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Behavior Modification Treatments for Addicts and Their Limitations

Foucault, Michel Foucault

There are many ethical and philosophical arguments I’m tempted to make against the use of behavior-modification techniques on adult prisoners and mental patients. That’s not the first issue we are looking at here. The most compelling objection anyone could make is that behavioral approaches simply don’t work all that well on adult humans. While drastic short-term behavioral changes are often observed, these changes tend to fade rapidly after the incentives for change and penalties for misconduct are removed. “At best, behavior modification results in temporary token changes by the criminal.” (Samenow, 1984, pp 199, 200)

Some of the modern therapeutic communities employ a more sophisticated cognitive dissonance based system of behavioral psychological control. In these programs, the subject in fact must do a great deal of guesswork to determine what pattern of behavior will gain the reward, and avoid the negative stimuli. Compliance is punished just as much as rule-breaking is, albeit usually with a different form of penalty. Subjects who appear compliant are constantly suspected, and often punished for manipulation via compliance. Even those who have the sincerest intentions find that their best efforts amount to nothing. Compliments and encouragement from staff are rare, and even though positive acknowledgment from peers is encouraged by the program, the words of fellow criminals are of little comfort to many. Rewards come without warning, seemingly at random intervals. The consistency of punishment and apathy from the controllers is broken by this interval of apparent kindness and decency, and the emotional impact is much greater than that of a consistent pattern of rewards. In these situations, many give up hope.

Among those who survive, a core of loyal, thoroughly brainwashed fanatics or “TC warriors” as they are sometimes called, develops. Almost indistinguishable from this group is another, larger group of survivors, who find self-esteem in the refinement of their “game,” knowing that they have in the process of treatment become more sophisticated and self-disciplined criminals. How this serves society, or the unsuccessful majority of persons entering, and then leaving before completion these programs, I fail to see. The punishment itself is grounds for these programs popularity with criminal justice functionaries. What these approaches succeed in doing is creating misery and degradation that serves only a political purpose. This approach makes programs look “tough.” The objections many participants in these programs raise, and the overall level of discomfort, conflict, and general despair these programs generate in their initial phases makes them palatable to the most conservative politicians, judges, DAs, and case managers, not to mention parole officers. When I was in court for sentencing on a drug charge, a Denver DA recommended the Therapeutic Community at Arrowhead Correctional Center to me, stating that I had a good chance of sentence reduction if I completed it. The tendency of Colorado judges to sentence drug offenders to Denver Colorado’s Peer-1 is well known. When my co-defendant was sentenced, the judge tacked on two years of Peer-1 at the end of his sixteen-year sentence. The unimpressive track records of these programs seem not to matter. The punitive aspects are enough to satisfy these officials. A political and moralistic/religious agenda, certainly not the healing of any given individual is the purpose of the traditional TC, as it is seen by criminal justice system.

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None of this is anything new really; as Dr. Samenow also points out in Inside the Criminal Mind, a lot of these techniques are centuries old (See also, Discipline and Punish: The Birth of the Prison, by Michel Foucault). Why their overall ineffectiveness has not set them to rest by could only be explained by the other purposes they serve. In a sense, substance abuse treatment exists as “virus mechanism,” simply because it can. In prison, there is little pretense about the purpose of the rules; they are just there to “keep order” as far as the enforcers are concerned. The general safety of an institution and its overall sociopolitical climate, in my experience, reflect to a great degree the priorities and beliefs of the administration. Here in Colorado, in spite of the increasingly right-wing political climate of the state during the reign of Governor Bill Owens, I have encountered a surprisingly large number of prison staff members, from bottom-level corrections officers to wardens, who actually, as evidenced by their statements and behaviors, were trying to help inmates. They seemed to believe sincerely in the increasingly disfavored idea of rehabilitation. While I have done some “hard time,” by the standards of the Colorado prison system, the nightmarish reports that emerge from places like California, New York, Texas, and other states in the deep south and southwest make what I have been through seem soft. In either of these settings however, the long-term behavioral changes that are seen are more often the result of prison culture, than of the institutions’ efforts. Changes that take place in the personality of a prisoner may linger for a long time after release from the institution. However, “deterrent” is a harder concept to prove. The idea that repeated consequences applied to a behavior will correct the behavior is directly contradicted by the high rates of recidivism associated with most traditional prisons. What most people learn, which even most house cats have the ability to reason out, is how to behave when they are being watched. It is relatively simple for an adult human to discern the source of the stimuli required for operant conditioning. Yet professionals cling to this mythology in spite of all the evidence that exists to the contrary. The reason for this may be the sheer simplicity of the treatment, the immediate measurability of the treatment’s effects, and the ability of relatively uneducated and poorly paid individuals to administer it. (Dineen, p119) What my own experiences have shown me is that even relatively sophisticated approaches to correcting criminal behavior and illegal drug use are only effective when the individuals being treated and the program’s staff have sincerely shared common goals. Patterns of drug consumption and/or criminality are nearly impossible to coercively correct. In the case of “drug abuse,” however self-destructive this behavior may be for certain individuals, coercive modification by the state or persons subcontracting with the state, imply ownership of the individual’s body and mind (see Szasz, 1984) by the state. Even the most well-intentioned treatments are intolerable, if ownership of individuals by persons other than themselves is the result.

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References:

Dineen, Dr. Tana
Manufacturing Victims: What the Psychology Industry is Doing to People, 1996,
Westmount, Quebec, Canada,
Robert Davies

Foucault, Michel
Discipline and Punish: The Birth of the Prison, 1977,
New York, NY Random House/Vintage

Samenow, Stanton E. PhD
Inside the Criminal Mind,
1984, New York, NY
Random House

Szasz, Thomas:
Our Right to Drugs: The case for a Free Market, 1992
Syracuse NY Syracuse University Press,