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Episode 4: AshleyAshley is a prison psychologist who works within the California Department of Corrections and Rehabilitation (CDCR). She describes her journey toward working in mental health; a typical day in her life reckoning with an astronomical caseload; and her understanding of why it is so difficult for people in prison to access consistent and effective care.
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INTRO
Conductor Trig: You are now boarding Teleway 411, departing from the realm of brick and barbed wire. Next stop, inside the minds and lives locked away behind bars. Beware of the shifting airwaves as they may cause turbulence. Please stand clear of the evolving doors.
Casper: Dispatching from the Telegraph and Broadway terminal in Oakland, we transport the stories of queer artists in prison througout the United States. Our conversations with people navigating the justice system work to shed light on the reality of life inside. My name is Casper and I am the co-founder and host of Teleway 411, a podcast produced by A.B.O. Comix.
The Teleway was invented because of the archaic routes required to navigate the prison system. The restrictions put in place require creative detours to reach our contributors inside. Communication is halted at the discretion of the prison, and can leave our passengers feeling stranded. However, by using the Teleway to defy space and time, we’re able to come together and traverse the lives that have been stalled indefinitely, while also giving them a push to move them forward.
Our guest today is Ashley, a prison psychologist who works within the California Department of Corrections, also known as CDCR. Today we’re discussing the concept of rehabilitation and what it’s like providing counseling within an overcrowded system. I’ll let Ashley introduce herself.
Casper: Dispatching from the Telegraph and Broadway terminal in Oakland, we transport the stories of queer artists in prison througout the United States. Our conversations with people navigating the justice system work to shed light on the reality of life inside. My name is Casper and I am the co-founder and host of Teleway 411, a podcast produced by A.B.O. Comix.
The Teleway was invented because of the archaic routes required to navigate the prison system. The restrictions put in place require creative detours to reach our contributors inside. Communication is halted at the discretion of the prison, and can leave our passengers feeling stranded. However, by using the Teleway to defy space and time, we’re able to come together and traverse the lives that have been stalled indefinitely, while also giving them a push to move them forward.
Our guest today is Ashley, a prison psychologist who works within the California Department of Corrections, also known as CDCR. Today we’re discussing the concept of rehabilitation and what it’s like providing counseling within an overcrowded system. I’ll let Ashley introduce herself.
JOB DESCRIPTION
Ashley: So I'm a licensed psychologist. I've been with CDCR for about four years now. I've worked primarily in one institution. I meet with 5, 6, 7, 8 clients a day, or patients as they refer to them in CDCR.
Casper: That’s a lot of clients. What does your schedule tend to look like?
Ashley: I see my patients 50 minutes. It's a 50 minute hour -- after I'm done seeing them, I write a note. The bulk of the rest of the day is consulting with different clinicians, doing a lot of case management. I at least have agency as far as when I schedule my clients as long as they are within their timeline. And I get to say how many people I see, how often I see them, what kind of interventions I'm doing. So mine tends to be very static.
Casper: That’s a lot of clients. What does your schedule tend to look like?
Ashley: I see my patients 50 minutes. It's a 50 minute hour -- after I'm done seeing them, I write a note. The bulk of the rest of the day is consulting with different clinicians, doing a lot of case management. I at least have agency as far as when I schedule my clients as long as they are within their timeline. And I get to say how many people I see, how often I see them, what kind of interventions I'm doing. So mine tends to be very static.
COLEMAN LAWSUIT
Casper: How is mental healthcare within the prison system structured?
Ashley: You've heard of the Coleman lawsuit.
Casper: I haven’t.
Ashley: So the Coleman lawsuit. I think it started in 1991. It was finalized in 1995. It's a federal lawsuit. Essentially CDCR lost a lawsuit because the prisoner's rights were being violated because they weren't receiving adequate mental health treatment. And so now you have a bunch of lawyers dictating, “You need to see these patients. This is how often you need to see them.” This is what a lawyer thinks mental health treatment should look like. And so mental health dockets, which are their appointment cards, prioritize everything else. So if you're at work and you get a mental health docket, that's priority, if you miss your mental health docket, it could lead to a rules and violations report (an RVR) which is a disciplinary thing. It could either be counseling or administration, it can be serious. So my dockets always take priority. But I think my patients know me pretty well. Whenever they show up, I tend to see them anyway. It's like my one area of flexibility because it takes time and things get in the way of it, but yeah, they have to show up.
Casper: What sort of disciplinary action do people face if they don't?
Ashley: It's like a counseling chrono, which is the lowest level. And that's only if the clinician chooses to do that. So I think a lot of times the inmates or patients forget that if you misuse the mental health program, if you don't show up for your dockets, it's an obligation, right? If you come into the program, it's an obligation, it’s part of your program, we can write you up, right? If you're disrespectful, if you keep missing your appointments, we can write you up. Clinicians don't tend to do that because it's a weird role for them to be in. A lot of clinicians don't feel comfortable, toggling the line between being a humanistic mental health clinician, and being very structured and holding people accountable, which is like an RVR. I've never had to do it, but I've had to have a lot of stern conversations with my patients.
Casper: I imagine it's a really hard line to have to straddle between getting the trust of your patient and working with them on a consistent basis. And then also, potentially having to issue them disciplinary action, but is most of this court ordered or can people voluntarily sign up for your services?
Ashley: The extent of the mental health program, what it's become is because of the lawsuit. Inmates are not required to be in the mental health program. It is volitional with the caveat that we can actually, per our mental health program guidelines, and I've heard psychiatrists say this, we can force someone to stay in the program if we think we know what's best for them. So that's where involuntary medication comes in. That's where placing someone in a crisis unit comes in. So if they're a danger to themselves, someone else, they're gravely disabled, we can force treatment that way. If we think that they would decompensate if we discharge them from the mental health program, regardless of what they say, we can still keep them in. I've never played that card. That's not my vibe. I think someone's mental health needs to be their choice and they need to volitionally be in that room with me. Otherwise it doesn't work. You can't force someone to be different than how they want to be.
Casper: Yeah, that's something we work a lot with even in publishing, is that when you're thinking about prison reform or you're thinking about prison abolition or anything, there's this large gap between people who are willing and ready to accept help, and people who are really like working towards changing their lives and that's sort of the want for them, like working towards bettering themselves for their families and their communities and stuff. And then people who are a little more adverse to that. So how do you kind of reconcile that with a court ordered treatment where it's like people who are mandated to receive services versus people who are voluntarily signing themselves up for it?
Ashley: A lot of what would be considered strictly mandatory is the medication component. So let's say someone has bipolar disorder and when they are manic, they are very violent and they can't make adequate treatment decisions for themselves. That's where you'll see someone who's truly quote, unquote forced into treatment. It's very difficult to toggle that line because if someone is mandated to take medications per the court, has to be a court order, and I'm their clinician, it's very hard to build rapport because that client or that patient does not want to be there. They don't want to take medications. And so you have to see them on this rollercoaster of how do I give into something that I know makes my life easier, knowing it's forced on me and knowing that I already have so little agency here. And how do I trust you when you're a part of the system, you're here for that big buck paycheck, right? That's something that they say often, you're only here because you're paid and you're part of the problem because you're here. And it really just takes patience. And I just have to, I acknowledge that to them, like, yes, I do get paid for this job. I am here partially for the money, because I also have to pay my bills. I tend to be very truthful with my patients, if they ask me a question, I'm going to be truthful. I'm not going to sugar coat things. And I think once they've picked up that even if the circumstances suck, I'm being honest with them, they can start to feel like they can trust me as much as possible, but still that loss of control over your own being never really goes away.
Ashley: You've heard of the Coleman lawsuit.
Casper: I haven’t.
Ashley: So the Coleman lawsuit. I think it started in 1991. It was finalized in 1995. It's a federal lawsuit. Essentially CDCR lost a lawsuit because the prisoner's rights were being violated because they weren't receiving adequate mental health treatment. And so now you have a bunch of lawyers dictating, “You need to see these patients. This is how often you need to see them.” This is what a lawyer thinks mental health treatment should look like. And so mental health dockets, which are their appointment cards, prioritize everything else. So if you're at work and you get a mental health docket, that's priority, if you miss your mental health docket, it could lead to a rules and violations report (an RVR) which is a disciplinary thing. It could either be counseling or administration, it can be serious. So my dockets always take priority. But I think my patients know me pretty well. Whenever they show up, I tend to see them anyway. It's like my one area of flexibility because it takes time and things get in the way of it, but yeah, they have to show up.
Casper: What sort of disciplinary action do people face if they don't?
Ashley: It's like a counseling chrono, which is the lowest level. And that's only if the clinician chooses to do that. So I think a lot of times the inmates or patients forget that if you misuse the mental health program, if you don't show up for your dockets, it's an obligation, right? If you come into the program, it's an obligation, it’s part of your program, we can write you up, right? If you're disrespectful, if you keep missing your appointments, we can write you up. Clinicians don't tend to do that because it's a weird role for them to be in. A lot of clinicians don't feel comfortable, toggling the line between being a humanistic mental health clinician, and being very structured and holding people accountable, which is like an RVR. I've never had to do it, but I've had to have a lot of stern conversations with my patients.
Casper: I imagine it's a really hard line to have to straddle between getting the trust of your patient and working with them on a consistent basis. And then also, potentially having to issue them disciplinary action, but is most of this court ordered or can people voluntarily sign up for your services?
Ashley: The extent of the mental health program, what it's become is because of the lawsuit. Inmates are not required to be in the mental health program. It is volitional with the caveat that we can actually, per our mental health program guidelines, and I've heard psychiatrists say this, we can force someone to stay in the program if we think we know what's best for them. So that's where involuntary medication comes in. That's where placing someone in a crisis unit comes in. So if they're a danger to themselves, someone else, they're gravely disabled, we can force treatment that way. If we think that they would decompensate if we discharge them from the mental health program, regardless of what they say, we can still keep them in. I've never played that card. That's not my vibe. I think someone's mental health needs to be their choice and they need to volitionally be in that room with me. Otherwise it doesn't work. You can't force someone to be different than how they want to be.
Casper: Yeah, that's something we work a lot with even in publishing, is that when you're thinking about prison reform or you're thinking about prison abolition or anything, there's this large gap between people who are willing and ready to accept help, and people who are really like working towards changing their lives and that's sort of the want for them, like working towards bettering themselves for their families and their communities and stuff. And then people who are a little more adverse to that. So how do you kind of reconcile that with a court ordered treatment where it's like people who are mandated to receive services versus people who are voluntarily signing themselves up for it?
Ashley: A lot of what would be considered strictly mandatory is the medication component. So let's say someone has bipolar disorder and when they are manic, they are very violent and they can't make adequate treatment decisions for themselves. That's where you'll see someone who's truly quote, unquote forced into treatment. It's very difficult to toggle that line because if someone is mandated to take medications per the court, has to be a court order, and I'm their clinician, it's very hard to build rapport because that client or that patient does not want to be there. They don't want to take medications. And so you have to see them on this rollercoaster of how do I give into something that I know makes my life easier, knowing it's forced on me and knowing that I already have so little agency here. And how do I trust you when you're a part of the system, you're here for that big buck paycheck, right? That's something that they say often, you're only here because you're paid and you're part of the problem because you're here. And it really just takes patience. And I just have to, I acknowledge that to them, like, yes, I do get paid for this job. I am here partially for the money, because I also have to pay my bills. I tend to be very truthful with my patients, if they ask me a question, I'm going to be truthful. I'm not going to sugar coat things. And I think once they've picked up that even if the circumstances suck, I'm being honest with them, they can start to feel like they can trust me as much as possible, but still that loss of control over your own being never really goes away.
LICENSE
Casper: How long have you been doing this for and what kind of got you interested in working within the prison system?
Ashley: So I've been licensed, what is it? Five years now? I've been practicing with clients for about eight years. I knew I wanted to be a psychologist since I was a child. I was like one of those weird little kids who was watching, you know, CSI and movies with psychologists. And I just knew that's what I wanted to do. And I never questioned, I just went all the way. I think based off my life experiences and the people that I was raised around and raised with, I just realized that I had the ability to sit with people who don't make the best choices in their lives. And I was able to really not have a reaction to that, to not judge them, to not hold biases, to be able to filter through that. And I know based on my experiences now, when I tell people who I work with, the stigma is still very strong, right. They have a lot of prejudiced questions of how do you work with someone who murders children or rapes children? A choice is not a person. And my ability to see that is what made sense for me to start working with people in this population. Not necessarily a prison. Pretrial, post-conviction, on probation or parole, just work with people who have struggled in this way, makes sense for me. So I've just not fallen into it, but intentionally gotten into it.
Casper: I really empathize with that a lot too, because we publish people who have been convicted of all sorts of different things. And that seems to be the question that people ask the most is like, well, what are they convicted of? What is the crime that they committed instead of, what is their story as a human being? So that's how people are reduced simply to like this one moment in their life that probably for all intents and purposes was probably the most horrible moment of their life. And then that's all that person is seen as going forward. But as far as working with CDCR, how did you get involved in that job? What was the application process and stuff like that for you?
Ashley: The application process was miserable, just as it is with any state job. It's mostly waiting. I was working with clients in the community who were on parole and probation, and I knew when I was in graduate school, I wanted to work in CDCR. Because I had heard from my clients over and over again, “When I was in prison, I wish I had someone to talk to. I wish there was actual mental health treatment.” I was like, “Well, great. I can do that. Let's go in there and do that.” So I started applying probably a year before I heard anything. And then out of the blue, I get an email. “Hey, do you want to interview for this position? Here's when you can interview.” And it's like, the next week. So you go to the interview, you walk into the prison and you're like, oh, I've never been in a prison in this capacity before. You sit in this little room and you're being interviewed by these people. They're not giving you any feedback to work with. And so it feels like you're just putting these answers into nothingness. You can't read the room and then you leave and randomly two months later, you get another email. Hey, here's the job. We think you'd be great. And then another couple of months go by and then you start and then you do all the trainings and things like that. Trainings quote-unquote. It's not necessarily an arduous process, but you don't really know what's happening. And that's a very good analogy for what it's like working in CDCR. A lot of the times you're just told, “Here's this thing,” and you have no idea why it's there or why you have to do it, but you just have to.
Ashley: So I've been licensed, what is it? Five years now? I've been practicing with clients for about eight years. I knew I wanted to be a psychologist since I was a child. I was like one of those weird little kids who was watching, you know, CSI and movies with psychologists. And I just knew that's what I wanted to do. And I never questioned, I just went all the way. I think based off my life experiences and the people that I was raised around and raised with, I just realized that I had the ability to sit with people who don't make the best choices in their lives. And I was able to really not have a reaction to that, to not judge them, to not hold biases, to be able to filter through that. And I know based on my experiences now, when I tell people who I work with, the stigma is still very strong, right. They have a lot of prejudiced questions of how do you work with someone who murders children or rapes children? A choice is not a person. And my ability to see that is what made sense for me to start working with people in this population. Not necessarily a prison. Pretrial, post-conviction, on probation or parole, just work with people who have struggled in this way, makes sense for me. So I've just not fallen into it, but intentionally gotten into it.
Casper: I really empathize with that a lot too, because we publish people who have been convicted of all sorts of different things. And that seems to be the question that people ask the most is like, well, what are they convicted of? What is the crime that they committed instead of, what is their story as a human being? So that's how people are reduced simply to like this one moment in their life that probably for all intents and purposes was probably the most horrible moment of their life. And then that's all that person is seen as going forward. But as far as working with CDCR, how did you get involved in that job? What was the application process and stuff like that for you?
Ashley: The application process was miserable, just as it is with any state job. It's mostly waiting. I was working with clients in the community who were on parole and probation, and I knew when I was in graduate school, I wanted to work in CDCR. Because I had heard from my clients over and over again, “When I was in prison, I wish I had someone to talk to. I wish there was actual mental health treatment.” I was like, “Well, great. I can do that. Let's go in there and do that.” So I started applying probably a year before I heard anything. And then out of the blue, I get an email. “Hey, do you want to interview for this position? Here's when you can interview.” And it's like, the next week. So you go to the interview, you walk into the prison and you're like, oh, I've never been in a prison in this capacity before. You sit in this little room and you're being interviewed by these people. They're not giving you any feedback to work with. And so it feels like you're just putting these answers into nothingness. You can't read the room and then you leave and randomly two months later, you get another email. Hey, here's the job. We think you'd be great. And then another couple of months go by and then you start and then you do all the trainings and things like that. Trainings quote-unquote. It's not necessarily an arduous process, but you don't really know what's happening. And that's a very good analogy for what it's like working in CDCR. A lot of the times you're just told, “Here's this thing,” and you have no idea why it's there or why you have to do it, but you just have to.
STAFF TREATMENT
Casper: That sounds eerily like what I've heard the parole process is like for folks who are coming up on their parole date, and I'm wondering, do you feel like staff and people who work within the prison system are treated kind of similarly to how folks who are incarcerated in the prison system are? Is that just kind of like a switch people have to turn on in their brains to be able to interact in that environment? They just treat everybody as robots?
Ashley: Myself and other clinicians on my team often have parallel processes with the inmates. There is this sense when you are at work, you are there, you live there, you can't leave the institutional grounds during your shift. You have to do certain things within certain timeframes. There's a lot of nonsensical rules that are imposed on you. So it often is this weird parallel process. Here's this steadfast rule. You have to abide by it. If you don't abide by it, we're giving you an LOI, which is essentially like a warning, right? If you don't get your shit together, then disciplinary things are going to happen. Then you're going to get fired, you're never coming back. And there's this concept of the golden cuffs. So people who are in CDCR for a very long time, they're known as wearing the golden cuffs where they're stuck because of the pension or the benefits of retiring. But I genuinely think that being there long-term, you do feel institutionalized. You feel like you're stuck there, even if everyday you get to leave. And I'm not saying it's in any way similar to what the inmates feel, but there is a piece of that that I think staff hang on to, if they don't have a separate life outside of work.
Casper: That makes a lot of sense to me because I've done a couple prison visits with my friends and it's always a very weird feeling going into the prison. I visited my friend in Texas two years ago. My visit was only, maybe like four hours long but it was very weird because I couldn't see any clocks on the walls. I had no like semblance of the time passing, and it was very scary because we were being watched the entire time and I felt very much treated like as if I was a person who was incarcerated there. The guards were very standoffish. We had to request permission to go to the bathroom. If I had to stand up and stretch, I was getting really weird looks from the guard. And I knew that I would be able to walk out of there at the end of the day, but it was just, it was a horrible feeling, knowing I was going to leave my friend behind. Do you have a good working relationship with the other staff, maybe guards and stuff? Do you have to interact with other folks who work there or do you kind of just walk in clock your time, do your job, and then you leave at the end of the day?
Ashley: I've been on either end of the spectrum. Right now, I'm definitely on the, I get in and I get out as soon as possible. And I keep all of my stuff to myself. I used to tow the other line and I was friendly with officers, friendly with inmates who weren't even in the program. I still try to be as friendly as possible, but more so friendly. And I had a good relationship with a lot of the officers, but I think what happens is because you never know what's in another person's mind and you never know who's watching, that feeling that you're talking about is very accurate. You are always being watched and there's always an air of suspicion. Some things happened and I realized it's not safe to do that, right? Because regardless of what your intentions are, regardless of who you are as a person and what fits for your personality, there are too many people around to interpret your behaviors in a way that they see fit, for whatever agenda they have. It sounds a little paranoid, but it's hard not to have a little bit of paranoia when you've really been exposed to the spectrum of behaviors that comes with working in CDCR.
Casper: If there's anything that I've learned from working with folks in prison for the last decade is that prisons seem to really foster this atmosphere of paranoia and deception. You're encouraged to keep the truth to yourself in order to not snitch on other people. It seems like everything that prison is, is what they're trying to teach people not to do outside of prison walls, which doesn't make a whole lot of sense if you're focused on rehabilitation over punishment.
Ashley: What's the term I'm looking for? Hypocrisy? So I'm exposed to, when I hear stories from my patients, of officers and staff acting in ways that they condemn the inmates for. So whether it be sexual harassment towards staff on staff, staff on inmate, physical abuse, verbal abuse, emotional abuse, I've bore witness to many of those things. I see how some staff act, and I don't know how you can hold another human being accountable for behaving a certain way if you can't model that. It's very frustrating. I had this experience when I worked in a high school where I had this little client in front of me. And I was like, “Don't worry. The world's not that bad. I'm going to teach you all the skills that you need. And I'm going to help you with effective communication with your parents and being assertive,” and they'd have all these skills. But when they went back out there, the world was not reflective of what they were putting out there. So I teach my patients now, “Here's how you regulate your emotions and here's how you learn distress tolerance and conflict resolution.” And then they go out and they confront a staff member who doesn't use those skills and invalidates their entire experience. Because regardless of what they're doing, that person's telling them that doesn't work here. So how do you expect them to go from that, to out in the community and feel comfortable and safe using proper skills like that when their expectations are now: “Oh, well that doesn't work. I need to find a different way.”
Casper: So do you get to do any sort of training with the staff there to try and help them find the, like the proper ways to actually interact?
Ashley: Part of the Coleman lawsuit is this thing called partnership training. So it's how custody and mental health become partners. They don't co-parent, they parent together. They're on the same team. In my experience, it falls to deaf ears on custody side. I've seen it when I walked into a housing unit and I'm like, “Hey, I'm a doctor. I'm here to see my patient. Where are they?” And they roll their eyes or they refuse to escort me up the tier to see my patient, or they don't know where my patient is, which is problematic. The perfect example is we have to check in about certain client populations in certain housing units. And I went in there, I had this form and I was like, “Hey, Sergeant, you need to sign this form. We need to talk about any client issues or patient issues that are happening.” And he just refused to sign the form and said he's not part of the mental health program. And this form says Mental Health Sergeant. And I just looked at him, and my response was, because I'm not always stoic and professional, was: “Well, if you don't sign the form, I don't really care. It's up to you. You're the one who's going to suffer the consequences.” Not saying every officer’s like that. Some of them are really great. Some of them understand when a inmate is in their housing unit and they're not showering, they're talking to themselves, you should refer to mental health. That might be a mental health issue. And some of them just leave them there. It's a mixed bag, but there is a training.
Casper: I feel like there needs to be so much more training. There needs to be actual protocol that's followed. I get really frustrated when I'm dealing with anything that happens in the prison system, because we try to help people navigate the bureaucracy, to try to help people file medical grievances, or just any sort of grievances with the ombudsman or anything in general. And every time I call a prison, it seems like I get bumped up the chain of command, but I never actually get to talk to a person I really need to talk to. My information gets written down and they're like, “Oh, we'll call you back when we have an answer,” they never call me back. And then it's just sort of like chasing my own tail for weeks on end, sending out mass amounts of emails, trying to get as many people on the phone as humanly possible. And then the issue just gets resolved in the sense of, “Oh, we investigated the issue, we found no wrongdoing. We found no evidence of what you're claiming and now we consider the matter closed,” and then they just don't respond to me any further. So I imagine that's pretty frustrating when you're trying to help people out on a psychology, mental health sort of aspect. Just sort of getting the run-around from folks who don't really want to do their job?
Ashley: Yeah. It sounds like you, in that moment, were having a parallel process with the inmates also. I don't even understand the grievance procedure. There's so many different levels when an inmate is like, “Hey, this thing should not be happening. They file a 602, that 602 goes somewhere. They don't know where it's going. They don't even know if it got there, because sometimes officers intervene. Let's say the 602 is about them.
And then that usually gets kicked back. Most of my patient’s expectation is that their initial 602 will get denied. So they have to file another one and then appeal and then go up and up and up the chain. And now it's in this no man's land of, I don't know what's happening. Maybe it'll get resolved. Maybe not. Most of the time I ask my patients: “What makes you keep trying? You've gotten nothing but pushed down every single time.” And they usually just say it's like blind faith or just hope keeps them going. That if enough people file the same grievance that something will happen.
Casper: I run into that a lot too, where it seems like you're just kind of banging your head against the wall. And a lot of times it takes a lot of push on everybody's part. The person filing it needs to file it multiple times and then you need as much outside help as humanly possible to even get the prison to take a look at it. So a lot of times I'll send an email and then my assistant Ollie will send an email. And then we'll just do a social media blast and be like everybody in the world who sees this, please just take the time to send an email to this prison so they'll actually take a look at it and maybe on the off chance that they don't just throw it in the trash, somebody will take a look at the issue and see if they could get it resolved. But it's extremely frustrating.
Ashley: Myself and other clinicians on my team often have parallel processes with the inmates. There is this sense when you are at work, you are there, you live there, you can't leave the institutional grounds during your shift. You have to do certain things within certain timeframes. There's a lot of nonsensical rules that are imposed on you. So it often is this weird parallel process. Here's this steadfast rule. You have to abide by it. If you don't abide by it, we're giving you an LOI, which is essentially like a warning, right? If you don't get your shit together, then disciplinary things are going to happen. Then you're going to get fired, you're never coming back. And there's this concept of the golden cuffs. So people who are in CDCR for a very long time, they're known as wearing the golden cuffs where they're stuck because of the pension or the benefits of retiring. But I genuinely think that being there long-term, you do feel institutionalized. You feel like you're stuck there, even if everyday you get to leave. And I'm not saying it's in any way similar to what the inmates feel, but there is a piece of that that I think staff hang on to, if they don't have a separate life outside of work.
Casper: That makes a lot of sense to me because I've done a couple prison visits with my friends and it's always a very weird feeling going into the prison. I visited my friend in Texas two years ago. My visit was only, maybe like four hours long but it was very weird because I couldn't see any clocks on the walls. I had no like semblance of the time passing, and it was very scary because we were being watched the entire time and I felt very much treated like as if I was a person who was incarcerated there. The guards were very standoffish. We had to request permission to go to the bathroom. If I had to stand up and stretch, I was getting really weird looks from the guard. And I knew that I would be able to walk out of there at the end of the day, but it was just, it was a horrible feeling, knowing I was going to leave my friend behind. Do you have a good working relationship with the other staff, maybe guards and stuff? Do you have to interact with other folks who work there or do you kind of just walk in clock your time, do your job, and then you leave at the end of the day?
Ashley: I've been on either end of the spectrum. Right now, I'm definitely on the, I get in and I get out as soon as possible. And I keep all of my stuff to myself. I used to tow the other line and I was friendly with officers, friendly with inmates who weren't even in the program. I still try to be as friendly as possible, but more so friendly. And I had a good relationship with a lot of the officers, but I think what happens is because you never know what's in another person's mind and you never know who's watching, that feeling that you're talking about is very accurate. You are always being watched and there's always an air of suspicion. Some things happened and I realized it's not safe to do that, right? Because regardless of what your intentions are, regardless of who you are as a person and what fits for your personality, there are too many people around to interpret your behaviors in a way that they see fit, for whatever agenda they have. It sounds a little paranoid, but it's hard not to have a little bit of paranoia when you've really been exposed to the spectrum of behaviors that comes with working in CDCR.
Casper: If there's anything that I've learned from working with folks in prison for the last decade is that prisons seem to really foster this atmosphere of paranoia and deception. You're encouraged to keep the truth to yourself in order to not snitch on other people. It seems like everything that prison is, is what they're trying to teach people not to do outside of prison walls, which doesn't make a whole lot of sense if you're focused on rehabilitation over punishment.
Ashley: What's the term I'm looking for? Hypocrisy? So I'm exposed to, when I hear stories from my patients, of officers and staff acting in ways that they condemn the inmates for. So whether it be sexual harassment towards staff on staff, staff on inmate, physical abuse, verbal abuse, emotional abuse, I've bore witness to many of those things. I see how some staff act, and I don't know how you can hold another human being accountable for behaving a certain way if you can't model that. It's very frustrating. I had this experience when I worked in a high school where I had this little client in front of me. And I was like, “Don't worry. The world's not that bad. I'm going to teach you all the skills that you need. And I'm going to help you with effective communication with your parents and being assertive,” and they'd have all these skills. But when they went back out there, the world was not reflective of what they were putting out there. So I teach my patients now, “Here's how you regulate your emotions and here's how you learn distress tolerance and conflict resolution.” And then they go out and they confront a staff member who doesn't use those skills and invalidates their entire experience. Because regardless of what they're doing, that person's telling them that doesn't work here. So how do you expect them to go from that, to out in the community and feel comfortable and safe using proper skills like that when their expectations are now: “Oh, well that doesn't work. I need to find a different way.”
Casper: So do you get to do any sort of training with the staff there to try and help them find the, like the proper ways to actually interact?
Ashley: Part of the Coleman lawsuit is this thing called partnership training. So it's how custody and mental health become partners. They don't co-parent, they parent together. They're on the same team. In my experience, it falls to deaf ears on custody side. I've seen it when I walked into a housing unit and I'm like, “Hey, I'm a doctor. I'm here to see my patient. Where are they?” And they roll their eyes or they refuse to escort me up the tier to see my patient, or they don't know where my patient is, which is problematic. The perfect example is we have to check in about certain client populations in certain housing units. And I went in there, I had this form and I was like, “Hey, Sergeant, you need to sign this form. We need to talk about any client issues or patient issues that are happening.” And he just refused to sign the form and said he's not part of the mental health program. And this form says Mental Health Sergeant. And I just looked at him, and my response was, because I'm not always stoic and professional, was: “Well, if you don't sign the form, I don't really care. It's up to you. You're the one who's going to suffer the consequences.” Not saying every officer’s like that. Some of them are really great. Some of them understand when a inmate is in their housing unit and they're not showering, they're talking to themselves, you should refer to mental health. That might be a mental health issue. And some of them just leave them there. It's a mixed bag, but there is a training.
Casper: I feel like there needs to be so much more training. There needs to be actual protocol that's followed. I get really frustrated when I'm dealing with anything that happens in the prison system, because we try to help people navigate the bureaucracy, to try to help people file medical grievances, or just any sort of grievances with the ombudsman or anything in general. And every time I call a prison, it seems like I get bumped up the chain of command, but I never actually get to talk to a person I really need to talk to. My information gets written down and they're like, “Oh, we'll call you back when we have an answer,” they never call me back. And then it's just sort of like chasing my own tail for weeks on end, sending out mass amounts of emails, trying to get as many people on the phone as humanly possible. And then the issue just gets resolved in the sense of, “Oh, we investigated the issue, we found no wrongdoing. We found no evidence of what you're claiming and now we consider the matter closed,” and then they just don't respond to me any further. So I imagine that's pretty frustrating when you're trying to help people out on a psychology, mental health sort of aspect. Just sort of getting the run-around from folks who don't really want to do their job?
Ashley: Yeah. It sounds like you, in that moment, were having a parallel process with the inmates also. I don't even understand the grievance procedure. There's so many different levels when an inmate is like, “Hey, this thing should not be happening. They file a 602, that 602 goes somewhere. They don't know where it's going. They don't even know if it got there, because sometimes officers intervene. Let's say the 602 is about them.
And then that usually gets kicked back. Most of my patient’s expectation is that their initial 602 will get denied. So they have to file another one and then appeal and then go up and up and up the chain. And now it's in this no man's land of, I don't know what's happening. Maybe it'll get resolved. Maybe not. Most of the time I ask my patients: “What makes you keep trying? You've gotten nothing but pushed down every single time.” And they usually just say it's like blind faith or just hope keeps them going. That if enough people file the same grievance that something will happen.
Casper: I run into that a lot too, where it seems like you're just kind of banging your head against the wall. And a lot of times it takes a lot of push on everybody's part. The person filing it needs to file it multiple times and then you need as much outside help as humanly possible to even get the prison to take a look at it. So a lot of times I'll send an email and then my assistant Ollie will send an email. And then we'll just do a social media blast and be like everybody in the world who sees this, please just take the time to send an email to this prison so they'll actually take a look at it and maybe on the off chance that they don't just throw it in the trash, somebody will take a look at the issue and see if they could get it resolved. But it's extremely frustrating.
REHABILITATION
Casper: Do you feel like in CDCR, there is a focus on getting folks prepared to re-enter and to be prepared to be back in their communities and find jobs and reintegrate with their families and their communities? Or do you feel like it's mostly just punishment based?
Ashley: Not every institution is known as a quote-unquote programming institution. Some have many more programs based off, kind of, community support. So some institutions have a lot of volunteer programs. The issue is that people who want to get out work their points down to go to an institution with programming, but there's never enough. It's like a funnel, right? You have all these people clogging the system and maybe a couple get through. Something that's frustrating is that sometimes people who aren't good at advocating for themselves, who aren't good at being the squeaky wheel, who don't like to push things, but would really benefit from those programs don't get in. A lot of them are run by other inmates. And sometimes those inmates have preferential treatment and let in their friends who maybe just want to get milestone credits to knock time off but aren't really invested. The programs are there and if people really want to work the programs, they can change the things that led them to committing their crimes or learn the things to not recidivate when they get out. But it's so rare when A plus B equals C in that equation, because there's so many confounding factors that intervene. So I think that's the frustrating part for me is, well, “Hey, why don't you go to that job skills training group?” And then, you know, my patient will say to me, “Great, I'm 300 on the waiting list. I will be out of prison by the time I get into that program.” Or I have patients who just stop going because whatever cohort they're in at that time isn't taking it seriously. And so they feel like they're not valued. And then the volunteers get burned out so they're not helpful. So it's just, hey, it's like anything, right? Too many people, not enough services, things get burned out. And it really takes a lot of diligence and resiliency from the patients who do make it through those programs to stick with it and withstand the consequences of it.
Casper: And the prison you work at is pretty well known for having a ton of programs but do you feel like even with that amount of help and the amount of people that are employed at your CDCR prison, that that's enough or could it benefit from a lot more resources?
Ashley: It's not enough and it's not enough because it's overpopulated with inmates. So, if you cut down the amount of people that you incarcerated or the length of time that they're incarcerated, or you had programs that would help people live a productive life so that they didn't have to offend, it would all work. But the problem is in an institution, regardless of how many resources there are, if you are overpopulated, you can't help everyone. And so there is no “R”, you're just housing people.
Casper: Are there a bunch of people at the prison you work that you think could be anywhere else? Like they don't need to be in prison, they might benefit from just having outside counseling?
Ashley: There's not a direct correlation between mental health functioning and criminality. It may increase the risk of someone engaging in criminal behavior. Let’s say again, using the example of bipolar, if you're very manic, you may not intentionally punch someone in the face, but let's say they trigger you. You're really agitated. You're already very manic, you might hit them. We could say that, “Hey, this person, if they are properly medicated, and then they have an adequate mental health treatment team in the community, they would function.” Putting them in prison is not going to be helpful for them.
But the problem is, what's the old adage: You can lead a horse to water, but you can't make it drink. A lot of people, even when they've been offered mental health services in the community, don't choose to do it. Either because they're homeless and being sedated by medications makes them more vulnerable or they get out and they quote unquote, go back to living the old lifestyle. And there's no space for medication and there’s stigma in their community about medications or mental health treatment. It makes them more vulnerable. There are so many different factors that yes, I think for a lot of my patients, especially the lifers, let's just get you housing. Let's get you employment resources. Let's get you a mental health treatment team. That will serve you so much better than staying in this box, laying on your cot, wishing you were anywhere else and being severely depressed. That's not helpful for anyone. You could be a quote, unquote productive member of society. If A, you were let out, and B, if we had those services set up for you.
Casper: Yeah, something that comes to mind is one of our contributors who got out of prison recently. His diagnosis is personality disorder, but he doesn't identify with that so much. Do you think in your experience there's anything we can do for folks who are struggling with really intense mental illness, that'd be better than mandatory counseling through the prison system or these hard and fast rules of, “Oh, you violated your parole. And that is the rule. So you have to go back to prison now.”
Ashley: I think that's one of the hardest things is that I don't have an answer. That's such a niche on how things typically work. Where you have this person, A, has a diagnosis that they don't buy into. That's not a path to success. “You're putting this label on me. I don't agree with this.” So even if, and I'm not speaking for this person, in my experience, I put a label on a patient and they're like, “I'm not bipolar. I'll take the medications, but I'm not bipolar.” I'm just using that example because most people know it has extremes, right? It's hard to be responsive to treatment if you don't buy into what you're being treated for. And I think a lot of times what happens in the system is that the system gets burned out of people who are in and out, in and out, in and out, and there's not a good way of catching them.
You could easily just say, “Let's create a mental health institution specifically for people who have criminal histories, who shouldn't go to prison, but can't be out in the community.” That's even then you're still forcing treatment on someone for a thing that they don't think they have. So that's still going to lead to suffering. Either way, it's a struggle. I wish I knew what the solution was. I probably wouldn't work in CDCR. I would have my own business and be able to help those people. Yeah, I don't have a good answer to your question.
It's unfortunate that a lot of the times, my patients, the first time that they actually received good treatment was when they came to prison. Because it was forced on them, it pushed through that defense that most people have of, “I don't have a problem, but bad things keep happening.” So they're sitting in front of me and they're like, “Maybe I have a problem, but I don't know what it is.” And then that little space that is opened, they can now really benefit from it. And I don't like that. I don't like that most of the time I catch people when they've already suffered so many consequences from their behaviors, but I also don't know what the solution is.
Ashley: Not every institution is known as a quote-unquote programming institution. Some have many more programs based off, kind of, community support. So some institutions have a lot of volunteer programs. The issue is that people who want to get out work their points down to go to an institution with programming, but there's never enough. It's like a funnel, right? You have all these people clogging the system and maybe a couple get through. Something that's frustrating is that sometimes people who aren't good at advocating for themselves, who aren't good at being the squeaky wheel, who don't like to push things, but would really benefit from those programs don't get in. A lot of them are run by other inmates. And sometimes those inmates have preferential treatment and let in their friends who maybe just want to get milestone credits to knock time off but aren't really invested. The programs are there and if people really want to work the programs, they can change the things that led them to committing their crimes or learn the things to not recidivate when they get out. But it's so rare when A plus B equals C in that equation, because there's so many confounding factors that intervene. So I think that's the frustrating part for me is, well, “Hey, why don't you go to that job skills training group?” And then, you know, my patient will say to me, “Great, I'm 300 on the waiting list. I will be out of prison by the time I get into that program.” Or I have patients who just stop going because whatever cohort they're in at that time isn't taking it seriously. And so they feel like they're not valued. And then the volunteers get burned out so they're not helpful. So it's just, hey, it's like anything, right? Too many people, not enough services, things get burned out. And it really takes a lot of diligence and resiliency from the patients who do make it through those programs to stick with it and withstand the consequences of it.
Casper: And the prison you work at is pretty well known for having a ton of programs but do you feel like even with that amount of help and the amount of people that are employed at your CDCR prison, that that's enough or could it benefit from a lot more resources?
Ashley: It's not enough and it's not enough because it's overpopulated with inmates. So, if you cut down the amount of people that you incarcerated or the length of time that they're incarcerated, or you had programs that would help people live a productive life so that they didn't have to offend, it would all work. But the problem is in an institution, regardless of how many resources there are, if you are overpopulated, you can't help everyone. And so there is no “R”, you're just housing people.
Casper: Are there a bunch of people at the prison you work that you think could be anywhere else? Like they don't need to be in prison, they might benefit from just having outside counseling?
Ashley: There's not a direct correlation between mental health functioning and criminality. It may increase the risk of someone engaging in criminal behavior. Let’s say again, using the example of bipolar, if you're very manic, you may not intentionally punch someone in the face, but let's say they trigger you. You're really agitated. You're already very manic, you might hit them. We could say that, “Hey, this person, if they are properly medicated, and then they have an adequate mental health treatment team in the community, they would function.” Putting them in prison is not going to be helpful for them.
But the problem is, what's the old adage: You can lead a horse to water, but you can't make it drink. A lot of people, even when they've been offered mental health services in the community, don't choose to do it. Either because they're homeless and being sedated by medications makes them more vulnerable or they get out and they quote unquote, go back to living the old lifestyle. And there's no space for medication and there’s stigma in their community about medications or mental health treatment. It makes them more vulnerable. There are so many different factors that yes, I think for a lot of my patients, especially the lifers, let's just get you housing. Let's get you employment resources. Let's get you a mental health treatment team. That will serve you so much better than staying in this box, laying on your cot, wishing you were anywhere else and being severely depressed. That's not helpful for anyone. You could be a quote, unquote productive member of society. If A, you were let out, and B, if we had those services set up for you.
Casper: Yeah, something that comes to mind is one of our contributors who got out of prison recently. His diagnosis is personality disorder, but he doesn't identify with that so much. Do you think in your experience there's anything we can do for folks who are struggling with really intense mental illness, that'd be better than mandatory counseling through the prison system or these hard and fast rules of, “Oh, you violated your parole. And that is the rule. So you have to go back to prison now.”
Ashley: I think that's one of the hardest things is that I don't have an answer. That's such a niche on how things typically work. Where you have this person, A, has a diagnosis that they don't buy into. That's not a path to success. “You're putting this label on me. I don't agree with this.” So even if, and I'm not speaking for this person, in my experience, I put a label on a patient and they're like, “I'm not bipolar. I'll take the medications, but I'm not bipolar.” I'm just using that example because most people know it has extremes, right? It's hard to be responsive to treatment if you don't buy into what you're being treated for. And I think a lot of times what happens in the system is that the system gets burned out of people who are in and out, in and out, in and out, and there's not a good way of catching them.
You could easily just say, “Let's create a mental health institution specifically for people who have criminal histories, who shouldn't go to prison, but can't be out in the community.” That's even then you're still forcing treatment on someone for a thing that they don't think they have. So that's still going to lead to suffering. Either way, it's a struggle. I wish I knew what the solution was. I probably wouldn't work in CDCR. I would have my own business and be able to help those people. Yeah, I don't have a good answer to your question.
It's unfortunate that a lot of the times, my patients, the first time that they actually received good treatment was when they came to prison. Because it was forced on them, it pushed through that defense that most people have of, “I don't have a problem, but bad things keep happening.” So they're sitting in front of me and they're like, “Maybe I have a problem, but I don't know what it is.” And then that little space that is opened, they can now really benefit from it. And I don't like that. I don't like that most of the time I catch people when they've already suffered so many consequences from their behaviors, but I also don't know what the solution is.
COLLEAGUES
Casper: Yeah, I think that's something we kind of struggle with a lot too, where a lot of times people ask, well, you're sort of advocating so much for prison reform, you're advocating even in some cases for prison abolition, like “What is the solution on the other end? What do you think would be a better system?” And it's really difficult to try and find what those solutions are because they're all theoretical. It's not things that we have tried in practice really. And like you said, there's such an emphasis on warehousing so many people, and then they don't have access to the help that they need, because there are so many people who really would probably benefit. It's too many people, not enough resources.
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MENTAL HEALTH FIELD
Casper: How many people work within the prison with you who are psychologists, who are in the mental health field, if you know?
Ashley: I'm gonna do a rough guess that there's 30 psychologists. A lot of clinical work is actually done by social workers. And so maybe 30 psychologists, 30 social workers, something like that. There's very few psychiatrists. It's very hard for CDCR to hold on to psychiatrists. So the ratio of patients to clinicians is very high and it just keeps getting higher. And that’s a big issue. Again, supply and demand. So they're actually chronically understaffed because of that.
Casper: We work with a lot of folks in Texas, just because they have an insanely high prison population and something that they're always struggling with is the turnover rate where people just do not want that job. They get into the prison system and they see what it's really like and they go, “This is not for me and I cannot handle it.” The guards who do tend to stick around for the long haul, from what I've heard, and this is biased on the end of we work exclusively with people who are incarcerated in prison – this might not be the perspective of the people who work within the system – is that the people who stick around for the long haul have maybe more of a tendency to like power and authority over people. And they get their kicks, for lack of a better word, working within the prison system, because they do have a sense of authority and control over human lives. Is that something that you've seen working within the prison system, or do you think that's more of a biased view on the side of folks who are incarcerated?
Ashley: I don't think it's a biased view, but I also don't think that there's a correlation between how long you've been in the prison system and more sadistic traits like that. There are some officers I've worked with that have been there longer than I've been alive and are genuinely good people. They're very empathic towards the inmates. They're as helpful as they can be, but they're still able to have those boundaries, which is really great.
And then you see some of these younger officers come in and they are very sadistic. You can feel it when you talk to them. There's an air of, “I don't like you because you're in mental health and you're in my wheelhouse and you're preventing me from doing what I want to do.” There is a very much like, “These are criminals. I'm going to punish them. That's my role is to keep them in line however I see fit.”
It’s kind of a mixed bag also because I don't have the inmate's experience of what they're like when I leave the room. So when I'm there, for the most part, they tend to be on the best behavior that they could possibly dig down and get to, because they know someone's there who can hold them accountable, that they can't really touch. They can't do anything to me, but the second I leave, they can be a completely different person and I'll never know that. There are definitely sadistic people. There are people there who are there to retire and they do the best that they can and then there's people there who genuinely want to make a good impression and be helpful to the inmates.
Casper: It's good to hear that there are folks who are more on the empathic side, who are willing to stick out through all of the extreme difficulties I would imagine this job has, in order to try and help people.
Ashley: I'm gonna do a rough guess that there's 30 psychologists. A lot of clinical work is actually done by social workers. And so maybe 30 psychologists, 30 social workers, something like that. There's very few psychiatrists. It's very hard for CDCR to hold on to psychiatrists. So the ratio of patients to clinicians is very high and it just keeps getting higher. And that’s a big issue. Again, supply and demand. So they're actually chronically understaffed because of that.
Casper: We work with a lot of folks in Texas, just because they have an insanely high prison population and something that they're always struggling with is the turnover rate where people just do not want that job. They get into the prison system and they see what it's really like and they go, “This is not for me and I cannot handle it.” The guards who do tend to stick around for the long haul, from what I've heard, and this is biased on the end of we work exclusively with people who are incarcerated in prison – this might not be the perspective of the people who work within the system – is that the people who stick around for the long haul have maybe more of a tendency to like power and authority over people. And they get their kicks, for lack of a better word, working within the prison system, because they do have a sense of authority and control over human lives. Is that something that you've seen working within the prison system, or do you think that's more of a biased view on the side of folks who are incarcerated?
Ashley: I don't think it's a biased view, but I also don't think that there's a correlation between how long you've been in the prison system and more sadistic traits like that. There are some officers I've worked with that have been there longer than I've been alive and are genuinely good people. They're very empathic towards the inmates. They're as helpful as they can be, but they're still able to have those boundaries, which is really great.
And then you see some of these younger officers come in and they are very sadistic. You can feel it when you talk to them. There's an air of, “I don't like you because you're in mental health and you're in my wheelhouse and you're preventing me from doing what I want to do.” There is a very much like, “These are criminals. I'm going to punish them. That's my role is to keep them in line however I see fit.”
It’s kind of a mixed bag also because I don't have the inmate's experience of what they're like when I leave the room. So when I'm there, for the most part, they tend to be on the best behavior that they could possibly dig down and get to, because they know someone's there who can hold them accountable, that they can't really touch. They can't do anything to me, but the second I leave, they can be a completely different person and I'll never know that. There are definitely sadistic people. There are people there who are there to retire and they do the best that they can and then there's people there who genuinely want to make a good impression and be helpful to the inmates.
Casper: It's good to hear that there are folks who are more on the empathic side, who are willing to stick out through all of the extreme difficulties I would imagine this job has, in order to try and help people.
TRANSGENDER PATIENTS
Casper: So switching gears just a little bit, do you work with any queer or transgender prisoners in your practice? Do you have to do any sort of sensitivity training or learn specific ways to work with specific populations?
Ashley: As far as in CDCR are there any trainings? I believe there is a memo. It's mostly for officers to use like the correct pronouns, to be a human being. And so a lot of how I've learned to work in that population is just learning from my patients. So if I accidentally use the wrong terminology or I have a question, like, I don't understand something that they're explaining, I just humbly say, “I'm ignorant to that. I don't know what you're talking about. Please inform me, please teach me.” But as far as in CDCR, there is no formal training about it.
There is a transgender specialist that's supposed to be in every institution. There are people who try their best to advocate. A lot of the advocacy actually comes from the inmates themselves. I've worked with some very inspirational inmates who have just made it their life's mission to change everything from the bottom up. Things as important as what kind of packages you have available to you, shower times for transgender inmates being separate from that of the rest of the inmates, which is very critical, housing. Housing is different if you are someone who identifies as transgender, you're like closer to the officer's tier, you're all on the same level. You have access to more support theoretically.
Casper: Are there specific issues that trans prisoners within CDCR have to deal with that you don't see so much with folks who don't identify that way?
Ashley: Well, there's two things. I think there's an inherent vulnerability that my patients speak to me of where, “I don't really know where I fit in. I'm transitioning to be a woman, that's who I am, but they won't let me. I'm stuck somewhere in the gender reassignment process, but I can't go to a women's institution until I fully transition in that way.” Or I have patients who say, “I'm not going to do that transition, but I don't belong here. I feel vulnerable. I'm with another person in my cell who is predatory or just scares me. I feel unsafe.”
There's a lot of sexual victimization that happens whether or not people speak about it. Sometimes what happens is also a lot of transactional things that happen. And so I have had patients who've really said, “The only way to get through, because I don't have any support on the outside, is to really just use myself as currency.” And that's very unsafe. That puts you in a very vulnerable position but I can't say that, I don't feel like it's my position to say that, where it's you've learned how to navigate things in the best way that you've learned how.
Casper: Yeah, there's this big controversy right now over where should transgender prisoners be housed within the prison system? Should they be put in the facilities that align with what's on their birth certificate or should they be able to choose the prison that aligns with the gender that they identify as, and that's something we get a lot of questions on as well. And it seems like people are really mixed on this within the prison system. So I've talked with some trans women who really want to be housed in women's facilities, and they think that that would be very affirming for them. And then I've talked with some trans women who are like dead set against going to women's prisons, for just like a variety of reasons, whether that be, they are attracted to the people who are in men's facilities. So they would prefer to stay there, or they are in a relationship with somebody, or even some stuff like safety reasons, like where they just think that the prejudice that they'll face from cisgender women in women's prisons would be worse than the prejudice they face in men's prisons. Is that something that's come up with any of your clients?
Ashley: That's definitely something that's come up even more recently, where I had a patient say, “For the longest time, I didn't want to do the gender reassignment surgery because I knew as soon as I did, they would ship me to a women's prison. And I didn't feel like I would be welcomed.” And I think they were saying something along the lines that they had like a meet-and-confer something with some advocates in the women's prison and just how welcoming they were and how that really changed their perspective. But, that definitely comes up.
I'm trying to come at it from CDCR’s perspective. That is a very wobbly decision for them to make either way, because the fact of the matter is that there are people in the prison system who are predatory and who have been known to say that they're transgender to get those rights or to get into that circle and be a predator and take advantage of them, and that's a big risk for CDCR. So I understand from a legal perspective that, how are they really going to know? And it's unfortunate that it's an example of, “It just takes one person to ruin it.”
Casper: That's something I know the Central California Women's Facility is dealing with right now. And that gets really tricky when you're trying to legislate issues of this magnitude. Because like you said, there are sometimes people who are going to try and take advantage of a system that's put in place with the best of intentions. So at CCWF there were a group of, I think, three registered gang members who claimed to be transgender women, who then got moved to the women's facility. And these were people who were not on hormones, they had not taken any sort of medical steps to transition. And they were placed into a vulnerable women's section of the facility. From what I've heard from the women who are incarcerated there is that now CCWF is facing a lawsuit because there was a sexual assault case from one of the people who was moved there.
It gets really hard when you're working with the legislation on this, because I think that the intentions are like, “Yes, we want to make” – this sounds ridiculous – “we want to make prisons safer for transgender people.” But it's like when you're actually doing that in practice, things fall through cracks. There's situations that you are not going to anticipate that will come up. And then with society changing as quickly as it's changing and rules around that changing just as quickly, you're going to have unexpected outcomes for things.
Do you have a personal opinion on what you think would be the best route for transgender prisoners, whether that be placing them in, what's done right now is a lot of times solitary housing for their benefit, but that in essence is even considered torture in a lot of cases. I haven't been able to come up with a good solution to it. So I don't know if in working with a lot of trans folks and hearing their perspectives, you've come to any sort of conclusions?
Ashley: This is another question I don't have a definitive answer for, but I think what I hear more often than not is, “I just want to find a place where I feel like I belong and I feel like I'm okay. And whether that be in a men's institution or a women's institution, I just want to find people that I feel safe with.”
If you want anything to change in CDCR, it takes a lawsuit. My fear and my concern is that the lawsuits that would happen in this process mean that there are going to be victims, whether it be emotional or physical or sexual, putting people in administrative segregation, even if it's for non-disciplinary reasons is extremely detrimental. The suicide rates are higher. You're isolating people who, from my experience, just want a community, right? So you're saying, “You don't really belong anywhere. We're going to put you in ad-seg.” That is not helpful at all. That's not a solution. That's a temporary fix. That's putting someone in the back corner so you don't have to hear them advocate for themselves anymore.
Casper: That's something I've heard so many times from so many people, the lawsuit thing. If anything is going to change, it takes a lawsuit. But trying to do that from within the prison system is next to impossible. I have a lot of friends who have been trying to get their cases heard for decades and have not had any sort of luck. So like you said, on this long enough timeline, unfortunately there are going to be people who are victims of whatever sort of legislation we have. Some people are going to just take advantage of the system and it takes a long time to figure out what the correct answer is there. So, it's unfortunate to hear, but I am glad that there are some people on the inside who have people like you to talk to.
Ashley: This is even more evidence that we need to stop putting as many people in prison. It's not a system that is built to be adaptable to what's happening in society. That's a problem.
Ashley: As far as in CDCR are there any trainings? I believe there is a memo. It's mostly for officers to use like the correct pronouns, to be a human being. And so a lot of how I've learned to work in that population is just learning from my patients. So if I accidentally use the wrong terminology or I have a question, like, I don't understand something that they're explaining, I just humbly say, “I'm ignorant to that. I don't know what you're talking about. Please inform me, please teach me.” But as far as in CDCR, there is no formal training about it.
There is a transgender specialist that's supposed to be in every institution. There are people who try their best to advocate. A lot of the advocacy actually comes from the inmates themselves. I've worked with some very inspirational inmates who have just made it their life's mission to change everything from the bottom up. Things as important as what kind of packages you have available to you, shower times for transgender inmates being separate from that of the rest of the inmates, which is very critical, housing. Housing is different if you are someone who identifies as transgender, you're like closer to the officer's tier, you're all on the same level. You have access to more support theoretically.
Casper: Are there specific issues that trans prisoners within CDCR have to deal with that you don't see so much with folks who don't identify that way?
Ashley: Well, there's two things. I think there's an inherent vulnerability that my patients speak to me of where, “I don't really know where I fit in. I'm transitioning to be a woman, that's who I am, but they won't let me. I'm stuck somewhere in the gender reassignment process, but I can't go to a women's institution until I fully transition in that way.” Or I have patients who say, “I'm not going to do that transition, but I don't belong here. I feel vulnerable. I'm with another person in my cell who is predatory or just scares me. I feel unsafe.”
There's a lot of sexual victimization that happens whether or not people speak about it. Sometimes what happens is also a lot of transactional things that happen. And so I have had patients who've really said, “The only way to get through, because I don't have any support on the outside, is to really just use myself as currency.” And that's very unsafe. That puts you in a very vulnerable position but I can't say that, I don't feel like it's my position to say that, where it's you've learned how to navigate things in the best way that you've learned how.
Casper: Yeah, there's this big controversy right now over where should transgender prisoners be housed within the prison system? Should they be put in the facilities that align with what's on their birth certificate or should they be able to choose the prison that aligns with the gender that they identify as, and that's something we get a lot of questions on as well. And it seems like people are really mixed on this within the prison system. So I've talked with some trans women who really want to be housed in women's facilities, and they think that that would be very affirming for them. And then I've talked with some trans women who are like dead set against going to women's prisons, for just like a variety of reasons, whether that be, they are attracted to the people who are in men's facilities. So they would prefer to stay there, or they are in a relationship with somebody, or even some stuff like safety reasons, like where they just think that the prejudice that they'll face from cisgender women in women's prisons would be worse than the prejudice they face in men's prisons. Is that something that's come up with any of your clients?
Ashley: That's definitely something that's come up even more recently, where I had a patient say, “For the longest time, I didn't want to do the gender reassignment surgery because I knew as soon as I did, they would ship me to a women's prison. And I didn't feel like I would be welcomed.” And I think they were saying something along the lines that they had like a meet-and-confer something with some advocates in the women's prison and just how welcoming they were and how that really changed their perspective. But, that definitely comes up.
I'm trying to come at it from CDCR’s perspective. That is a very wobbly decision for them to make either way, because the fact of the matter is that there are people in the prison system who are predatory and who have been known to say that they're transgender to get those rights or to get into that circle and be a predator and take advantage of them, and that's a big risk for CDCR. So I understand from a legal perspective that, how are they really going to know? And it's unfortunate that it's an example of, “It just takes one person to ruin it.”
Casper: That's something I know the Central California Women's Facility is dealing with right now. And that gets really tricky when you're trying to legislate issues of this magnitude. Because like you said, there are sometimes people who are going to try and take advantage of a system that's put in place with the best of intentions. So at CCWF there were a group of, I think, three registered gang members who claimed to be transgender women, who then got moved to the women's facility. And these were people who were not on hormones, they had not taken any sort of medical steps to transition. And they were placed into a vulnerable women's section of the facility. From what I've heard from the women who are incarcerated there is that now CCWF is facing a lawsuit because there was a sexual assault case from one of the people who was moved there.
It gets really hard when you're working with the legislation on this, because I think that the intentions are like, “Yes, we want to make” – this sounds ridiculous – “we want to make prisons safer for transgender people.” But it's like when you're actually doing that in practice, things fall through cracks. There's situations that you are not going to anticipate that will come up. And then with society changing as quickly as it's changing and rules around that changing just as quickly, you're going to have unexpected outcomes for things.
Do you have a personal opinion on what you think would be the best route for transgender prisoners, whether that be placing them in, what's done right now is a lot of times solitary housing for their benefit, but that in essence is even considered torture in a lot of cases. I haven't been able to come up with a good solution to it. So I don't know if in working with a lot of trans folks and hearing their perspectives, you've come to any sort of conclusions?
Ashley: This is another question I don't have a definitive answer for, but I think what I hear more often than not is, “I just want to find a place where I feel like I belong and I feel like I'm okay. And whether that be in a men's institution or a women's institution, I just want to find people that I feel safe with.”
If you want anything to change in CDCR, it takes a lawsuit. My fear and my concern is that the lawsuits that would happen in this process mean that there are going to be victims, whether it be emotional or physical or sexual, putting people in administrative segregation, even if it's for non-disciplinary reasons is extremely detrimental. The suicide rates are higher. You're isolating people who, from my experience, just want a community, right? So you're saying, “You don't really belong anywhere. We're going to put you in ad-seg.” That is not helpful at all. That's not a solution. That's a temporary fix. That's putting someone in the back corner so you don't have to hear them advocate for themselves anymore.
Casper: That's something I've heard so many times from so many people, the lawsuit thing. If anything is going to change, it takes a lawsuit. But trying to do that from within the prison system is next to impossible. I have a lot of friends who have been trying to get their cases heard for decades and have not had any sort of luck. So like you said, on this long enough timeline, unfortunately there are going to be people who are victims of whatever sort of legislation we have. Some people are going to just take advantage of the system and it takes a long time to figure out what the correct answer is there. So, it's unfortunate to hear, but I am glad that there are some people on the inside who have people like you to talk to.
Ashley: This is even more evidence that we need to stop putting as many people in prison. It's not a system that is built to be adaptable to what's happening in society. That's a problem.
INTERACTING WITH PATIENTS
Casper: What is the setting like? Do you have an office or do you have a specific part of the prison that people come to to do therapy sessions with you? And then what is the safety protocol for you?
Ashley: There's always an office available. If you ever get a patient who just straight up refuses their appointment, you have to go cell-front to see them, which is non-confidential. And it's always very awkward. As far as safety protocols, I have a whistle. So, if something happens, I blow my whistle, which is difficult when you're wearing a mask. There are little things that beep and then notify custody that you're in crisis. I've never had to test that. Usually if I feel like something is off in the room, I just end the session. I don't risk things in that way. And I also don't want to make my patients uncomfortable and feel like I'm scared of them, by holding that fear, instead of just acting on it. And I really haven't had any issues other than people who tend to get too close when they’re meeting with me, which is just a personal space thing.
Casper: I’ve had that happen to me a couple of times. Do you learn any sort of de-escalation tactics? Does the prison teach any sorts of things like that? Or did you learn any of those in your psychology background?
Ashley: The de-escalation stuff came from my psychological training. That being said, we have a lot of trainings in CDCR. Incessant. I'm getting an email every day about some random training and a new memo. I'm fairly sure that on the custody side we've had those trainings, but they're informal or vague enough where I'm not retaining it. Again, I've never had to really use my de-escalation skills a lot. I guess it comes naturally. As a psychologist, we tend to not escalate people. So it's more of a psychological thing than custody-trained technique.
Casper: I think it takes a certain type of personality-type to want to be a psychologist. But I'm wondering if you feel like the psychologists that you know, who work within the prison system are similar to you and your temperament and your personality-type?
Ashley: So at the end of the day, people get into psychology for different reasons. So I will not say everyone is like me on my team. There are a handful of people that have a pretty similar disposition to me who have a similar perspective, but there are a lot of people who have the opposite. We definitely have psychologists who should not be working in a prison, who view them wholly as criminals or inmates who think that mental health isn't real, which is weird. It's a weird perspective to have. Their experience is that people come into the mental health program to manipulate us and avoid custody, or have someone to talk to, which does happen. There's a lot of lonely people in prison. Understandably so, but they become jaded. Some of the clinicians become jaded. They're not taking care of themselves. They already have a weird perspective of clients or patients in the first place. In my experience, psychologists are just people and make of that what you will.
Casper: Something we've seen is, since we are focused on like a very specific subgroup of people working with LGBT prisoners, a lot of times other folks who are outside of that community, or don't identify that way, who have nobody else to reach out to, will say that they are part of the community or whatever, because they just are so lonely.
Like they don't have family or friend support. It gets really difficult to figure out how to properly set boundaries and not turn away people who are requesting help from you, but also not over-extend yourself because like in your work, there's only 30-somewhat psychologists who are working with, what, thousands of people in prison. Your time and your resources are very limited, but there are so many people who really could benefit from even just having a conversation with another human being who sees them as another human being. And that's something that we always really struggle with working within the prison system.
Ashley: That is one of the most challenging parts of my job is that again, coming from a non-institutional setting, I am used to working with people who want to do work. Even if they don't know, they just come in, they're like, “I don't know, something's off. I need help with that.” And you see them and you treat them and you help them. And I've had to have a conversation with a lot of people where they come in and they're like, “I need help gaining insight into my offense.” I would love to do that work. I do not have the capacity to do that. And I have to tell them, “Listen, per our guidelines, I can't diagnose you with a major mental health disorder. You don't have one, you don't suffer any functional impairments because of mental health related symptoms. I can't place you in the system. I can't continue to meet with you.”
I've had to tow the line of what I have available and my helping-self, which is I always want to give more, and so what I'll do with those people, you know I’ll say “I'll meet with you three or four times more just to give you support, but I can't put you in the program,” and it's really difficult. In the helping profession, how do you tell someone you don't deserve help? Because that's what they're hearing. “What I'm going through isn't valid.” That's always my fear with them. “It's not that it's not valid and I would love to help you. But if I give you this help, then someone else doesn't get it who may have worse symptoms or may be struggling a little bit more.” I hate that, I do.
Casper: Yeah. Something that comes to mind for me is this sort of societal switch we've made in the last, I'd say a couple hundred years where our societies went from very close knit communities of where everybody knows everybody because you're in a small community and you have people that you can rely on for friendships and neighbors and community assistance.
That's not a highly specialized thing. Part of our mental health is just having good relationships with other people. So having people you can have a conversation with and laugh with and sometimes cry with. We've lost so much of that in our society, where most of us don't know our neighbors.
There's not people that we feel comfortable reaching out to in a crisis. And so people have nowhere to turn when there is something that's really bad going on in their life. And I feel like prisons also don't foster that sort of atmosphere of community. I don't know if this is so much the case in California, but in a lot of places, prisons are racially segregated.
People are not encouraged to interact with each other and build friendships. They're definitely discouraged from building relationships with each other, like intimate relationships. Those are even criminalized within the prison system. Do you think a lot of the issues that you see, that are not diagnosable mental illnesses, these people could benefit from just having stronger interpersonal relationships?
Ashley: Absolutely. This happens so often where I hear people and they come in and they’re like, “I have all these things to say, and I can't trust anyone. They're going to use this information against me. And I just want someone to talk to,” and I hear this over and over again, and I'm just like, “This is so weird.”
It's so weird. “You're surrounded by people, but you have no one to talk to?” You can't say that to them. You can't say, “Well, I know that there's other people who feel just like you, if only we can start a group and then everyone's in that group.” But that paranoia is always there.
I do believe that if you felt like you were part of a community, you wouldn't engage in crimes against a community, right? Like if you felt like you belonged, you had your needs taken care of, you wouldn't violate quote unquote social norms. You wouldn't feel isolated and alone. You would feel like you had a safe place to build yourself up from, and that doesn't really exist in a prison.
I have some clients or patients who are really great at building nurturing relationships with other inmates and they either serve as a guide for the younger people, or they glob onto the lifers and they gain wisdom through them. I think a lot of like YOP offenders, so youth offenders, who come in and they're very young and either they're still young or they grow up very fast and they do build those relationships. And those people are always much better adjusted. Their depression is less severe. Their anxiety is less severe. It really is that closeness that you're talking about. Feeling like you belong is just naturally healing for general mental health disorders.
Ashley: There's always an office available. If you ever get a patient who just straight up refuses their appointment, you have to go cell-front to see them, which is non-confidential. And it's always very awkward. As far as safety protocols, I have a whistle. So, if something happens, I blow my whistle, which is difficult when you're wearing a mask. There are little things that beep and then notify custody that you're in crisis. I've never had to test that. Usually if I feel like something is off in the room, I just end the session. I don't risk things in that way. And I also don't want to make my patients uncomfortable and feel like I'm scared of them, by holding that fear, instead of just acting on it. And I really haven't had any issues other than people who tend to get too close when they’re meeting with me, which is just a personal space thing.
Casper: I’ve had that happen to me a couple of times. Do you learn any sort of de-escalation tactics? Does the prison teach any sorts of things like that? Or did you learn any of those in your psychology background?
Ashley: The de-escalation stuff came from my psychological training. That being said, we have a lot of trainings in CDCR. Incessant. I'm getting an email every day about some random training and a new memo. I'm fairly sure that on the custody side we've had those trainings, but they're informal or vague enough where I'm not retaining it. Again, I've never had to really use my de-escalation skills a lot. I guess it comes naturally. As a psychologist, we tend to not escalate people. So it's more of a psychological thing than custody-trained technique.
Casper: I think it takes a certain type of personality-type to want to be a psychologist. But I'm wondering if you feel like the psychologists that you know, who work within the prison system are similar to you and your temperament and your personality-type?
Ashley: So at the end of the day, people get into psychology for different reasons. So I will not say everyone is like me on my team. There are a handful of people that have a pretty similar disposition to me who have a similar perspective, but there are a lot of people who have the opposite. We definitely have psychologists who should not be working in a prison, who view them wholly as criminals or inmates who think that mental health isn't real, which is weird. It's a weird perspective to have. Their experience is that people come into the mental health program to manipulate us and avoid custody, or have someone to talk to, which does happen. There's a lot of lonely people in prison. Understandably so, but they become jaded. Some of the clinicians become jaded. They're not taking care of themselves. They already have a weird perspective of clients or patients in the first place. In my experience, psychologists are just people and make of that what you will.
Casper: Something we've seen is, since we are focused on like a very specific subgroup of people working with LGBT prisoners, a lot of times other folks who are outside of that community, or don't identify that way, who have nobody else to reach out to, will say that they are part of the community or whatever, because they just are so lonely.
Like they don't have family or friend support. It gets really difficult to figure out how to properly set boundaries and not turn away people who are requesting help from you, but also not over-extend yourself because like in your work, there's only 30-somewhat psychologists who are working with, what, thousands of people in prison. Your time and your resources are very limited, but there are so many people who really could benefit from even just having a conversation with another human being who sees them as another human being. And that's something that we always really struggle with working within the prison system.
Ashley: That is one of the most challenging parts of my job is that again, coming from a non-institutional setting, I am used to working with people who want to do work. Even if they don't know, they just come in, they're like, “I don't know, something's off. I need help with that.” And you see them and you treat them and you help them. And I've had to have a conversation with a lot of people where they come in and they're like, “I need help gaining insight into my offense.” I would love to do that work. I do not have the capacity to do that. And I have to tell them, “Listen, per our guidelines, I can't diagnose you with a major mental health disorder. You don't have one, you don't suffer any functional impairments because of mental health related symptoms. I can't place you in the system. I can't continue to meet with you.”
I've had to tow the line of what I have available and my helping-self, which is I always want to give more, and so what I'll do with those people, you know I’ll say “I'll meet with you three or four times more just to give you support, but I can't put you in the program,” and it's really difficult. In the helping profession, how do you tell someone you don't deserve help? Because that's what they're hearing. “What I'm going through isn't valid.” That's always my fear with them. “It's not that it's not valid and I would love to help you. But if I give you this help, then someone else doesn't get it who may have worse symptoms or may be struggling a little bit more.” I hate that, I do.
Casper: Yeah. Something that comes to mind for me is this sort of societal switch we've made in the last, I'd say a couple hundred years where our societies went from very close knit communities of where everybody knows everybody because you're in a small community and you have people that you can rely on for friendships and neighbors and community assistance.
That's not a highly specialized thing. Part of our mental health is just having good relationships with other people. So having people you can have a conversation with and laugh with and sometimes cry with. We've lost so much of that in our society, where most of us don't know our neighbors.
There's not people that we feel comfortable reaching out to in a crisis. And so people have nowhere to turn when there is something that's really bad going on in their life. And I feel like prisons also don't foster that sort of atmosphere of community. I don't know if this is so much the case in California, but in a lot of places, prisons are racially segregated.
People are not encouraged to interact with each other and build friendships. They're definitely discouraged from building relationships with each other, like intimate relationships. Those are even criminalized within the prison system. Do you think a lot of the issues that you see, that are not diagnosable mental illnesses, these people could benefit from just having stronger interpersonal relationships?
Ashley: Absolutely. This happens so often where I hear people and they come in and they’re like, “I have all these things to say, and I can't trust anyone. They're going to use this information against me. And I just want someone to talk to,” and I hear this over and over again, and I'm just like, “This is so weird.”
It's so weird. “You're surrounded by people, but you have no one to talk to?” You can't say that to them. You can't say, “Well, I know that there's other people who feel just like you, if only we can start a group and then everyone's in that group.” But that paranoia is always there.
I do believe that if you felt like you were part of a community, you wouldn't engage in crimes against a community, right? Like if you felt like you belonged, you had your needs taken care of, you wouldn't violate quote unquote social norms. You wouldn't feel isolated and alone. You would feel like you had a safe place to build yourself up from, and that doesn't really exist in a prison.
I have some clients or patients who are really great at building nurturing relationships with other inmates and they either serve as a guide for the younger people, or they glob onto the lifers and they gain wisdom through them. I think a lot of like YOP offenders, so youth offenders, who come in and they're very young and either they're still young or they grow up very fast and they do build those relationships. And those people are always much better adjusted. Their depression is less severe. Their anxiety is less severe. It really is that closeness that you're talking about. Feeling like you belong is just naturally healing for general mental health disorders.
COMMUNITY
Casper: I think that especially with the rise in our interest in the prison system and all of the media and stuff, people who are going into the prison system for the first time view it as a very predatory, very punitive based thing that they have to prepare themselves mentally to be on their own. Nobody is going to have their back. They're not going to be able to find community or friendship or anything like that on the inside.
When we're thinking about recidivism and curbing crime rates, if people are only operating on the fear of going to prison as a deterrent for not committing whatever crime, it's obviously not working. We've got an insane amount of people in the prison system.
So obviously the fear of going to prison is not working as a deterrent to our crime rates. Is there anything you can think of as far as a societal mental switch that we could make to strengthen communities where we're not just focused on, “We'll just throw people in prison and that'll solve the problem.”
As a psychologist, do you think there's anything we can do to rebuild the trust in our communities and get to know each other again?
Ashley: It's such a cyclical problem. First of all, socioeconomic class. You have the very rich people and then you have the poor middle class, and then you have the very poor people. There's no resources, or limited-to-none resources for people who have lower income. Then you have people with a bunch of money saying, “You don't get my money. I worked really hard for that.” But if they paid more taxes, there'd be more resources for lower income people. And if they had those resources, they'd be less likely to commit offenses. This is true in San Francisco. At least when I worked in San Francisco where, let's say the Bayview district, is known for being super dangerous. That's where all the gang people are. No one wanted to go there.
When I told people like, “Yeah, I work in the Bayview, I'm doing X, Y, and Z.” They’d be like, “Oh, I'm never going to the Bayview. It's too dangerous.” Well it's like, “Well, it wouldn't be dangerous if we put resources there and we helped people out of poverty and we helped them stigmatize mental illness less so that people could get adequate care. It would help if you reached out your hands a little bit to treat other people like a human being so that they felt like we were on the same page, but people don't do that. I could get into why people are othering each other, especially in an individualistic society. Every person for themselves. And in America, the richer you are, the happier you are, the better that you are. I guess, to put it simply, if people were less selfish.
Casper: No, I think there is this emphasis on almost immediate gratification. Like you said, if we took the time now to sacrifice a little bit for our communities and really reach out. It's not going to be easy to go into communities that are really suffering and it's not going to be easy or safe to do this in the short term, a lot of people are going to have to sacrifice a lot right now to make things better in the future.
That's something that I see is so few people are really willing to sacrifice short-term comfort to make sure that things are better in the long-term.
Ashley: That’s all it is. It's comfort. I've become comfortable with the way things are. And that's even true for people who are struggling.
Your brain is so adaptable. It's very smart in that way, but it's also very stupid. It doesn't choose what it adapts to. So even if you've spent your whole life suffering, that is normal to you. Even if you spent your whole life being happy and successful, that's what's normal to you. It's so difficult and uncomfortable for people to step outside of that.
If you're going to acknowledge another human being that you've always othered and let in their suffering or their difficulties, that challenges your status quo. And how does that sit with you? Can you adapt to that? And if you can't, you're always going to push against that.
When we're thinking about recidivism and curbing crime rates, if people are only operating on the fear of going to prison as a deterrent for not committing whatever crime, it's obviously not working. We've got an insane amount of people in the prison system.
So obviously the fear of going to prison is not working as a deterrent to our crime rates. Is there anything you can think of as far as a societal mental switch that we could make to strengthen communities where we're not just focused on, “We'll just throw people in prison and that'll solve the problem.”
As a psychologist, do you think there's anything we can do to rebuild the trust in our communities and get to know each other again?
Ashley: It's such a cyclical problem. First of all, socioeconomic class. You have the very rich people and then you have the poor middle class, and then you have the very poor people. There's no resources, or limited-to-none resources for people who have lower income. Then you have people with a bunch of money saying, “You don't get my money. I worked really hard for that.” But if they paid more taxes, there'd be more resources for lower income people. And if they had those resources, they'd be less likely to commit offenses. This is true in San Francisco. At least when I worked in San Francisco where, let's say the Bayview district, is known for being super dangerous. That's where all the gang people are. No one wanted to go there.
When I told people like, “Yeah, I work in the Bayview, I'm doing X, Y, and Z.” They’d be like, “Oh, I'm never going to the Bayview. It's too dangerous.” Well it's like, “Well, it wouldn't be dangerous if we put resources there and we helped people out of poverty and we helped them stigmatize mental illness less so that people could get adequate care. It would help if you reached out your hands a little bit to treat other people like a human being so that they felt like we were on the same page, but people don't do that. I could get into why people are othering each other, especially in an individualistic society. Every person for themselves. And in America, the richer you are, the happier you are, the better that you are. I guess, to put it simply, if people were less selfish.
Casper: No, I think there is this emphasis on almost immediate gratification. Like you said, if we took the time now to sacrifice a little bit for our communities and really reach out. It's not going to be easy to go into communities that are really suffering and it's not going to be easy or safe to do this in the short term, a lot of people are going to have to sacrifice a lot right now to make things better in the future.
That's something that I see is so few people are really willing to sacrifice short-term comfort to make sure that things are better in the long-term.
Ashley: That’s all it is. It's comfort. I've become comfortable with the way things are. And that's even true for people who are struggling.
Your brain is so adaptable. It's very smart in that way, but it's also very stupid. It doesn't choose what it adapts to. So even if you've spent your whole life suffering, that is normal to you. Even if you spent your whole life being happy and successful, that's what's normal to you. It's so difficult and uncomfortable for people to step outside of that.
If you're going to acknowledge another human being that you've always othered and let in their suffering or their difficulties, that challenges your status quo. And how does that sit with you? Can you adapt to that? And if you can't, you're always going to push against that.
WORK/LIFE
Casper: How do you deal with the difficulties of your job and not bringing that into your home life or into your interactions with people outside of the prison system?
Ashley: I'm laughing because it's usually people ask me that question and they're talking about the inmates. “How do you deal with your patients' stories of their trauma and the things that happened to them when they’re in prison?” I can manage that. That stuff never bleeds through. I've always had a very good way of compartmentalizing. It's being an employee for CDCR that really seeps into my skin. I'm not perfect. I teach my patients more skills than I use myself and it does seep in and it bleeds out in different ways. I take a lot of me being a staff member home, which is very frustrating. It's consuming. It really is. And it goes back to that feeling of being institutionalized where I can't shake it. A lot of people say, “When you walk out of the gates, you just leave it with you.” That's not always f’n possible. It's like a smell that just sits with you.
Casper: I get the same question a lot. I'm pretty good at this point at compartmentalizing them as well, and letting them go. I usually refer to it as turning the pages of a book. Sometimes you have to let it sit with you for a little while to do the best you can to try and help folks. But then you have to be able to release that and let it go to continue to live your life. But the hardest part for me is dealing with the knowledge of how little is being done on the behalf of people who are in the care of the prison system, where it really just seems like intentional neglect or at times even intentional abuse, just to inflict suffering on people that some folks think deserve it because they are incarcerated of sometimes admittedly very horrific things that people have done to one another. And it's hard to reconcile that.
I've considered working within the prison system myself on many occasions. And even just working with folks who are incarcerated through mail and through phone calls and on rare occasions, prison visits and stuff, sometimes that does come home with me. And it's very difficult to let that go. It has become in essence kind of my entire life, even though it is I guess, a job, but it definitely creeps in when you don't want it to in rare moments. So I wonder if you've developed anything as a psychologist, any sort of coping mechanisms for people who are involved in advocacy or who are involved in this kind of work so that they can help let some of that energy go at the end of the day.
Ashley: So something that I do is I, this is going to sound counterproductive, but I get angry about things a lot. And then I vent about it or I do something with that. And then I let it go. Anger tends to be a motivating emotion where being what I really am, which is very frustrated and sad and helpless. A lot of the times when I see things happen or hear about things, it's de-motivating right, it makes you want to curl up on the couch and just numbly stare at the wall. So I’m often very angry and frustrated about things. And then I vent to my coworkers and I complain to managers and supervisors. Not that it shifts anything, but I want them to be aware that I think this is wrong and this needs to be fixed. We need to work on this.
I feel like you're in more of a helping role than I am. I always tell people in those positions that if you are going to be the tool that helps other people better themselves, whatever that looks like, you have to keep yourself sharp. Part of doing your job is taking care of yourself because the second you burn out, you can not do your job. And then what is it all for? So taking care of yourself is part of your job. And you have to be able to section off that time, whether it be 15 minutes or an hour, whatever it is, if it's staring at the wall, if it's meditating, it's playing video games, whatever, drawing, you have to put that into your schedule and stick to it and hold yourself accountable. And it's always good. And it's also good for modeling, right? Because if you can't use it, how do you expect other people around you to use it? And again, this is another example of me giving advice that I don't take myself, but that's what I tell people.
Casper: Yeah. Psychologists make the worst patients.
Ashley: I'm laughing because it's usually people ask me that question and they're talking about the inmates. “How do you deal with your patients' stories of their trauma and the things that happened to them when they’re in prison?” I can manage that. That stuff never bleeds through. I've always had a very good way of compartmentalizing. It's being an employee for CDCR that really seeps into my skin. I'm not perfect. I teach my patients more skills than I use myself and it does seep in and it bleeds out in different ways. I take a lot of me being a staff member home, which is very frustrating. It's consuming. It really is. And it goes back to that feeling of being institutionalized where I can't shake it. A lot of people say, “When you walk out of the gates, you just leave it with you.” That's not always f’n possible. It's like a smell that just sits with you.
Casper: I get the same question a lot. I'm pretty good at this point at compartmentalizing them as well, and letting them go. I usually refer to it as turning the pages of a book. Sometimes you have to let it sit with you for a little while to do the best you can to try and help folks. But then you have to be able to release that and let it go to continue to live your life. But the hardest part for me is dealing with the knowledge of how little is being done on the behalf of people who are in the care of the prison system, where it really just seems like intentional neglect or at times even intentional abuse, just to inflict suffering on people that some folks think deserve it because they are incarcerated of sometimes admittedly very horrific things that people have done to one another. And it's hard to reconcile that.
I've considered working within the prison system myself on many occasions. And even just working with folks who are incarcerated through mail and through phone calls and on rare occasions, prison visits and stuff, sometimes that does come home with me. And it's very difficult to let that go. It has become in essence kind of my entire life, even though it is I guess, a job, but it definitely creeps in when you don't want it to in rare moments. So I wonder if you've developed anything as a psychologist, any sort of coping mechanisms for people who are involved in advocacy or who are involved in this kind of work so that they can help let some of that energy go at the end of the day.
Ashley: So something that I do is I, this is going to sound counterproductive, but I get angry about things a lot. And then I vent about it or I do something with that. And then I let it go. Anger tends to be a motivating emotion where being what I really am, which is very frustrated and sad and helpless. A lot of the times when I see things happen or hear about things, it's de-motivating right, it makes you want to curl up on the couch and just numbly stare at the wall. So I’m often very angry and frustrated about things. And then I vent to my coworkers and I complain to managers and supervisors. Not that it shifts anything, but I want them to be aware that I think this is wrong and this needs to be fixed. We need to work on this.
I feel like you're in more of a helping role than I am. I always tell people in those positions that if you are going to be the tool that helps other people better themselves, whatever that looks like, you have to keep yourself sharp. Part of doing your job is taking care of yourself because the second you burn out, you can not do your job. And then what is it all for? So taking care of yourself is part of your job. And you have to be able to section off that time, whether it be 15 minutes or an hour, whatever it is, if it's staring at the wall, if it's meditating, it's playing video games, whatever, drawing, you have to put that into your schedule and stick to it and hold yourself accountable. And it's always good. And it's also good for modeling, right? Because if you can't use it, how do you expect other people around you to use it? And again, this is another example of me giving advice that I don't take myself, but that's what I tell people.
Casper: Yeah. Psychologists make the worst patients.
*BREAK*
Conductor Trig: Teleway now approaching station. Please prepare for arrival.
Conductor L.A.: The ouija: is it simply a novelty item or is there a more sinister side of it as well? From prolific writer Jefferson Borba de Souza comes Dark Matters and Prophecy: Secrets of the Ouija Board, an incredible compilation of evidence suggesting a deep history of the U.S. government’s involvement in paranormal experimentation. Jefferson was contracted as a consultant on black budget projects by the U.S. government in the 80’s and 90’s. He was then incarcerated by that same government for over 2 decades. After his release in 2020, Jeferson has struggled to survive his deportation to a country with which he has virtually no ties. He experiences day-to-day food insecurity, having to ration his Insulin, and lack of work due to the pandemic. By purchasing his book, you are providing desperately needed assistance to an individual who has little to no resources to support themselves. Head to abocomix.com to purchase Dark Matters and Prophesy: Secrets of the Ouija Board. And be sure to check out Jeferson’s website KnowhereRepository.com for more information. That's k-n-o-w-h-e-r-e-r-e-p-o-s-i-t-o-r-y .com. Thank you.
Conductor Trig: Teleway preparing to depart.
Conductor L.A.: The ouija: is it simply a novelty item or is there a more sinister side of it as well? From prolific writer Jefferson Borba de Souza comes Dark Matters and Prophecy: Secrets of the Ouija Board, an incredible compilation of evidence suggesting a deep history of the U.S. government’s involvement in paranormal experimentation. Jefferson was contracted as a consultant on black budget projects by the U.S. government in the 80’s and 90’s. He was then incarcerated by that same government for over 2 decades. After his release in 2020, Jeferson has struggled to survive his deportation to a country with which he has virtually no ties. He experiences day-to-day food insecurity, having to ration his Insulin, and lack of work due to the pandemic. By purchasing his book, you are providing desperately needed assistance to an individual who has little to no resources to support themselves. Head to abocomix.com to purchase Dark Matters and Prophesy: Secrets of the Ouija Board. And be sure to check out Jeferson’s website KnowhereRepository.com for more information. That's k-n-o-w-h-e-r-e-r-e-p-o-s-i-t-o-r-y .com. Thank you.
Conductor Trig: Teleway preparing to depart.
WORKLOAD
Casper: Do you think there was anything about your job that if you could change it, you would be able to for the better of the people who work there and for the better of the people who are incarcerated there?
Ashley: Let me take a step back and explain in CDCR how the mental health program is structured. So there's GP: general population, which is considered a level of care for the mental health program. There's CCCMS, which is the lowest level. Then there's EOP, which is the highest level you can get to before you're kicked to crisis bed. And then there's PIP ICF after that. There's no intermediary between CCCMS, which is once every 90 days and EOP, which is once a week. The problem is I come from outpatient, like a classic psychologist who meets with their clients once a week. However long that takes, a year, two years, six months, whatever. Every 90 days is not therapy. That's not therapeutic. That's a check-in. It's very frustrating for me. That is what essentially comes up when you say, “My caseload is too high,” and they say, “What are you talking about? You only meet with people every 90 days.”
What happens is that I overbook my schedule and really the best I can do right now is once a month. There are some patients who I do see more often than that, because I'm human. Not that I have favorites, but they're doing the work, right. So I want to carry through with them, but that comes out of my mental health pocket. I'm the one who pays for that at the end of the day, because I'm seeing so many clients or I'm doing so much paperwork. And the caseload just keeps going up.
So when the program was created, they said, “This one clinician can be responsible for this many patients.” So at the highest, I think my caseload was up to 120. Right now it is much lower, still borderline unmanageable, but it's much lower. So I'm able to see people a little more often without going completely crazy. Whenever we get an influx, that fills up and when you say, “Hey, that's too much, I can't do the work.” They say, “What are you talking about? Like I said before, you only meet with them once every 90 days, what are you doing? You have plenty of time.” And my response is, “If you want people to actually get therapy and get what they need and accomplish their treatment goals and feel like they have a continuity between sessions, you need to see them more often than that. Our case loads are too high.”
If this patient isn't getting better and you keep asking me, “Why has this patient been in mental health treatment for five years?” My answer is going to be, “Cause I can only see him four times a year,” which is crazy-making. So there needs to be an intermediate. There are some people who genuinely just need medications. Patients who have schizophrenia, they're not interested in therapy for the most part. Some of them are. And they're great. But mostly it's just medications. I can understand once every 90 days for that person, but for the patient who has major depressive disorder, passive suicidal ideation, medication’s not going to cut it. And they also don't want to be on medications their whole lives. How do you expect me to accomplish that in four times a year?
Ashley: Let me take a step back and explain in CDCR how the mental health program is structured. So there's GP: general population, which is considered a level of care for the mental health program. There's CCCMS, which is the lowest level. Then there's EOP, which is the highest level you can get to before you're kicked to crisis bed. And then there's PIP ICF after that. There's no intermediary between CCCMS, which is once every 90 days and EOP, which is once a week. The problem is I come from outpatient, like a classic psychologist who meets with their clients once a week. However long that takes, a year, two years, six months, whatever. Every 90 days is not therapy. That's not therapeutic. That's a check-in. It's very frustrating for me. That is what essentially comes up when you say, “My caseload is too high,” and they say, “What are you talking about? You only meet with people every 90 days.”
What happens is that I overbook my schedule and really the best I can do right now is once a month. There are some patients who I do see more often than that, because I'm human. Not that I have favorites, but they're doing the work, right. So I want to carry through with them, but that comes out of my mental health pocket. I'm the one who pays for that at the end of the day, because I'm seeing so many clients or I'm doing so much paperwork. And the caseload just keeps going up.
So when the program was created, they said, “This one clinician can be responsible for this many patients.” So at the highest, I think my caseload was up to 120. Right now it is much lower, still borderline unmanageable, but it's much lower. So I'm able to see people a little more often without going completely crazy. Whenever we get an influx, that fills up and when you say, “Hey, that's too much, I can't do the work.” They say, “What are you talking about? Like I said before, you only meet with them once every 90 days, what are you doing? You have plenty of time.” And my response is, “If you want people to actually get therapy and get what they need and accomplish their treatment goals and feel like they have a continuity between sessions, you need to see them more often than that. Our case loads are too high.”
If this patient isn't getting better and you keep asking me, “Why has this patient been in mental health treatment for five years?” My answer is going to be, “Cause I can only see him four times a year,” which is crazy-making. So there needs to be an intermediate. There are some people who genuinely just need medications. Patients who have schizophrenia, they're not interested in therapy for the most part. Some of them are. And they're great. But mostly it's just medications. I can understand once every 90 days for that person, but for the patient who has major depressive disorder, passive suicidal ideation, medication’s not going to cut it. And they also don't want to be on medications their whole lives. How do you expect me to accomplish that in four times a year?
DRUGS
Casper: So I've heard, and this is all just hearsay that drugs are making the rounds again, like there's K2 coming into the prison system. Have you seen any evidence of that? Do you ever interact with patients who are clearly intoxicated on anything that they probably should not be?
Ashley: I'm laughing because the rate of substance use disorders is double that of someone with a mental illness, of the prevalence of mental illness in an institution. So let's say in one institution, 26% of the population is in the mental health program. They have any form of mental illness or severe mental illness, double that, two-thirds of the inmate population tend to have substance use issues or a disorder.
I have many times had a patient in my office and I'm just like, “Hey, you seem very high. Are you high?” And then they look at me and they say, “No, of course not.” And meanwhile, they're standing and sitting and standing and sitting and they're hyper verbal. And I just have to say, “Okay, let's try this again next week. I'm going to reschedule you. Please try to show up sober.”
A, it's not my place to stop anyone from using substances. As an adult, that's their decision. Even if it's illegal, you're not supposed to be using in prison, clearly. But B because of confidentiality, I can't say anything. I can't go up to the officers and say, “Hey, this guy is using meth again, please go get the drugs from his cell so I can actually do therapy.”
A lot of them have substance use issues. Drugs have always been an issue in the institution. I don't know of a time that it wasn't ever an issue. I know around two years ago, big fentanyl thing going everywhere. There were overdoses left and right, there were a couple of deaths because of it.
Some of the institutions, you have people who have life without the possibility of parole. You have people who are on death row. People who have the possibility of parole, but never get out. So their incidents of substance use is much higher, overdose is much higher. It’s a huge problem.
Casper: That's something that I've heard from so many people that we work with is, when you're a lifer or when you're looking at a 30, 40 year set off of your sentence, there's almost nothing to do except for engage in some sort of escapism. So some people turn to art, some people turn to religion, some people turn to drugs.
Unfortunately it seems really easy to access a lot of different drugs within the prison system. It's very much against the rules, but I'm wondering if you have any sort of suspicions on how drugs get into the prison system?
Ashley: Any way. Staff, free-staff of volunteers, medical staff, mental health staff, custody, visitation, mail, drones.
If there is a way into the prison, there will be a drug on that thing to get into the prison. I've had some patients say, “It's harder to get drugs on the street than it is in this prison.” It's so hard for some of them to stay sober. And we have substance use programs. So replacement therapy like Suboxone, Methadone, sometimes the person will start selling their Suboxone and Methadone, and then you have another person who's now somehow addicted to Suboxone.
They keep getting it from this other person and then they're having issues. So it's like we've introduced this substance use treatment program, but now some people are starting to misuse it and it always runs the risk of, what happens to the program? Cause CDCR’s tendency is, “This one person misused it, we're going to get rid of it.” So it's difficult.
What do you do when even in the substance use program, you have people who are using substances or misusing the program? I had this conversation with someone the other day, they were commenting on one of my patients who is just not going to stop using. I had a conversation with them and I said, “Listen, you cannot force someone to be sober. Let me ask you this. If you were in prison and you had a 200 year sentence, all your family cut you off, you were severely depressed and you were sitting in a cell all day by yourself, what would keep you from using? What would it take for you to make the decision to stay sober?” I'm not saying it's impossible, but you have to empathize a little bit to understand all of the different barriers.
You can't force them to be sober. You have to give them a reason to be sober.
Ashley: I'm laughing because the rate of substance use disorders is double that of someone with a mental illness, of the prevalence of mental illness in an institution. So let's say in one institution, 26% of the population is in the mental health program. They have any form of mental illness or severe mental illness, double that, two-thirds of the inmate population tend to have substance use issues or a disorder.
I have many times had a patient in my office and I'm just like, “Hey, you seem very high. Are you high?” And then they look at me and they say, “No, of course not.” And meanwhile, they're standing and sitting and standing and sitting and they're hyper verbal. And I just have to say, “Okay, let's try this again next week. I'm going to reschedule you. Please try to show up sober.”
A, it's not my place to stop anyone from using substances. As an adult, that's their decision. Even if it's illegal, you're not supposed to be using in prison, clearly. But B because of confidentiality, I can't say anything. I can't go up to the officers and say, “Hey, this guy is using meth again, please go get the drugs from his cell so I can actually do therapy.”
A lot of them have substance use issues. Drugs have always been an issue in the institution. I don't know of a time that it wasn't ever an issue. I know around two years ago, big fentanyl thing going everywhere. There were overdoses left and right, there were a couple of deaths because of it.
Some of the institutions, you have people who have life without the possibility of parole. You have people who are on death row. People who have the possibility of parole, but never get out. So their incidents of substance use is much higher, overdose is much higher. It’s a huge problem.
Casper: That's something that I've heard from so many people that we work with is, when you're a lifer or when you're looking at a 30, 40 year set off of your sentence, there's almost nothing to do except for engage in some sort of escapism. So some people turn to art, some people turn to religion, some people turn to drugs.
Unfortunately it seems really easy to access a lot of different drugs within the prison system. It's very much against the rules, but I'm wondering if you have any sort of suspicions on how drugs get into the prison system?
Ashley: Any way. Staff, free-staff of volunteers, medical staff, mental health staff, custody, visitation, mail, drones.
If there is a way into the prison, there will be a drug on that thing to get into the prison. I've had some patients say, “It's harder to get drugs on the street than it is in this prison.” It's so hard for some of them to stay sober. And we have substance use programs. So replacement therapy like Suboxone, Methadone, sometimes the person will start selling their Suboxone and Methadone, and then you have another person who's now somehow addicted to Suboxone.
They keep getting it from this other person and then they're having issues. So it's like we've introduced this substance use treatment program, but now some people are starting to misuse it and it always runs the risk of, what happens to the program? Cause CDCR’s tendency is, “This one person misused it, we're going to get rid of it.” So it's difficult.
What do you do when even in the substance use program, you have people who are using substances or misusing the program? I had this conversation with someone the other day, they were commenting on one of my patients who is just not going to stop using. I had a conversation with them and I said, “Listen, you cannot force someone to be sober. Let me ask you this. If you were in prison and you had a 200 year sentence, all your family cut you off, you were severely depressed and you were sitting in a cell all day by yourself, what would keep you from using? What would it take for you to make the decision to stay sober?” I'm not saying it's impossible, but you have to empathize a little bit to understand all of the different barriers.
You can't force them to be sober. You have to give them a reason to be sober.
EMPATHY FROM OUTSIDE
Casper: People seem to look down upon folks who are engaging in that activity or that lifestyle but interacting with people on a day-to-day basis and hearing the very, highly regimented, highly structured, lack of control of their own life and the lack of things that they are even allowed to do, whether that be having personal or romantic relationships with people, whether that be the kind of activities that they're allowed to do, the movies they're allowed to watch, the music they're allowed to listen to, there's just this complete lack of control over every aspect of a person's life.
Not even allowed to go to the bathroom without permission. I can't say very many people in those same circumstances wouldn’t want to engage in some sort of escapism. So I think it's really important to have the empathy for people who are going through that kind of stuff. Is there anything that we can do as people who exist on the outside to be more empathetic to folks on the inside? Is there anything you might be able to share about what folks are going through inside the prison system just to give us a better understanding of what their lives might be like?
Ashley: It's really challenging. It's asking a lot of people in the community to have empathy because they don't sit in the room with these patients like I do. They don't sit in the room and they don't see this person and they don't hear the stories and they don't see the emotions on their face and they don't see the behaviors that happen when they start to decompensate or struggle.
And they don't understand their stories. No one for the most part. There are definitely outliers to any spectrum. I genuinely don't think that 99.9% of my patients woke up one day and they're like, “You know what? I'm just going to go shoot someone in the face.” No, that's not what happened.
That's never what happens. There's so much context. People like to see things in black and white and they like to villainize people and they like to other people because they don't want to see that aspect of themselves. People forget, anyone outside hanging out in the sun, living their life has the capacity to do any of the things that any of my patients have done.
It's just about what flips on that switch. I have the capacity for great darkness. Those things just haven't been switched on. A series of events haven't lined up where this thing has happened. People don't want to see that. That is most prominent when it comes to sex offenses.
People don't want to see that you too have the capacity to have done this. Whether it be rape or child molestation or voyeurism or exhibitionism. You are still a person. You have the capacity to do that, but people don't want to look at that. So most sex offenders are stigmatized and they're othered and they're put in a corner and no one wants to look at them because we don't want to acknowledge that we have the capacity to do that.
It's much easier for us to relate to people who have murdered someone. Have you ever been in traffic and that person cuts you off in their decked out Tesla and you're driving your crappy little used car, and “You know what, buddy, I'm going to let you hit me. And your car is going to get dinged.”
You feel that rage. You watch these shows and murders are sometimes glorified. “Ooh, what's the next serial killer movie?” But when it comes to other offenses, absolutely not. “Those people are trash. They're terrible. Get rid of them.” Some people just need to get over themselves.
You are not this pious creature who is incapable of ever doing anything wrong.
Casper: I had this conversation with my mom pretty recently and she goes into hyper mom mode when I talk about the prison system and she worries for my safety a whole lot.
And a question she had for me was, “Do you understand when people tell you the crimes that they've committed and the horrible things that they've done, does it make any sense to you?” And my answer was, “Yes, every time when people tell me their stories and they tell me in detail what happened. Yes. It makes sense.” It's not as black and white as people want to think. Like you said, somebody just woke up one day and had the grand idea, “I'm going to go hurt somebody.” There's these series of circumstances that in a lot of times lead up from years, decades, prior of your timeline, your personal history, all contributes to this other moment in time where things tend to happen very quickly.
People aren't always thinking to the best of their ability in the moment. A lot of times fight or flight comes into things. There's just a very complex set of circumstances that all contributed to this one moment in time where something horrible happened. A lot of times as humans, we're trying to rationalize where we sit apart from the person who did something that we would like to think we're not capable of, but like you said, we're all capable of these dark moments in time if we are in the right circumstances.
And I think that's really important to remember, and to sit with when you're thinking about, “How do we make sure these sorts of things don't continue to happen? And how do we offer people help to make sure that they don't.” Instead of just saying, “This person's irredeemable, they committed something so atrocious that they should never be allowed to exist within our society.”
Do you feel like there's any sort of common thread that you can find? Every person's unique, every person's got their own individual set of circumstances and identities and stuff, but have you found any sort of common thread in the folks that you work with as far as if there's trauma in their background, if they come from specific sort of socioeconomic backgrounds or anything like that?
Ashley: I don't think it is a surprise to anyone that again, 99.9% of the patients that I've had or inmates I've interacted with have suffered trauma of various kinds and trauma is subjective. Right? It's all about an event that you carry with you and it impacts you in some way, whether it be your father leaving, your mother dying, your sister abusing you, X, Y, and Z. It changes the way you perceive things, right? When you experience trauma, your whole life is seen through these glasses that are now colored different.
Your brain is hardwired different, you behave differently. People often times forget to take that into account. I have a lot of patients who will come in and I'll say, “Hey, so what was going on before you got to this point? What kind of life were you living? What are the things that you've gone through?”
And a lot of them don't even understand that they have trauma. Because what happens is they suffer trauma. Their brain develops in that way to respond to the trauma. They perceive things differently. It's normal for them. So they live their whole life, really just acting out of their trauma. And it's only now where I'm coming in, like saying, “Hey, maybe when you walk into a room and you're instantly scanning and you're looking at everyone and you're reading their body language and you're responding to the pitch of their voice, maybe that's not you having anxiety issues. Maybe that's your brain trying to protect itself.
Maybe you always feeling tense and reactive to people is because of your trauma. And maybe that may have contributed to your offense, right? Walking down a street late at night, you already have a gun on you because you never left the house without a gun because you didn't feel safe. A noise was made and there was someone across the street and you reactively used the gun.” Trauma is a huge component of it. Also substance use, but substance use is usually secondary to something else. I had an experience with another staff member who essentially said that anything that this patient was presenting with was because of the substance use.
And they said, “Is it the chicken or the egg?” And I said, “Well, maybe a toddler didn't start drinking, which made them depressed, which made them drink more, maybe something precipitated the substance use.” So that's usually how it goes. It's very rare to find someone who had the white picket fence family, no issues, start using methamphetamines, gave up everything in their life and then decided to start committing crime.
That's usually not how it goes, usually trauma first.
Not even allowed to go to the bathroom without permission. I can't say very many people in those same circumstances wouldn’t want to engage in some sort of escapism. So I think it's really important to have the empathy for people who are going through that kind of stuff. Is there anything that we can do as people who exist on the outside to be more empathetic to folks on the inside? Is there anything you might be able to share about what folks are going through inside the prison system just to give us a better understanding of what their lives might be like?
Ashley: It's really challenging. It's asking a lot of people in the community to have empathy because they don't sit in the room with these patients like I do. They don't sit in the room and they don't see this person and they don't hear the stories and they don't see the emotions on their face and they don't see the behaviors that happen when they start to decompensate or struggle.
And they don't understand their stories. No one for the most part. There are definitely outliers to any spectrum. I genuinely don't think that 99.9% of my patients woke up one day and they're like, “You know what? I'm just going to go shoot someone in the face.” No, that's not what happened.
That's never what happens. There's so much context. People like to see things in black and white and they like to villainize people and they like to other people because they don't want to see that aspect of themselves. People forget, anyone outside hanging out in the sun, living their life has the capacity to do any of the things that any of my patients have done.
It's just about what flips on that switch. I have the capacity for great darkness. Those things just haven't been switched on. A series of events haven't lined up where this thing has happened. People don't want to see that. That is most prominent when it comes to sex offenses.
People don't want to see that you too have the capacity to have done this. Whether it be rape or child molestation or voyeurism or exhibitionism. You are still a person. You have the capacity to do that, but people don't want to look at that. So most sex offenders are stigmatized and they're othered and they're put in a corner and no one wants to look at them because we don't want to acknowledge that we have the capacity to do that.
It's much easier for us to relate to people who have murdered someone. Have you ever been in traffic and that person cuts you off in their decked out Tesla and you're driving your crappy little used car, and “You know what, buddy, I'm going to let you hit me. And your car is going to get dinged.”
You feel that rage. You watch these shows and murders are sometimes glorified. “Ooh, what's the next serial killer movie?” But when it comes to other offenses, absolutely not. “Those people are trash. They're terrible. Get rid of them.” Some people just need to get over themselves.
You are not this pious creature who is incapable of ever doing anything wrong.
Casper: I had this conversation with my mom pretty recently and she goes into hyper mom mode when I talk about the prison system and she worries for my safety a whole lot.
And a question she had for me was, “Do you understand when people tell you the crimes that they've committed and the horrible things that they've done, does it make any sense to you?” And my answer was, “Yes, every time when people tell me their stories and they tell me in detail what happened. Yes. It makes sense.” It's not as black and white as people want to think. Like you said, somebody just woke up one day and had the grand idea, “I'm going to go hurt somebody.” There's these series of circumstances that in a lot of times lead up from years, decades, prior of your timeline, your personal history, all contributes to this other moment in time where things tend to happen very quickly.
People aren't always thinking to the best of their ability in the moment. A lot of times fight or flight comes into things. There's just a very complex set of circumstances that all contributed to this one moment in time where something horrible happened. A lot of times as humans, we're trying to rationalize where we sit apart from the person who did something that we would like to think we're not capable of, but like you said, we're all capable of these dark moments in time if we are in the right circumstances.
And I think that's really important to remember, and to sit with when you're thinking about, “How do we make sure these sorts of things don't continue to happen? And how do we offer people help to make sure that they don't.” Instead of just saying, “This person's irredeemable, they committed something so atrocious that they should never be allowed to exist within our society.”
Do you feel like there's any sort of common thread that you can find? Every person's unique, every person's got their own individual set of circumstances and identities and stuff, but have you found any sort of common thread in the folks that you work with as far as if there's trauma in their background, if they come from specific sort of socioeconomic backgrounds or anything like that?
Ashley: I don't think it is a surprise to anyone that again, 99.9% of the patients that I've had or inmates I've interacted with have suffered trauma of various kinds and trauma is subjective. Right? It's all about an event that you carry with you and it impacts you in some way, whether it be your father leaving, your mother dying, your sister abusing you, X, Y, and Z. It changes the way you perceive things, right? When you experience trauma, your whole life is seen through these glasses that are now colored different.
Your brain is hardwired different, you behave differently. People often times forget to take that into account. I have a lot of patients who will come in and I'll say, “Hey, so what was going on before you got to this point? What kind of life were you living? What are the things that you've gone through?”
And a lot of them don't even understand that they have trauma. Because what happens is they suffer trauma. Their brain develops in that way to respond to the trauma. They perceive things differently. It's normal for them. So they live their whole life, really just acting out of their trauma. And it's only now where I'm coming in, like saying, “Hey, maybe when you walk into a room and you're instantly scanning and you're looking at everyone and you're reading their body language and you're responding to the pitch of their voice, maybe that's not you having anxiety issues. Maybe that's your brain trying to protect itself.
Maybe you always feeling tense and reactive to people is because of your trauma. And maybe that may have contributed to your offense, right? Walking down a street late at night, you already have a gun on you because you never left the house without a gun because you didn't feel safe. A noise was made and there was someone across the street and you reactively used the gun.” Trauma is a huge component of it. Also substance use, but substance use is usually secondary to something else. I had an experience with another staff member who essentially said that anything that this patient was presenting with was because of the substance use.
And they said, “Is it the chicken or the egg?” And I said, “Well, maybe a toddler didn't start drinking, which made them depressed, which made them drink more, maybe something precipitated the substance use.” So that's usually how it goes. It's very rare to find someone who had the white picket fence family, no issues, start using methamphetamines, gave up everything in their life and then decided to start committing crime.
That's usually not how it goes, usually trauma first.
ARE PRISONS OBSOLETE?
Casper: I read this book pretty recently about a person who was convicted of multiple murders throughout his life and his perspective, being a person who was severely abused from a very young age, was that there are certain people who, for lack of a better word, have just been so broken in their lives, that there's just almost no hope for rehabilitation for them. And his perspective was there should be prisons and there are people in the world who that is the only option, because if they're not kept from society, then they're going to just keep hurting more and more people. Despite one or two people really invested in him and trying very hard to work with him, he maintained that perspective to the end of his life and advocated for the death penalty on his behalf, because he was like, “The only way I am going to not hurt people is if I am dead.”
I don't know what percentage of people in prison to attribute that sort of mentality to. This is a very complex issue, but I don't know what amount of people in prison really do not need to be there. And what amount of people in prison we can really work with, and what amount do not want help, do not want to change. Is that an issue that you grapple with?
Ashley: It is definitely an issue that's just inherent in being a psychologist. You come to me, you have a problem. You either want to change or you don't. I run a couple of groups and someone asked me, “Well, how many of your patients recidivate?”
It completely varies year to year. But I said, “I don't know the answer, but I do know this. I know when I can feel when people aren't going to quote unquote recidivate, because they've made the choice to be different. You can feel it in them. They've made a conviction to not live this lifestyle anymore.”
And you can feel that as a psychologist, you can feel when someone is open and receptive to what you're saying, even if they’re like arguing with you. “That's not true. No way. I don't distort my perception.” They come back a week later like, “Well, actually I do that.” I've come across patients who don't want help. They want someone to, as my old supervisor used to say, “Don't let anyone come into your room, just throw up, feel better, leave and then come back and do the same thing.” Which is essentially, they're just using me to absorb all of the bad things that are in them, not wanting to change anything, but just wanting to displace it onto another person.
I've definitely had the thought of, “You really belong here. There's nothing getting through to you. It's bouncing off of a wall,” and there are people who I've had like that, who two years down the line something's stuck and something cracked the facade. Yes, there may be people who indefinitely belong in prison.
But I think more often than not, we say that about people who actually do have a chance. We just haven't given them the time or the resources.
Casper: And then it comes down to how many of our resources do we extend to a single human being, which is a horrible thing to have to consider.
But it is a reality, where it's we could put this person in a really intense therapy and we could work with them for years. And then that person could heal and grow and learn. But when you're working with thousands of people and you only have a couple people willing to do this kind of job, it comes down to that cost-benefit analysis. It's just a horrible way to treat human beings, but we don't have anything better in this moment. We don't have better solutions. So I'm sure that kind of takes its toll.
Ashley: It's really challenging. I always have really high expectations of my patients. Cause I come in, I'm like, “Alright, I know what's going on. Let's fix that. I see your potential. I want you to reach that potential.” And I just ram myself into the wall over and over again, trying to get them there. But at a certain point, I have to sit down with them and have this conversation of, “I'm the only one doing work in this room. So you either start doing the work or you need to get out.”
At some point I have to hold them accountable for doing the work. And if I'm not doing that, I'm helping them stay the same. And yes, it's a difficult conversation to have, but at the same time, it is completely necessary for some people. “We can't just keep dumping resources into you.” Cause that's what it is.
It's transactional, being a human being is transactional. Whatever that looks like. It has to be a give and take. If you don't want to help yourself, why should I want to help you? When we have these people who it feels like we're wasting all of our resources on them, it's because they're not receptive. They're not putting in the work. They want you to fix them. One of the things that really frustrates me is when someone gets angry at me and they're saying, “Why aren't you fixing me?” That's the problem right there. You have to want to do this.
Casper: That was something that was a hard lesson for me to learn after probably a decade of working with folks in prison was when I heard the line, this sunk in so hard for me, like “Never do anything for anybody that they can do for themselves.” That was such a hard lesson for me to learn because I finally realized I was in some senses infantilizing people.
Where they would come to me and they'd be like, “I have this problem. Can you help me through it?” And my instinct is always, “Yes, of course, I'll do whatever I can to help,” but then the same issue would come up and I would just be doing it again for them instead of teaching them, “Here's how you can do this on your own” sort of thing.
And then that became extremely exhausting for me. So in some senses, it's like you have to help people start taking responsibility to be able to do this on your own while being a good support system and being a cheerleader for them, but being like, “You can do this and I know you can do this. So let's work together to make sure that you can do this going into the future.”
Ashley: I mean, what sounds more infantilizing as you're speaking, it really makes me think of my role as a psychologist. And a lot of the times, it is being a parent. It is modeling quote unquote pro-social things. It's teaching them how to cope better, how to interpret things better.
It's giving them empathy and support and a feeling of belonging and being seen by another person. Going back to the trauma thing, a lot of it is attachment related. Other people are scary, the world is dangerous. I'm vulnerable. It's about re-parenting sometimes.
It's good to be mindful that you can take on too much. What's that stupid metaphor, addage or whatever, of teaching a man to fish, something like that. That's what it is.
Casper: That's really difficult. Cause a lot of people have not had good familial relationships. A lot of times we will see folks who are telling us stories of growing up in households where both parents were absent, who have not learned good interpersonal skills, do not know how to form good bonding relationships with people and having to take it back to a kindergarten level and teach skills that we will hope people learn in their formative years that people have not learned as an adult. It's a very tricky issue.
Ashley: That also goes back to something else that we were talking about, having empathy for people incarcerated, how do you bridge that gap?
Part of it is really understanding that piece where this person legitimately did not learn that. They didn't learn to self-sooth, they didn't learn how to be comfortable with another person. They didn't learn how to have boundaries with other people. They didn't have food on the table.
So they started stealing when they were young. People take for granted that these normal things, that quote unquote, make us civilized, those are taught and they're modeled by other people. If you don't have that, you can't really expect that person to just automatically pick it up.
Casper: Do you feel like in your sessions with people, you do have to take things back to the basics a lot, or explain things that we do take for granted a lot of times?
Ashley: Yes and no. Again, part of this comes down to motivation, wanting to be different. I have some great patients who are honestly, probably better people than I am sometimes. They see that something is off and they try to learn it. They glean onto people who emulate those behaviors that they want, or that they've seen but for a lot of people, I do have to really start at the basics where it's like, “Hey, do you know that whenever you are sad, you become enraged and you start assaulting people verbally? Did you know where that comes from? Did you know that every time you get depressed, you start using methamphetamine? Let's talk about where that comes from and how you can do that differently. There are other options.”
Casper: And I think a lot of it stems from having people you can talk to and communicate with and be truthful with about your feelings and your emotions and the things that have happened in your past.
And it seems like so often that’s just non-existent and it's amazing to me that in the world that we live in, more of us don't snap and go completely crazy.
I feel like this was an amazing conversation and thank you so much for coming in and doing this with us.
Ashley: You're welcome.
I don't know what percentage of people in prison to attribute that sort of mentality to. This is a very complex issue, but I don't know what amount of people in prison really do not need to be there. And what amount of people in prison we can really work with, and what amount do not want help, do not want to change. Is that an issue that you grapple with?
Ashley: It is definitely an issue that's just inherent in being a psychologist. You come to me, you have a problem. You either want to change or you don't. I run a couple of groups and someone asked me, “Well, how many of your patients recidivate?”
It completely varies year to year. But I said, “I don't know the answer, but I do know this. I know when I can feel when people aren't going to quote unquote recidivate, because they've made the choice to be different. You can feel it in them. They've made a conviction to not live this lifestyle anymore.”
And you can feel that as a psychologist, you can feel when someone is open and receptive to what you're saying, even if they’re like arguing with you. “That's not true. No way. I don't distort my perception.” They come back a week later like, “Well, actually I do that.” I've come across patients who don't want help. They want someone to, as my old supervisor used to say, “Don't let anyone come into your room, just throw up, feel better, leave and then come back and do the same thing.” Which is essentially, they're just using me to absorb all of the bad things that are in them, not wanting to change anything, but just wanting to displace it onto another person.
I've definitely had the thought of, “You really belong here. There's nothing getting through to you. It's bouncing off of a wall,” and there are people who I've had like that, who two years down the line something's stuck and something cracked the facade. Yes, there may be people who indefinitely belong in prison.
But I think more often than not, we say that about people who actually do have a chance. We just haven't given them the time or the resources.
Casper: And then it comes down to how many of our resources do we extend to a single human being, which is a horrible thing to have to consider.
But it is a reality, where it's we could put this person in a really intense therapy and we could work with them for years. And then that person could heal and grow and learn. But when you're working with thousands of people and you only have a couple people willing to do this kind of job, it comes down to that cost-benefit analysis. It's just a horrible way to treat human beings, but we don't have anything better in this moment. We don't have better solutions. So I'm sure that kind of takes its toll.
Ashley: It's really challenging. I always have really high expectations of my patients. Cause I come in, I'm like, “Alright, I know what's going on. Let's fix that. I see your potential. I want you to reach that potential.” And I just ram myself into the wall over and over again, trying to get them there. But at a certain point, I have to sit down with them and have this conversation of, “I'm the only one doing work in this room. So you either start doing the work or you need to get out.”
At some point I have to hold them accountable for doing the work. And if I'm not doing that, I'm helping them stay the same. And yes, it's a difficult conversation to have, but at the same time, it is completely necessary for some people. “We can't just keep dumping resources into you.” Cause that's what it is.
It's transactional, being a human being is transactional. Whatever that looks like. It has to be a give and take. If you don't want to help yourself, why should I want to help you? When we have these people who it feels like we're wasting all of our resources on them, it's because they're not receptive. They're not putting in the work. They want you to fix them. One of the things that really frustrates me is when someone gets angry at me and they're saying, “Why aren't you fixing me?” That's the problem right there. You have to want to do this.
Casper: That was something that was a hard lesson for me to learn after probably a decade of working with folks in prison was when I heard the line, this sunk in so hard for me, like “Never do anything for anybody that they can do for themselves.” That was such a hard lesson for me to learn because I finally realized I was in some senses infantilizing people.
Where they would come to me and they'd be like, “I have this problem. Can you help me through it?” And my instinct is always, “Yes, of course, I'll do whatever I can to help,” but then the same issue would come up and I would just be doing it again for them instead of teaching them, “Here's how you can do this on your own” sort of thing.
And then that became extremely exhausting for me. So in some senses, it's like you have to help people start taking responsibility to be able to do this on your own while being a good support system and being a cheerleader for them, but being like, “You can do this and I know you can do this. So let's work together to make sure that you can do this going into the future.”
Ashley: I mean, what sounds more infantilizing as you're speaking, it really makes me think of my role as a psychologist. And a lot of the times, it is being a parent. It is modeling quote unquote pro-social things. It's teaching them how to cope better, how to interpret things better.
It's giving them empathy and support and a feeling of belonging and being seen by another person. Going back to the trauma thing, a lot of it is attachment related. Other people are scary, the world is dangerous. I'm vulnerable. It's about re-parenting sometimes.
It's good to be mindful that you can take on too much. What's that stupid metaphor, addage or whatever, of teaching a man to fish, something like that. That's what it is.
Casper: That's really difficult. Cause a lot of people have not had good familial relationships. A lot of times we will see folks who are telling us stories of growing up in households where both parents were absent, who have not learned good interpersonal skills, do not know how to form good bonding relationships with people and having to take it back to a kindergarten level and teach skills that we will hope people learn in their formative years that people have not learned as an adult. It's a very tricky issue.
Ashley: That also goes back to something else that we were talking about, having empathy for people incarcerated, how do you bridge that gap?
Part of it is really understanding that piece where this person legitimately did not learn that. They didn't learn to self-sooth, they didn't learn how to be comfortable with another person. They didn't learn how to have boundaries with other people. They didn't have food on the table.
So they started stealing when they were young. People take for granted that these normal things, that quote unquote, make us civilized, those are taught and they're modeled by other people. If you don't have that, you can't really expect that person to just automatically pick it up.
Casper: Do you feel like in your sessions with people, you do have to take things back to the basics a lot, or explain things that we do take for granted a lot of times?
Ashley: Yes and no. Again, part of this comes down to motivation, wanting to be different. I have some great patients who are honestly, probably better people than I am sometimes. They see that something is off and they try to learn it. They glean onto people who emulate those behaviors that they want, or that they've seen but for a lot of people, I do have to really start at the basics where it's like, “Hey, do you know that whenever you are sad, you become enraged and you start assaulting people verbally? Did you know where that comes from? Did you know that every time you get depressed, you start using methamphetamine? Let's talk about where that comes from and how you can do that differently. There are other options.”
Casper: And I think a lot of it stems from having people you can talk to and communicate with and be truthful with about your feelings and your emotions and the things that have happened in your past.
And it seems like so often that’s just non-existent and it's amazing to me that in the world that we live in, more of us don't snap and go completely crazy.
I feel like this was an amazing conversation and thank you so much for coming in and doing this with us.
Ashley: You're welcome.
OUTRO
We’re so happy to be able to speak with Ashley today. Sitting down and really diving into the work of someone who sees prisons through a different lens helped us understand why some of our friends experience the things that they do. Gaining insight on all aspects of the prison system lets us look at exactly what needs to change. Hopefully her words get you thinking about how there isn't such a big separation between people we deem reputable and those who we silence.
Thank you to everyone who made this podcast possible. Shoutout to the Bay Area’s finest tattoo artist and my wife, Brett Baumgart, for their eternal support and assistance with every endeavor we pursue. Special thanks to our Teleway Conductors, Trig, L.A., Ollie, Caroline, Nic, Emma, Aryn, and Jo for their countless hours spent ensuring that we can provide a voice for those that have been silenced. Our Patreon supporters help keep the Teleway fueled and running smoothly. Thank you to Darrius, B, Carla, Daphne and Catherine. If you would like your name read in a future episode, become one of our Patrons at patreon.com/abocomix. To find out how you can contribute to our cause, visit abocomix.com. That’s a-b-o-c-o-m-i-x.com. Next stop, Sirbrian Spease in New Jersey.
Thanks for riding Teleway 411. Please remain seated as the Teleway proceeds forward in T-minus 3, 2, 1.
*Teleway startup*
Thank you to everyone who made this podcast possible. Shoutout to the Bay Area’s finest tattoo artist and my wife, Brett Baumgart, for their eternal support and assistance with every endeavor we pursue. Special thanks to our Teleway Conductors, Trig, L.A., Ollie, Caroline, Nic, Emma, Aryn, and Jo for their countless hours spent ensuring that we can provide a voice for those that have been silenced. Our Patreon supporters help keep the Teleway fueled and running smoothly. Thank you to Darrius, B, Carla, Daphne and Catherine. If you would like your name read in a future episode, become one of our Patrons at patreon.com/abocomix. To find out how you can contribute to our cause, visit abocomix.com. That’s a-b-o-c-o-m-i-x.com. Next stop, Sirbrian Spease in New Jersey.
Thanks for riding Teleway 411. Please remain seated as the Teleway proceeds forward in T-minus 3, 2, 1.
*Teleway startup*