Do prisons have more room for emotions than we think? Staff views on the link between suicide, violence and emotions

alexas_fotos-WoPxj4W58C0-unsplash

Prison staff across England often encounter violent behaviour with the intent to either self-harm or harm others (McGuire, 2018; Boudhoukha et al., 2011). The reasons that lead to aggressive behaviour from prisoners are important to understand to help reduce violence and suicide rates, both of which have been a major concern for institutions.

Previous research by Hemming et al. (2019) has suggested that alexithymia, defined as a difficulty identifying and in turn communicating emotions plays a part in violence and suicide. The extent to which prisoners struggle to identify and express emotions is not clear, although some studies have shown that adults with a history of offences or anti-social personality disorder exhibit alexithymia. It can be difficult to help people with aggression who struggle to identify their feelings, especially when one is negatively predisposed against them.

Prison staff have been found to sometimes be biased against prisoners who self-harm or attempt to harm their peers and interpret such behaviour as manipulation or attention-seeking (Kenning et al., 2010). These attitudes can create further barriers for communication between prison staff and prisoners.

Hemming and her colleagues (2020) aimed to explore the prison staff views on the role of emotions on violence and suicide in prison.

People with alexithymia find it difficult to express their emotions and are more likely to experience suicidal thoughts.

People with alexithymia find it difficult to express their emotions and are more likely to experience suicidal thoughts.

Methods

The study recruited 20 members of staff from different professional roles and effort was put in to maximise variation in sampling. Open-ended interviews were used to explore the staff views on the role of emotion in prisoners’ suicide and violence. At the beginning of the interview, participants were shown a text defining alexithymia. The explanation of this term could have introduced a significant bias to members interviewed, who may have started attributing violence and suicide incidents to prisoner’s difficulty communicating emotions so they fulfil the expectations of the researcher, when they would not have done in a different context. This would make the interviewees less likely to discuss other explanations for violence and suicide as they were prompted to examine alexithymia from the start.

Results

Prisoners don’t do feelings

Data collection led to five main themes. The first one, “Prisoners don’t do feelings”, related to staff’s accounts of prisoners’ difficulty to identify, understand and communicate emotions. Lack of communication was attributed by staff to both inability to speak openly, but also to reluctance for reasons of trust, or rather lack of trust. The study describes a cognitive inability of prisoners to communicate emotions, however there is no clear explanation why lack of communication to prison staff was interpreted as cognitive inability. When they would speak about their feelings, prisoners were found more likely to use non-verbal methods and would often not do it in real time.

He can get angry very quickly

According to staff, prisoners would often interpret other emotions as anger. Anger appeared to be the result of an emotional build-up that was not expressed at earlier stages leading to outbursts.

Managing mood

In the third theme, “Managing mood” the authors reported that drugs and alcohol were amongst the commonest ways for prisoners to deal with intense emotions, when harming self or other was not the case. Some staff could link emotional turmoil with self-harm but less with suicide, which they perceived as an act of manipulation. In contrast, other interviewees thought that prisoners genuinely affected by their emotions were more likely to end their life than self-harm, which they associated with attention seeking as a means of asking for help without appearing weak. Self-harming behaviour was sometimes picked up by staff as an opportunity to open conversations about buried emotional difficulties.

“No room for emotions growing up”

There was a general impression that prisoners were likely to have been brought up in an environment where they did not learn to identify and express emotions; thereby hindering their ability to do so in adult life.

“No room for emotions in prison”

The last theme suggested that the prison environment was in itself an impeding factor for the communication of emotion. Strict prison norms meant that people who opened up more would appear more vulnerable in the eyes of others and so such behaviour was avoided. Violent behaviour could also be interpreted as a sign of power, in line with the toxic masculinity culture in prisons. The staff also confessed that the prison macho culture had also impacted their ability to communicate their emotions or even ask prisoners about theirs. It was described that staff found it difficult to have meaningful conversations, for multiple reasons including lack of appropriate opportunities, feeling unprepared or uncomfortable or generally lacking a personal connection with prisoners.

Prisoners find it difficult to speak openly about their emotions to prison staff because they cannot identify and communicate their emotions or are reluctant to trust staff members.

Prisoners found it difficult to speak openly about their emotions to prison staff because they could not identify and communicate their emotions or were reluctant to trust staff members.

Conclusions

The researchers indicated that staff acknowledged that prisoners faced emotional difficulties and often did not communicate their problems to their peers or staff members. This could be because prisoners misinterpret other feelings as anger or because of a gradual build-up of suppressed emotions. The stressful prison environment that promotes masculine role models with no emotional vulnerabilities can precipitate this phenomenon, whereby people are no longer able to identify, process and talk about their feelings. Coping strategies included drugs, alcohol and violence, either to harm oneself or others.

Violent behaviour can be a coping strategy for emotional difficulties, according to staff.

Violent behaviour can be a coping strategy for emotional difficulties, according to the prison staff interviewed in this study.

Strengths and limitations

The main strength of this study is the opportunity it offers to use prison staff insight to devise strategies to improve the prison environment. Given that prison staff make up a part of all prisoners’ experience in prison, it is important that we understand what they believe about the role of emotions in a prisoner’s behaviour. This is not necessarily because their views most accurately reflect prisoners’ emotions, but rather because they can be considered a point of intervention to help open communication and reduce the risk of harm. However, it would also be useful to conduct interviews with prisoners about their experience of identifying emotions and their difficulty in communicating about their feelings to their peers or staff. This would be a more direct way to explore the role of emotion regulation in prison in violent behaviour and self-harm. This could also be done in parallel to staff interviews, to compare and cross-reference their views.

Out of all participants, 30% were female and 95% were White British. The predominance of White British males in the interviewee pool, could make it more difficult to generalise the conclusions due to cultural biases, which ultimately are likely to play a part in communication between prisoners and staff. This can be an important limitation, especially in cases where prisoners come from a minority ethnic group.

Due to the design of the study, there was no control group to compare the role of alexithymia in aggressive behaviour in other people, whether they are in or out of prison. Apart from the theme relating to the toxic prison environment that makes it more difficult for people to express their emotions, other arguments could apply to populations out of prison cells.

Speaking to prisoners as part of the study design would be a more direct way to explore the role of emotion regulation in violent behaviour and self-harm.

Speaking to prisoners as part of the study design would be a more direct way to explore the role of emotion regulation in violent behaviour and self-harm.

Implications for practice

Hemming and colleagues (2020) discuss several recommendations, highlighting the need for changes to improve prisoners’ access to help and associated mental health care. The first one involves ensuring there is private space and time for them to speak about their emotions, when this can be helpful for them. As a lack of personal connection was a common observation reported in interviews, the role of personal officers in some prisons, who can take up the role of providing individual support to a person, could work to improve communication rates. However, at present there is not enough evidence to evaluate the benefits of this role.

In future work, it would be interesting to see if there were differences in the views of staff depending on their profession and their role within the prison environment. This could be useful to potentially identify staff in favourable positions or others who are less likely to be trusted by prisoners based on their role. Given different professions come from different training backgrounds, differences could point to weaknesses in psychological training for some roles more than others, which could be an important area for improvement. As the researchers suggest, training staff to open meaningful conversations with prisoners who may be experiencing very stressful emotions, could improve quality of life for prisoners and improve work experience for staff too.

Achieving an effective and long-lasting cultural shift in prison will be very challenging and, in my opinion, results from community campaigns encouraging men to talk about their feelings cannot be transferred to the prison environment. More work is needed, potentially involving speaking to the prisoners directly, to help address toxic prison norms. To my mind, this is a more systemic issue that can only change slowly if changes are made to the overall prison experience where people feel prisons aim for rehabilitation rather than social exclusion and are provided with safe conditions and appropriate support for this to be achieved.

Training staff to open meaningful conversations with prisoners who may be experiencing very stressful emotions, could improve the quality of life for prisoners and the work experience for staff too.

Training staff to open meaningful conversations with prisoners who may be experiencing very stressful emotions, could improve the quality of life for prisoners and the work experience for staff too.

Statement of interests

No conflict of interests.

Links

Primary paper

Laura Hemming, Daniel Pratt , Jennifer Shaw and Gillian Haddock (2020). Prison staff’s views and understanding of the role of emotions in prisoner suicide and violence, The Journal of Forensic Psychiatry & Psychology, DOI: 10.1080/14789949.2020.1807584

Other references

Boudoukha AH, Hautekeete M, Abdellaoui S, Groux W, Garay D. Burnout and victimisation: impact of inmates’ aggression towards prison guards. Encephale. 2011 Sep;37(4):284-92. French. doi: 10.1016/j.encep.2010.08.006. Epub 2010 Oct 18. PMID: 21981889.

Hemming, L., Haddock, G., Shaw, J., & Pratt, D. (2019). Alexithymia and its associations with depression, suicidality and aggression: An overview of the literature. Frontiers in Psychiatry, 10, 203.

Kenning, Cassandra & Cooper, Jayne & Short, Vicky & Shaw, Jenny & Abel, Kathryn & Chew-Graham, Carolyn. (2010). Prison staff and women prisoner’s views on self-harm; their implications for service delivery and development: A qualitative study. Criminal behaviour and mental health : CBMH. 20. 274-84. 10.1002/cbm.777.

McGuire J., (2018). Understanding prison violence: a rapid evidence assessment. HM Prison and Probation Service.

Photo credits

Share on Facebook Tweet this on Twitter Share on LinkedIn Share on Google+