#4 : “Will you let him come (to work here)?” – a prisoner asks my wife.

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Picture the scene – a long narrow hall, tall, up to three storeys high, with two sets of balconies running round all four sides, no windows in the walls but with rows of doors in their place, on all three levels. More like a warehouse than a place to accommodate human beings. Or a multi-level barn, with numerous stalls for horses or other livestock. Leading down from each of the balconies is a central, iron staircase. Across from side to side, stretching out from each balcony are rather clumsy suicide prevention nets, to stop distraught souls ending it all, by throwing themselves to certain destruction on the concrete floor below. Ugly, as if intended.

Standing in a line in the middle of the ground floor, are a group of men and one woman. It’s the Prison Governor, John Marriott, the Chief Medical Officer, the Wing Governor, assorted wing staff, me, and Sue, my wife. I’m on my second day, visiting the wing, it’s her first. It’s the Special Unit in Parkhurst Prison, built by the Victorians on the Isle of Wight, so as to deploy the Solent as a moat. And we are discussing general topics, how the Unit is run, where the prisoners come from – the resident staff are showing off the premises to an important visitor, me.

Suddenly, to our enormous surprise, one of the prisoners detaches himself from the rest. He barrels down the central staircase, from the upper landing, rattles straight past the line of “important” men, stops in front of my wife, and asks – “will you let him come?”

It was Friday, 3rd of May 1991. The prison was needing an extra psychiatrist, one to live within 10 miles of the prison, to work with the most dangerous, illdisciplined, unstable lifers in the entire UK prison system. The previous doctor there, had departed in February of that year, and they were becoming desperate for a replacement – though what could induce an established consultant psychiatrist – which was the grade they were looking for – to leave an orthodox NHS post to work under cramp and coercive conditions, was an enigma, to say the least.  

The last thing members of this posse expected, myself included, was this dramatic, courteous, but determined intervention by one of the inhabitants of this bizarre habitation, himself. Yet, there he was, presenting himself to the most important person in the coterie – my wife. Just look deeper into the question he posed to her – it presupposed a whole series of assumptions. First that he had paid scrupulous attention to me, on my previous “sight-seeing” visits. Second, that he had concluded, from his shrewd examination, that my input would likely be helpful. And third, that my accepting the post would depend upon my wife. 

Bear in mind, Sue had only just walked into the room – she can’t have been there long. Yet this man, a benighted soul in the prison system, had concluded, rightly as it turned out, that her support was crucial to my decision to work there, or not.

I don’t recall speaking with this man earlier – he turned out to be the Baron on the wing. I had merely been taken round on a superficial tour – and had noted that the 15 or so prisoners there, were not that dissimilar to the shuffling patients in the long-standing back-wards of the “asylum” east of London, where I had served my psychiatric apprenticeship. Nor did they look radically different from the general practice patients, I had been working with in the North of England. 

So where did this sudden initiative, this explosive enquiry, come from? And what did it signify, in terms of how, or indeed whether, I could succeed? How many people do you know who can sum up a situation in so little time? He had decided in his own mind, that what I could bring to that Unit was of value. Perhaps he felt stuck, and could see a glimmer of light, to show him a way out of his emotional pits. Where did he acquire the insight to analyse my very own, personal relationship – with my wife, bless her, the nearest person to me on this peculiar planet?

At all events, the Baron was an exceptional individual. I call him the Baron, because anything that was happening on the wing was laid at this door. He was a stocky man, medium height – but with a determination that was palpable. In a way, his dramatic intervention, even before I took up the post, was an endorsement, a certification for all to see, that I was likely to be a “good thing”. That I was welcome there. Looking back, it remains one of the most glowing attributes I have ever received.

And as far as his emotional pits were concerned, he was right. I did plumb them with him, and we did shed light on where his violence came from, and how to put it right. I still wonder how he could have foreseen something of this, beforehand. The reason I was there, was because I had unearthed what could best be described as the long-term effects of child abuse, of childhood tortures. And he had these in spades. And true to his initial assessment, we could work fruitfully, together. But speedy, it was not.

In my previous post (3 : on Dennis, who punched walls), I described how it was crucial for me, that it was Dennis who had responded, within a matter of months. Without this, I might have begun to question whether merely talking to prisoners, the infamous “psychopaths”, admittedly concerning things they never wanted to be open about ever again – whether this could indeed bring about improvement. And I have to admit, had I only had the Baron as a client, or most of his ilk, then my doubts would have grown, and my confidence and optimism, ebbed.

The time scale was as follows. I did begin work in that Special Unit, two months after this incident, on 1st July 1991. I began videoing my sessions on 11 September 1991, as described in that earlier post. And Dennis, bless him, had got rid of his terror (his speechless-terror) of his mother by November – a mere 4½ months since I started. Unhappily for the remainder of his comrades, the time scale stretched much longer, even into years, without any visible signs of impact. As I say, without Dennis, I might well have wilted. The really severely damaged people took proportionately longer to unpack. In this, the Baron was no exception.

It was not until the following February, 1992, that the first cracks began to appear in his heavily protected damage. As with all the seriously dangerous individuals, the severity of their aberrant behaviour was matched almost precisely by the depth of depravity they’d been handed as infants. Well, that was revealed to be the case, but only when you (and they) could dig it out. Before then, as with Little David in post number 1, it was simply unavailable either to them, or to anyone else.

So here was the real enigma – the worse the violence and all the other symptoms, then the worse their origin in disabling childhoods – something you could guarantee – BUT, no one knew. No one could put two and two together – bang the child, and they’ll bang you as soon as they’re big enough. But unhappily for most, this simple logical connection only becomes available when you/they can finally (and with fully informed consent) uncover the initial harm. 

And that’s where the pathology came from – the “harm” was hidden, was hidden as a matter of course, as a matter of self-defence – “this isn’t happening to me”, says the child to protect themselves. The damage arises, and it can be considerable, because what they first needed to protect themselves from, they learn to deliberately avoid. This was done to “run away” from deadly danger at the time. Sadly, the same mechanism is repeated later – though then it’s rational attention itself, which “runs away”, and is no longer available. The hurt therefore remains – torturing the individual as much, if not more, than it did when they were infants. And it only disappears when it is brought to light – for then, and only then, can they agree with the rest of us that it’s out of date, that it’s bonkers.

So what had happened to the Baron? Where had his grossly anti-social behaviours come from? But why should he ever tell anyone about them? What could persuade him to re-visit the worst possible time in all his young life? No one had ever taken any interest, or at least any sympathetic interest – so why should he divulge any of the intensely painful details? Why rehearse past agonies at all? What good could possibly come to him if he did? He’d been too small at the time to do anything sensible, or effective about it – so what was different now? Why re-open old wounds, when there had never been anything he could possibly have done to salve them? Why indeed?

So there was the dilemma I had to solve – self-defence meant never talking about what had nearly killed you. So it stayed as it always had done – life-or-death. You and I could well see that the lethal threats that the Baron, and all, had suffered, were now firmly in the past – but he couldn’t. At least he couldn’t unless he opened up. And opening up in the past seemed guaranteed to kill him. Problem? I should say so.

As for the Baron, he had been relatively fine, until about the age of 10 or so, when his grandmother had died. She had supplied consistency, reliability, and therefore been a material and necessary support to keep him stable. Once she was gone, things sank. His father started abusing him. He ended up being thrown out of the house. He eventually told me how he had crept back home one Christmas Eve, to look in through the window, and see the rest of his family enjoying themselves, while he was out in the cold.

Worse, as a young boy he then took himself to London – homeless, helpless, intensely vulnerable. I remember a poem he wrote, heartbreaking. He speaks of being a “rent-boy”, hiring himself out for dangerous sexual liaisons. What else could he do? Eventually, after inflicting further violence while in prison, he found himself in the Special Unit in Parkhurst Prison – where he grasped at a passing straw – me. 

But it all took time. Progress with excavating Baron’s pits was slow. Even by the following February, 1992, after 8 months diligent and hard work, we had barely scratched the surface. He was keen. He was determined. But his mental strengths here, which served him well enough elsewhere, showed the thickness of the concrete that we, or rather he, had now to dismantle, from the inside. Slow. Then gradually, things began to melt. One morning, he told me, he woke up, and it all fell into place. He could, so he said, snap his father in two, as easily as snapping his fingers. That was when he saw him as an older man. Then that picture would fade, and his image of his father reverted to where it had always been – enormous, dangerous, lethal.

You could see the past and the present wrestling with each other in his mind – which would win? But the key was that he now understood where all the poison came from. So it was only a matter of time before the present, the reality of today, would establish itself 100% – and he could rid himself forever of his toxic parental figment.

He made excellent progress. He joined those prisoners who worked well enough with me to see life, for the first time, as positive and unharmful. Let’s take the incident that occurred with his special ‘mate’ – James. When I first arrived on the Unit, I was keen to set up group therapy sessions. These can be very useful in watching how others react, and comparing that with the emotions that are going through your mind at the time. I well recall my first full-time psychiatric post in Claybury Hospital to the east of London – a most enlightening training. The superintendent there, Dr Denis Martin, supervised a wonderful, courteous hospital. He even organised group therapy sessions for all the junior doctors – highly instructive. 

So I shall never forget sitting there, listening to the others musing about this and that, and occasionally chipping in for myself. There was one unique occasion when a Greek doctor said, almost in a complaining voice, that all the ladies in the Residential Neurosis Unit kept wanted to have sex with him. He was puzzled. I was not. This was a graphic illustration for me of Freud’s notion of the “counter-transference” – he was communicating that sex was available – he wasn’t terribly aware of this himself, but his clientele responded to his “hidden” cues. Until he saw this, he couldn’t rid himself of it. Precisely the same logic applied to me – not regarding my sexuality, but to my residual fear of my father, which only went, after 19 long years in family medicine.

So back to the Baron and group work. He saw that groups were something I wanted to do, so he whipped up a group, in no time, to help me. His management skills of personnel were second to none. Thus in short order, I had half a dozen prisoners sitting there, once a week, participating in group work. The Baron could also see that I loved to video everything, so he organised the “group” to sit in a straight line along the wall, so that the camera could capture everyone (except me). The arrangement went well.

At least it did, until his managerialism hit an emotional reality. Among those who he “volunteered” into the group, was, of course, his special buddy, James. Now one of the basic rules in emotional education, is that the person must unpack their problems, from within. This was the case with Little David, and it is the case throughout. The sufferer has built the concrete box in which to conceal the disaster – thus only she or he, has the necessary tools to unbuild it.

His special mate James, came along because he was told to – not because he had given his fully informed consent. Rule 1 had been breached. And it showed up in an unexpected and rather challenging way. I came to work on the wing one morning, and was given an urgent message. James wouldn't come out of his cell. He refused. He declined to participate in any wing interactions – he was “on strike”. This was something the doctor had to sort, and fast.

Well, the first thing to do was visit James in his cell, and get him to explain himself. Sounded a good idea – didn’t work. Of course, I went in, sat on the bed, and opened the conversation. Meanwhile, the Baron was hanging around the open cell door, hoping for the best.

In response to general enquiries, James would only talk about other things – his cell wall had a poster of the terracotta warriors – so his remarks centred on them, for a while, before moving on to other even less relevant matters. DNA, as I remember came up, for no very good reason.

“This is something I’ve done”, I kept saying to myself. So I set out through the front door, and firmly told him it must be something to do with the group. “Oh no”, he protested, “the group is wonderful. Nothing wrong with the group”. He was rigid in telling me that it wasn’t the group, though rather less informative as to what it was.

The refrain kept going round in my head “ – something I’d done”.  But what? Every thing I suggested was either rebuffed or made the meanderings worse. Then I had a brain-wave. In the firmest, most doctorial voice I could muster, I told him, definitively, that – “You are forbidden from ever coming to the group again”, adding in the small print – “until you want to come again”.

The reaction was immediate – he focussed directly on eye contact, and told me that what I’d just said made eminent sense. He then proceeded with the rest of the day, as if nothing had happened. Meanwhile, the Baron, who could readily see my verbal sleight of hand, grinned from ear to ear.

Thus the Baron was a positive help, a constructive influence in the Unit, rather different from his impact there earlier. He was moved on, out of the Unit, perhaps prematurely, because he later collapsed mentally and was eventually admitted to Broadmoor, the prison hospital. As it so happened, I was later offered a part time job there, to continue the work I had been doing at Parkhurst. Naturally, on learning where he was, I went straight to his ward, to catch up, and assure him we could continue the work we had already begun. I hugged him in full view of the staff, who were unaccustomed to such behaviour. Our relationship was as solid then as it had always been. 

Unhappily for both the Baron and myself, though my appointment there was fully funded, and due to start any time – it never happened. A psychotherapist who had worked in Broadmoor before, came out of his retirement, deliberately and solely, to block it. He was using his remaining mental energies to make matters worse, with zero benefit to himself – precisely the non-thinking that the Baron and I had worked so hard to eliminate. I never saw the Baron again. Sadly emotional ignorance is indeed rampant, as later posts will explore.

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MEDICAL NOTE – at one level this is just as simple as it sounds. At another, it involves life-or-death emotions – which is why it all gets so gummed up. So you need to be extra careful when discussing these points with people who might have similar, deeply buried problems. IF IN DOUBT, DON’T. Life-or-death could mean yours.

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NOTE These posts are a new venture for me. I’ll aim for at least twice monthly. If you like what I write, please encourage me by responding, all but the latest will be free. You can always read the academic background to it all, free, by clicking The Simple Science of Sanity. Thanx.

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