CHAPTER 6 The California rehabilitation center

Material in chapters 6, 7, and 8 was collected while the author was a consultant and research sociologist at the California Rehabilitation Center, Corona, California, from 1964 to 1966.
The views expressed in this publication are those of the author and do not necessarily represent those of the California Rehabilitation Center nor of the California Department of Corrections.

IN POPULATION, CALIFORNIA IS THE LARGEST STATE IN THE union. It has newly arrived to that status as a result of the explosive migration there in the last few decades. The very newness of this vast, mobile population, with its rootlessness and lack of tradition, provided a climate conducive to the development of relatively progressive public programs in the early 1960s. The southern part of the state is sprawling and especially new. Los Angeles, which epitomizes this as a city, has a large population of uprooted lower and working-class Mexican-Americans and Blacks who are unskilled and unemployed. It is close to Mexico with its long, unpatrollable border. These conditions combine with others to effect a sizeable underworld traffic in marijuana and heroin.

It was Southern California which saw the birth of Synanon, a totally voluntary organization for addicts who want to conquer their addiction without legal sanctions or state supervision.' It was also Southern California which gave birth to the California Rehabilitation Center, a state-operated institution designed specifically to handle the criminal addict population of the state. Its character was fashioned and styled by the progressivism of the state administrators of the period.

The California Rehabilitation Center (CRC) is strategic for study not only because it is the first large institution of its kind, but also because it has served and will serve as a model for other states with a narcotics problem. At the present, New Jersey has already followed the model of CRC; and Illinois is looking over the program with careful interest. Ideally, the plan is to separate the addict population from other criminals locked up in prisons, and to administer a separate kind of therapeutic treatment designed particularly for the addict. The two federal hospitals at Lexington, Kentucky and Fort Worth, Texas are quite different in that they are primarily voluntary. At CRC, most of the inmates, called "residents," are convicted felons who have been rerouted and committed to this special institution for addicts. During the period that this study was conducted, from early 1964 through 1965, the population was in the vicinity of 1,300 residents. The figure fluctuates by several score in each direction due to the rate of release and commitment and/or return. The ratio of males to females is roughly 6 to I.

Despite its title and selected euphemisms about its operations, CRC is a prison in almost every sense of the word. Well over 90 per cent of the inmates were brought in after a conviction, involuntarily. As in every prison, the custodial function takes precedence over every other function. The larger society, at all critical points, demands this. Whenever there is an escape, the public's reaction insures that the custodial wing of a prison gets tighter control and more power, while those primarily concerned with treatment must bend and accommodate. The therapeutic part of the program, which is an explicitly stated reason-for-being of the institution, is dramatically curtailed by the very context of the institutional setting.

For example, an important part of normal life outside of prison walls is the decision-making ability and the consequent independent action of the individual. If a prisoner is to be "rehabilitated," he must be "trained" in doing those normal and essential tasks of life as lived outside the prison. It is normal in the world to have the opportunity and ability to express an independent identity through distinctive manners of dress, form, style, and speech. It is normal outside the prison to have an occupation through which one achieves a clear position in the world vis-a-vis others. It is normal outside of the prison to have sexual interests and pursuits, and to have the occasional realization of them.

Before turning to those features of the Rehabilitation Center which are unique, it is important to relate those things which it has in common with other prisons. The normality of sexual contact, the expression of independent identity through appearance, dress, and occupational distinctiveness are all nullified systematically. For the inmate to be given more normal responsibility means that he will not be programmed as carefully. If he is not programmed as carefully, his chances for escape are greatly increased. If the chances for escape are greater, a few will take advantage of the situation and escape. Once the public hears of an escape, all of the forces of reaction are mobilized against the institution in order to force it to strengthen security. This means that the inmate must be watched more carefully and programmed more completely. This destroys his ability to exercise the "training" in assuming the responsibility so vital to his "rehabilitation," and the program therefore contains intrinsic strain that is the seed of its own increasing custody and decreasing ability to rehabilitate.' These things CRC has in common with all other American prisons. Later, focus will turn to those things it holds in common with other total institutions, as well as to its uniquenesses on both counts.

Physical Setting

The Rehabilitation Center is located in the Norco-Corona hills, in natural seclusion from the neighboring towns of the area. The administrative and women's units are housed in architecturally interesting structures at the top of the hill. The building used by the administration was first opened in the 1920s as a resort area for a Southern California exclusive social set of the period. With the coming of the Depression, this use lapsed until World War II, when the military took over the whole and constructed rows and rows of army-type barracks in an intermediate valley below the old resort area. These barracks, twenty-three in total, accommodate most of the residents.* After the War, the premises on the hill lay unoccupied for several years. When the Rehabilitation Center personnel moved in during 1960-61, extensive renovation was required. Landscaping, gardening, and work on the exterior have continued to the present, providing work activity for many of the residents.

The 1,100 men live below in the barracks. Each residential unit houses about sixty men. The barrack-dormitory is not only the basic living unit, it is also the basic therapeutic arena. Each barrack has a counselor who works in the barrack eight hours a day, five days a week. During the remainder of the time, the custodial staff rotates and has complete control. Even while the counselor is on duty, the custodial staff is present, and this provides for a measure of strain and conflict built into the system that is to be reviewed.

The 200-250 women in the institution live in a setting more like a college dormitory. They are housed in a brick building across from the administration, and live in small rooms, usually four to a room. Unlike the men's situation, the residential unit does not at all coincide with the therapeutic unit, and the consequences of this for administration and control are remarkably different.

The resident has an eight-hour day in which he is engaged in moreor-less required activities. Four hours are spent in either a work-group, training, or formal education. Work may consist of preparing earth for planting, driving a taxi around the premises, fire station duty, cooking and kitchen help, waiting table in the cafeteria for staff, and so on. The other four hours are spent in group therapy sessions (one hour), cleaning up the dorm, and recreation. While one half of the institution is doing one kind of four-hour activity, the other half is doing the other. They then shift, and it is possible to observe at any time during the day a large number of residents playing football, handball, or baseball while another large group is watering, mowing the lawn, digging, or working with a ground crew. It is during this eight-hour day that the counselor is in the barrack.

Getting Committed to CRC

A little more than half of the inmates of the institution have been convicted of a felony in a County Superior Court (often robbery, sometimes narcotics sales), and after conviction, the judge suspends criminal proceedings and refers for civil commitment to the Center. He may do this if there is evidence that the felon was either an addict or in "imminent danger of becoming" an addict. For a convicted felon, commitment to CRC is certainly not a bad deal. First of all, his sentence there is one to ten years, and the chances are good for release within two to three years under extended parole for the remaining period (assuming good behavior). Second, the atmosphere is more liberal and the freedom of movement for inmates is greater than at any of the medium and maximum security prisons.

Officially, CRC is for the rehabilitation of addicts. However, any observer familiar with the administration of justice in the United States will recognize that the structure of this situation places great bargaining power in the hands of the prosecuting attorney. An armed robber who would ordinarily face say, a twenty-year sentence, can now be offered a deal. If he informs on his contacts in the narcotics black market, the prosecution may guarantee his civil commitment to CRC in return for the favor. Certainly, a plea of guilty is more easily won in these instances because the stakes for the convicted man are clearer. With a twenty-year sentence, he can not be eligible for parole until at least one third of the time is served in prison. That means a minimum of seven years. However, with a civil commitment to CRC, we have seen how his one-to-ten-year investment may allow his parole after twelve to fifteen months. Cooperation in the bargaining with the prosecution is thereby increased even more than in ordinary circumstances.

The deal is not so good for those convicted of a misdemeanor. The maximum prison sentence for such offenses is one year in any case. They have little time to gain by having their convictions suspended and the civil commitment to CRC invoked, since the latter carries with it the one to ten year situation just described for felons. Approximately 20 per cent of those inmates at CRC are in such a circumstance. Many of these are the prostitutes (prostitution is a misdemeanor in California) who were discovered to be drug users or addicts. While they were convicted of prostitution, they effectively serve their time as drug addicts. There is a serious question of a civil liberties or constitutional violation in these cases, and it will some day soon get a review in a high court. These are undoubtedly the bitterest residents in the institution. They have the strong feeling that they have been tricked by the law enforcement people, and have an excess of venom for the whole system, including the therapeutic community conception of the institution. In this investigation, they proved to be the group most hostile to the institution and its goals and programs.

The remaining 25-30 per cent of the inmates are commitments without a court conviction for a crime. Typically, either law enforcement authorities or family members bring such cases to the attention of the courts.

Despite the range of types of commitment sources, the inmates at CRC must be described as predominantly a population with a criminal history. The arrest list for many reads like Pepys' diary, underscored by the fact that the inmates have an average number of three jail terms behind them for narcotics or narcotics-related offenses prior to their commitment to CRC.

Group Therapy and the Therapeutic Community

For one hour, the residents gather for a session of "group," "grouping," or "group therapy." The officially designated time set aside for this purpose is a relatively small part of the day, but the stated policy of the treatment staff is that everything which goes on in the day should have therapeutic purpose and value. The one hour spent in the group session is thus seen as arbitrary focusing on the central reason of the whole program. The work crews, the classroom, the recreation are all considered to be elements of the therapeutic community, and the treatment staff feels that it can not, and should not be set apart. Problems that arise in the rest of the day are to be brought to group, freely and openly aired, discussed, faced, and resolved where possible. The counselor leads each group session. For the men, the group consists of those in the living unit, the barrack. Thus, sixty men come to group at the same time to discuss, challenge, squeal, argue, support, destroy, build, and devastate. The counselors have latitude in deciding how they will run the group sessions. Some require that all residents of the unit attend, and some make no official note of attendance. Some counselors are aggressive and domineering in the sessions simply by force of personality, and they tend to sway the group and control it. Others are relatively passive, and allow the session to go very much its own way.

The women also come together in a central location for group sessions of about sixty under a single counselor. However, an important difference is that the women's group is not living together in a single barrack, but has separate rooms of four inhabitants. The staff readily acknowledges that for the women, the group is therefore far more an artificially constructed one-hour experience than a living part of the ordinary day. For example, if a male complains about something that is going on in the dorm, every other person in the sixty-man group is likely to be part of it by his presence in the larger unit. If the reason for the complaint persists, many members of the group session are likely to become involved in the living experience. However, if a female has a complaint about what is going on in her small living unit of four, and brings this up in a group of sixty, the others are more likely to treat it as a private problem which need have no effect upon them.

Despite the wide divergence of temperaments and strategies of the counselors who guide the groups, there is a common theme that threads throughout these sessions. The theme emanates from the institution's approach to the problem of narcotics addiction, an approach reflecting the reigning interpretation of addiction in society. The common feature of the group sessions is the focus upon the psychic makeup of the individual addict, and the central issue at hand is the motivation of the actor. Sometimes there is an attempt to explain past behavior, but there is increasing emphasis in both the rhetoric and the guidance of the counseling staff to explain present behavior. This concern is appropriately termed the "here and now," parlance borrowed from current usage in psychotherapy. The self-conscious progressivism of the institution and its treatment staff must be contrasted with traditional prisons and traditional institutional treatment in order to be appreciated. Prisons typically deny the inmate any responsibility, autonomy, or decision-making about even the most minute aspects of his personal life. The prisoner is told not only when to get up in the morning and when to go to bed, when to eat and what to eat, what to wear, how long the hair can be, and other routinized features of prison life, but as well, he is told that there are specifically legitimate channels of grievance to handle every conceivable problem. However, at CRC there is an attempt to allow the residents to solve selected problems in an emergent manner within the community. For the men, this means that they may want to bring up in group a problem such as the distribution of towels and soap. Unlike most prisons, where towels and soap are distributed individually to inmates by the staff, in CRC, a counselor may place sixty towels in a dorm and leave it up to the community to solve the distribution problem. If someone hoards, or takes even a small bit more than his share, the sanctions are left to be administered internally. It is the hope that this strategy is more rehabilitative in the sense that it forces participation and communal involvement.

The one-hour group sessions provide the arena for the realization of such a strategy, according to the treatment staff. The towel hoarder must confront the group, during which time he is called individually to account before those with whom he must live a daily life, as a peer. Because the living unit is coterminous with the group for the males, the connection between what goes on in group and daily activities is a close one. The men can bring to bear collectively the implementation of the group session. The extent to which spatial arrangements and ecological patterns determine the nature of the control relationships among people is clearly demonstrated when this situation is contrasted with that of the women. After the women finish with the group session of sixty, they return to the specific problems which attend to group life among four. There is thus a tendency to treat the group as a separate theatrical performance which need have no forced or sanctionable connection with life in the institution.

For example, one male may be the object of intensive scrutiny in one of the sessions, where barrages of questions are fired at him examining his psychic integration and the motivation for his social relationships in the barrack. One of the complaints against him may be that he takes the ping-pong paddle back to his bunk and stores it under his bed. Not only does this behavior affect everyone else in the barrack who wants to play (it would have the same effect among the women), but it can also be observed and sanctioned by any of the other fifty-nine. For the females, the probabilities of control are limited to an additional three.

This is not to say that the men do not feel that they are very much on stage when they are the focus of the group's attention. It is to say that the performance in group for men has more of a consequence after its completion. This is remarkably at variance with traditional prisons, to the point of being opposite. The common saying which captures the spirit and practice of the ordinary prison is "Do your own time." That is, when the prisoner arrives, he learns immediately that the best way to get his time off for good behavior is to stay out of the way of other inmates and to avoid fights, squabbles, and the like. If he minds his own business, he is acting in the maximally efficient manner. There are, of course, times when his own business may coincide with the business of others, in the form of deals for favors, cigarettes, induced or extorted homosexuality, and so forth. However, these activities are always hidden and are never part of the explicit policy that guides the official destiny of the inmate in the prison. He is not supposed to be doing any of these things, and if these things remain officially undiscovered, as they usually do, they have nothing to do with his good behavior and his likelihood for early parole. For a man with a twenty-year sentence, one third off is the critical reality which impinges upon his prison behavior. When it comes to how he relates to the institution, then, it is characteristically accurate to say that he will do his own time.

This is in sharp contrast to the CRC resident's pet phrase, which encapsulates how he feels about the quickest way to get out of the institution: "If you wanta walk, you gotta talk." The residents are poignantly aware that one of the most important criteria for being released is to demonstrate in group sessions that one is aware of the psychic disturbance that the staff feels brought about the narcotic delinquency, and what is more important, that one is able to express in some kind of searching, groping, or perhaps articulate fashion that this is the case. The staff must see some outward sign that the ex-addict is struggling with and mastering his psychic integration problem, the essence of that which is said to have resulted in his addiction. The resident can display this in a number of ways, but he knows that one way is minimal: "you gotta talk" in the group sessions.

Here it will help to clarify the addict's subjective feeling that there is pressure to be expressive if the pathway out of the institution is examined. The staff here has much more to say about when the resident is to leave than in an ordinary prison. In the latter, the inmate knows precisely how much time he must "do" and what "good time" and "good behavior" consist of in behavioral terms. If he has a twenty-year sentence, he must serve at least one third in the prison. The other two thirds is determined by whether he stays out of fights and whether he obeys certain prison rules that are explicit and known, formal and informal.' That is, the whole emphasis in the ordinary prison is upon structuring with great clarity those activities and inactivities which lead to early parole. What one may think of those activities, the lack of humaneness in them, the degradation, the shortsightedness; all of that is a different order of question. The point is that the behavior which leads out is clear, and the individual knows how to do his own time. This is not the case for residents at CRC. A good analogy is the difference between undergraduate and graduate training in the United States.

Matters are very clear for the undergraduate. He knows that if he takes certain courses and passes the exams in them, he will move to the next level. He knows that as he passes through four levels, for a period of four years, he will graduate. He knows because the catalog tells him so. There is a public statement of activities of which he is aware, and which administrators and faculty must honor. Just as with the prisoner in the typical prison, things are relatively fixed. The professor has latitude only in so far as it refers to his single course. The cataloged character of the requirements restricts the malleability of interpretation for all parties, whether it is a prisoner in a penal institution or a student in an educational institution.

Contrast this with the situation of the graduate student, the counterpart of the CRC resident. Graduate studies are specifically ambiguous. The graduate student has no guarantee that his completion of the required course work will lead to a degree. There are activities in which he is required to engage, but there is no assurance that these activities are sufficient. The faculty retains the right to make a judgment about the preparedness of the candidate for an advanced degree—as to whether he is ready. This means that the graduate student must try to figure out what it is that the faculty wants over and above the publicly stated criteria. To be successful, he must find this out in a subjective and intuitive way. There is no catalog publicly honored. The dissertation must demonstrate "individual creativity and scholarship." But the interpretation of what is creative and scholarly is left to the faculty. It is not a matter for public perusal, where anyone can see that an exam has been passed. At what point does the dissertation meet those requirements? As for the preliminary qualifying examinations, when does one ever really display a grasp of a whole field of inquiry? The answer is that this resides in the judgment of the reviewers, and the judgment occurs at some future time, ambiguous and unknown to the actor acting in the present. The same is true for the CRC resident.

The CRC staff is in the position of the graduate faculty. It is not behaviorally clear and demonstrable as to what is meant by demonstrating maturity, or displaying a grasp of one's own essential personality problems. It is not at all clear to the staff, much less to the resident. If it were clear to the staff in cernis of some specific behavior, then it could simply be recorded and published for the residents to read and so accommodate their behavior.

The graduate student is ridden with a kind of anxiety that the undergraduate never experiences in the pursuit of his studies. The CRC resident is ridden with a kind of anxiety that the ordinary prison inmate never experiences in his quest to leave the institution. If it is possible to find parallels in the production of anxiety, it should also be possible to find parallels in the behavioral response. To the extent that a character of the requirements restricts the malleability of interpretation for all parties, whether it is a prisoner in a penal institution or a student in an educational institution.

Contrast this with the situation of the graduate student, the counterpart of the CRC resident. Graduate studies are specifically ambiguous. The graduate student has no guarantee that his completion of the required course work will lead to a degree. There are activities in which he is required to engage, but there is no assurance that these activities are sufficient. The faculty retains the right to make a judgment about the preparedness of the candidate for an advanced degree—as to whether he is ready. This means that the graduate student must try to figure out what it is that the faculty wants over and above the publicly stated criteria. To be successful, he must find this out in a subjective and intuitive way. There is no catalog publicly honored. The dissertation must demonstrate "individual creativity and scholarship." But the interpretation of what is creative and scholarly is left to the faculty. It is not a matter for public perusal, where anyone can see that an exam has been passed. At what point does the dissertation meet those requirements? As for the preliminary qualifying examinations, when does one ever really display a grasp of a whole field of inquiry? The answer is that this resides in the judgment of the reviewers, and the judgment occurs at some future time, ambiguous and unknown to the actor acting in the present. The same is true for the CRC resident.

The CRC staff is in the position of the graduate faculty. It is not behaviorally clear and demonstrable as to what is meant by demonstrating maturity, or displaying a grasp of one's own essential personality problems. It is not at all clear to the staff, much less to the resident. If it were clear to the staff in terms of some specific behavior, then it could simply be recorded and published for the residents to read and so accommodate their behavior.

The graduate student is ridden with a kind of anxiety that the undergraduate never experiences in the pursuit of his studies. The CRC resident is ridden with a kind of anxiety that the ordinary prison inmate never experiences in his quest to leave the institution. If it is possible to find parallels in the production of anxiety, it should also be possible to find parallels in the behavioral response. To the extent that a graduate program is not fixed, graduate students spend that much more of a proportion of their time trying to convince the staff that they are committed, or some other such attitude with which they can display to indicate that they should be chosen. Surely enough, CRC residents spend that much more of their time concerned with the appearances of commitment than do prisoners who are doing time. The group session is the part of the day when such commitment activity is most appropriate. To talk, to engage others in reflective and penetrating probes is to display a commitment in the direction that is believed to be most rewarding. It is the path out, and whether it is thought to be most rewarding because of its use as a technique to fool the staff or its use to understand the self is not at issue here. The point that is to be emphasized is that the residents feel the pressure to actively engage in the lives of others via the communal character of the group and group life. It is a shift from the traditional method that has some dramatic consequences.

One of the striking things about the institution has been the enthusiasm of the staff members for the desirability and effectiveness of the group-therapy program. There is typically a great deal of cynicism by staff members in other total institutions (regular prisons, mental hospitals, army barracks) as to the desirability and effectiveness of the program. The treatment people at mental hospitals and prisons often seem to have doubts as to the good, much less the effectiveness, of what they are doing.4

In these first years, the treatment staff of the Rehabilitation Center has been very committed to the group-therapy program. They rely heavily upon psychological interpretations of the residents' behavior, and their commitment seems to be based on the belief that this interpretation is the key therapeutic device.

After the first three weeks in the institution, the new resident takes an examination to determine his scholastic achievement level. If he tests out at a grade of over 8.5, which is the equivalent of about a high school freshman, he may choose to go into vocational training provided by the Rehabilitation Center. In the early stages, this consisted of training in upholstering, certain kinds of carpentry, some painting, and allied pursuits. There is a plan to expand the alternatives of the training. If the new resident scores below 8.5, he is strongly urged to go to the school within the institution for classroom instruction. The educational program is tied in with the local public school system, which allows the successful student to be granted a diploma from that system. The student attends classes daily, and pursues studies in a manner which is an attempt to approximate the normal classroom.

CRC and the Rehabilitation Issue

Following Goffman's usage, the California Rehabilitation Center is a total institution.5

When we review the different institutions in our Western Society, we find some that are encompassing to a degree discontinuously greater than the ones next in line. Their encompassing or total character is symbolized by the barrier to social intercourse with the outside and to departure which is often built right into the physical plant, such as locked doors, high walls, barbed wire, cliffs, water, forests, or moors. These establishments I am calling total institutions. . . .6

One of the essential characteristics of large total institutions is that masses of people (1,30o in the case of CRC) must be systematically mobilized through bureaucratic organization to do such things as eat, sleep, and wash, in a coordinated and orderly fashion. From this, other things follow. The first problem of the administration of the institution is to accomplish these massive tasks with some efficiency. As Goffman points out, the staff is therefore very much concerned at the very outset with surveillance, in seeing to it that everyone behaves in the properly coordinated manner. The trouble-maker is the individual who spoils this mass social ordering of behavior by being late, or in any way by being individually deviant in these essential efficiency-producing procedures. The point is not that the staff is replete with intolerant personalities. The point is strictly sociological: the structure of relationships forces a degree of intolerance of individualistic behavior in basic matters of everyday living. It is a structural problem that all total institutions have in common, CRC not excepted. There is always the staff-inmate split which transcends the mere roles of the two parties. It is more than simply a difference between two groups who have clearly different positions to maintain.

The entrance of the inmate into the institution meets several of the conditions of a successful degradation ceremony." The individual is stripped of the most typical appearances of a unique identity and is confronted with a proliferated set of rules that are to be mastered immediately. His early success is measured in these first encounters, or other situations covered by procedural handbooks. As he proceeds in the institution, the resident learns that as long as he stays within the boundaries specified in the rules, it is the treatment staff that he must primarily deal with and not the custodial staff. That is, the treatment staff has a superior structural position so long as the life of the resident does not cross over normally routinized parameters of everyday life.

The fact that the treatment staff has the upper hand in this regard produces an interesting response on the part of many, if not most residents. Simply stated in summary form, it is issued as a challenge: "If I am psychologically sick and you are so smart in matters psychological, cure me !" Here we find the first important conflict of ideologies between staff and inmate populations. If one is sophisticated in contemporary psychotherapeutic matters, he knows that someone with a psychic problem can be cured only to the extent that he is receptive to the idea of his own committed participation in the therapy. For the therapist to be effective, he must have the cooperation of the subject at least to the point that the subject is willing to conceive of the problem in the same terms.8 The subject, according to psychotherapists, must be willing to introspect, then express. Whether the procedure followed is directive or nondirective is not critical to this basic point. But as Hollingshead and Redlich have pointed out, sophistication about psychotherapy resides primarily in the middle and upper classes.8 The lower and working classes are skeptical and even hostile to treatment that is not more clearly organic. For the lower classes, if one is sick, one goes to the doctor who knows about the sickness. The doctor prescribes the appropriate medicine, and the pill or liquid either works or does not.

The inmate population at the Rehabilitation Center is overwhelmingly working and lower class. The treatment staff population is overwhelmingly middle class. In the Hollingshead and Redlich study, middle-class therapists administering therapy to middle-class patients find relatively little difficulty with the initial point of contact in coming to terms with the problem. The patients accept their role as introspecting and expressing patients, and would be alarmed at an attempt to treat their mental problem organically with, say, pills. Quite the contrary, the middle-class therapists had severe problems of communication with the lower classes of patients, who regarded the psychotherapy as evidence of incompetence, or stalling, or charlatanism, or worse. Where, indeed, is the pill? After a series of such encounters with the patients, the therapists began to prescribe organic treatment systematically for the lower classes. This helps to account for the fantastically distorted proportion of organic treatment of mental illness among the lower classes.' °

There are two important differences between CRC and the mental hospital situations reported by Hollingshead and Redlich. First of all, the CRC resident has a far more forced and continuous relationship with his group therapist. Second, there is a general enthusiasm within the CRC treatment staff for the group-therapy program. Parenthetically, there is no middle-class clientele with which the treatment staff can compare the CRC residents. The treatment staff confronts the resident with only one possible conceptualization of the path to cure, that of the individual's introspection and then expressive communication in the group therapy.

The resident's statement, "Cure me !" is an assertion of ideology. The staff's reply is steeped in its own ideology: "Enter into the therapeutic community in order to cure yourself, and I will watch closely to assess what progress you make." The staff—inmate split inherent in any total institution is thus reemphasized in an additional sphere at CRC. However, there are structural properties peculiar to the institution that produce accommodation rather than conflict. Obviously, the typical inmate wants to get out of the institution. For reasons that have been cited elsewhere, the approval of the treatment staff is critical for early departure, and this approval comes primarily from "good behavior" in the therapeutic community. Whether or not the inmates really believe what they are saying about themselves and others in the group is not at issue here. The important thing is that they realize that they are forced to maintain the appearance of a strong commitment to the therapeutic principles. In the first stages of the resident's entrance into the institution and therefore into the group sessions, he is likely to be hostile and cynical. Afterward, he is likely to take one of two paths. Even if one starts out "playing the game of therapy," a continual daily dose of it can affect the participants greatly. About one third of those who said that they started out cynically about the program later said that they came around to accept the positive and helpful aspects." About 40 per cent indicated that they remained skeptical of utility of the program for themselves, but interestingly enough, most of these said that they thought the program might be beneficial to others.' 2 To the extent that the first one third are being helped by their acceptance and belief in the program, this is a remarkably accurate perception of reality for the more skeptical and cynical.

There is a peculiar consequence of each pathway taken by the inmate. If he remains cynical about the program, he is relatively detached and analytic in his approach to it. From this posture, it is not very difficult to develop some ability to practice skillfully those responses that are asked for by the treatment staff. It is ironic that the detached can be far more expressive as a direct consequence of the glibness that comes from the detachment. The sincere are sincerely struggling and are often reluctant to express an intimate, personal, and potentially self-devastating piece of information before fifty-nine other men, some of whom are covertly hostile to the whole proceedings. This problem comes up significantly in the discussion of the criteria that the treatment staff employ in deciding when a resident is ready to leave the institution.

The Creation of Community, Identity, and Total Identity

A drug intended for one purpose may be quite successful in achieving that purpose, but it often is accompanied by undesirable side effects. The critical problem before the drug researcher is how to develop a pure drug, one free from deleterious side effects that are sometimes more serious than the problem the drug was trying to cure. For example, chloromycetin is a cure for the streptococcic infection, but it also is known to produce the side effect of aplastic anemia in a dangerous number of cases, and aplastic anemia is often fatal."

A social institution faces a similar problem. It may be intended for one purpose, but it may have side effects that are deleterious in and of themselves. In fact, they may be as deleterious as the fatal side effects of some drugs. The trouble, of course, is that while it is very clear when a drug has side effects, the side effects of institutions are very subtle, compounded, and often obscured. The explicit purpose of CRC is to provide an enforced drug-free environment for the rehabilitation of the addict. As has been pointed out, the program is designed to meet the specific problem of the addict, and so he is separated from other prisoners and placed in an all-addict community. The rehabilitation of the addict is seen in terms of his return to normal life outside of the correctional facility, free from drug use or other trouble with the law. This smooth return to normal life is contingent upon two kinds of acceptance. First, the general population must be willing to accept such a return as possible and legitimate, if not normal. This alone is a critical problem that is the subject of much of the rest of this work. There is a second kind of acceptance that is of equal importance: namely, the addict himself must regard his return as possible and desirable. It is with this issue that the therapeutic community becomes so interrelated. The hope of the treatment staff is that the therapeutic community provides the addict with the strong motivation to stay off narcotics, and therefore to stay away from the addict community.

However, the very existence of CRC as a separate institution for addicts, and the very notion of a group session of addicts, reinforce the idea of the addict as a separate kind of person, thereby creating unanticipated and very undesirable side effects. To a lesser extent, this occurs with every prisoner, addict or not, but it is greatly exacerbated by two practices current with the addicts. Ordinarily, the great diversification of a prison precludes the possibility of a consciousness of kind, or a community developing. The Rehabilitation Center emphasizes consciousness of kind because it is a separate structure for addicts. What is more important, the group-therapy sessions have the explicit function of developing a community of men involved in elaborate introspection about themselves as a special and different case. The importance of an identity as an addict is set against the "normal" or nonaddict world.

Addicts are trained to conceive of themselves as a class of men apart who have something very binding in common, namely, the personality weakness of which they are continually reminded. A side effect of the success of this program may be to instill in the ex-addict a sense of his identity as an addict who best belongs among others of the same type—other addicts. It may be that the ex-addict comes to believe that "squares are really different," that there is something about one who takes drugs which does make a qualitative difference. The unanticipated consequence of such a community, whether it is a therapeutic community or a living community, is that the members may come to feel a kinship with each other which supercedes their involvement with those outside the community.

The best parallel example comes from the sociology of minority relations. One of the effects of ethnic segregation in a "dominant" culture, whether the segregation is voluntary or forced, positive or negative, is the emergence of primary identification of ethnic members with the successes or failures of members. For the drug addict, the crisis of identity may not be as clear to the outsider, but it may well be worth more serious consideration and deliberation by "segregationists."

Thoughtful consideration of the nature of individual and group identity would be fruitful to an understanding of the community issue. Most people may shift from one social setting to another w ithout a carry-over of "who they really are" being the sole determinant of how people will react to them. When a lawyer meets a corporation executive or a judge socially, he may choose to consider chess-playing ability as the focus of their identities. It is a simple, necessary, and common fact that one be able to parcel out the relevant identity of the person with whom one is dealing at the moment. For most, there is no one partial identity that is sufficiently important to color the total person with such completeness so as to become what the person always is. There are exceptions, and being a social deviant is one of them. The moral interpretation of the individual infuses into every aspect of his being. The public's conception of what a drug addict is revolves around the imputation of immorality of the total person. To place a number of addicts into the same highly structured living community is to reinforce the separateness as well as the totality of the moral identity. It is easy to see how a group of men who are regarded as immoral, when herded together into a single community, might develop a consciousness of kind or kinship to the newly created community and a feeling of real separateness from those outside the community. The development of this kind of community can only undermine the rehabilitation of the addict. He may feel that he cannot, or has no desire to enter a world where men are so totally different; namely, where they are nonaddicts and complete squares. The issue of total versus partial identity cuts both ways. The addict, too, may begin to see the nonaddict as being so completely different that communicating or relating is undesirable, if not impossible. The whole program of rehabilitation in the institution is officially designed to make the ex-addict's reentrance into the normal community smooth and successful. Yet, the use of the community to achieve that purpose has built into it a side effect that is detrimental to its aims.

The treatment staff makes a judgment as to when the resident is ready to leave the Rehabilitation Center and return to the community. As has bcen indicated, there is no clear set of actions that are known to be the pathway out of the institution. One critical factor that is commonly acknowledged is the readiness of the community to which the addict is returning to provide a place for him that maximizes a drug-free life. The primary indicators of this for the staff seem to be (1) the existence of an occupation and (2) the newness of surroundings and the nature of acquaintances. It is especially important that the acquaintances are not users. The treatment staff makes a decision to release the resident based largely upon their imputation of what the receiving community is like. This means that the staff must have some conception of what a good community is, and this conception will greatly influence its judgment of who is ready to leave the institution. The staff—inmate split, as we have seen in another context, coincides with a social-class split. The differing views of what constitute appropriate relations in the community may follow these class lines, and therefore some of the staff's criteria may be irrelevant to the living conditions that inmates face when they leave. For example, middle-class treatment staff may regard it as perverse when the inmate refuses to engage in a certain kind of free and open expressiveness in group. He should, according to the treatment staff, participate in the group's uncovering of a delinquent culprit among them. If he does not, then he needs more rehabilitation. However, from the point of view of the community to which the inmate is to return someday, this training is hardly preparatory or rehabilitative. The lower- or working-class community will heavily sanction the free and open and expressive cured addict who helps to uncover antisocial and antimiddle-class culprits in the working-class community. If he takes as his own the set of directives for living that he learned in the institution, the translation into action in a lower-class community will bring him continual trouble.

Within the institution, there is strain that is built into the two types of relationships that the staff has with the resident. It has been pointed out that the treatment staff is separate from the custodial staff. The former work an eight-hour day for five days of the week, while the latter must be on duty for twenty-four hours of a seven-day week. That information alone is an accurate reflection of the locus of the public's concern.

When the counselor from the treatment staff is on the job, he has the larger measure of control over the resident. However, when he leaves at five in the evening, authority lapses automatically to the custodial staff. All recognize that there ought to be some continuity between the rules laid down by the treatment and custodial overseers. Strain is therefore siphoned into the internal staff relations. The custodial staff works eight-hour days also, but in three shifts. The counselor may leave some directives for residents and some strong suggestions for the custodial men who are to see that they are carried out. However, the custodial men are responsible directly to the custodial line officers, not to the treatment people. Their rewards and promotions come from the custodial wing, and a certain amount of resentment develops when directives originate from a source to which the line officers are not responsible. The manner in which the inmate interprets and exploits these strains is the source of a separate study. This introductory profile of the institution is continued in the next two chapters, though the direct -focus shifts to an empirical study of the inmate himself.

* The terms "resident" and "inmate" will be used interchangeably hereafter. Resident is the term used on the grounds of the institution by the staff.