On May 25th Pamela Stewart presented at 35th Forensic Arts Therapy Conference at Holloway. Below is a transcript of her talk on the closure of the prison and the end of the psychotherapeutic work undertaken there.

 

Good bye Holloway: grief and gratitude

First, thank you to Jessica Collier for arranging this day to bring us together and thank you all for coming.

In psychotherapy and psychoanalysis the setting in which the therapy takes place is of immense importance. Reflecting on this today where we are meeting holds meaning. Where are we?

We meet in a chapel for what could be the funeral of psychological therapies. Or, it seems to me, we are here to honour the years of therapeutic work done within these walls which will soon fall down. Together over the years we have shared our insights and struggles. The key is that we have struggled and worked together embodying one of the 2 key principles of forensic psychotherapy: never to work in isolation.

Team work is required to keep not only the patient in therapy but also to help us maintain perspective, to keep our feet on the ground and our minds in the room. This is no place for the conquistador or the narcissistic do-gooder. Our work is hard and we need each other to stay the course.

So this is one of the reasons today is sad. We are together in the same room where many of us heard the news on Nov 25 that the rumour was now a reality: Holloway would close. I watched people, officers, admin colleagues, therapists as tears rose in their eyes. And mine. What we are losing is not only the building but the relationships that have taken years to build, brick by brick.

My hero, Freud (remember him) makes it very clear that loss is a form of madness, at least at first. The world feels upside down. We might feel angry, out of balance, disbelieving. However if the process of mourning is allowed to flow these feelings transform and the memories of the person or place come more steadily and healthily into focus. However if the process silts up through an inability to work through – the toxic feelings never have the chance to transform into meaning and memory. I will explore this further in a clinical example written during my early days in Holloway working on my MA project which I later named Born Inside.

My gratitude to Holloway for my own beginnings as a psychotherapist is huge. Today I give thanks and pay tribute to the people who helped me when I first showed up, keen, much younger and full of energetic assumptions in autumn 1995. Perhaps only female therapists thank their children. Becoming a mother is a psychological process and in many ways they gave birth to this work. My thanks also goes again to my supervision group and supervisor for their tolerance and support over many years as well as to Chrissy Reeves for her imagination and commitment to therapy and to my previous colleagues Kimberley Wilson and Paola Franciosi.

Now back to mourning – or what happens when this potentially creative process does not proceed.

The clinical material I am about to present comes from my MA dissertation for the Tavistock Clinic. The dissertation proposal came out of my intense frustration with the emphasis on the inner world. This was the mid-nineties when I was unaware the psycho-social model.

Melanie Klein with her intense emphasis on the important of anxiety as an impediment to development was all well and good. I could see the importance of the inner world. But I kept wondering about where the inner world came from, and indeed how the outer world reflects and changes our internal worlds. I wondered how I could study the intersection of inner and outer. One day it came to me, driving down Holloway Rd. If I could find a place of great anxiety perhaps I could put this theory to the test. If I wanted to observe and test the impact of anxiety on the mother’s relationship to her baby where could I do this? Up popped Holloway prison. As often happens, even on Holloway Rd, the answer was under my nose.

Long story but my project was accepted by the prison who admonished me not treat the women like animals in a zoo to be clinically observed. The prison’s stance impressed and surprised me. My assumption that the prison would be a harsh place, disrespectful of the mothers was one of my first assumptions to be wrong. Quickly I learned the Importance of making good relationships with the officer. This has certainly born fruit over my years here. Learn their names! They are people, too and after all isn’t therapy is all about relationships?

My work began on the mother and baby unit, D4. After any false starts I began to realise that I had made a fundamental mistake. My assumption that HMP Holloway was terrible dungeon and the women would be very anxious and depressed had to go; to be honest what I was experiencing was quite the reverse. The mothers and babies were doing well until the time for release arrived. What I did learn was how central unmourned loss in childhood was for the mothers….. Broken attachments, time in care, the witnessing of violence, the experience of very little talking ….. These became themes arising in the work.

As unmourned loss might have some relevance for us today I will share with you a vignette from the early days of my sentence to remind us of how pivotal the experience of grief is for all of us and how we avoid mourning at our psychic peril.

Maria – the mother and Terry (8 months old)

The mothers were eating their lunch in a windowless room. Many were facing the wall. In came Marie with her daughter Terry in her buggy. Wearing a soiled t-shirt, worn-out cotton slippers and torn sweatpants the Mum, Marie, appeared disorientated. Terry’s pink shorts were crusty with old food. Terry was wearing only one slipper that looked to small on her little, puffy foot. Even the buggy appeared battered. The other mothers seemed to pull away from Marie. I knew from a previous session that Marie had also been born while her mother had been in prison. The baby was watching her mother carefully with a serious, down turned mouth. Sitting well back in her buggy the 8 month old at first appeared relaxed with the slipperless foot dangling down. In contrast her other leg was pulled up tight into her body held close, like a shield.

Marie told Terry that she was going to make her lunch. Terry watched as her mother left the room without reacting and shifted her gaze to me. Terry made little kicking movements with her dangling leg – a methadone marking time until her mother’s return. She smiled at me and started to kick harder. This time she touched my knee, looked up again and smiled as if happy to make contact.

Marie entered the room and I was struck by how small she looked compacted to her huge daughter. Terry looked from me to her mother and then at the purple plastic bowl. Pulling her eyebrows down she frowned.

Marie put the bowl down and settled Terry into the plastic high chair. Terry did not react to be being moved apart from stiffening her arms as if bracing herself for a fall. The food was ready but there was no drink, only the bowl. Without putting a bib on Terry Marie quickly started feeding the baby huge, dripping spoonfuls saying:

“This is Weetabix with lots of lovely sugar in it. …. Just the way you like it.”

Obediently Terry opened her smooth, pink little mouth.

In a way which is hard to describe her mouth seemed to stay open – as if the food was not being fed but funnelled straight down into her stomach. This reminded me of the suffragettes being force-fed in prison. The food looked rough and dry, like dirty hay. Hot and lumpy I wondered if it would be hard to swallow.

Terry’s eyes were wide, glued to her mother’s face. She was watching her mother – not the spoon that was coming at her. Her mouth looked like a target – a bull’s-eye. As Marie fed the baby she poured her story into me.

She told a long tale. There were 4 children in her family. One of them, her little sister, died of leukaemia. Marie said the child’s name was Erica. I remembered that Marie has a son named Eric. When I said this Marie smiled and nodded. “Yeh, I named him after me sister.”

Continuing Marie said that the family “just fell apart with the grief. We was all round the bed when she died. Me mum and dad never to spoke to each other after that.”

A year later Marie said that she was working on the street. She was 15.

“Me Mum was never home. After the hospital she spent all her time in the pub. No one ever looked after me.”

This led me to think of Marie’s other 3 children at “home” with both of their parents in prison. Marie had told me that when she gave birth to Terry, her son Eric, had run away from home and turned up in the hospital to see his mother. When he finally found her she was waiting to go to the labour suite. She was in chains.

Marie’s eyes filled with tears and she pulled in her lips. Suddenly Terry started to vomit in a strange way, as if her head were haemorrhaging.

With what looked like no effort at all – no retching or signs of distress, all the straw coloured food started streaming out of her mouth. Great lumps tumbled from her mouth as if a tap had been turned on full by remote control.

Weetabix shot out like lava, falling into the creases of her neck, down into her collar and into her shorts. Food fell onto the seat of the highchair and slid down her bare legs. Food feel between her toes and into the edges of her one slipper.

As if shaking herself awake or coming up for air Marie roused herself. Looking around frantically Marie saw a small roll of thin prison loo paper. Desperately she tried to mop up the mess. The thin paper was inadequate for the job. Weetabix was everywhere. Terry started out into the distance with her moth still open, like a door off a hinge.

Unblinking, her eyes unfocused, glassy like marbles, as if she had seen a ghost.

Finally Marie yanked Terry from her molten seat, smearing her own clothes with the residue of lunch. Rushing out Marie said she was going to change Terry and left the hot and now smelly room.

Thoughts

Marie’s slight build was in striking contrast to her heavy-set baby. Visually to me this expressed how packed Terry was with passed on, undigested emotion. Sitting in her buggy Terry reminded me of an overflowing plastic bucket.

It is impossible to know whether Marie had lost her capacity to mother through imprisonment or, whether given all of her undigested grief she had never had it.

The feeding felt like force. In with the food went all the undigested grief – all the unmourned losses. Terry did indeed seen to be looking at the Ghosts in the Nursery. For me there was the feeling of history mindlessly repeating itself stuck in a cracked groove skipping down the generations.

Absence of understanding guarantees repetition. Being unable to learn from the past we are condemned to repeat it – emotional experiences in cased like Russian Dolls. Without understanding our emotions there can be no working though grief brought about by feelings of loss, abandonment and rage.

So today I am grateful for the opportunity to work through some of my feelings about the loss of Holloway with you. In Mourning and Melancholia Freud offers us the hope that successful mourning can open us up to new experiences and creativity to go forward in our lives and not to repeat the patterns of the past.