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Mental Health in the Prison System

Mental Health in the Prison System

Dr. Kate: Good evening Los Angeles, welcome to Behind Closed Doors heard every Saturday at 6 pm right here on Talk Radio 790KABC. I’m Dr. Kate Balestrieri.

Lauren: I’m Lauren Dummit, Marriage and Family Therapist.

Dr. Kate: Together we are the co-founders of Triune Therapy Group, a psychotherapy practice based in Los Angeles. Behind Closed Doors is a show about Sex, Relationships, Mental Health, Addiction, Staying healthy and related current events and all those things are things that we treat in our practice as well, really specializing and helping people get from places of pain into places of actualizing their potential and really stepping into a life of vitality and fulfillment. Today on our show we are going to be talking about mental health care and medical health care in the prison systems and this all came about as Lauren and I were talking a little bit about the idea of redemption and thinking about what’s been going on in the news lately regardless of your political leanings. I think we all can agree that there seems to be a lot of polarization between what is good and what is bad and it brings up for me a lot of ideas about how do we resist that kind of polarization as we think about ourselves as humans.

Lauren: Right, and so often it’s just not black and white. I think a lot of times people are products of their environment or products of their trauma, their childhood and so by making judgments I think people first of all feel somewhat like they feel safe from judgment when they are the ones judging. It doesn’t take into consideration the person as a whole.

Dr. Kate: Right and I am always left asking myself or patients will ask me why do we get stuck in this black and white pattern of thinking and the answer is usually because it’s uncomfortable to not have answers and so rather than sit with ambiguity or grey area we end up making up answers and that can feel very relieving to our nervous system, to our brain, to the way we view the world. If we have a direct black or white answer whether or not it includes the whole picture, it gives us an illusion of safety.

Lauren: I think that’s also why so many people are very drawn to religion because it gives them a set of answers and a set dogma to believe in where there is no room for grey area, not makes them feel safe.

Dr. Kate: Right and that’s not to priorities any sort of religious beliefs but what we are talking about here is to understand the function of having a dichotomist or black and white view point in the world. As human beings we just don’t do well living with uncertainty because it trickles for us all kinds of fears about our survival and so the more we can capture answers even if they are made up in our heads then we feel like okay I can get through this, I can get through this scenario. Coming back to this idea of redemption if we are talking about all the different things that are going on in the news and often times people think one side is all the way right and one side is all the way wrong and that’s just really not the case in life ever. The only time I feel comfortable using finite language is when I say it’s never black and white. So we are thinking about this idea of how do we take into consideration a really good people can do things that go against their value system or go against societies value system or any kind of legal boundary.

Lauren: That also reminds me of a topic that I come across a lot in talking to clients. It’s like is there such a thing as a good or bad person? I think we are all born good but we develop certain soul sickness based on our experiences and so are they bad or are they maybe sick in whatever area they are acting out?

Dr. Kate: Yeah. That’s a really important question I think and I would say what is the function of the word bad here, what are we saying is bad? Is it really maybe a question of an ineffective strategy to try to get someone’s needs met right? That’s often what we are looking at. That’s not to say that there aren’t people who enjoy hurting others and then get pleasure out of that. That diagnostically will usually get sadism and comes with lots of other clinical concerns. When we are talking about people who don’t fall into that level of equity psychologically, really what we are talking about is people who have transgressed usually their own boundaries, first and foremost and then the boundaries of those around them that can be financially, emotionally, sexually, physically, all sorts of ways.

Lauren: That comes up a lot in working with addiction because you see people that are in recovery and they are trying to change their lives and they really want it, but when they were on drugs or when they were drinking they did things that were beyond their wildest dreams in terms of how low they would go and that just speaks to their desperation and we can easily say at the time they were sick and it’s so hard because they often had like a scarlet letter or they feel as if it’s like pasted on their chest. So it’s like that shame that they feel almost follows them around and it makes it really difficult because shame is often what drives addiction and keeps our trauma staying in our trauma because it keeps us sick.

Dr. Kate: It does and so what happens is those secrets stay deeply hidden and they just fester in someone and it becomes so unattainable that they have to act it out sideways or in a way that is in indirect or they do what’s called ejective identification which is a really fancy psychological term which means I am so unconsciously uncomfortable with how I feel and I have to just spit it out of me and place it into someone else. Guess what, that other person has what we call valiance for that feeling and then they own all of our stuff and their stuff too. They carry it around for us which is what we see happening in a lot of this finger pointing going back and forth societally whether we are talking about people who exhibit criminal behavior or addictive behavior there are a lot of people who get very self-righteous and say well that person is bad or that person is a piece of you know what. The reality is we all have the ability to go dark and to feel negative things and to act out in a way that is not in accordance with how we might like to envision ourselves.

Lauren: One of the things I like to do personally when someone is really bothering me or triggering some really strong negative feelings, we have all heard that saying you spot it, you got it. I always think it’s really worth going deep and exploring what it is it that is making me feel so passionate about this and what is it in me that maybe I am not conscious of or I am trying to adamantly deny. Again like you said people like answers, I think people are afraid of their own subconscious drives and so when they see it in someone else they have to make it bad and outside of them and separate.

Dr. Kate: It’s a safeguard against our own shame because if we have to acknowledge that we have shadowy parts or dark spots or green stripes or whatever it is we don’t like then we have to get into reality about what we want to do about that. We can continue to live with our green stripes and just be in acceptance of that or we can say you know I don’t want green stripes maybe I want purple spots instead and work towards making that happen. The reality is we are so subjective as humans that my excellent might be your worst nightmare and vice versa. We go about the world pointing fingers at people saying well that’s good or that’s bad and what we are really doing is engaging a very primitive part of our development that’s trying to access where I belong, who am I, how do I stay safe. When we form allegiances and alliances and cast out things that feel bad or threatening. That’s a way that we are trying to stay safe and collected and ensure our survival.

Lauren: I was just thinking about that too, is the fact that a lot of times people don’t even have all the information but they are just quick to get on their high horse and judge and I think part of that is just jumping on the band wagon so that they can feel part of and that’s part of our human nature is wanting to belong to the group and that’s the survival mechanism as well and it’s very primitive.

Dr. Kate: It is and it’s not to shame people for having what is a very natural human reaction. We all do it. I think what we are inviting listeners to consider is how might I be jumping to conclusions in these black and white areas and not making room for people’s growth and redemption. That’s really what I think about when we are going to be talking to our guest coming up in the next segment is…How do we Navigate as a culture this idea of redemption and people learning and growing and stepping into the path that for them is most meaningful and is most contributory for society when in fact they have some blemishes in their history.

Lauren: I think that is such an important topic right now with everything that’s going on in the media. I know a lot of my male clients it’s been a really hard time for them because throughout their early 20s or their late teens or earlier in their lives, they have done things that they are horrified by and they have changed their lives immensely and they are so afraid of being crucified because of everything that’s going on. That’s a conversation we have been having is how do you make amends for what you have done so that you can feel like you have a clean slate so you are not carrying around that shame anymore and can we make room for that as a society.

Dr. Kate: I think a lot of people feel like if they give breath to their shame then it becomes their current reality and they are going to receive this sort of pastramis stoning that they didn’t get when they in their minds deserved it but now they are living more congruently. One of the things that we will talk about when we come back is what happens when our systems to help people in their process of redemption don’t work the way that they are intended to and we’ll be bringing on a very special guest today, Eric Fredrickson. Eric is joining us from a law firm in Atlanta and we will be talking with him about a very interesting case that he is working on. If anyone has any questions on anything that you have heard today or will hear on our show please feel free to give us a call at Triune Therapy Group at 310-933-4088. Lauren and I specialize in helping people find their own paths to redemption and with that note we’ll be right back. Stick with us.

[Break]

Dr. Kate: Welcome back you are listening to Behind Closed Doors. I’m Dr. Kate Balestrieri.

Lauren: I’m Lauren Dummit, Marriage and Family Therapist.

Dr. Kate: Together we are the cofounders of Triune Therapy Group, a psychotherapy practice in Los Angeles that specializes in treating trauma, addiction, sex and relationship issues. Today on our show we are talking about mental health care in the prison systems with a very special guest Eric Fredrickson who is from the Atlanta based law firm the Harman Law Firm. Eric are you with us?

Eric: Yes. Thank you for having me.

Dr. Kate: Thanks so much for joining us we are so excited to talk with you today.

Eric: Glad to be here.

Dr. Kate: Well tell us a little bit about yourself and your firm.

Eric: So I grew up in a small town in Colorado called Craig. I moved to Atlanta about 10 years ago to attend Law School in Emery Law. When I was graduating it just so happened that Matt Harman was in the process of setting up his own clean up. He had been a defense lawyer for about 10 years was starting a firm so I joined him at the Harman Law Firm and we now specialize in a couple of difficult legal areas. Matt ends up being product liability especially pharmaceutical and medical device products. I mainly manage is a subset of civil rights litigation dealing with the conditions of confinement for people who are incarcerated.

Dr. Kate: I know civil rights have been a really important and pressing topic in the news in the last couple of weeks.

Eric: Yeah.

Lauren: What are some of the biggest problem areas that you come across?

Eric: Certainly mental health is a major problem area in jails, prisons, state prisons, central prisons across the board. It’s always a concern because the population that is prone to mental health issues, people with mental health problems are more likely to wind up incarcerated. Also in some cases the conditions of incarceration can exacerbate or cause mental health problems.

Lauren: I’m sure there’s a lot of trauma that goes on within the system.

Eric: Absolutely. Most people are familiar with the general problems facing detention centers and it’s a population prone to violence and all these problems but most people don’t realize that depending on where you are it’s a safe bet that the largest providers of mental health services in your state is the Department of Correction.

Dr. Kate: Which is so interesting because after having worked in various correctional facilities for about 10 years, I often found that was one of the most under resourced areas within the prison systems, the mental health department.

Eric: Yes absolutely, it goes ignored or underappreciated in so many cases. Every correctional facility because there are certainly some out there who are absolutely doing it right and they deserve credit for that. In so many cases there is just clearly poorly resource to mental health services at these facilities.

Lauren: What are the biggest contributing factors to that?

Eric: Well, I’m of the opinion that it’s partly because it’s the easiest population to sort of ignore the tendency among some people to say well they committed crimes, they are criminals, and they get what’s coming to them, that sort of attitude.

Lauren: They are like dehumanized?

Eric: Yeah and it’s easy for policy makers or politicians to say well we have our own problems with health care for people who aren’t incarcerated that should kind of be our last concern is the implication that we have all these other problems to deal with. There are certainly their problems with homelessness and our own healthcare systems outside of the correction systems and so it’s easy to sort of put it at the very bottom of the list for resources but obviously I think that’s a mistake.

Dr. Kate: In your opinion why is that a mistake? I can’t wait to throw in on that too.

Eric: Well, a couple reasons. I guess if you are not like me there is a Russian author and philosopher in 1860s. He famously wrote the Degree of Civilization and a Society can be judge by entering in its Prisons. It does show you that what you think of the value of human life as a sort of a humanist manner regardless of what that person may have done in the past. If you don’t treat them at some basic level of human dignity it does speak to broader problems from the society which gives you more practical answers. If someone has made a large mistake they will line them up incarcerated. One of the best ways you can ensure that they don’t become deformed and become a better member of society later is by not treating them with basic human dignity.

Dr. Kate: Exactly. Which goes I think indicated to what a lot of people who have no involvement with the prison systems tend to think? When people have never worked in one or have never worked with somebody who has been incarcerated or they don’t know someone who has been incarcerated it’s very easy to quickly just say well this person did wrong, let’s castigate them for the rest of their lives, they become a throw away part of our culture. A repository for all of the things within our culture that we don’t really want to look at and own in the rest of the walking wounded population who are not incarcerated.

Eric: That’s exactly right and that’s something we actually capture it as a very practical matter, a standpoint that the jury pool for our cases. There is a very quick and sort of easy instincts to have this kind of negative attribution where people will look at someone who is in prison and think this doesn’t really concern me because I would never be in that situation. I would never have done that. They sort of willingly refuse to try to relate to the people who are in the correctional facilities.

Lauren: I always laugh at that a little bit because I think most people have probably done something that could have landed them in prison, they just didn’t get caught.

Eric: Many more than who are actually in prison. That’s for sure.

Dr. Kate: Definitely.

Lauren: Also I think that people that often are committing crimes are often people that have a lot of like emotional wounds based on their own trauma in childhood or throughout their life. By adding insult to injury it seems like you are only making their criminality worse.

Eric: That’s absolutely right and then another subject I know you guys know a lot more about than I do is addiction and the way we choose to treat it as a crime rather than a disease. There are over 2 million people who are incarcerated in America. 1 in 5 are for nonviolent, drug related crime. If you told any corrections department that I have an idea for treating this differently and it could reduce your burden by 20% they would be pretty ecstatic.

Dr. Kate: It would be really phenomenal if there was an audience for that kind of change. I know in working in the prisons for so long. I worked with adult men, adult women, adolescent boys and adolescent girls in various parts of my career but some of the most high risk sex offenders and violent offenders that existed in the criminal systems in the various states where I have worked but one of the things that always stood out to me is how so many of the inmates that I have worked with are in prison for crimes committed while they were intoxicated or in the process of trying to maintain their addiction not because they wanted to but because the disease had become so progressed that it compelled them down a trajectory that really they were not operating consciously. I am not condoning or excusing behavior saying that their shouldn’t be consequences but I think we are really failing culturally to understand the role that trauma and emotional disregulation and addiction play in the kinds of behaviors that are penalized in our criminal system.

Lauren: I also used to work at a outpatient psychiatric hospital and there was so many that had a record of having been incarcerated and lot of their crimes were done when they were having a psychotic break or they had gone off their medication or what not. It was really sad because they are not functioning at a level that they often know what they are doing.

Dr. Kate: What are your thoughts on that Eric giving all the cases that you have worked on?

Eric: That’s absolutely right and to add on to something you mentioned I am the first to admit the very asset of any case that when someone breaks the law they should be punished according to whatever the law is. It’s not an excuse and we never deny that they should be punished for whatever the law is. You can argue that you want it to be changed or that you want drug counts to be treated differently. Whatever the law is we want it to be applied as long as it is the law. We have a system with a judge and jury for imposing sentences and so many of my cases and obviously it involves the person who died. One was a 14 year old boy who stole an iPhone certainly was not sentenced to death for that crime and so he fell to the correctional systems shouldn’t change retroactively is how I put it.

Dr. Kate: Well that’s a really interesting way to look at it. What were the conditions for his death?

Eric: It was a suicide. A lot of cases there are so many cases where people are known to be suicidal and that facility either can’t or won’t do anything about it.

Dr. Kate: Right. I mean if you think about it if most people who are being incarcerated either for the first time or if they are repeat offender being incarcerated can be really scary and as Lauren I think you pointed out earlier often times there is a lot of institutionalized trauma that occurs in this facility so people sometimes know what they are getting themselves into as they are going into the reception area or any prisoner jail but often times they don’t and if they have a mental illness or if they have a predisposition to pressure their suicidal even if they don’t that can be such an extreme stressor that it does create a catalyst for action around suicidality. We are going to take a break right now but when we come back we’ll talk more about mental health in the prison systems with Eric Fredrickson from the Harman Law Firm in Atlanta and we are going to continue talking more about the implications of untreated mental health and addiction so stick with us we’ll be right back.

[Break]

Dr. Kate: Welcome back you are listening to Talk Radio 790KABC. This is Behind Closed Doors. I’m Dr. Kate Balestrieri.

Lauren: I’m Lauren Dummit, Licensed Marriage and Family Therapist.

Dr. Kate: Together we are the cofounders of Triune Therapy Group, a psychotherapy practice based in Los Angeles that focuses on treating trauma, addiction, sex and relationship issues and today we are talking about Mental Health care in the prison systems with Eric Fredrickson from the Harman law Group. Is it Harman Law Group or Harman Law Firm in Atlanta?

Eric: Harman Law Firm.

Dr. Kate: Thank you. Eric thanks again for being here with us and just before we took a break we were talking about all the different wrongful death cases that you work on as part of your specialty area. I know you recently brought to the department of corrections a case about a young man named Jimmy Lisarowes, is that something you can talk about with us on air today?

Eric: Yeah you bet. This is a very sad case. Jimmy was a 19 year old who was sentenced to 2 years in prison for property theft. Shortly after starting to serve his sentence he started losing weight rapidly and quickly became…started suffering from depressive cationic. That progressed to a point where he was not speaking, not moving, not eating or drinking. Eventually he wouldn’t even get up to use the bathroom. He was taken to a medical prison here in Georgia where that until he eventually became unconscious and taken to a local hospital but died from blood clotting essentially caused be the severe dehydration. Basically this 19 year old kid was allowed to starve to death in prisons here in Georgia.

Dr. Kate: That is not a fast process.

Lauren: No it’s not.

Eric: It took place over about 6 months.

Dr. Kate: That sounds incredibly painful. What compelled you to take this case forward?

Eric: That fact pattern I mean those kinds of conditions cannot be tolerated in a modern civilized society. I mean it’s not that it should be any different but just for an example we know that Guantanamo Bay for example accused mass murders would go on hunger strike and have them use feeding tubes to make sure they didn’t die. This 19 year old kid who just stole a car can’t get at least that level of care is just not acceptable.

Dr. Kate: Exactly. That’s so alarming. From your perspective what happened that people were not recognizing the severity of his symptoms.

Eric: That’s a really good question and I usually have a better answer for that about most of my cases and this one I don’t know what the explanation is and it’s barely in the litigation process so no one is formally made an effort to defend themselves which they will. I honestly wish I better answer for you but I just don’t know if well documented especially that last month when he is in the medical prison it’s well documented, he is not eating. They write it down what’s going on and then move on and get to the next cell and nothing was done about it.

Lauren: I’m guessing you would know better than I because you have worked with people that have been incarcerated. For our listeners what are some of the things that they could do to help someone that’s at that point?

Eric: Well, certainly there was a point long before it became deadly that he should have been taken to a hospital. Before that there are protocols and procedures that correctional department have for hunger strike for example. He wasn’t intentionally on a hunger strike, it was mental illness but they have protocols and procedures to deal with inmates who are not eating or drinking so that they don’t start to suffer from malnutrition. If you have to you can certainly use a feeding tube if it gets to that point but there’s protocols that certainly they can use to prevent it from getting even that far.

Dr. Kate: When I worked in the prison systems we often had inmates who would attempt to get certain needs met or get certain wants met and use hunger strike manipulatively and often times the system was very quick in nipping that in the butt to keep inmates safe and make sure that their health did not deteriorate to the point of danger because when someone’s not eating, it very quickly impacts their brain functioning. It makes them more impulsive, less clear in their thought process and that can present a large danger to themselves or to people around them.

Lauren: I’m also thinking about even just the sanitary conditions. If he wasn’t able to even come out of the Catania to use the bathroom. Typically people have a cell mate as well.

Dr. Kate: I wonder did this individual have a cell mate?

Eric: No I don’t believe so, at least not in a medical prison but you are absolutely right about the sanitary conditions in the facility.

Lauren: Do you know where they are treating him with at least medication or anything prior to this?

Eric: No they did not.

Dr. Kate: Did Jimmy have a history of mental illness or depression? What do you think prompted such a rapid escalation in his symptoms?

Eric: In hindsight it may have been related to schizophrenia. It’s about that age where it may manifest if it’s ever going to but it was something that came on for the first time unexpectedly.

Lauren: It is definitely a psychotic symptom of schizophrenia and also schizophrenia coupled with that age, coupled with a severe trauma and I could imagine being in prison experienced as extremely traumatic probably more than he could handle.

Dr. Kate: That’s often when we see psychotic breaks happen when there is a really big stressor and right around that window of Jimmy’s age, he was 19 you said when he was brought into the department of corrections?

Eric: Right.

Dr. Kate: What are your thoughts on how a jury will precede this case?

Eric: There is always the issues that we sort of discuss before in these cases of people wanting to sort of forget how prisoners. Either it’s just low priority or its well there is a second of the population that they committed a crime so they get what’s coming to them it doesn’t really matter. There is that concern. I think Jimmy’s case is pretty sympathetic. We try to stick very strictly to the philosophy that everyone no matter what the crime is as basic human rights and gets basic medical care and all these things. I’ll admit like probably anyone else there are crimes out there that are so difficult to define for that person. It’s a natural human reaction I think. Jimmy being 19 falling in with the wrong crowd and the car is what he stole but nonviolent with like a carjacking he was riding around in a stolen car and ended up getting sentenced to 2 years in prison and I don’t think that the mysteries will excuse the treatment he endured.

Lauren: This brings to mind as well when someone has not yet developed schizophrenia as recognized as schizophrenia. It’s a thought disorder so quite frequently they have symptoms leading up to that, that goes unnoticed because they are not as severe. They do have a thought disorder so making decisions, their ability to make wise decisions is often frequently impaired as well as they often are people that do not fit in and so I can imagine you mentioned him falling into the wrong crowd. He might have been someone that was very vulnerable to outside influences and not able to make very wise decisions on his own.

Eric: Absolutely.

Dr. Kate: What do you know about Jimmy’s upbringing and how that may or may not have played a role into falling into the wrong crowd or becoming incarcerated?

Eric: He grew up in New York with his mom. They moved to the Atlanta area when he was a kid around preteen or maybe early teenage years looking for better opportunities down here. I guess that’s kind of beyond my expertise to know whether his upbringing may have contributed to it. I know that sort of social pressures and those kinds of kids that cause kids to fall into the wrong crowd are the same kind of things certainly happen in Jimmy’s case.

Dr. Kate: I know I am sort of taking all of this in and it’s such a heavy thing to think about this young man’s life was completely truncated for so many different reasons and it’s really sad. I wonder what your goal is as a litigator in terms of helping the family or affecting change. What would you like to see ideally happen when you are handling this kind of case specifically or any wrongful death cases?

Eric: We certainly want to try to have change. We chew one law litigation legally we can’t force them to change it. There is ancillary effect of litigation in a shiny light disinfected light and things that are going on and causing people to take notice. So a lot of times litigation does cause change just sort of indirectly. So that’s always one of our goals is to make it as public as we can to shine and to bring attention to it and shine line on it so that hopefully people will take notice and let the right people know that we can tolerate this kind of thing.

Dr. Kate: Well we so appreciate you coming on the show so that we can highlight that kind of social justice issue because really Jimmy could have gone on to being very strong contributing member of society had he been given proper assessment, proper treatment and an opportunity for redemption and rehabilitation. On that note we are going to take a quick break and when we come back we will continue talking a little bit about Mental Health in the Prison Systems with Erik Fredrickson from the Harman Law Firm in Atlanta. If you have any questions about anything you have heard today on our show you can always call Lauren or I at 310-933-4088 or check out our website triunetherapy.com and stay with us we will be right back.

[Break]

Dr. Kate: Welcome back, you are listening to Talk Radio 790 KABC. If you have just tuned in you are listening to Behind Closed Doors, I’m Dr. Kate Balestrieri.

Lauren: I’m Lauren Dummit, Marriage and Family Therapist.

Dr. Kate: Together we are the cofounders of Triune Therapy Group, a psychotherapy practice based in Los Angeles that specializes in treating all different kinds of trauma, addiction, sex and relationship issues. Feel free to give us a message on Instagram or Facebook at Triune Therapy Group or you can always call us at 310-933-4088 if you have any questions about anything you have heard on today’s show or you would like to schedule a consultation. Today we are talking about Mental Health Care in the Prison systems with Eric Fredrickson from the Harman Law Firm in Atlanta. We were just talking about this really unfortunate case of wrongful death that you are petitioning Eric and I wonder of all the cases that you have worked with around this topic is there any one case that really stands out to you as the most heart breaking?

Eric: This certainly may be one of them. Another I mentioned earlier with the 14 year old kid who committed suicide is certainly one of them particularly because he was in a pre-trial detention facility. He hadn’t been convicted of any crime which again that people who commit crimes shouldn’t get basic health care but it’s so heart breaking for a 14 year old kid who probably made a poor decision one time his life just ended.

Dr. Kate: That is so sad, so tragic. I remember working in the various prison systems and there definitely were inmates who would play the I am going to commit suicide card and certainly they were acting out and trying to get attention and trying to manipulate whatever leverage they could to get some needs met and so I completely empathize with the prison staff who need to monitor that and not encourage that kind of behavior. It’s so sad when there is a case like this where someone is not crying wolf and really does need all kinds of different kind of attention especially with adolescents. That’s just heartbreaking a 14 year old.

Eric: I certainly recognize that the problem that inmates will threaten suicide at the way of manipulating or even just to try to get attention they might not know what they want. I certainly recognize that and in the case where you are talking about Jimmy, his condition was so well documented over so long that there was this so many chances to permeate him from dying that it boggles the mind that someone couldn’t do what need to be done to prevent that death.

Dr. Kate: It really is flummoxing. In our practice at Triune Therapy Group, if we are working with someone who’s anorexia for example it’s so acute that they are on the verge of death from malnutrition, we have to make a report and initiate hospitalization process so they can start some sort of life regeneration process and to get a higher level of care. When you are in a prison system that is a fully contained facility, health care is there, medical care, mental health care is there, dental is there, everything is self-contained so it’s so unfortunate that he was missed.

Eric: That’s right and that’s really one of the important features especially from the litigation standpoint but just from the practical standpoint too is if you are incarcerated in any kind of detention facility you don’t have any other choice, you can’t call Dr. Kate and say I want to make an appointment. That prison is all you have got so if they are not going to give it to you; you are not going to get it.

Dr. Kate: Some prisons are so overburdened and under resourced that it can take inmate upwards of 3 to 6 months to get an appointment with a basic primary care physician who they are waiting because they have a broken wrist for example or a broken finger. It would take them months or weeks at times to get treatment for those kinds of things and I don’t necessarily know that’s because of neglect but certainly there was just a long list of people who had to put in those requests so it can be really under resourced in those systems.

Eric: There is no question there at least for the most part so many of them just are so far under resourced that it may not be any one person’s fault, it’s just a matter there is only so many resources to go around and too many people who need them. We certainly see that all the time.

Lauren: Considering the fact that his condition was documented I just love to be a fly on the wall over hearing those conversations about his care and what were they thinking.

Eric: Me too. I would very much like to get into the thought process there.

Dr. Kate: Again as somebody who has worked in the prison systems for a very long time. I can say I don’t know what that staff was thinking but often times my observation was that a lot of the correctional officers and the frontline staff in the various departments are very burnt out. They experience a lot of vicarious trauma, they don’t always communicate well from shift to shift and often time’s prison systems operate with a really antiquated record keeping system so it can be very challenging for one team or one shift to know what the next is doing. A lot of information falls through the cracks. The staff who work there find themselves bogged down with endless kind of paper work and it does prevent sometimes ineffective continuity of care and I think that there is a plea from me personally to all the prison systems out there to upgrade the way in which information is shared technologically within the system to help expedite that process free up some of the bandwidth that the correctional officers and the non-correctional staff have available to make the system operate more efficiently.

Eric: I can fully agree with that. Any personal injury litigation involves a lot of medical records, what happened, what went wrong and maybe what the consequences were of the injury that results in and I can tell you that prison and other correctional facility are all the only place where we still get hand written medical records. Occasionally there are maybe family doctors who have a few handwritten notes and that kind of thing. As far as hospitals and major facilities prisons are the only places that are still using completely handwritten medical records.

Dr. Kate: Which is really challenging for any physician who is taking notes, I mean it’s laborious and it takes a lot of time to write those notes but it’s also challenging to bring in the kinds of technology into the prison that would expedite that from a contraband perspective so it’s a challenging position that the prison systems are in often but some have progressed into the 21st century with technology and others continue to maintain more of an antiquated system that does in fact contribute a dearth of care available. I’m curious Eric for you what do you think about the privatization of the prison systems versus state run? I don’t actually know for Georgia which is the case? How does the privatization of the prison systems help or hurt the cause?

Lauren: I’m curious about that question as well.

Eric: There are some private facilities in Georgia we still state run. I”ll tell you it can go both ways. I have seen them better and I have seen them being worse. In Georgia we actually another issue sometimes is hybrid so a lot of state prisons or county jails will contract a private company to run the medical services. In Georgia they even do something even stranger which is the Department of Correction has a contract with Georgia University system to provide the medical services which is a little bit unique. They face all of the same challenges whether it’s a private company, entirely private detention facility or private company providing the medical services they really have all the same challenges that the government, budget, obviously it’s hard working conditions if you limit it in resources you are not going to get the most promising candidates for a job in that field to work in a prison for less paid and they can work anywhere. That’s certainly difficult. I think there is an opportunity. They answer what should we do about our prison sometimes splits along political lines where someone will say one group of people will say Eric aren’t they just terribly under resourced and under staffed and underfunded and I will say yes absolutely correct. Another group may say aren’t they bureaucratic top heavy and have a bunch of administrative jobs that aren’t really providing any service indirectly inside the prison and I’ll say that’s correct too. Sometimes we see that the private companies do a better job using the resources where they are actually needed or at least when they tell us to wait. I think there is opportunity there but I have a decent portion of our case but something like half of our cases are involving private companies of some kind so there are certainly not doing much better across the board, that’s for sure.

Dr. Kate: Very interesting. Eric, thank you so much for joining us today. How can our listeners learn more about you or the Harman Law Firm if they want to get in touch with you for representation or just to learn more?

Eric: You can go to our website harmanlaw.com.

Dr. Kate: Great. Thank you so much, this has been such an important conversation and we are grateful to have had you on today. Lauren I am so curious in hearing all of that and coming back to this idea of redemption what do you think is the biggest take away for you of this conversation?

Lauren: I just keep thinking about how people go to prison and just really learn to become better criminals or just get sicker and so people often want people punished to the most severe level that fits the crime yet they are not realizing that ultimately that might contribute to a less safe society.

Dr. Kate: It brings me back to the idea of being proactive with treatment. I am not saying that we shouldn’t punish what needs to be punished but being more adept to what mental health symptoms are showing up and providing treatment and being willing to get treatment. Thank you everyone for listening today. If you have any questions you can call us at 310-933-4088 or find us at Triunetherapy.com. Have a great weekend everyone.

FAQ

Ask the experts

Often, when anger is the first response, it’s considered impolite, crazy, bitchy or dismissed as overly emotional. Yet, there are many instances in which one’s anger is stirred, and the key is putting it to good use. For instance, when a loved one is unfaithful, or when insensitive remarks are made concerning one’s ambitions or dreams, when feelings are questioned or when a woman is told to be more vulnerable and subservient. Though family and social expectations place unnecessary burdens on women (and men too), they can channel their anger-filled responses into action by going against the grain, pursuing their own interests or business, going to graduate school and much more. In turn, they’re encouraged to surround themselves with like-minded individuals, committed to supporting and cheering on one another, and ultimately helping the other discover their true potential. This system of support will continue to help individuals convert their anger into action, and perhaps enjoy a few laughs, too.

Yes. One hundred percent. Women are socialized to put relationships before themselves, and this often leads to stifling anger or any feeling that might compromise the bond between two people. This is especially the case in their relationships with men, or in competition for men, and over time, women’s anger and aggression has become more user wraps, or covert. Passive aggression seems to be both the only “acceptable” means of communicating anger, but women are also labeled “manipulative” when they attempt to express themselves indirectly. It becomes a vicious circle of anger, denial or minimization of anger, and then make ourselves smaller just to avoid being a “problem.”

While it is becoming more acceptable for women to show anger, progress is slow. Most of the time, female anger is couched in comedy or parody, and only accepted in small soundbites. Those invested in a patriarchal perspective, men and women, hold firm in their beliefs that women ought to act a certain way, or not make waves. The vary act of saying “we’re angry!” is a bold and pioneering move. Further, some women hold more internalized oppressive views, and refuse to participate in a movement that is labeled feminist or angry. For some women, to do so would compromise their social standing, romantic relationships, financial security, etc. It is scary, because the backlash is real. To take a stand is mark of bravery, and not everyone is ready to avail themselves to the fiery response of those in opposition. My opinion is that over time, the backlash will subside and change will take place. Cultural growth is a slow moving process, and with every voice heard, the collective voice of a paradigm shift grows louder and more effective. I don’t think women (or men) should care about acceptability. The more those who are angry attempt to hustle for the approval of their oppressors, the more power is given away. From my perspective, those who are angry a well suited to unite and establish new norms, refusing to tolerate mistreatment any further.

There are so many way to channel one’s anger constructively. I do not condone any violence (unless in self-defense) and instead think about using anger as a collaborating force within and with others. Being of service to others is one way to channel anger. This is especially relevant because so many women today do not have strong female role models, who they can turn to for advice. Get engaged. Mentor younger women, get a mentor, get creative. How can you pass along the resources (i.e., emotional, financial, logistic, etc) that were not available to you and resulted in your marginalization? What do you wish existed that could have helped you through a particularly challenging experience? Create it. I did, and it changed my relationship with anger and helped me take it for what it is a healthy emotion that lets us know when we feel disrespected or mistreated. This is key information that keeps us psychologically and rationally healthy. Anger is invaluable and an essential part of the human experience. When we embrace that, we can make it work for us in myriad ways.

As a psychologist, patients, friends and family are always asking me advice on their relationships and, let’s be real, everyone else’s relationships. One of the biggest questions they have, is why are there no good men or no good women out there? There are good people out there, I reassure them, but they inevitably come back with some retort about having to settle or face being single forever; for some, a fate worse than death. So herein lies the conundrum stay single forever or settle. Well, let’s back out of the black and white thinking that keeps us stuck for a moment and think about what it means to settle. Most of us have arbitrary ideas or checklists we drag around to assess our swiping situation. Does he make a certain amount of money? Is she pretty enough to take around my friends? Is she/he tall enough/too tall? Is she/he fit enough? What kind of car does he/she drive? Do they like dogs? All-important questions, but what do they really mean about a person’s character or how well you’ll get along? When considering the question of settling, it is important to ask what we:

  1. need in relationships
  2. want in relationships and
  3. won’t tolerate in relationships?

No two relational blue prints will look the same, and there are no right or wrong answers. Let’s look at needs first. We all have intimacy needs, like support, trust, security, communication, touch, respect, etc. They may change over time. That’s okay. Its hardwired in us. We also have relationship wants, the qualities that might ignite our fire a little more intensely. Physical appearance, fitness level, similar hobbies, values, job, financial standing, etc. are examples of wants. There is nothing wrong with wanting whatever you want in a partner. But many times, we mistake our wants for needs and then we feel like we’re settling if the want boxes are not checked, because we’re ignoring the meaning we assign to these traits. For example, consider meeting someone who is two inches shorter than your preferred height in a partner. He or she is funny, witty, charming, consistent, honest, and generous with their time, all of the other wants and needs you’ve identified. They just happen to be a little short-changed in the height department. What does height mean to you? Does it represent strength? Safety? Protection? Status? What does it mean about you if you date this person anyway? Whose judgment do you hear in your head? Why is their judgment so important? Asking these tough questions can help you decide if this is a want or a need, and if the underlying meaning is a need, can that need be met in other ways by this partner or other people in your circle? We often expect our partner to meet all of our needs, and overlook the inevitable disappointment in that expectation. Many people do not know what they need or want in relationships, because they are so eager to be in a relationship that they haven’t stopped to consider what they are looking for in their other half. They accept what is available, to avoid being alone. One day, they wake up and think, “Hey, I think I want more than this. I wish my partner would….” and realize that they might be settling but are afraid to leave. This brings me back to the last point, knowing what you won’t tolerate in relationships. It is just as important to know what doesn’t work for you when considering whether to start, stay in or leave a relationship. For some, deal breakers might include violence or infidelity. For others, perhaps smoking or liking heavy metal is the end of the line. Knowing yourself is key in defining your needs, wants, and deal breakers for relationships. If you don’t know some answers to these three factors, perhaps you’ve been neglectful (and settling!) in the most relationship of all, the relationship you have with yourself. Only when you set intentions and cultivate a relationship with yourself can you invite in the kind of love you are seeking and deserve to have. Until then, you’ll be running in circles, chasing ideas and looking to define yourself in the reflection of another.

Obsession, a thought that continually preoccupies or intrudes on a person’s mind, is often what drives addiction. Obsession is about hypervigilance. When we feel the object of our affection (whether real or in fantasy) may not feel the same way, we perseverate about them, ourselves and the relationship. This rumination and over-focus is an emotional survival strategy that keeps our brain playing out all of the what-ifs and looking for answers to the sometimes unconscious ques- tion, “How can I make sure my partner doesn’t leave me?” A milder version of obsession can look like ruminating thoughts. “What if he likes her more than me?” “Did she talk to her ex-boy- friend last night?” “If only I lost those last 10 pounds…” Perhaps you find yourself checking their social media accounts for proof they are with you, or have moved on. Maybe you enlist your friends or family to investigate or check on your desired. At the extremes, obsession can morph into stalking and domestic violence. If we feel threatened at the loss of someone, and re- taliate with this level of possession, it can be dangerous for everyone involved. Contrary to what may be glamorized in movies, extreme jealously and stalking are not healthy courtship behaviors, and can lead to emotional and physical trouble.

Obsession with another person may be a symptom of love addiction, which is essentially an ad- diction to the experience or “high” of being in love, and generally appears on the form of putting another person on a pedestal, creating the fantasy that they are perfect or the one, ignoring their faults or certain red flags that point to the contrary. Love addicts often expect their partners to care for all of their needs. Love addicts often neglect to care for or value themselves while they in the relationship. There often exists a toxic bond or an obsessive attachment in love addicted relationships. Love addicts often continue to engage in the relationship, trying desperately to connect as they search for their self-worth in the relationship, even if the object of their desire is pejorative, hurtful, or abusive. Inappropriate boundaries, abuse, neglect, intimacy issues, chaos, drama are some of the deleterious characteristics of these relationships. Love addicts suffer from profound feelings of shame, anguish, and fear of abandonment.

Since love addicts typically suffer from an anxious or preoccupied attachment (hypervigilance about their partner or the relationship), some signs to watch out for would be someone who is wanting speedy closeness, says “I love you before the first argument, has poor boundaries, is constantly expressing insecurities and worrying about rejection, is often very unhappy when not in a relationship, plays games to keep your attention, has difficulty with direct communication, struggles to effectively express their wants, needs, thoughts, and feelings, expecting you to guess or read his or her mind, acts out, tries to make you jealous, always makes things about him/her- self in the relationship, lets you set the tone of the relationship, seems preoccupied with the relationship, calls or texts excessively, stops by your home or work unexpectedly, fears that the small acts will ruin the relationship, seems to be trying too hard to keep your interest, and is extremely jealous.

If you suspect that the person you are getting to know has obsessive or love addicted tendencies, this does not mean you have to cut them out of your life completely. However, it is important to take things slowly, establish very clear boundaries, assess what works for you and get consulta- tion from friends and loved ones about your experience, pay attention to any attempts to get you to change or disregard your boundaries or needs, use direct, clear communication, and effectively verbalize your wants, needs, thoughts, and feelings. – Dr. Kate Balestrieri, Psy.D., CSAT-S, Licensed Clinical and Forensic Psychologist, and Lauren Dummit-Schock, LMFT, CSAT, CoFounder

The first step to getting help from this type of toxic relationship is to recognize narcissism in your partner or spouse. This involves identifying the traits and warning signs of this disorder, which you may have been living with for quite some time. At Triune Therapy Group, we have skilled clinicians who are highly trained to treat those that are in a relationship with a narcissist.

To help you understand the condition and how you may or may not have been affected, please explore the following Frequently Asked Questions and Answers provided by Licensed Psychologist Dr. Kate Balestrieri: Read More FAQs About Narcissistic Personality Disorder

Perhaps the greatest hope surrounding the #MeToo movement and other similar movements is that it will generate an awareness of the magnitude of sexual assault and harassment, particularly in the workplace. In doing so, maybe it will initiate and rebirth conversations regarding equality that have since gone underground. This is important, because many people fail to see the ways in which others misuse power and privilege, and how this leads them to engage in predatory behaviors. In another sense, the #MeToo movement could educate people on how to avoid being exploitative, while enlightening them on affirmative consent, power imbalances and how to classify and pursue intimacy and happiness in a authentic, healthy manner.

I work with new mothers and I have on multiple occasions worked with mothers who have experienced a the loss of a pregnancy close to becoming a mother. It is indeed a double whammy. There is so much that gets stirred up, and it intensifies the transition into motherhood and the processing of these loss, exacerbating common life-cycle events, and resulting in undue pressure on new moms, emotionally, physically, spiritually. When we’re trying to understand how motherhood and losses affect us, it is imperative to remember that the transition into motherhood and assimilation of loss are multi-dimensional and encompass physical, social, emotional, spiritual aspects of humanity. Although we mostly associate motherhood with new beginnings and joy, the questions of loss and death and endings actually also come up. Becoming mothers is a definite end to our earlier self, our pre-motherhood bodies and relationships, and mothers must mourn how the idealized fantasy of motherhood is never matched with the reality of the day to day. This is all considered “normal” to go through unless it gets complicated with trauma or major stressors. But if the transition to motherhood coincides with a loss, mothers get all of this thrown at them at the speed of light. It’s like existential pressure overload. – Helena Vissing, M.S., Psy.D. Clinical Associate, Psychological Assistant

The mental health of mothers is a major public health concern. Research demonstrates that depression and anxiety in mothers impact their children. The exact ways children are impacted by their mothers’ mental health involves a complex interplay of factors. We always have to look at the unique combination of risk factors and protective factors for each mother-child couple. If you grew up with a mother who suffered from postpartum depression, you are not necessarily determined to suffer. But we know that on a large public health scale, there is a clear connection between mothers’ mental health and lifelong mental health of their children. The immediate effects of mothers’ depression is that babies become withdrawn and irritable. This is happening at a sensitive time when babies are beginning their lifelong development of emotion regulation. Development is layered and scaffolding throughout life, so a baby who is experiencing these challenges already during their first years will be What we often experience in the consulting room is adults who struggle with feelings of shame and inadequacy or “never being enough”, even when they are normally functioning. They might describe a vague sense of unworthiness that has always “haunted” them. Although it’s widely acknowledged now that our sense of ourselves is rooted in our earliest relationships, it is still overlooked how issues in this area can stem from the emotional pain the child of a depressed mother experienced. This pain does not just disappear as the child grows or if the mother’s mental health improves, as it has influences the very core of the child’s sense of self. Infants and children are developmentally unable to make sense of the intensity of their mother’s depression, but they still feel it. This is because our earliest sense of self is built from our early nonverbal and physical experiences of being cared for. The only way and infant can interpret the signals from a depressed mother is to internalize it, which manifest as a sense of never being enough. Even when the child grows up to be an adult who can rationally separate their mother’s emotions from their own self-worth, the early experiences can still linger and manifest as issues with unworthiness. For each person, it’s a unique story of with all the risk factors and the negative impact on one hand, and then all the mitigating factors and strengths on the other hand. The adult who describes feeling shame and unworthiness might struggle to pinpoint the root of their issues, especially if their mother’s emotional issues were hidden, denied in the family, or minimized. The mother’s emotional state during the crucial early years is often that missing piece to help an adult fully understand their development and life story. Often they are not in a position to communicate about sensitive material with their mothers. This is why it’s crucial that maternal mental health is addressed clearly at all levels of society. The taboo still surrounding motherhood and postpartum emotional issue has devasting consequences for the entire family. I know this is a lot. Feel free to use what makes sense, and let me know if I should clarify things? I tried to use language for laypeople. – Helena Vissing, M.S., Psy.D.