Post Incarceration Syndrome: A Dirty Little Secret
by: C.Z. Knight-McManus
July 31, 2019
According to the U.S. Department of Justice, over 10,000 convicts are released from U.S. prisons every week. Simple mathematics translates this number to 1,428 prison inmates reentering society each day. After discharging a 20-year sentence, I became one of the 1,428 one September morning in 2011. Like countless others before me, and countless others afterwards, I was woefully unprepared for what lay on the other side of the razor wire, and most of all, unaware of PICS, otherwise known as Post Incarceration Syndrome.
PICS is a type of PTSD long-term convicts often experience. Most of us have viewed the scene in Shawshank Redemption where Brooks Hatlen commits suicide after serving 50-years in prison; Brooks succumbed to the ravages of PICS. To further shed light on the severity of this relatively unknown malady, within the first few months after release, long-term ex-cons own a suicide rate 13-18 times higher than the rest of society. What does this startling number tell us? 13-18 times higher.
On the day of my release, I did not understand how to use a cellphone, a debit card, email, turn on/off a laptop, nor have social interaction skills beyond what was necessary to survive within the Orwellian confines of prison. During long periods of incarceration, a convict’s day is micro-managed to the smallest degree; they tell you when to wake up, when to eat, what clothing to wear, when using the toilet is permitted, when you can speak; over time, the convict cannot help but to become institutionalized. Your entire existence does not exist beyond prison walls. Those very same walls cloister prisoners from having direct interaction with the so-called “free-world.” Subsequently, the sense of self becomes identified with the convict they had no choice but to become. Or, to state another way, the prison environment erases a convict’s autonomy and self-reliance. They design the prison environment to carry out this task, which is does quite well.
As the weeks, months, years and decades fall off the calendar, the convict adapts to the routine to the point of relying upon it for her complete existence, but, what choice does she have? Then one day, the convict is tossed to the curb with no more dignity than being a garbage bag of soiled baby diapers. The day of release for the long-term convict is not always a joyous event; myriad questions and doubts have been bombarding their thoughts. Can I “make it” out here? Where do I find work? Where do I find clothing, medical care, housing? The barriers an ex-con must negotiate are formidable.
After the thrill of release fades and the stark reality of life on the streets grabs the long-term ex-con by the throat, PICS becomes an issue. Suicidal thoughts often creep in, as they did with me because of realizing the world I now lived in did not and shall not forgive my sins. Like countless others, it was impossible to “relate” with those who had never set foot in prison, nor were those who tried to help able to relate to what I was experiencing, despite their words of “I understand,” which they cannot. Sleep became impossible… constant distrust and anger… flashbacks… hate for crowds while seeking isolation… fear… sense of hopelessness… thoughts of purposefully committing a crime for the purpose of returning to prison and other indicators of PICS which routinely assail the long-term ex-con.
Recognizing PICS for what it is must be the first step in coming to terms with the problem. Unfortunately, most ex-cons are ignorant of PICS being a literal malady, much less know where to turn for help. Like so many others, I found self-medication in alcohol; others utilize drugs. In turn, PICS appears to be a leading cause for recidivism, yet too few studies on the subject have been embarked upon.
It has been eight years since I discharged my sentence. Only within the past year has the battle with PICS subsided to a manageable level. I found the best therapy is communicating with ex-cons who understand what PICS is and does. PICS is a lifetime struggle; contrary to the frequent statements by those who have never lived in a cell block for decades, the ex-con cannot “turn off” her prison experience like a light switch and magically reintegrate as if decades behind the wire are void of psychological and physical consequence. It just does not work that way.