Solitary: The Inside Story of Supermax Isolation and How We Can Abolish It, by Dr. Terry Allen Kupers (University of California Press, September 2017). 304 pages, $29.95 hardcover

Book review by Christopher Zoukis

There are nations around the world that routinely torture their own citizens. Government actors in those oppressive regimes use inhumane practices to punish, to crush resistance and to retain control. The United States, that great beacon of freedom and democracy – the shining city on the hill – is one of those nations. Unbeknownst to most members of the public, tens of thousands of Americans are tortured at the hands of government authorities every year.

The people subject to this regular practice, described as “barbaric” by the U.S. Supreme Court over a century ago, have been taken by corrections officials in a most commonplace way – call it an un-extraordinary rendition – to a place that is essentially invisible to the public. That place is known by various names – control unit, SHU, SMU, the hole – and the cruel and sadly usual practice is called solitary confinement.

Also referred to as segregation, ad seg or isolation, it is used in virtually every prison and jail across the country. Prisoners are placed in solitary for breaking the rules, for protection from other prisoners, as retaliation by prison or jail staff, and all too often because they are mentally ill. The practice is an entrenched part of the American “corrections” system. Author and scholar Keramet Reiter explained the normalization of solitary confinement as not necessarily malicious or deliberate, but simply a product of “path dependency” and everyday bureaucratic indifference.

Normalized or not, segregation has long been understood to cause serious damage to prisoners. Charles Dickens, who toured U.S. prisons that made heavy use of isolation over 150 years ago, called it a “secret punishment.” The impact of solitary confinement on prisoners isn’t always readily apparent, but it is almost always there. “Research shows that some of the clinical impacts of isolation can be similar to those of physical torture,” the ACLU stated in a 2014 briefing paper.

In his new book, Solitary: The Inside Story of Supermax Isolation and How We Can Abolish It, Dr. Terry Allen Kupers, the foremost expert on the effects of isolation on prisoners, confirms the terrible cost associated with the widespread use of this immoral practice. Dr. Kupers has unique insight into this issue, and when he speaks on the subject of solitary confinement, everyone should listen.

He has toured supermax isolation units in 15 states. As a forensic psychiatrist, Dr. Kupers has interviewed thousands of prisoners who have experienced isolation. And he has provided expert testimony in over 40 cases, including Ashker v. Brown – the case that sounded the death knell for California’s use of indeterminate, long-term solitary confinement at Pelican Bay State Prison. Dr. Kupers not only knows what the research says about segregation, he has also seen it firsthand.

Solitary is a highly readable account of the history of isolation, the use of solitary confinement today, the damage it causes and the unique impact of segregation on minorities, women and juveniles. Dr. Kupers illustrates the dehumanizing and inhumane nature of solitary through the experiences of prisoners who have been subjected to that practice. The abuse heaped on the men, women and children he has interviewed is shocking, and their stories will anger readers.

That is the point. Solitary confinement is by its very nature an abuse of power that is acknowledged as torture all the way up to the United Nations. Yet the routine use of isolation is business as usual in U.S. jails and prisons. The impact is severe and long-term; experts have compared the impairments caused by solitary to those that result from traumatic brain injury. Prisoners in segregation attempt and succeed at suicide at much higher rates than other prisoners. They have mutilated their genitals, disemboweled themselves and set themselves on fire due to mental illness caused or exacerbated by long stints in segregation. But solitary continues to be used with little to no thought by corrections officials, and often for non-violent, relatively minor disciplinary offenses.

Dr. Kupers devotes a third of his book to proposing and describing alternatives to isolation. There is a central premise running through those ideas: For any changes to take hold, there must be a shift away from a culture of punishment to a “rehabilitative ideal.” An environment of mutual respect that fosters a vision of the future for prisoners who will eventually be released is needed to fundamentally alter the environment that leads to the use – and overuse – of segregation.

Practically speaking, Dr. Kupers proposes the adoption of a community mental health care model in prisons and jails. Prisoners, especially those suffering from mental illness, tend to cycle in and out of solitary confinement. Human Rights Watch estimates that as many as 30 to 50 percent of prisoners held in isolation suffer from some sort of mental illness. As a rule, they do not receive anything remotely resembling appropriate mental health care while incarcerated – especially while in segregation.

Dr. Kupers outlines the components necessary for a properly functioning correctional mental health care program. Treatment of mentally ill prisoners, including those in isolation, should be robust and ongoing, and must include more than the zealous over-prescription of psychotropic medications. Indeed, Dr. Kupers argues that medications can be dangerous in the absence of other treatment modalities. This is a serious problem in the U.S. correctional setting, both in segregation and general population units, as mentally ill prisoners tend to be heavily medicated but do not receive other forms of therapy.

When it comes to dealing with mental health care in the prison setting, Dr. Kupers suggests that “we need to decide whether we believe prisoners with serious mental illness are human beings with feelings and rights or whether they are more like animals who should be kept in a cage with no social interactions or productive activities, and then sprayed with immobilizing gas as punishment for behaviors they often cannot control.”

The current state of affairs in this nation suggests there is support, at least among corrections officials, for the latter approach. But the public is blissfully unaware of how routinely solitary confinement is used in prisons and jails, and what it does to prisoners. They are unaware that, as criminologist Jonathan Simon has said, isolation is “the denial of a recognizable human existence and the reduction to a pure biological existence.”

Dr. Kupers has done his part in exposing the reality of solitary confinement as a form of torture for all to see. Solitary gives the lie to arguments that segregation has correctional value; it is ineffective as a form of punishment and amounts to torture under just about any definition of that term. Almost two centuries ago, Alexis de Tocqueville said that putting prisoners in isolation “does not reform, it kills.” It is an unqualified disgrace that public officials countenance the continued use of a punishment that literally drives people insane, and Dr. Kupers’ book should be required reading for all corrections professionals and lawmakers. 

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