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Therapy Behind Bars

Growing up I had seen some of my friends and family move in and out of the prison system. I had heard horror stories of Victorian style Prisons with Dickensian officers, on the flip-side I heard tales of “cushy jails” being run by inmates. I had seen strong men swagger in and then stagger out, broken, whilst others had done their time, and proceeded to move on.

They managed to move on from the experience, apparently rehabilitated, or at least sufficiently scared enough to put a life of crime behind them. I had come close to following them. But in the end, I entered the prison system for a different reason, as a qualified Counsellor.

Before beginning counselling in a male prison I had waited 12 weeks for my advanced vetting to be completed and was still waiting, my standard vetting and criminal records checks having already been done by the counselling agency I worked for. Due to lack of staff the process of handing in forms and documents being checked was moving at a snail’s pace, and it had been decided I would begin seeing clients before this process was complete.

This meant I would have no keys and would have to be escorted everywhere I went within the prison. I would begin seeing clients in the Medical Suite until I received my keys and had access to the wings.

When I first entered the prison, my bag was searched and emptied out. It turned out I was carrying things on the banned list; phone, headphones, gum and hair gel. These things were taken and kept in a locker behind the main desk, to be collected when I left. The officer gave me a stern look, which to me suggested she was wondering how I managed to dress myself in the mornings.

I was buzzed through the first set of doors, and not knowing how it all worked, tried to open the second set of doors. This then caused the doors to freeze and slowly the entrance filled up with people grumbling about whatever numpty had caused the hold up, making everyone late. I grumbled along with them, shaking my head and adopting a suitable disapproving look.

'the feeling you are somewhere you shouldn’t be, can feel overwhelming'

I was met on the other side and taken to the health suite. It felt very much like a doctor’s waiting room, maybe a little livelier. I found a room I could use, which apart from the bars on the window was pleasant enough, and settled into seeing clients once a week within the Medical Suite. I felt very much insulated from the rest of the prison, hiding away in my little room, in a place that felt like there was a sense of order and structure.

When I was first escorted onto the wings to speak to clients, who for some reason or another had missed their session, my first experience was one of a sensory overload. The noise felt deafening and seemed to come from everywhere, prisoners constantly approaching you, seeing if there was a chance to maybe utilise a service that has so far alluded them, “Oi mate you from education?”,” Can you get a message to my Probation Officer?”, “Big man, you from Medical? “Can you book me a Docs appointment?”, “You from Mental Health”,” I told them this shit’s serious”.

When you’re on the wings, there is a sense of constant movement, an ebb and flow which can at first be disorientating. Every now and then there is what they call a lockdown, and then the wings take on an almost ghostly atmosphere. And the feeling you are somewhere you shouldn’t be, can feel overwhelming.

Often there is a background smell of Cannabis or Spice, and every so often you will see a prisoner a little worse for wear, struggling to keep himself together.

I now have keys, and the ability to move round the prison unescorted. I feel I have become accustomed to the feel of the prison, but still every now and then, there is an unexplainable change in the atmosphere, that will put you on edge, reminding you that you are in an alien environment that’s not governed by the societal norms of the wider world.

The first time I saw someone subject to intense suicide watch, is an image that feels scratched into my memory, likely to stay with me forever. A guard sat on a chair facing an open cell, inside a prisoner rocked back and forth. His arms were wrapped tightly around himself, as if trying to keep himself from exploding, fragmenting throughout the wing. He seemed the very definition of someone in psychological or existential crisis, and I have never been surer, at that at least in that moment, he could not be in a less therapeutic environment and should not be in Prison.

To give counselling in this environment offers its own unique set of challenges. You are not guaranteed to see your client and sometimes your client will be transferred without your knowledge, bringing the work you are doing to a sudden stop, throwing them back onto another waiting list in another Prison. When seeing clients in rooms on the wing, you may be interrupted by another curious prisoner, you’re not always guaranteed a room, there is no obligatory box of tissues on the side, no comfortable chairs or pictures of soothing landscapes. Sometimes the room might have been trashed, the table and chairs unsteady, and the sense that whatever happened in the room recently did not end well.

The clients you see, have varied complex needs and there is often a history of multiple traumas in their lives. Some have been sexually and/or physically abused, and often neglected in childhood. Sometimes they have been through the Care system, often being moved around. The sense they have no control of their lives, being reinforced from an early age, and the theme of powerlessness continuing through adulthood.

'The system squeezes everyone through the same holes, no matter where they’re from, or what their journey was to the Prison system'

Although I feel there is no typical client I see in prison, an experience of trauma seems to surface time and time again. The amount of sessions you can give means that you must often prioritise the work that can be done, and be very conscious of your time limitations and what can be worked through in this time. This often leaves you feeling frustrated and with a sense of a job half done. The clients themselves are often charming, polite and funny, although sometimes you are met with distrust or animosity, and occasionally a sense you are being played, and with this you must be careful of the dynamic in the room, and the intention of a client.

My overall experience is that they often seem incredibly grateful to be heard and listened to, it feels sometimes, for the first time. You are taking them seriously, and this on its own can have huge therapeutic power. If you’re willing to give what’s happening in their lives a sense of importance, then you are communicating to them that maybe they are also important, and that they matter. If we can instil a sense of self-worth, then maybe they can feel that their life and future is worth taking some responsibility for. Often you sense clients have been on a journey they feel they have had little control over, like they have been placed on some horrific, funfair ride and there simply has not been an opportunity to get off.

I am often told by clients that the use of drugs is widespread, and that bullying is also a common occurrence. This increases a sense of lawlessness and a sense that Prison is a place to be survived, not rehabilitated in. The system squeezes everyone through the same holes, no matter where they’re from, or what their journey was to the Prison system. Of course, there must be a sense of justice being done, and punishment being dished out, but with this we need to look to the future and consider how we stop people being on a continual conveyer belt in and out of Prison.

In my opinion, the Prison system is in crisis. My own experience is there is a sense of staff feeling unappreciated and demoralised. People working in Prisons want to do the right thing and there are opportunities in Prison for people to rehabilitate and change their lives, but there is so few staff that a lot of the time they are conducting a policy of damage limitation.

My experience in prison has raised the question for me, why is there so many people with complex mental health issues in Prison? This seems a fundamental failure of society that often seems to begin with our attitude to how we treat children who grow up in unstable environments. It strikes me that these are surely the very people who deserve our care and love. Prison is not suited to giving therapeutic care, the environment is harsh, and seems too often to send people on a psychological nosedive.

Maybe we need to look at what we do with forensic clients. Is there a place for mental health to be treated in Prisons? If so, how do we make the environment therapeutic? And how do we help people take responsibility for their lives when we continually reinforce their sense of powerlessness?

For now, people working in Prisons will muddle on, those working with mental health will do the best they can against the odds. Prisoners will continue to use drugs, bully, self-harm or even kill themselves. And many people will continue to ignore the fact that for every prisoner we send back into society unrehabilitated, or still suffering from mental illness, we create more crime, more victims and more people stuck on a hellish rollercoaster ride they can’t get off.

Authors Bio


Lee White is an Integrative Counsellor and holds a degree in Integrative Counselling. He has a background of working with bereavement and complex trauma as well as more general counselling. Lee has a private practice and works on a voluntary basis one day a week as a prison counsellor.

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