Incurable
Breaking Women: Gender, Race, And The New Politics Of Imprisonment
By Jill A. McCorkel
New York: New York University Press, 2013, 271 pp., $23.00, paperback
Reviewed by Susan Sered
America’s “race to incarcerate” (the title of a 1999 book by Marc Mauer, the executive director of the Sentencing Project) is a strikingly racialized national project—the “new Jim Crow,” in author Michelle Alexander’s words (The New Jim Crow, 2010). Alexander adds that “[m]ass incarceration is also a highly gendered national project.” Far more men than women are incarcerated; men overall are incarcerated for longer sentences than women; men—in particular black men—are more likely than women to be stopped and frisked by law enforcement officers; and women inmates are substantially more likely than male inmates to have experienced sexual abuse and to live with chronic mental and physical illnesses. In all, writes Alexander, approximately 2.2 million people are currently in the nation’s prisons and jails, and around 7 million Americans are under some form of correctional supervision, according to the Bureau of Justice Statistics.
Though women remain more likely than men to engage with the “benevolent” arms of the state—such as welfare and Medicaid—rather than its punitive ones, throughout the last two decades of the twentieth century and into the twenty-first, the rate of incarceration of women—and dramatically, of black women—has increased more rapidly than the rate of incarceration of men. During the past few years, male incarceration rates have gone down nationally, while female incarceration rates have mostly held steady—except for the rate of incarceration of white women, which is going up. This (albeit very partial) closure of the prison gender gap does not mean that women’s and men’s carceral experiences are the same. On the contrary, gender serves as the core organizing principle of prisons—as well as of homeless shelters, rehabilitation programs, and many welfare programs. Within correctional institutions, gender segregation is taken for granted; gendered messages are taught, drilled and expected to be internalized; and gendered standards for appropriate behavior are enforced.
While the structural inequalities of racism and sexism remain foundational to American society, the ways in which they are articulated change. In the early 1990s and again in the mid 2000s, Lynne Haney carried out studies of community-based residential facilities for women offenders, documenting how the ideological orientation as well as the day-to-day functioning of the programs became more restrictive. (See her Offending Women: Power, Punishment, and the Regulation of Desire, 2010) By the mid 2000s, the emphasis had switched away from teaching women job skills so that they could become independent, in line with the requirements of “welfare reform” as codified in the 1996 Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA). Instead, programs emphasized therapeutic counseling and learning to lose the so-called victim mentality. In these programs women were told that their illness (addiction) was due to their gender: to having been sexually abused, to having failed to learn healthy ways to express their anger, and to putting others’ needs before their own. The goal of treatment—recovery—centered on learning to recognize and acknowledge one’s many flaws: codependency, battered women’s syndrome, and other gender-specific emotional propensities.
In Breaking Women, Jill McCorkel presents her observations and analysis of an experimental, privately run drug-treatment program for women, Project Habilitate Women (PHW), which pushes the gendered therapeutic rhetoric in a new direction. Drawing on a decade of ethnographic work inside a women’s prison, she describes an intense, all-encompassing regime based on the notion that women addicts suffer from “diseased selves” that must be “broken down” (hence the title of the book), but that can never be fully mended. Unlike traditional rehabilitation, which assumes that people can fundamentally change, “[i]n habilitation … there is no hope that prisoners will become self-governing, rational, and autonomous subjects,” writes McCorkel. Rather than cure, the aim of the program is to encourage women to acknowledge their fundamental disease, surrender to the program, and accept that treatment can at best keep their disorders at bay.
The move toward this sort of essentialist view of female criminality took place, McCorkel points out, as black women came to greatly outnumber white women in many prisons. Gender and racial essentialisms merged: as the black woman became “typical,” the woman prisoner was no longer viewed as vulnerable and victimized (white) but rather as criminal and bad (black). Tellingly, in my home state of Massachusetts, where the large majority of residents both in and out of prison are white, the dominant prison discourse still casts women as suffering from illness and violence, not as incorrigible law breakers.
McCorkel does a superb job of bringing individual women to life for the reader, while simultaneously developing a strong and always readable theoretical analysis. In the culture of PHW, the diseased self has a broad range of cognitive, emotional, behavioral, and social deficits, including unconventional lifestyles and “confused” values. The holistic disease of addiction requires holistic cures. Thus, at frequent group therapy sessions, women are pressed to confess their “diseased” thoughts and actions. In public rituals of humiliation they are encouraged to hurl hurtful comments at a chosen target, ostensibly for her own good. The staff call the women names; they are “Crack Whores, Bad Mothers, and Welfare Queens,” writes McCorkel. The purpose of these insults is to bring “diseased” attributes to the surface so the inmates will recognize them. Motherhood is especially targeted, with counselors repeatedly telling women (many of whom struggled for years to care for and protect their children from violent men and the ravages of impoverished neighborhoods) that their greatest crime is the harm they inflict on their children. They can’t be “real” mothers, they are told, because they are addicts—an identity that supersedes all others. The women’s sexuality is similarly criticized. They are told that the only positive sexuality is to be found in long term, monogamous, heterosexual relationships—an ideal that necessarily eludes women who are locked up in single-gender prisons and who (in many cases)were forced into sex work to survive.
Habilitation, as opposed to rehabilitation, uses surveillance, confrontation, and discipline to break down the self. In many ways, PHW and similar programs teach women to distrust not only themselves but also one another. McCorkel writes, “Toward the end of PHW’s first year of operation, handmade posters and signs began to appear on doors and walls around the unit. The posters featured a painting of a large, blue eye with stenciled or handwritten lettering that read, “EVERYWHERE YOU GO, EVERYTHING YOU DO, KNOW THAT SOMEONE IS WATCHING YOU.” In an especially powerful passage, she describes how each week a particular woman is singled out for enhanced surveillance with a note placed on her cell door so that all will know. One of the prisoners with whom McCorkel developed a long-term relationship explains, “Girls in here started dropping out like crazy and they [staff] wanted us to take responsibility for it. Like we’re going to watch each other, everyone is a snitch. … Like they say, there are no friends in treatment.”
Because she established such long-term relationships with some of the women, McCorkel was able to delve into the question of resistance to the Big Brother culture of PHW—although she acknowledges the limited power of the women to change their circumstances. Of the 74 prisoners she interviewed, thirteen reported that they at least temporarily “surrendered” to habilitation and completed the program. They used language such as “renting out your head” to describe the process. Even among the women who did graduate, just over half said that they rejected the program’s core philosophy and that they made it through by faking it. Some women purposely broke the rules so that they could be expelled, since there was no mechanism for voluntarily leaving the program. They chose to go into the general prison population rather than remain in the ostensibly more benevolent PHW. In follow-up conversations held with the women several years post-release, McCorkel found that for the most part they had resisted the construction of the diseased self that they had been taught in PHW. At the same time, she learned how little in their lives had changed for the better: they were still poor, still marginalized, and still struggling and not even really scraping by.
Throughout the book McCorkel draws comparisons between PHW and twelve-step programs such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). Like AA and NA, PHW identifies the individual self as the source of addiction; attributing one’s problems to outside factors or social forces is dismissed as “denial.” And, as in AA and NA, in PHW the addict is fundamentally flawed and will always need supervision and control (though in twelve-step programs that supervision is voluntary and shared, unlike in PHW). But that is where the similarities end. For McCorkel, the PHW assessment of addiction is a fundamentally a moral claim, which, she argues, distinguishes it from the less problematic AA understanding of addiction as an “allergy.” (In the introduction to the AA “bible,” the Big Book [1939], the organization’s founder, Dr. Bob, considers alcoholism to be an allergy. However, the term “disease” is now commonly used in twelve-step literature and meetings.)
To my mind, it would strengthen McCorkel’s argument to place PHW and twelve-step programs in the wider context of moral crusades cum health movements in the United States. The discourse preceding and supporting Prohibition, for instance, framed alcohol as a public health problem as well as a threat to American moral values. Alcoholics Anonymous grew out of the Oxford Group, a Christian fellowship espousing the view that sin is a contagious disease driven by individual self-centeredness. Building on the Oxford Group’s theology and practices, the twelve steps of Alcoholics Anonymous rest on the notion that alcoholism is a spiritual disease that requires the spiritual remedy of accepting one’s limitations and turning to a higher power for help. This seamless integration of medicine and morality is deeply embedded in American culture, in which, as Susan Sontag has argued, sick people are blamed for causing their own illnesses through their irresponsible, promiscuous, or undisciplined behavior.
Coercive therapies such as PHW, McCorkel argues, are not alternatives to traditional forms of punishment but rather gendered extensions of them. Thus, while PHW claims to emphasize treatment over punishment, it in fact “collapse[s] the distinction between treatment and punishment,” writes McCorkel. In many ways, medicalization and criminalization are two sides of the same phenomenon: both define and manage socially unwanted behaviors as expressions of personal flaws rather than as manifestations of social, economic, racial, and environmental inequalities and degradation.
The United States boasts not only the highest rate of incarceration in the world but also the highest rate of prescription drug use. One in five adults currently takes a psychotropic medication; in 2010 Americans spent $16 billion on legal antipsychotics, $11 billion on antidepressants, and $7 billion on drugs to treat ADHD (according to Brendan L. Smith, “Inappropriate Prescribing,” in the American Psychological Association journal, June 2012). Here in Massachusetts, where more than half of incarcerated women are charged with a drug-related offense, 56 percent are treated with psychiatric medication in prison (The figures for male inmates is seventeen percent, according to “Massachusetts Department of Correction Prison Population Trends,” 2011). PHW discourages the use of psychiatric medication, so it does not figure prominently in Breaking Women, but since it is such a central (and highly profitable) part of the treatment/corrections nexus, it will be interesting to see if similar programs embrace medication as part of the habilitation arsenal.
Breaking Women is a timely book. As much of the country has begun to move away from the “race to incarcerate” for a variety of reasons, including the high financial cost of keeping millions of Americans locked up, public conversations contrast “treatment”—benevolent, scientific, cost-effective and progressive—and “punishment”—mean-spirited, violent, racist, and a failure at reducing recidivism. Well-suited to broad neoliberal political and economic policies, including the move towards privatizing social services, programs such as PHW are becoming national models, despite the fact that they show no evidence of successful outcomes by any accepted measure. As McCorkel points out, the incurable, disordered self that will always need supervision and treatment is very profitable indeed for the private companies that provide an increasing portion of correctional and welfare services nationally.
Susan Sered is professor of Sociology at Suffolk University. Her books include Makes Women Sick: Maternity, Modesty and Militarism in Israeli Society (2000); Uninsured in America: Life and Death in the Land of Opportunity (2005) and Can’t Catch a Break: Gender, Jail, and the Limits of Personal Responsibility (forthcoming).
