Prof. dr. Siebrecht Vanhooren Prison & Meaning Prof. dr. Siebrecht Vanhooren

Is there life on Mars? Source: NASA (https://www.irishmirror.ie/news/world-news/dark-lady-mars-nasas-rover-6201711)

Is there meaning in prison? Wolff, Morgan, & Shi (2013): N= 4,204 prisoners Inmates at the end of their imprisonment show high levels of hopelessness and the absence of goals in life Serious risk factors for recidivism

Is there meaning in prison Meaninglessness > meaning in life Not your ideal destination for your spiritual journey or your search for meaning Source: http://www.marianmatthews.com/category/the-reality-of-humanity/between-lives/

However! Prisoners attend more spiritual/religious/humanistic practices inside prison they do ‘outside’ (O’Connor & Duncan, 2011) Prison converts (Maruna, Wilson, & Curran, 2006) What is going on in there?

Prison as an existential challenge? Committed crime and imprisonment as a source of Shattered assumptions (Janoff-Bulman, 1989), existential shattering (Hoffman & Vallejos, 2019), break-down of one’s meaning system (Park, 2010), or loss of meaning (Tillich, 1952) Search for meaning (Park, 2010) Posttraumatic growth and new meaning in life (Tedeschi & Calhoun, 2004; Park, 2010)

Research questions Challenging life circumstances can also be evoked by our own actions (Janoff-Bulman, 2013) Do prisoners experience a loss of meaning? Does a loss of meaning lead to distress? How do they cope with distress evoked by loss of meaning? Do they experience posttraumatic growth? How can therapy support posttraumatic growth among prisoners?

Studies (2013 – 2018) in Belgium Mixed-method pilot study (N = 30) Qualitative study (N = 10) Cross-sectional study (N = 365 ; 85.48%) Ongoing case studies (k=16)

Participants Pilot study (N = 30) ex-prisoners Qualitative study (N = 10) prisoners Cross-sectional study (N = 365 ; 85.48%) in 3 prisons 490 prisoners were available 427 prisoners signed an informed consent document 411 returned a sealed envelope (96.25%). Final sample: 365 prisoners (85.84%) Case studies (k = 16): prisoners and forensic inpatients (ex-prisoners)

Loss of meaning and prison distress

Loss of meaning and prison distress « You enter prison and your whole life is destroyed. Everything that once was certain becomes uncertain. I am not sure if I still have the right to live. Everybody wants to mean something in life. If I died right now my life wouldn’t have had any meaning at all. » (Qualitative study, N=10) « It is like being in hell. Suddenly, you lose everything. Nothing remains. You don’t recognize yourself anymore. So strange. Do you understand? It feels like you are totally a different person ». (Qualitative study, N=10)

Loss of meaning ‘Loss of meaning’: difference between one’s meaning in life before incarceration and during incarceration ‘My life has meaning’ ‘I have a purpose in life’ ‘My life makes sense’ Each item was scored on a 5-point Likert scale, ranging from 1 (‘totally not true’) to 5 (‘totally true’) Cronbach’s alpha of the scale was satisfactory (.91).

Prison distress General Health Questionnaire (GHQ-12, Goldberg & Williams, 1988) 12 items , 4-point Likert scale ‘Have you recently felt constantly under strain’, ‘Have you recently lost much sleep over worry’, ‘ Cronbach’s alpha was .83 In other studies the GHQ has shown to be a good measure of prison distress

Loss of meaning & prison stress Mean level of distress in the 3 prisons (closed and one half-open regime) was higher than the clinical threshold score: pathogenic distress Loss of meaning showed a significant significant correlation (medium effect size) with prison distress (r= .38**)

Loss of meaning and prison regime predict prison distress Predictor  Step 1  Step 2  Step 3  Step 4 Gender .02 .03 Age .01 .05 .00 Educational level .10 .08 Number of times in prison   .11* Time spent in prison - .13 * - .10 Loss of meaning .35 *** .33 *** Prison regime - .24 *** - .22 *** Loss of meaning and prison regime  R² .19 *** * p < .05, ** p < .01, *** p < .001

Un-sentenced vs. sentenced Un-sentenced prisoners Significant higher levels of loss of meaning Significant higher levels of prison distress More recently incarcerated, future is not clear. Confirms previous research?

Loss of meaning interacts with (un-)sentenced Predictor  Step 1  Step 2  Step 3  Step 4 Gender .02 .03 .05 .04 Age .01 .00 Educational level .10 .08 .09 Number of times in prison   Time spent in prison - .13 * - .06 - .07 Loss of Meaning .37 *** .30 *** (Un-)sentenced Loss of meaning and (un-) sentenced .14 *  R² .14 *** .01 * * p < .05, ** p < .01, *** p < .001

Conclusions Loss of Meaning Loss of meaning predicts prison distress New: loss of meaning is a stronger predictor than prison regime Existentials issues and meaning in life matters Neither therapy nor chaplaincy prevents or buffers the existential shattering or loss of meaning.

Coping, search for meaning, and posttraumatic growth

How do prisoners cope with this loss? Based on qualitative studies: Seeking emotional support Religious coping Denial Substance use Behavioral disengagement BRIEF COPE (Carver, 1997) Search for meaning Meaning in Life-questionnaire (MLQ; Steger, 2006) Posttraumatic Growth Posttraumatic Growth- Inventory (PTG-I; Tedeschi & Calhoun, 1996)

Coping & PTG (qualitative; N=10; N=30) Emotional support « There was one guard who took some time for me now and then. He asked me how I was doing and he was really interested in me. He gave me the feeling that I was still a human being. » Being seen, feeling understood by the other Acceptance of another person

Coping & PTG (qualitative; N=10; N=30) Coping strategies and posttraumatic growth Religious and spiritual coping « Religion is keeping me from committing suicide. I pray a lot and I read the Bible. The stories in the Bible help me to understand what is happening here and tell me that life isn’t easy. »

Coping & PTG (qualitative; N=10; N=30) Search for meaning « You start to reflect on the meaning of your life. Shouldn’t I have done things differently? » « You start to wonder about the essential questions in life, things I never thought about before. »

Correlations Posttraumatic growth Age (r= -.12*) Educational level (r= -.19**) Time spent in prison (r= .18**) Search for meaning Time spent in prison (r= .12*)

Predictors of posttraumatic growth  Step 1  Step 2  Step 3  Step 4 Age - .09 - .14 * - .18 ** - .15 ** Educational level - .17 ** - .13 * Number of times in prison .02 .06 .07 Months in prison   .21 *** .23 *** Denial .11 * .10 Substance use - .03 - .04 Emotional support .32 *** Disengagement - .21 *** - .22 *** Religious coping .20 *** .17 ** Search for meaning .16 **  R² .04 ** .04** .02 ** * p < .05, ** p < .01, *** p < .001

Coping strategies, search for meaning, & PTG Posttraumatic growth positively predicted by Emotional support Religious coping Search for meaning Negatively predicted by Behavioral disengagement Psychotherapy and chaplaincy were positively associated with posttraumatic growth (however, low effect sizes)

Posttraumatic growth: Shifts in meaning (N=10) “Thanks to incarceration I have the feeling that I know better who I am and what I want in life. I had time here to search for who I was. Without this period, I would never have had such a clear vision of who I am.” “ I don’t want to be rich anymore or make a career. If I could make a difference in a person’s life, my life would be successful.”

Posttraumatic growth: Shifts in meaning (N=10) “I now think that there is a God, but I don’t think I have the capacity to fully understand what God is. I think it’s something universal, God is in each of us and it doesn’t matter if you’re a Muslim or a Catholic. I think that God transcends religions. In the past, I thought religion was for sissies, for pedophile priests and for terrorists.”

Posttraumatic growth: Relating to other and self (N=10) “For the first time in my life, I started to see people as real individuals with their own needs and stories.” “I felt really agitated with him. Then I started to ask myself the question: ‘Why does he agitate me?’ I could see that he reminded me of myself and my junky behavior in the past. Okay, that’s not his fault.” How to relate to one’s self: self-care, self-respect, listening to own emotions, respecting physical boundaries of body,…

Differentiation between prisoners when it comes to meaning in life Meaning profiles

Meaning profiles based on search and presence of meaning Cluster 1: 39.50% Cluster 2: 17.40% Cluster 3: 37.29% Cluster 4: 5.80% Search: 76.79% Meaning: 56.90% Low meaning: 43.09% Hopeful and alarming!

Meaning profiles These four groups of prisoners score significantly different on certain variables Posttraumatic growth Prison distress

Meaning profiles Caring for others (subscale SAIL) World Assumptions (WAS, Janoff-Bulman) Traumatic experiences in childhood

Meaning profiles In clusters with low levels of meaning (high search, low search) More older prisoners More traumatic expeciences in childhood Capacity to find/make meaning or make sense Unresolved issues and traumatic experiences Emotion regulation (Angus & Greenberg, 2011)!!!

Lessons for psychotherapy in prison

Lessons for psyhotherapy Emotional support Meet the person in front of you Don’t reduce the prisoner to his/her crime Take the person and his/her inner parts seriously Also in this kind of therapy is an empathic and genuine therapeutic relationship primordial Loss of meaning Hold space for existential concerns, the effect of the crime on the prisoner, and the effect of incarceration on the prisoner

Lessons for psychotherapy Explore older traumatic experiences as well Traumatic experiences in childhood Life story (often a story of failure…) Work with the experiential world of the prisoner Empathy and emotion-regulation Focusing, emotion-focused therapy Help to make sense of everything Experiential exploration Victim – offender parts, life story Be open for the possibility of growth and change Help your client to notice small steps of change

Conclusions

Conclusions Crime and incarceration can induce a loss of meaning in life and an existential challenge. This loss of meaning is accompanied by distress in prison. Emotional support, religious coping, chaplain support, therapy, and search for meaning can foster posttraumatic growth

Conclusions Most prisoners search for meaning Some of them find new meaning: there is hope! Some of them don’t Former victims and older prisoners. Existential issues are far more important than expected.

Prof. dr. Siebrecht Vanhooren KU Leuven Faculty of Psychology and Educational Sciences Research Group Clinical Psychology Tiensestraat 102 3000 Leuven Belgium siebrecht.vanhooren@kuleuven.be