Community Mental Health: The Role of Church and Temple by Howard J. Clinebell, Jr., (Ed.)
Howard J. Clinebell, Jr., is retired professor of Pastoral Counseling, School of Theology at Claremont, California. Published by Abingdon Press, New York, Nashville, 1970. Used by permission. This material was prepared for Religion Online by Ted & Winnie Brock.
Chapter 17: The Religious Community and the Returning Inmate by Thomas W. Klink
"Inmate" is not the usual term to identify a patient in a mental hospital. It is not the familiar term to describe youngsters in correctional institutions or, usually, the term for adult prisoners. But it does have the virtue of being generally applicable to persons who spend some significant segment of life within an institution. This paper concerns the functions of religious communities -- churches and congregations -- in the effective reintegration of inmates into the open community. Thus, this paper deals with the "tertiary preventive" segment of a comprehensive system of care -- that is, those efforts which tend to reduce the likelihood of a recurrence of disorder.(Gerald Caplan, Principles of Preventive Psychiatry [New York: basic Books, 1964], pp. 113-27.)
Inmates discover that returning home can be a complicated and frustrating process. Two collect prayers, products of ministry to inmate congregations, reveal the complexity of the process.
"Almighty God, loving Father of us all, we acknowledge before Thee our shortcomings and our impatience. We know so much in solitude. We fall so short of making others understand. Forgive us our isolation behind the walls of fear and doubt, for with Thee and Thy people there is that love which is perfect understanding. Perfect love casteth out fear. Give us the grace to communicate ourselves and the patience to wait for healing understanding."
The second prayer reveals the inner experience of being an inmate.
"Oh, God, the strength of those who suffer and the repose of them that triumph, we rejoice in the communion of saints. We remember all who have faithfully lived, all who have passed on into Heaven. We remember especially those who have been important to us. We have not always lived true to their ways. We have found that their ways are not our ways. We have tried to be more obedient to them than to Thy living spirit. We have borne the burden of bondage to the past. Forgive us our missteps. Grant us the freedom to stand strong in our heritage, and the wisdom to discern the newness of Thy creation in us.
Although there are important differences among inmates, there are two similarities: all have been inmates, and nearly all return home. These similarities frame the opportunity for the religious community in its service to the returning inmate.
The basic study of the inmate’s experience is Goffman’s Asylums: Essays on the Social Situation of Mental Patients and Other Inmates.(Garden City, N.Y.: Doubleday, 1961.) He discusses the situation of those who spend some time in "total institutions." There are five categories of total institutions: (1) for the care of the harmless but incapable (sick, blind, aging, etc.) ; (2) for those threatening to the community (tuberculous, leprous, and some mentally ill) ; (3) for those against whom the community seeks protection (criminals, political or social deviants, and some mentally ill) ; (4) isolated work organizations (including military posts, boarding schools, work camps) , and (5) organized retreats from the world (monasteries, cloisters, and other asylums)
Goffman’s analysis makes evident the similarity of all inmates: they have been isolated from their pre-inmate world, they have been inducted into another world. Meanwhile, in some degree, something has happened to the world "outside." The dogs barking at the returned Ulysses or the children ridiculing Rip Van Winkle are symbols of the invariable changes during a person’s period as an inmate (or wanderer).
The dissociation of streams of events is revealed in an excerpt from a pastoral contact with the wife of a mental hospital patient who seeks marriage counseling:
"We tried so hard not to have John go to the hospital, and then it just couldn’t go on and he went and you have no idea how we’ve had to scrimp to make it possible, but we managed by everybody taking an extra load. But after a while John’s letters were disinterested. He seemed to have found a place for himself in the ward. He’s coming back home weekends now but he seems in a hurry to get back. He doesn’t seem to appreciate how we’ve taken over his load. Last Saturday, Reverend, he called to say he would be discharged in two weeks, but he wouldn’t be home this Sunday because his ward government group was in charge of an open house for an infirmary ward at the hospital. (And here she breaks down into tears.) What do you think has happened?"
A comparable insight into the effect of separation is found in the following statement to a parish clergyman by a paroled prisoner returned to his family after eighteen months in an adult correctional institution:
"Reverend, I thought I was better off than some guys. My wife stayed steady; no divorce, no running around. She kept the station open. She hired some help. She cared for the kids. She even managed to get the lawn mower started once or twice. I am so grateful I can’t see straight. That’s what gets me about how mad I get about little things. I’ve never felt so angry before as about a little thing that’s going on now. I wonder if I am going off my nut. While I was gone she and the boys rearranged the seats at the dinner table -- it sort of makes sense -- closer for her to the kitchen and to the phone but my old place is gone.
Such quotations illustrate rather than exhaust the significance of the inmate phase of a treatment or correction process. It may be hard to believe -- given our preconceptions about hospitals and prisons -- but, however well-staffed or ill-programmed, such institutions are organized societies. For inmates who have been alienated from the larger society the institutional society may often be more satisfying or secure. The religious community or clergyman who would be of help to the returning inmate or his family needs to be aware -- as in the illustration above -- that a weekend pass at home may be less attractive than responsible participation in a ward project.
If we can understand the positive involvements in an inmate society we may also be able to understand its negative results, the recidivists or chronic inmates. They are a small but important minority who cannot tolerate having their human needs for food, shelter, work, and companionship satisfied unless they can at the same time be mutinously hostile at the personal or institutional provider. The dynamics of such nursing and biting by immature persons makes it clear that pastoral or religious services to inmates must support a redirection of hostility as well as meeting their needs.
Motivation for the clergyman or religious community is important in insuring effective service to returning inmates. Easy and presumptuous compassion, undisciplined pity or guilt, even "love" are poor motivations for significant work. The process of re-adaptation for nearly all inmates involves stressful work which he alone must be encouraged to do. Those who would be of service to him must be willing to administer a tolerable dose of such strong medicine fully as much as they are moved to be "his friend." (See T.W. Klink, Depth Perspectives in Pastoral Work [Englewood Cliffs, N.J.: Prentice-Hall, 1965], p. 58.)
The religious community dare not presume that to be released is an unambiguous occasion of joy or achievement. Ex-inmates need frank, open responses. They need to be free to reveal, for example, "just how crazy-mixed-up I was and what happened to me in the hospital," or "how tempted I am by the non-responsiveness of the new outside world."
A church men’s group went to a weekly prisoner-citizen fellowship meeting in an adult prison. They were made uncomfortable by, "how unfair the law is which demands a prisoner have a job or a sponsor before he can be discharged even though he has been approved for parole." In their guilt and anxiety this group volunteered to be a sponsor. When the discharged prisoner was fired from his first job for abusing fellow employees, the group increased financial assistance! When he met their visitor at his living quarters drunk, they bought him a coat! When he wanted to break parole conditions by taking a job as a cab driver, the vocational circumstances which led to this original troubles, they intervened with his parole officer. It was only when they discovered, with help from the prison chaplain, how guilty and angry their motivations were for dealing with this man and how immobilized they were in responding rather than giving that they were able to discover limit setting, goal setting, responsive listening. Then they found more charitable pastoral acts than just destructive guilty giving.
An inmate prayer from a psychiatric hospital reveals this desperate need for responsiveness:
Our Father, God, whose watchful care extends to the least of Thy creatures, to the utter-most parts of the earth, we confess our temptation to feel neglected. We have been in need, and our needs have seemed not to have been met. We have done wrong and our wrong-doing has gone unpunished. We have set forth plans and our dreams have aroused no enthusiasm. We acknowledge our temptation to feel that there is little response to us. Forgive us for blinding our eyes to the fullness of Thy response. Understand our efforts to carry on a dreary monologue. Restore us to confidence in Thy patient attentiveness, to all that we do, or need, or dream. Amen.
Inmates are the butts of very traditional, often derisive humor. Such humor is revealing, not obscene. They have been "drunk," "crazy," "in jail," or "in the clink." Ex-inmates know the quality of humor. Until the religious leader or community can be free to accept such humor we will be as stiff and unhelpful as starched and fearful Gray Ladies passing Kool-Aid across a table at a ward bingo party.
This is a creative pharmaceutical age. Thousands of modern inmates are able to leave hospitals because of regular and often continuing dosages of anticonvulsants, tranquilizers, energizers, hormones, or alcohol-sensitive compounds. I have met a few exinmates back in hospitals because they have heard such wonderful potions derided at church or from the pulpit as evidence of modern corruption, comparable to subway rapes or God-is-dead theology. A minor but not insignificant element in the function of the religious community with the returning inmate is its understanding of the functions of drugs.
The inmate’s situation is fraught with ambiguity. For example, Mr. A. has a serious drinking problem. Once, this was dealt with punitively (a police charge for driving-while-intoxicated) His family was puritanically religious; he knew that they regarded his drinking as a sin. This led him to seek pastoral help to "put down the devil." His enlightened religious leader properly rejected this idea and encouraged him to seek help for a medical-psychological problem. In the alcoholic treatment institution he was exposed to a group-oriented program in which his problem was identified as properly shameful before the official group standards.
Most inmates have experiences comparable to Mr. A’s. They meet an ambiguous or conflicting set of evaluations of their trouble. Hopefully, by the time of their discharge, some dominant judgment has emerged. But as they return to the community they meet the varied or ambiguous judgments again. They need support in maintaining that judgment which has proved most useful for their recovery.
Treatment institutions are intended to change inmates. It is not easy to change, we all know that; inmates are no exception. Inmates resist the power of the treatment institution to effect change. A subtle and universal device for resisting genuine change is to accede to change because somebody or something bigger or stronger is making you change. At least that defers the issue of stable change until the power of the institution is withdrawn at the time of discharge. At that point, when the institutional supports and sanctions, group encouragement, and/or behavior reinforcements terminate, the inmate emerges into the arena of personal choice. Rarely can a clergyman or religious community pick up the change-supporting function of the treatment institution. What can be done is to support and aid the exinmate to make the changes his own rather than those which have been forced on him by the power of law, drugs, confinement, shock therapy, or control of privileges. To be free is never easy, but no group or individuals should be more prepared for aiding others to use freedom than clergymen and religious institutions who teach or preach of the yetzer tov and the "grace of God."