Relationally based psychodynamic psychotherapy in prison: processes of control, shame, and dissociation

Abstract

The scant literature relative to the application of relationally based and psycho-dynamic therapies within correctional settings clearly illustrates the contextually driven challenges to employing such approaches (Haley, 2010; Huffman, 2006; Kita, 2011; Stein, 2007, 2009). Stein (2001, 2004, 2007, 2009) in particular has written extensively about the psychotherapeutic needs of the high concentration of severely developmentally traumatised and dissociative individuals in our prisons, who are unlikely to receive psychodynamic therapies due to resource constraints. Such acute treatment needs can be exacerbated by the operational design of correctional settings—which are predicated on the maintenance of safety and security through the exercise of behaviour management and controlled access to personnel and resources. The over-representation of relationally traumatised individuals within prison populations is confounded by the structural parallels of the controlled environment that inadvertently trigger these inmates. The counterproductive results are not necessarily unexpected given how trauma is routinely re-enacted (Chefetz, 2015; Kupers, 1996; Van der Kolk, 1989, 2014; Van der Kolk & McFarlane, 1996). Nonetheless, this reactive cycle represents an unfortunate re-enactment of relational control both intrapsychically and environmentally. Discussion of the dynamics of control inherent within correctional settings, followed by a case study of an inmate suffering from traumatic exposure to an austerely narcissistic and abusive father, is illustrative of this cycle. The isomorphism of coercive internal object relations and institutional control is striking and will be illustrated.