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Women Offender Programs and Issues

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Report on Self-Injurious Behaviour in the Kingston Prison for Women

Introduction

This report is based on a study conducted to guide the development of a therapeutic programme for women who self-injure at the Kingston Prison for Women. A preliminary study (February, 1989) determined that my definition of both the spectrum of self-injurious behaviour and the dynamics involved match the experience of those who work with this behaviour within the prison system. The model I work from is based on the understanding that self-injurious behaviour is a coping strategy that manifests itself as a result of childhood abuse (usually sexual). When a child is sexually abused she most often reconciles the abuse through self-blame. Self-blame allows the victim to believe she has some control in a powerless situation; if she is responsible for the abuse, she can also stop it. The cumulative effect of the self-blame coupled with on-going sexual abuse is the further belief that bad things do and will happen. The belief in the inevitability of bad things happening, at particular moments, results in extreme anxiety. Self-injury is an attempt to control the extent and the timing of the anticipated pain which is seen as inevitable. Once pain is invoked (e.g., through slashing), the anxiety is immediately decreased. Thus, to the extent that self-injury results in a reduction of anxiety it is an adaptive and resourceful bahaviour (see figure 1 for a schematic representation of this process).

Through the February 1989 preliminary study on self-injurious behaviour, I identified injury response, injury reduction, and suicide identification as the major issues needing to be addressed. To examine these areas, the present study involved the following:

  • Prisoners were interviewed to acquire a thorough understanding of the experiential aspects of self-injurious behaviour within the prison context.

Figure 1. Self-Injurious Behaviour as a Coping Strategy

ABUSE

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The dynamics of childhood (sexual) abuse lead to self-blame by the victim as a method for believing she has some control in a powerless situation. This is largely a result of the ambivalent feelings the victim has toward the abuser (a significant other) in conjunction with the either overt or covert threats made by the abuser.

CONTINUED ABUSE

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The cumulative effect of on-going childhood (sexual) abuse and the resultant self-blame is the belief by the victim that bad things do and will happen to her.
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The belief in the inevitability of bad things happening results, at particular moments, in extreme anxiety sometimes experienced as deadness or numbness.

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The resulting self-injurious behaviour is an attempt to control the timing and extent of the anticipated pain which is seen as inevitable.
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By invoking painful stimuli (e.g. slashing), the anxiety is immediately decreased.

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To the extent that self-injury results in a reduction of anxiety, it is an adaptive and resourceful behaviour

 

  • In total, 45 prisoners were interviewed. The results of one interview were not included due to a language barrier.
  • Security personnel (CX staff) were interviewed to assess front-line issues and concerns regarding self-injurious behaviour among prisoners. In total, 41 members of the security staff were interviewed. An additional three individuals were contacted but refused to be interviewed.
  • Relevant groups of individuals were interviewed to determine the best strategy for establishing a structure in which to implement recommended actions. These groups included staff from the psychology department, staff from health care services, and staff from the Regional Treatment Centre. Discussions with these individuals focused on programme implementation, programme delivery, and training requirements.

Interview questions were designed to gather information relevant to formulating policy in each of the three identified areas (i.e., injury response, injury reduction, and suicide identification).

The report is presented in six sections. The first section involves an examination of the extent of the problem of self-injurious behaviour in the Kingston Prison for Women. This discussion is based on responses from both prisoners and security personnel and includes data pertaining to outbreaks of self-injury in the prison. In the second section, the current response to self-injury is outlined followed by a presentation of reactions of prisoners and security personnel to this protocol. The third section of the report focuses on injury reduction. This begins with a presentation of data relating to the frequency of childhood sexual abuse among prisoners followed by an analysis of the factors identified as exacerbating self-injury. The fourth section focuses on suicide identification. The conclusions of the study are presented in the fifth section of the report, followed by the sixth and final section which outlines suggested direction for the remainder of the contract period.

Policy recommendations are provided throughout the report. These recommendations were designed to reflect the spirit of the Mission Statement of the Correctional Service of Canada (February, 1989). Three core values outlined in the Mission Statement were particularly relevant, and directed the recommendations:

Core Value 1: We respect the dignity of individuals, the rights of all members of society, and the potential for human growth and development.

Core Value 2: We recognize that the offender has the potential to live as a law-abiding citizen.

Core Value 3: We believe that our strength and our major resource in achieving our objectives is our staff and that human relationships are the cornerstone of our endeavour (p. 4).

Wherever possible, I will identify the way in which the particular recommendation operationalizes the guiding principles or strategic objectives of the core values.