A Dark Secret

Psychiatry Grand Rounds, Herrick Hospital;  The Role of Misogyny and Homophobia in Prison Sexual Abuse by Terry A. Kupers, MD, MSP

Secretiveness is a part of some human problems:  Some examples are, the symptoms of the eating disorder Bulimia such as binging and purging, alcoholism is another, and incest can only continue if it is kept a secret.  The ending of the secret is often key to the beginning of addressing the problem in treatment. 

The extent of the sexual abuse that occurs on a regular basis in our prisons is not commonly known. The victims must keep it secret or they will be subject to retribution.  Some of the reasons for the pervasiveness of this problem are overcrowding which causes an increase in violence, that the proportion of the mentally ill being shifted to the prison system instead of being hospitalized is on the increase, and, the exaggerated dominance hierarchy that exists in prisons.

In a prison, each person, inmate and staff alike, are either the top dog or the victim.  The dominant ones, besides the guards, show "..toxic masculinity; they don't show any emotions or express feelings, they have no trust, they are very watchful, they isolate, they are tough, burly, and buffed, big and mean.  The people at the bottom of the hierarchy are labeled in the prison as, losers, weaklings, faggots, and punks (punk meaning that they are the recipients of sexual advances by the perpetrators/tough guys)."

In prison, inmates, -both men and women- are raped, some of them, repeatedly; they are trapped in a situation that is impossible to be kept safe and can't report the attacks due to the repercussions they will be subject to.  Inmates sometimes suffer "...acute psychiatric decompensation and suicide; people are murdered and are demoralized by being called names such as, hoe, bitch and being infantilized and patronized."

Almost all of the "... prisoners have been massively traumatized..." prior to committing a crime and being imprisoned.  They are then further damaged, psychologically, during the prison experience.  The result is people, when they are released, who have suffered, are damaged and have no coping skills that will be effective on the outside.  What the men tend to do, if left to their own devices is, "...isolate, turn to drugs, and blow up.  The women gain weight, isolate and do everything to try to not show anything in their overt behavior that may be interpreted as a sexual invitation."

Suffice it to say, this is a part of our population that needs help.  (And, of course, as they are helped to, first, receive less damage while incarcerated, and second, to be rehabilitated, it benefits all of us and society, in general)  In 2003, the Prison Rape Elimination Act (a bi-partisan achievement) was passed, which will offer some help.  It requires that the facilities  provide safety.  Of course, they need to have enough supervision to implement that directive. 

Newly released prisoners need assistance with healing, with making the transition, and with learning how to be a productive, good citizen.

Is there anything you can do?  If someone in this situation is one of your relatives, is in your friend group, or gains employment at your work place, what can you do to facilitate their successful transition? 

If they are in therapy, you can be supportive and encouraging of that effort. "...You can express sincere interest in them, as a person.  You can remember to try to understand what goes on in a prison. .. You can be patient."

If you are a psychotherapist reading this post and are in or near the San Francisco Bay Area, you can volunteer one session per week to see a newly released inmate for therapy by calling this number;  510 841-0974.
Dr. Kupers is, of course, working in the American courts and describing the situation in prisons here.  I know that I have readers from all over the world but, I wouldn't be surprised if the conditions he has observed here would also be found in prisons elsewhere.
If you are living with a terrible secret, speak to a trusted person about it.  A therapist would be a good choice, and so would be a doctor.  Sometimes teachers can help or, in some countries, police officers.
Secrets kept in the darkness contribute to the pathology of some  human problems, such as incest, domestic violence, drug addiction and alcoholism.   Bringing the secret out into the open allows for the possibility of a healing light to shine on it.