Simon
Simon is an honorary integrative counsellor working with Forensic Therapies at HMP Pentonville… here he describes what it is like to work with both practical and clinical issues unique to the prison setting.
In January this year I began working as an honorary counsellor at HMP Pentonville (a Category B local prison for males) one day a week. Training, which began the previous October, was very useful in preparing me for the challenges that lay ahead but it proved quite a wait for all the necessary security checks to be completed before I received my pass and key tally and could begin client work. My first day was daunting, trying to find my way round, clutching my keys, hyper-vigilant re ensuring I locked every door behind me, although I soon became familiar with the traditional wing layout.
I’ve found that it’s been important to build relationships with staff to further the work but also to retain some independence from the establishment. Officers and other staff have generally been very helpful, when their time is often limited, and many appreciate the value of therapy. We are usually able to find a room in healthcare, although probation and interview rooms are sometimes available on the wings, and it can be a case of quickly trying to adapt the space to make it more therapeutic.
I’ve been encouraged by the way many clients have engaged intellectually and emotionally with the work. However, it has often proved a challenge to keep the work offence-focused as many clients are heavily invested in avoiding taking responsibility, especially if they are awaiting trial, so it’s sometimes a question of ‘rolling with resistance’. This can provide an opportunity to go deeper, often back to horrific childhood experiences that have shaped current beliefs and behaviours, and links can gradually be established. Indeed, many clients I see have been traumatised in one way or another – from living through horrific experiences of war to having been traumatised by their offence, arrest and trial and/or the effects of sudden loss of freedom, often for the first time. Index offences have ranged from burglary to sexual and violent assaults. Whilst I am always mindful about personal safety issues, I have never felt unsafe in the prison.
Clinical issues have included PTSD, self harming, depression, anger issues and addiction.
Sudden, unplanned endings can be difficult, for example when clients are transferred or released, especially if the work is going well, and I’ve written to one such client, wishing him well for the future and recommending taking advantage of further therapeutic opportunities.
Social exclusion is a broad umbrella and probably includes most prisoners I see, in one way or another, for example those who have been educationally or economically excluded. There is great ethnic and cultural diversity in the prisoner population and I have become very aware of the difficulties experienced by immigrants adjusting to a new society and culture. English is often a second language and precise communication of thoughts and feelings can sometimes be difficult. Our ground floor rooms are accessible. Prison can offer a positive sense of psychological holding in often otherwise chaotic lives, and services, including mental health and psychotherapeutic, are easier to access, often for the first time.
I’ve found I’ve needed to adapt to the needs and objectives of both our organisation and the Prison Service, whilst maintaining both my personal and professional philosophies and therapeutic integrity. As an integrative counsellor, an initial person-centred approach has helped to build relationships, then a psychoanalytic approach has proved useful in conceptualising the client’s inner world, while (offence-focused) CBT work facilitates cognitive restructuring. The work is very varied and always challenging. Supervision has proved very useful, especially in trying to unravel the complex transferential relationships in forensic psychotherapy.
The clients I’ve worked with really seem to have benefited from having been able to talk about their difficulties, often for the first time, beginning a journey of self reflection, increasing self awareness. I hope they come to feel more empowered to make individual, socially responsible choices based on their own needs, both short and longer term, and learn to cope more adaptively. Some inmates have no visitors and few relationships inside the prison and the therapeutic relationship is extremely important to them.
A day in Pentonville can be problematic – there might be a full or partial lockdown, restricting movement of some or all personnel, or a client might be on a family/legal visit, in classes or working, so a degree of flexibility/creativity is essential, and my schedule often undergoes several rewrites.
At the end of a day ‘inside’, it comes as quite a relief to walk through the gate into the outside world – a stark reminder of just what imprisonment means – and I find it’s important to ground myself with my family and a relaxing activity.