850. MCI-Framingham, which opened in 1877, is the oldest running women’s prison in the U.S., so its history could be instructive. But it falls into a depressingly rhythmic pattern: A reform-minded woman takes over and institutes changes aimed at true rehabilitation, and then a (usually male) higher-up decides that the programs and practices are self-indulgent and replaces the reformer with a traditionalist. And then a reform-minded woman takes over again . . . The regularity of the ups and downs made me wonder whether a permanent revolution will ever be possible.

rug hooking class at MCI-Framingham, 1948; photo via Framingham Public Library

rug hooking class at MCI-Framingham, 1948; photo via Framingham Public Library

In Rathbone’s account, MCI-Framingham, probably like many prisons in the era of government budget shortfalls, has very little in the way of programming. She writes: “Its website indicates a long list of programs available to the women of Framingham . . . but when you take into account the diversity and breadth of its population, it remains a fact that each women at MCI-Framingham has access to fewer programs, and therefore to fewer privileges and less prison-earned ‘good time,’ than most male prisoners in the state.” Indeed, Rathbone’s analysis is that the sexism of our society is reflected in the prison system: Men get disproportionate resources. But women in prison have disproportionate need, in part because of past abuse, drug addiction, mental illness, and their responsibility for children.

Sidebar: For what it’s worth, I should note a criticism of this analysis: Our class discussion on the book was led (in the absence of my professor) by Rev. Joyce Penfield, executive director of The Blessing Way, a Rhode Island institution that provides “spiritual guidance for reentry & recovery.” She argued that per capita, women get vastly more resources than men: There are more programs in men’s prisons, but they constitute 94% of the country’s prison population. I’m not sure that this changes the experience of scant resources that the women in Framingham report, but I feel compelled to mention this disagreement. And Penfield even went further, suggesting that her experience in the Rhode Island penal system is one of plenty where women are concerned.

Most compelling, as is so often the case, are the stories Rathbone tells. These are women you want to root for: None of them ever had much to begin with, were given pretty short shrift in life, and are now facing just about the steepest uphill climbs you can imagine. Most heartbreaking were the struggles with child-rearing. As women are most often the primary caregivers in our society, so too are they in prison. And they seemed to spend most of their energy behind bars monitoring the often insecure living situations of their kids. Unlike the majority of incarcerated men, each woman could not rely on her children’s other parent to do the care-taking in her absence.

Somewhat mystifying was Rathbone’s treatment of sexual relationships at the prison. She devotes a number of pages to the prevalence of these illicit affairs (physical touch between inmates and just about anyone is forbidden), both between prisoners and between prisoners and guards. Such contact is commonplace, even rampant, for all the same reasons that it is on the outside: One of the women in the book, who resists such affairs for most of her time in prison, even witheringly notes that her fellow inmates just replicate on the inside the same problematic relationships they had on the outside. Her cellmate hooks up with almost every officer that is interested, while another woman is involved in an abusive relationship with a fellow prisoner. And these relationships, like everything else in jail, are commodities. What’s lacking, to my mind, is a discussion of the question of whether carceral relationships can ever be truly consensual, particularly between inmates and guards. Rathbone only talks very briefly about allegations of rape in that institutional context — but devotes an entire chapter to a now-defunct web site that seeks to connect men to incarcerated women (ultimately called “Jail Babes” but originally and unfortunately dubbed “Jail Bait”). Maybe that says something important: As Rathbone begins her book, “Life in a women’s prison was full of surprises.”

the jazz baroness

On Sunday I attended a screening of the documentary “The Jazz Baroness” at the Washington D.C. Jewish Community Center, the kickoff event of the Washington Jewish Music Festival.

I can’t really remember what motivated me to buy a ticket: I’m not a music person, so I generally don’t even skim the program listings for this annual event. But something must have intrigued me about this documentary.

The film was written, directed, edited, and produced by Hannah Rothschild, whose great-aunt Pannonica, known to everyone as “Nica,” had a long friendship with Thelonious Monk, from when they met in Paris in 1954 until his death (at her house in Weehawken) in 1982.

By all accounts, they were not lovers, although Monk’s son tells the filmmaker that he believes Nica to have been “in love” with his dad. Indeed, both Nica and Monk were married when they met; Nica’s husband, Baron Jules de Koenigswarter, divorced her in 1956, at least in part because of her carrying on with New York jazz musicians.

The relationship seems to have been more one of patronage and caregiving on the part of Nica, who simply adored Monk’s music. In the film, she (voiced by the incomparable Helen Mirren) tells the story of the first time she heard it. In 1951, she stopped by a friend’s apartment in New York on the way to the airport to catch a flight to Mexico, where she was living at the time with de Koenigswarter and her children. He played for her “‘Round Midnight,” and she was completely captivated. She’d never heard anything like it, and she made her friend play the record over and over again. She missed her flight back to Mexico, and shortly thereafter, she moved to New York.

For his part, Monk was a musical genius but suffered from fairly severe mental health issues (undiagnosed in his lifetime, but later speculated to be manic despression, bipolar disorder, and/or schizophrenia). Several friends and his long-time manager also testified to his use of marijuana and heroin. Another friend explained that Nica, together with Monk’s wife, Nellie, shouldered the burden of caring for Monk, as his behavior was too much for one person to manage. Nica even took the rap for Monk when they were arrested for marijuana possession on the way to a gig in Delaware.

Overall, I liked the film. I certainly learned a lot, and I *loved* that Monk’s music played all throughout the film. You really can’t go wrong with his bebop. A few small items distracted me: Hannah Rothschild’s voice sounds remarkably like Helen Mirren’s, so at times during voiceovers it was hard to tell whose experience was being narrated. And a few of the interviewees were only identified during their first appearance in the film, leaving me to wonder in later scenes on what authority they were speaking. (Compounding this problem is that many of the Rothchilds interviewed were old, wrinkly, and therefore practically indistinguishable, women.)

My other complaint concerned the filmmaker’s attempt to show parallels between Nica’s and Monk’s lives. I don’t think that her search was in vain, but when she likened Monk’s upbringing — the son of a sharecropper in rural North Carolina — to Nica’s childhood — a member of one of Europe’s most prominent dynasties — she strained my credulity.

Mostly, though, I very much enjoyed the story of this “beautiful friendship.”