Monday, October 31, 2005

Incarceration, Pain, and Motivation for Change

In my workshop last week at IAODAPCA, a few important comments were made about the nature of pain (specifically incarceration) as a therapeutic factor in the process of change. I'll briefly summarize information I provided with key points made by workshop participants.

Elliott Currie suggests that incarceration fails to deter criminal behavior because of social factors that reinforce what may be called the “street-prison nexus”, also known as the revolving prison door. This street-prison connection may actually help to forge antisocial relations, turning the joint into another type of ‘hood’ that need not be feared.

According to Currie, incarceration fails to deter criminal behavior not in spite of its risks but because of them. In other words, doing hard time, or performing acts that could result in hard time, warrants respect and prestige on the street. Currie also suggests that the risks associated with incarceration provide a sense of challenge and meaning to committing street crime. This sense of meaning and challenge is necessary for human fulfillment and is often hard to find by legitimate means for many at the lower end of the socioeconomic scale. Therefore, the meaning and challenge of street crime may be more valuable than any other gains associated with it (money, drugs, etc), and may be more persuasive than the pain of incarceration.

On the other hand, some people suggest that the pain of being locked up is often a necessary ingredient in someone changing their behavior. Several relevant points were made during the workshop. One participant seemed pretty certain that the pain of incarceration is a very important factor in change. In other words, once the pain of committing crime or using drugs outweighs the pleasure, motivation for change is likely to occur. Others suggested that incarceration effects behavioral change for some, but not all, individuals. Another person pointed out that even if incarceration doesn’t work, that does not invalidate the “pain outweighs pleasure” theory, it just means that incarceration fails to cause meaningful pain for the individual. In other words, the sociological factors presented by Currie provide more meaning to the drug life than incarceration provides in deterrence.

So here are my questions to you:

Which side of this debate do you fall on? How is incarceration effective or ineffective for recovery?

If incarceration works for some substance abusing offenders but not others, which ones and why?

If you work in a correctional facility, do you see the trend toward more sanctions (limited movement, strict rules, etc) as enhancing treatment and recovery?

If pain motivates, how do we explain the cycle of substance abuse, relapse, and criminal recidivism in so many people’s lives despite what would seem to be immense amounts of pain?

How do you think this discussion should guide how we conduct substance abuse treatment with the court mandated/ incarcerated/ ex-offender?

(to respond, click on comments below, then type your comments in the new window, then click anonymous, then click publish.)


Anonymous Anonymous said...

The pain-pleasure balance has been debated for years. In the AODA field, we used to teach that once the pain of using became greater than the pain of not using, change is possible. This concept fails to take into account that people can grow tolerant to pain, just like building a tolerance to a drug. Over a period of adjusting to a painful life, someone is too numb to hurt. I hope that we can help folks before they get that far. In DOC facilities, it still seems that for every one inmate who gets treatment services, another 5 or 6 misses that opportunity, which increases recidivism because "if nothing changes, nothing changes." I think that successful reentry services means assisting folks in a way that they can stay drug-free and crime-free in their communities. Making prison more painful does not accomplish this. What is needed is instilling hope and creating community-based resources so that people returning home sense that they really have a chance to make it.

8:48 AM  
Anonymous Anonymous said...


8:49 AM  
Anonymous Anonymous said...

I wonder if the issue is not so much the impact of "pain" as it is the "meaning" one assigns to a given experience. Long ago Viktor Frankl suggested that it was not so much the event (suffering, as was in his case, the holocaust) itself, but the meaning one ascribed to the event that made one a successful survivor of it. If one's assigned meaning of incarceration is almost likened to that of a "graduation," then the pain is nothing more than one part of the person's experience. It might become a deterrent to having to give in to authority. "I made it through your little Hell and I beat you." However, if one assigns a less positive meaning to incarceration it might indicate that the pain would direct the person in another, more positive, direction. Too over simplify, it might be a kind of "mind over matter" issue. This is a great discussion.

9:58 AM  
Anonymous Andy said...

You both make great points. When I find myself in a conversation about pain as a motivation for change, I usually like to include hope in that discussion. Because I think hope often sustains motivation for change much longer than pain, precisely because of that tolerance to pain.

Interestingly, someone in the workshop who provides treatment in DOC felt that recent increases in sanctions within prison are having a positive effect on treatment/ recovery for some individuals.

The whole issue of "meaning" is very relavent, I think. Not only does it harken back to Frankl, but that is exactly the point of sociologists like Currie. Perhaps the fear of incarceration might work for the children of senators, but Currie would suggest it has very different meanings in other neighborhoods.

12:17 PM  
Anonymous Andy said...

I also see your point, bc, that not enough people in DOC are being offered treatment, which contributes to recidivism. But that doesn't negate the notion that much of that recidivism involves people who DID receive treatment in prison, does it?

I wonder if it's still not important that we ask the question: What kind of treatment is most helpful for the "criminal" substance abuser?

Does "treatment as usual" do enough to instill hope and connect to community resources for this individual?

11:48 AM  
Anonymous Anonymous said...

I find validity in all of the comments posted. What an interesting discussion, which prompts food for thought. In addition to giving the inmates hope, I would like to see their treatment while incarcerated include the teaching of self-love and self-respect. It seems to me that prisoners might seek illegal external validations for their own self-value. I understand their environment during their upbringing comes into play, and they can potentially be modeling other ex-offenders in their 'hood for the attainment of position. However, if taught internal self-validation, and how to establish an inner core of love for themselves (hard to do), this individuals can learn to believe in their own self-worth instead of in a gang's, or obtained through external means. This is a very difficult thing to teach. What someone else said earlier about reentry into the community including community efforts and training so they know they can make it anew is tatamount to them changing their life. They are not necessarily taught a viable skill for a new occupation in jail, nor psychologically treated to have a new outlook either. They learn maladaptive behaviors while in jail, and then are released without much assistance into the community. They need support to further their transition into a new, positive life that isn't being offered to them. Extra punishment while they are in jail make work for the time they are in jail, but I don't believe it will work long-term when they are released. Nice discussion.

2:28 PM  
Anonymous Anonymous said...

Very interesting discussion, wish had some time today to write more. I think though that pain can be seen as behavior (negative reinforcement) and prevent the individual from what brings it (the pain). although of course i am aware that one can get immune to it. will write again. andy - again, thank you so much for creating this blog

2:05 PM  
Blogger Dr. Deborah Serani said...

My husband is a crim defense lawyer, and I've seen firsthand how the system doesn't work. There are so many reasons that it fails certain individuals. But I don't think there are any easy answers in how to help the system evolve.


8:03 AM  
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