By Akili

                                                 POST INCARCERATION SYNDROME (PICS)

         After serving 25 years flat in California’s prisons, 17 of those in sensory deprived isolation of solitary confinement, I thought coming home I would be free, but what I learned was no one leaves prison behind. The trauma of inhumanity shackles the mind and follows you like a ghost rattling contemptuous chains. However, freedom begins when you learn the ghost’s name is Post InCarceration Syndrome (PICS). Knowledge is power and now I live everyday truly free.

Post InCarceration Syndrome (PICS) is clinically defined as a set of symptoms present in many currently incarcerated and recently released prisoners that are caused by being subjected to prolonged incarceration in environments of punishment with few opportunities for education, training, or (re)habilitation.(1) The symptoms being most severe in prisoners subjected to prolonged solitary confinement and severe institutional abuse.

PICS is a catch all phrase for a mixed mental disorder with five clusters of maladies:

(1)    Institutionalized Personality Traits (IPT),

(2)    Post-traumatic Stress Disorder (PTSD),

(3)    Antisocial Personality Traits (ASPT)

(4)    Substance Use Disorders (SUDS)

(5)    Social Sensory Deprivation Syndrome (SSDS)

This multitude of maladies share a common origin, milieu and character. They originated in trauma both pre- and post-prison. Their social environment is both oppressive and abusive, and their character is grounded in passive aggressiveness. As a more detailed description of the five symptoms of PICS reveals.

(1)    Institutionalized Personality Traits, manifest in persons subjected to having lived in or currently living in an oppressive social construct which demands, one passively complies with the demands of those in authority whether supposed or actual. One passively accepts the severely restricted acts of daily living within those environments. One represses personal lifestyle preferences. The elimination of ones’ critical thinking and individual decision making as well as the internalization of ones’ acceptance of severe restrictions of ones’ self-expression, thoughts and feelings.

(2)     Post-Traumatic Stress disorder originates in trauma both pre-incarceration and abuse inflicted during incarceration. It includes six clusters of symptoms: 1, intrusive memories and flashbacks to episodes of severe institutionalized abuse; 2, intense mental distress and mental reactions when exposed to cues which trigger memories of the abuse(s) suffered. 3, episodic dissociation, emotional numbing and restricted affect. 4, chronic difficulty with mental functioning which manifests as irritability, outbursts of anger, difficulty concentrating, sleep disturbances and exaggerated startle response. 5, a dogged avoidance of any cue which could trigger memories of traumatic events. 6, hypervigilance, general paranoia, and a diminished level of trust resulting from constant fear of the abusive environment, its authority figures(s) and other inmates which can be generalized to other persons post incarceration.

(3)    Antisocial Personality Traits develop from both preexisting symptoms and symptoms which develop during incarceration. This psychological defense mechanism is an institutional coping skill. Primarily involving a tendency to challenge authority, break rules, and victimize others. I have learned that for persons like myself whom have PICS these tendencies are disguised by a passive aggressive style that is born of our institutionalized personality. Characterized by duplicitous behavior, acting compliant and passive aggressive when dealing with authority figures, yet we are capable of directly threatening and aggressively behaving when alone with peers outside of the perceived control of authority. This is a direct result of the internalized coping behavior required to survive in a harshly punitive correctional institution. Use to the demand that one be passive aggressive with correctional officers/staff and often openly aggressive with predatory inmates.

(4)    Active Substance Abuse Disorders, most prison inmates and former inmates like myself entered prison with substance use disorders and did not receive treatment during incarceration or by default continued using to cope with the harsh realities of prison life. While many others developed addictions to substance use while confined within prison to cope with the harsh conditions that caused our PICS. Yet, still others became addicts as a result of using alcohol and other drugs upon release to numb the symptoms of PICS.

(5)    Social Sensory Deprivation Syndrome, which includes such symptoms as severe chronic headaches, developmental regression, impaired impulse control, dissociation, inability to concentrate, repressed rage, inability to control primitive drives and instincts, inability to plan beyond the moment, inability to anticipate logical consequences of behavior, out of control obsessive thinking and borderline personality traits developed from inhumane isolation and sensory deprivation of prolonged solitary confinement.

Although current literature indicates that there is a six-stage symptom progression leading to recidivism which includes:

Stage 1 – helplessness and hopelessness coupled with the inability to develop a plan for reentry to civilian life, complicated by the lack of funds for treatment and job training.

Stage 2 – intense immobilizing fear.

Stage 3 – emergence of intense free-floating anger and rage coupled with PTSD symptoms like flashbacks and nightmares.

Stage 4 – tending to impulsive violence from the smallest of provocation.

Stage 5 – attempting to avoid violence and the triggers of violence by isolating one’s self.

Stage 6 – self-imposed isolation leads to flashbacks, nightmares, sleep impairments, and impulse control problems. This leads to acting out behaviors, aggression, relapse, violence, and crime, which set the stage for arrest and (re)incarceration.

Using myself as a case study I have found that the ghost’s contemptuous chains were rattling long before I came home. In other words, PICS does not necessarily manifest nor progress with the exactitude of these six stages. In addition, as many of the symptoms outlined herein, such as the lack of job training, intense mobilizing fear, free-floating anger, flashbacks, nightmares, sleep impairments, impulse control problems, aggression and isolating manifested prior to my release from active incarceration.  For PICS Part Two Click Here.