The Hole | Hidden Brain The use of solitary confinement in prisons has grown since the 1970s. Criminologist Keramet Reiter talks with us about the psychological effects that long-term isolation has on our minds.

Inside The Hole: What Happens To The Mind In Isolation?

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This is HIDDEN BRAIN. I'm Shankar Vedantam.


UNIDENTIFIED RADIO HOST: All right. And next up, we have Diana (ph) shouting out to the Polunsky Unit.

DIANA: People, it's Mama D (ph). I know I sound kind of different. I'm very sick right now, got diagnosed with pneumonia. I've been sick already for quite some time now.

VEDANTAM: This is the voice of a woman calling into a radio show on the Texas station KPFA. She has a personal message for a prison inmate.


DIANA: Anyway, I want to tell you people that Mama D loves you. I always think of you. And it's just getting harder and harder. I know I'm not supposed to cry 'cause you're going to get mad at me. But I can't help but feel so much love for you.

VEDANTAM: Calling into a program like this is one of the few ways for spouses and parents and children to communicate with prisoners, especially inmates in solitary confinement. Many prisoners in solitary have been found guilty of heinous crimes, including murder, rape, terrorism. But here's something you might not know. Some are there because they are difficult to manage or because of bureaucratic inertia.

While judges and juries decide whether someone should go to prison, a decision that can be appealed in court, typically it's prison officials who decide whether someone should be in solitary confinement. In recent years, both liberals and conservatives worried about the psychological and financial costs of long-term solitary confinement have raised questions about the practice. This week on HIDDEN BRAIN, we thought we'd take a look at what happens inside the prison cells that few people ever see and the psychological effects of being alone for long periods of time.


VEDANTAM: Keramet Reiter is a professor of criminology at the University of California Irvine and the author of the new book "23/7: Pelican Bay Prison And The Rise Of Long-Term Solitary Confinement." Besides being a researcher, she's also been a prisoners' rights activist at Human Rights Watch. Keramet, welcome to HIDDEN BRAIN.

KERAMET REITER: Thanks for having me, Shankar.

VEDANTAM: You can't tell the story of solitary confinement without understanding the story of a man named George Jackson. He was sent to prison in the early 1960s after pleading guilty to armed robbery. And he was sentenced to a term of one year to life. What was the thinking behind this kind of indeterminate sentence?

REITER: So the idea for someone like George Jackson was that he would go to prison, and he'd have to prove that he'd been rehabilitated before he could get out of prison. Around the time Jackson went to prison, however, people started to look at these indeterminate sentences and realized that they were having truly disproportionate impacts depending on the race of the person with the sentence. So white people had a much easier time convincing prison officials that they had been reformed and should be let out of prison than African-American men, like George Jackson happened to be.

So George Jackson found himself essentially stuck in prison. Years went by when he was denied parole. And he became radicalized in this process. He wrote a book of best-selling letters that achieved national and international acclaim, letters to his family and to his lawyers articulating his revolutionary politics and the problems with things like this indeterminate sentence. This brought him to the attention of prison officials. And he was accused of murdering a prison guard in the early 1970s. And he was preemptively sent to death row at San Quentin while he awaited a death penalty trial for that murder he was accused of. And while on death row at San Quentin - in an isolation unit, interestingly - one day, his lawyer came in to visit him.

And this story that prison officials tell - and it's been repeated many times - is that his lawyer snuck a 9-millimeter gun into him inside of a tape recorder and that Jackson then used that gun to try to escape from this isolation unit. All we actually know is that he was shot to death on the San Quentin prison yard as he ran out of the isolation unit. And when staff ran into the unit to see what had happened, they found three officers and two more prisoners who'd been stabbed to death. So this was the most violent day in California's prison history ever, six deaths total, on August 21, 1971.

And this moment is a moment that people point to in California as incredibly important in understanding why the state needed long-term solitary confinement units. And similar things happened across the U.S., and prison officials in other states point to those moments. So two weeks after George Jackson died, the revolt at Attica happened. Similarly, following that, prisoners were locked into their cells. And that became a moment people pointed to as a justification for really long-term solitary confinement.

VEDANTAM: You also tell the story of a prison administrator, Carl Larson, who began his career the same year that George Jackson went to prison. I understand you interviewed Carl Larson, and his view gives us a glimpse into the other side of the story, how prison guards and prison officials see the need for solitary confinement.

REITER: So Carl Larson was one of the earlier people I interviewed in doing this work. And to my surprise, we got to be friends. I came at this work from a perspective of a prisoners' rights advocate, very critical of the system. But as I got to know Carl Larson, I saw that he had a really interesting perspective on the system. And he was one of the first people to point me to the story of George Jackson and to explain how scary it was to be a guard working in the California prisons in the 1970s, when these deaths were happening and to make that fear real for me in a way that helped me to understand why he thought a long-term solitary confinement facility made sense.

So Carl Larson is particularly interesting because, as you said, he started out as an officer in the 1970s in California prisons, actually even earlier. And then he worked his way up through the system, becoming a warden and then becoming head of the prison construction projects that California engaged in in the 1980s, when the state built one of these long-term solitary confinement supermax facilities. And he takes credit for designing one of the first of these institutions. And that's really interesting because he's a prison administrator. He's not an architect. He's not an expert in exactly what kinds of punishments work. He didn't have a law degree. He had just worked in prisons, and he designed this completely new facility.

VEDANTAM: I understand that there was some interesting architectural features of this facility, Pelican Bay. The cement for the facility was poured in one large block, and - so that the cells were not built in individual units.

REITER: So one of the things that's striking about the place is it's made of these poured concrete cells. So they're incredibly easy to hose down, which is - the fact that they can stay clean is important because courts earlier had criticized isolation units for being really dirty. And they're grouped together into these pods of eight. And then the pods of eight are grouped together again into these tesselated T structures, so that one officer can look out over six pods of cells at a time. So it's a modern panopticon. And that also - that allows - the fact that there are no windows makes it really easy to just fit all these blocks together, if you can imagine that structure.

VEDANTAM: I'm wondering, Keramat, if you can actually just describe what one of these cells looks like. Give me a sense of what's in the cell, how big it is. What does it actually feel like to be in one of these units?

REITER: So the cells in these units are generally about 8 by 10 feet. So imagine a wheelchair-accessible bathroom stall or a generous parking space - pretty small. You can - you can, you know, almost reach from one end of the cell to the other. And they're fairly self-contained. So they contain a poured concrete ledge with a very thin piece of foam over it. And that's the bed. And then there's another sort of concrete bit protruding that is a desk and seat combination.

So it's just like a concrete block that a prisoner could sit on and write there. And then there's - in another corner, there's this steel usually toilet-sink combination. So it's just, you know, one smooth, steel object that has running water and plumbing for the prisoner. Sometimes, there are showers in these cells. But generally, it's just a sink and a toilet. And again, if the prisoner is lucky and they can afford it and the system they're in allows it, they might have a TV or a radio. And usually, they're allowed maybe a few books at a time and a little bit of paper for writing letters or doing legal paperwork.

VEDANTAM: You say in the book that despite what prison officials say, it's not always the worst of the worst who end up in solitary confinement. But in general, are there patterns to predict who ends up in solitary confinement?

REITER: There's been shockingly little research over time on who ends up in solitary confinement and how. And it's very hard to track across states. But as people have paid more attention to this and through the work I've done, I've started to see some patterns. There's a disproportionate racial impact of solitary confinement. So we know that in our prisons in general, African-Americans and Latinos are more likely to be in prison than - in the general prison population. They're doubly likely, again, to be in solitary confinement than even the general prison population. That's often because gang members are being targeted for long-term isolation, especially in states like California.

Prison systems are not putting people there based on some act or rule that they broke but based on their status as dangerous. So prisoners get labeled dangerous gang members, and they get sent to isolation indefinitely. In general, I think one way to think about people who end up in isolation is that it's often the people who are really difficult for the system to manage. So that might include seriously mentally ill prisoners. There's recent research showing that transgender prisoners are really likely to end up in isolation, that pregnant women end up there. So people who the system just isn't equipped to provide resources to can end up there also.

VEDANTAM: So the rise of these institutions coincided in some ways with the decline or closing down of various institutions for the mentally ill, which speaks, of course, to the point that you were just making. But I also understand that this is reflected in the number of suicides we see in solitary confinement compared to the general prison population.

REITER: There is a very close relationship between solitary confinement and mental illness. One way to understand that is that in the 1970s and early '80s, when mental institutions closed, was the same time that mass incarceration and rates of incarceration were increasing across the United States. And that meant that some mentally ill people, unsurprisingly, ended up in prisons. And one of the arguments I make is that as those people ended up in prison, they tended to be put into solitary confinement. And that's one explanation for the fact that rates of suicide in solitary confinement can be twice as high as in the general prison population or even higher and that rates of mental illness and isolation can be high. And often, there's a real chicken-and-egg problem of, you know, did a person get sent to isolation because they were mentally ill, and states have tried to limit that? Or do people in isolation develop mental illnesses?

VEDANTAM: Most of us are never going to see the inside of a supermax. But we often do see scenes of solitary confinement described in pop culture. One of those examples is the TV show "Orange Is The New Black." We have a bit of tape. The character Piper is put into a security housing unit and starts speaking to a voice she hears through the grate of her cell.


TAYLOR SCHILLING: (As Piper Chapman) How long have you been down here?

CARLA BRANDBERG: (As The Voice) I lost track. I don't know... Nine months, a year.

SCHILLING: (As Piper Chapman) A year? That's insane.

BRANDBERG: (As The Voice) They keep the lights on, so you lose all sense of time. It's not living. I mean, yeah, you're breathing. But you ain't no person no more. It's bad. You start to see shit that ain't there. You start to hear voices.

SCHILLING: (As Piper Chapman) Oh, my God.

BRANDBERG: (As The Voice) They keep you here until they break you.

SCHILLING: (As Piper Chapman) I feel like I'm going to throw up.

VEDANTAM: Keramet, I'm wondering how accurate that description is of what life's actually like in solitary confinement.

REITER: I do think that the disembodied voice that you hear talking to Piper is accurate on a number of levels. The voice is kind of flattened in (unintelligible), and the prisoner was describing hearing voices, hallucinations. That's a very common side effect of isolation. And people talk about time - the way they perceive time changing because there is no way to mark time.

People talk about it exactly as that. Prisoners said it's not that it even feels long. It's just that it's almost endless that days can kind of in a weird counterintuitive way fly by because there's nothing marking anything about a day or a week. And so in that sense it's accurate.

VEDANTAM: I want to spend a moment talking about your own role in looking at this. On the one hand, you are a researcher who has spent time studying the question, but as you yourself have said, you know, you're also a prisoner rights advocate. You've been an activist at Human Rights Watch and other organizations. How do you preserve your ability to be analytical about the subject while you also have what are very clearly strong views about solitary confinement?

REITER: You know, when I went to interview Carl Larson (ph), he said, well, you're a Berkeley liberal, so he asked me to do some background reading and prove that I was serious and I would listen to him. And so I actually think in the process of doing this work, I have become more open minded and been criticized by advocates for talking so directly and so extensively to prison officials. And so I've had the interesting experience of trying to keep the conversation open across a really broad spectrum of perspectives on this process.

And I think in that way, I've been able to try to at least incorporate these different perspectives and tease apart the arguments and the positions people are coming from. And I do think that in reform, prison officials have to walk into these institutions and engage with these prisoners day in and day out. And they also need to be part of the reform conversation. And through this process, you know, surprisingly even though I came basically from the other side, if you want to think of it in terms of sides, I've come to see that perspective.

VEDANTAM: When we come back, I'm going to ask Keramet about the psychological toll of solitary confinement and the unexpected ways inmates manage life in isolation. Stay with us.


VEDANTAM: This is HIDDEN BRAIN. I'm Shankar Vedantam. Keramet, what sorts of things do people in solitary confinement say they miss? What are the kind of things that you miss that the rest of us might not think about?

REITER: So people talk about not having seen the moon in years or decades and how much they miss that. And then people talk about missing just pure human touch. And, you know, I tell a story in the book about a prisoner who - his cell door and the cell door of the prisoner next to him were accidentally opened at the same time.

And they were rival gang members, but they had been talking to each other shouting through the cell walls. And when the cell doors opened, they just reached around and grabbed each other's hands and held on because it had been so long since either of them had had a gentle, human touch like that.

VEDANTAM: Prisoners often stay alone in their cells for 22 or 23 hours a day, and you found that, perhaps, the only way to actually manage this psychologically is to stick to a series of very, very rigid routines. Tell me about those routines.

REITER: The prisoners who I was able to interview in this research to understand their experiences tended to be the prisoners who survived. And so they did develop all kinds of coping mechanisms, and one of the ones I heard about again and again was that they would wake up, you know, first thing in the morning 5 a.m. And they would do thousands of repetitive exercises, often what prisoners called burpees - so a combination of jumping jacks, push-ups and sit-ups - and, you know, literally a few thousand in the morning to start out their day and then clean their cells, write letters, work on legal cases.

And in general in these units, if prisoners are following the rules, and they have money being sent in from family, they can buy either a TV or a radio. And prisoners who develop these routines talk about really limiting the time they spent listening to media. So maybe only an hour a day or two hours a day or a special show they like to watch, so that they were keeping both their bodies and their minds really busy consciously over the course of a day.

And, interestingly, prisoners talk about having trouble letting go of these routines once they got out of prison, that they would still do those thousands of burpees every morning at 5 a.m. when they got up and that their ability to control everything in their space in that 8-by-10 cell they live in is also hard to let go of, that they could keep, you know - a prisoner described to me how he could keep the cap of his toothpaste perfectly clean. And it was really hard when he had a roommate when he got out of prison the fact that he couldn't control the cap of the toothpaste anymore. So - kind of gives you a sense of how intense it is to survive and then how long those coping mechanisms linger afterwards.

VEDANTAM: You talk in the book, Keramet, about inmates trying a number of different things to not just be physically active and mentally active, but emotionally expressive to try and find ways to do artistic things. Can you talk about that for a moment?

REITER: Prisoners do struggle to find ways to express themselves. Sometimes that's becoming really good at the law and litigating cases, but very often it's teaching themselves to draw, sometimes teaching themselves to speak a new language, sometimes teaching themselves to sew. One of my favorite stories was a prisoner who told me that he was in isolation for a number of months, and I'm not even sure how he made himself a needle.

I know that he pulled threads out of the jumpsuits they're given in order to make thread. And then he started tailoring his clothes so that they fit better. They're often given these very loose jumpsuits. And so he would add cuffs or shorten the sleeves. And I think other prisoners found out about him doing this, and in some cases a friendly officer would pass a uniform back and forth, and he started tailoring other people's uniforms. It's kind of not that anyone is even seeing them, but it's this amazing kind of self-expression and community that they're managing to create in this place.

VEDANTAM: I'm sure they're going to be people who say, look, there are lots of people in these units who really are the worst of the worst, maybe not all of them are, but some of them probably are. Some of them probably are really violent and really dangerous and ought to be there. And I'm wondering do you ever feel that they might be people who need to be in solitary confinement?

REITER: So there are certainly people in isolation who are dangerous. One of the really important points of analysis is the length of time people are spending in isolation, the fact that people - we're not talking about weeks or months. We're talking about years and decades often and that even people who might have been fairly scary or dangerous in their 20s are unlikely to be that way into their 40s and 50s.

And as we look at decades of these policies, we see that even some of the people who have been held up as the scariest, the system didn't control them very well while they were in it. And they're doing surprisingly well outside of isolation, so it really does call the practice into question on all different levels.

VEDANTAM: So your book comes at a time when many liberals and conservatives have joined hands to call for prison reform. For one thing, keeping people in prison and keeping someone in solitary confinement is very, very expensive. Give us a sense of how expensive it is and whether these ideological pairings are triggering any change in the system.

REITER: So solitary confinement is astronomically expensive. In states like California, it costs about $45,000 per prisoner per year to keep someone in the general prison population, and it costs about $90,000 per prisoner per year to keep someone in isolation. And so the cost of running the facilities is really expensive because these prisoners in isolation, you know, every need has to be met by someone working in the prison whether it's delivering mail or delivering legal documents or getting them a meal.

And so that's how the costs go up, and the costs of the facilities are also expensive to build these kinds of technologically advanced facilities. And that's not even wrapped into that per prisoner per year cost. So I think that has been part of the reform conversation, as you suggest, that perhaps there might be a less expensive way to do this - or one other cost of isolation is that the vast majority of people, even from long-term solitary confinement ultimately get out of prison. It's - 95 to 98 percent of all prisoners get out eventually.

And that's surprisingly true of people in isolation, too, and so there's the question of what are the social impacts of letting people out? And I think in combination, those economic costs and the social costs, people are beginning to think about alternatives. And that is a conversation that is - crosses political lines. And prison, as I suggested in many states, legislators are initiating reforms. Some litigation has happened, but in many states, prison officials within the system are looking at the norms changing in the critiques of this practice and initiating their own reform saying what can we do to reduce our reliance on this practice?

VEDANTAM: Keramet Reiter is a professor at the University of California at Irvine. She's the author of the book "23/7: Pelican Bay Prison And The Rise Of Long-Term Solitary Confinement." Keramet, thank you for joining me on Hidden Brain today.

REITER: Thanks for having me.

VEDANTAM: HIDDEN BRAIN is produced by Maggie Penman, Jenny Schmidt, Rhaina Cohen, Renee Klahr and Chloe Connelly. Our supervising producer is Tara Boyle.

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Before we go, we're currently working on a show about gender and jobs. In our rapidly changing economy, a lot of blue-collar jobs are disappearing, and a lot of so-called pink-collar jobs are cropping up. If you're a man who's had to change careers, maybe leave a position at a factory and take up a new job as a home health care aide or if you're a man who's been reluctant to make that kind of transition, we'd love to hear your story. Please call and leave us a message at 661-772-7246. That's 661-77-BRAIN. I'm Shankar Vedantam, and this is NPR.

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