# data[].attributes.body
This is a mind map I did when figuring out my ideas for this project. I settled on 3 possible directions to go in:

# data[].attributes.body
As the brief of the project is to base the letterform on a place I thought it would be interesting to investigate how its used as a saying for a place of madness.

'The term bedlam comes from the name of a hospital in London, “Saint Mary of Bethlehem,” which was devoted to treating the mentally ill in the 1400s. Over time, the pronunciation of “Bethlehem” morphed into bedlam and the term came to be applied to any situation where pandemonium prevails.'

# data[].attributes.body
You go to prison when you are bad. It would be interesting to investigate how the perception of good and bad is different in prison compared to regular society.

# data[].attributes.body
When children are bad or naughty they are given coal by Santa Claus. I could use coal in the making of my letterform. Building off this I could research how punishment- aka being given coal instead of presents- motivates people to be good and whether people are truly good.

# data[].attributes.body
Bedlam was mentioned as a hospital in 1329, and some permanent patients were accommodated there by 1403. In 1547 it was granted by Henry VIII to the City of London as a hospital for the mentally ill. It subsequently became infamous for the brutal ill treatment meted out to its patients.

# data[].attributes.attachment_link.title
Bedlam | mental health, psychiatric care, asylum

# data[].attributes.attachment_link.description
Bedlam, the first asylum for the mentally ill in England. It is currently located in Beckenham, Kent. The word bedlam came to be used generically for all psychiatric hospitals and sometimes is used colloquially for an uproar. In 1247 the asylum was founded at Bishopsgate, just outside the London

# data[].attributes.body
'Before his death in 1933, Dr Hans Prinzhorn assembled a collection of art by mentally ill patients that was the beginning of what is now known as “outsider art”. From something to be depicted by artists, “madness” has become a source of artistic originality in itself.'

I'd like to explore how mental illness can be represented visually in this 'outsider art' style. I think it would be good to analyse this style so I can represent Bedlam in my letterform.

# data[].attributes.attachment_link.readable_text
Art has led the way in seeing mental illness not as alien or contemptible but part of the human condition - even as a positive and useful experience. Modern art has even celebrated mental suffering as a creative adventure. This psychiatric modernism started with the "madness" of Vincent van Gogh and led to work by patients being discovered as a new kind of art. Yet it has much deeper historical roots. Albrecht Durer portrayed genius as melancholic as early as the Renaissance and Romantic painters identified with the "mad".

Perhaps it is not hard to see why artists often show empathy for what society calls illness: all creativity is an irrational voyage. The idea of going outside yourself to see things afresh is probably as old as the torchlit visions of cave artists and was expressed by the ancient Greek philosopher Plato when he wrote that poetic ecstasy is the only source of divine truth. "Madness is a gift from the gods", as Plato put it.

1. Vittore Carpaccio - The Healing of the Possessed Man at the Rialto (c. 1496)

This painting of everyday life in 15th century Venice reveals how mental illness was understood and treated in the middle ages. It is sometimes called "The Healing of the Madman", but "possessed" is closer to contemporary ideas about the mind. For the man being miraculously healed by a priest amidst the human drama of the Rialto bridge has been taken over by a demon. His suffering is neither a medical nor social problem, but a religious experience.

2. Matthias Grunewald - The Temptation of St. Anthony (c. 1512 - 16)

Late medieval artists were fascinated by the story of the early Christian hermit Saint Anthony the Great who was tempted by devils. For Grunewald, this becomes a truly personal and psychological terror, an image of a man whose sanity is under threat. The infinite horrible shapes of the demons are like malformed thoughts. It is a compassionate work, for this is part of the Isenheim altarpiece, painted for a hospital that treated people with disfiguring illnesses. One of the devils has the sores and grey skin that appear in other parts of the altarpiece and evoke the illnesses treated there. Does this swarming scene therefore portray the threat to mental health posed by extreme physical suffering? It influenced German expressionism and is to this day a masterpiece of the threatened mind.

3. Albrecht Durer - Melancholia (1514)

This visionary work of art is both a diagnosis and heroic celebration of what might now be seen as illness. Melancholia was known and experienced in the middle ages, a darkness of the mind resulting from an inbalance of the humours. That darkness is marked on the brooding face of Durer's spirit of melancholy. In her despond, she appears unable to continue with her great works. She is to judge by her tools a mathematician, geometer, and architect: a Renaissance genius. Durer portrays through this emblem his own inner life and intuits the mind's complexity. For Melancholy in his eyes is the badge of genius - to aspire to know and create is to slump into despair. Unhappiness is noble, for Durer. This print is arguably the beginning of modern psychology.

4. William Hogarth - The Rake in Bedlam (1733)

The insight of Durer - not to mention Shakespeare and Cervantes - that mental shadows are part of human life was lost on the founders of London's Bethlem Hospital. The notorious "Bedlam" was founded in the middle ages and may have specialised in mental illness as early as the 14th century. When Hogarth in the 18th century portrayed a young man whose career of gambling and spending had led him there, it was a place where Londoners could come and look at the "mad". Hogarth shows two "sane" women enjoying the spectacle of madness, which includes people who think they are kings and bishops. Of course, in Hogarth's view, the boundary between sanity and insanity is not that obvious at all.

5. Francisco Goya y Lucientes - The sleep of reason produces monsters (c. 1799)

Goya's depiction of a sleeping man - the artist - assailed by monsters of the night is an image of reason's frailty made at the end of the Enlightenment, the great 18th century movement that sought to change the world with encyclopaedias, scientific demonstrations and the first factories. Goya's pessimistic yet also compassionate view is that reason only ever rules part of our minds. It must share the world with nightmares. At the dawn of the modern age, this great image echoes old depictions of the Temptations of St. Anthony, whose assailants have not gone away after all.

6. Theodore Gericault - Portraits of the Insane (1822)

In the Romantic age extreme states of mind and inner suffering were the stuff of poetry and art. This mood of introspection opens new eyes on mental health in Gericault's portraits of the "insane". He painted ten of these, of which five still exist, all depicting patients of his friend Dr Etienne-Jean Georget. In this painting, there is deep respect and human sympathy for a woman whose illness seems mostly visible as deep unhappiness. Escaping from stereotypes and prejudice, Gericault portrays mental illness as a part of the human condition that he himself - as an artist whose paintings dwell on death and violence - clearly feels close to.

7. Gustave Courbet - Self-Portrait (The Desperate Man) (c. 1843 - 45)

In a moment of Romantic exhilaration Courbet portrays himself as a "madman", his face ecstatic and terrified. His desperate state of mind is not a shameful sickness but a badge of artistic pride. In a tradition that goes back to Durer's Melancholia but reached new power in the Romantic age, he equates genius and madness. This face of desperation is the face of the 19th century avant garde, risking and even courting sickness with drink and drugs. Courbet looks like a character in one of Edgar Allan Poe's stories, his mind unravelling in a way the first modern artists were fascinated by.

8. Vincent van Gogh - Self-Portrait with Bandaged Ear (1889)

Vincent van Gogh was fascinated by a 19th century painting called The Madness of Hugo van der Goes. In this picture the medieval artist Hugo van der Goes - who in real life was confined to a monastery because of mental illness - broods in torment, while those around him despair of helping the afflicted man. Van Gogh wrote that he sometimes identified with this painting. Here, shortly after cutting off his own earlobe, he scrutinises himself as a man similarly afflicted. Or is he? Vincent's eyes are crystal blue, his gaze acute and penetrating. He looks at his wounded face objectively, with deep truth. He is neither "sane" nor "insane" but a fellow human being who speaks to us with courage and honesty.

9. Edvard Munch - The Scream (1893)

Madness is the modern condition in this work of art that has the clarity of a theorem. The Scream is universal. This is how life today makes us feel, says Munch. Far from a pathology afflicting individuals, the desire to scream out in pain and isolation under the wobbly sky is a sane response to an insane world. Munch takes the artistic revaluation of mental illness that started in the Romantic age to its logical conclusion: there is no Bedlam but the world itself.

10. Josef Forster - Untitled work in the Prinzhorn Collection (after 1916)

Once Munch and Van Gogh made "madness" a positive value in modern art, a key to visionary truth, it was only a matter of time before the medical profession too started to see new connections between art and the mind. Before his death in 1933, Dr Hans Prinzhorn assembled a collection of art by mentally ill patients that was the beginning of what is now known as "outsider art". This example has the eerie power of Goya. From something to be depicted by artists, "madness" has become a source of artistic originality in itself.

# data[].attributes.attachment_link.title
A short history of mental illness in art

# data[].attributes.attachment_link.description
Art has led the way in seeing mental illness not as alien or contemptible but part of the human condition - even as a positive and useful experience. Modern art has even celebrated mental suffering as a creative adventure.

# data[].attributes.body
'Munch defined how we see our own age - wracked with anxiety and uncertainty. His painting of a sexless, twisted, fetal-faced creature, with mouth and eyes open wide in a shriek of horror, re-created a vision that had seized him as he walked one evening in his youth with two friends at sunset. As he later described it, the "air turned to blood" and the "faces of my comrades became a garish yellow-white." Vibrating in his ears he heard "a huge endless scream course through nature."'

# data[].attributes.body
'By the 18th century, Bedlam had become less a hospital and more a circus sideshow, and for a pretty straightforward reason: “freaks” made money. People came from all over to see the patients at Bethlem Royal Hospital, some even arranging holidays around it.'

# data[].attributes.attachment_link.readable_text
Learn about the real Bedlam, the Bethlem Royal Hospital insane asylum so notorious that it entered the English language as a word for confusion and disorder.

If you were to visit the Bethlem Royal Hospital circa the 15th Century, it would look like a scene out of American Horror Story. Bethlem was the only institution in Europe that handled society's "rejects"-namely the mentally or criminally ill-for the vast majority of European history.

It did not, however, treat patients with a kind and affirming hand. Quite the opposite happened: patients were subjected to horrendous cruelty, experimentation, neglect and humiliation - all of which was entirely socially acceptable up until the 20th century.

The term "bedlam", defined as "chaos and confusion", was coined as a descriptor for the Bethlem Asylum during the height of its chaos in the 18th century. Founded in 1247, it was the first hospital of its kind in Great Britain. Never before had there been a place for the mentally infirm, disabled and criminally-minded to be adequately locked away from society.

While patients came to Bethlem suffering from complaints such as "chronic mania" or "acute melancholy", people were just as likely to be admitted for crimes such as infanticide, homicide and even "ruffianism".

Being admitted to Bedlam, as it was called, didn't necessarily mean a person was well on their way to being rehabilitated, since "treatment" implied little more than isolation and experiment.

If the patient managed to survive the asylum at all, they and their families were typically worse for the wear by the end of their stay. Patients were subjected to "treatments" such as "rotating therapy" wherein they were seated in a chair suspended from the ceiling and spun as much as 100 rotations per minute.

The obvious purpose was to induce vomiting, a popular purgative cure for most ailments during this period. Incidentally, the resulting vertigo in these patients actually contributed a large body of research to contemporary vertigo patients. Their dizziness, it seems, was not all for naught.

Beyond social mores of the time, a lack of funding can explain why Bethlem became Bedlam. The asylum was a poorly-funded government institution heavily reliant upon the financial support of a patient's family and private donors.

Of course, the vast majority of those who found themselves at Bedlam had not come from wealth or even the middle class. Patients were often poor, uneducated and had been victimized not only by whatever mental infirmities they possessed, but a society that was repelled by them.

In fact, by the 18th century, Bedlam had become less a hospital and more a circus side show, and for a pretty straightforward reason: "freaks" made money. People came from all over to see the patients at Bethlem Royal Hospital, some even arranging holidays around it.

Of course, none of them were actually "freaks", but since Bedlam was so fiscally reliant upon the money guests would pay to see them, patients were certainly driven to behave as though they were mad.

By the mid 1800s, a man named William Hood became physician in residence at Bedlam and wanted to completely turn the institution around. He hoped to create actual rehabilitation programs, which would serve the hospital's patients rather than the administrators.

The "Bedlamites", as they were nicknamed, had been subjected to horrific treatments, both experimental and some downright cruel, and were often desired only for the study of their corpses. Others were simply thrown into a mass grave on Liverpool Street, which was only discovered a few years ago.

During World War 2, Bethlem Royal Hospital was moved to a more rural location, which was meant to improve the quality of life for patients. The move also helped rid the institution of its horrendous legacy. Though, thanks to the Museum of the Mind archives, we are able to get a glimpse of the haunted faces of Bedlamites.

Many of them were photographed upon their admission, with a note or two about their "diagnosis." One wonders, looking at these photos today, how many of these patients survived Bedlam - and if they did, if any of them were ever truly well again.
If you enjoyed this fascinating look at the history of Bethlem Royal Hospital, also knowna as Bedlam mental asylum, check out our other posts on interesting facts and the unbelievable reasons people were sent to mental asylums in the 19th century.

# data[].attributes.attachment_link.description
If you were to visit the Bethlem Royal Hospital circa the 15th Century, it would look like a scene out of American Horror Story . Bethlem was the only institution in Europe that handled society's "rejects"-namely the mentally or criminally ill-for the vast majority of European history.

# data[].attributes.body
These are freak show posters from 1876 from the British Library. There is a clear typographical style as well as drawing style.

# data[].attributes.body
'Released prisoners may be less capable of living a lawful life than they were prior to their imprisonment'
This could be because the norms and values of prison are different to those of the outside world. This is to be expected when you have a building filled with deviants that can't leave.

# data[].attributes.attachment_link.readable_text
Day after day, year after year, imagine having no space to call your own, no choice over who to be with, what to eat, or where to go. There is threat and suspicion everywhere. Love or even a gentle human touch can be difficult to find. You are separated from family and friends.

If they are to cope, then prisoners confined to this kind of environment have no option but to change and adapt. This is especially true for those facing long-term sentences - in England and Wales, around 43% of sentences now last more than four years.

In a report on the psychological impact of imprisonment for the US government, the social psychologist Craig Haney (who collaborated with Philip Zimbardo on the infamous Stanford Prison Experiment) was frank: "few people are completely unchanged or unscathed by the [prison] experience".
You might also like:
* The prison problem that's often ignored
* Why the Dutch treat crime differently
* When personality goes from bad to good
Based on their interviews with hundreds of prisoners, researchers at the Institute of Criminology at the University of Cambridge went further, stating that long-term imprisonment " changes people to the core". Or in the stark words of a long-term inmate interviewed for research published in the 1980s, after years in prison "you ain't the same".

In the field of personality psychology, it used to be believed that our personalities remain largely fixed in adulthood. But recent research has found that, in fact, despite relative stability our habits of thought, behaviour and emotion do change in significant and consequential ways - especially in response to the different roles that we adopt as we go through life. It is almost inevitable then that time spent as a prisoner, in a highly structured yet socially threatening environment, is bound to lead to significant personality changes.

Particularly for anyone concerned about prisoner welfare and how to rehabilitate former convicts, the worry is that these personality changes, while they may help the prisoner survive their jail time, are counter-productive for their lives upon release.

Key features of the prison environment that are likely to lead to personality change include the chronic loss of free choice, lack of privacy, daily stigma, frequent fear, need to wear a constant mask of invulnerability and emotional flatness (to avoid exploitation by others), and the requirement, day after day, to follow externally imposed stringent rules and routines.
'Prisonisation'
There is surprisingly little research on how these chronic features of the environment might change prisoners' personalities in terms of the "Big Five" model of personality that dominates most modern research on the general, non-prison population (based around the key traits like extroversion and conscientiousness).

Nonetheless, there is widespread recognition among psychologists and criminologists that prisoners adapt to their environment, which they call "prisonisation". This contributes towards a kind of "post-incarceration syndrome" when they are released.

Consider the findings from 'in-depth interviews with 25 former 'lifers' (including two women) in Boston, who had served an average of 19 years in jail. Analysing their narratives, psychologist Marieke Liema and criminologist Maarten Kunst found that the former prisoners had developed "institutionalised personality traits", including "distrusting others, difficulty engaging in relationships [and] hampered decision-making".

One 42-year-old male former prisoner said: "I do [still] kind of act like I'm still in prison, and I mean you [are] not a light switch or a water faucet. You can't just turn something off. When you've done something for a certain amount of time... it becomes a part of you."

The personality change that most dominated their accounts was an inability to trust others - a kind of perpetual paranoia. "You cannot trust anybody in the joint," said another of the interviewees, a man now aged 52. "I do have an issue with trust, I just do not trust anybody."

Interviews with hundreds of UK prisoners undertaken by Susie Hulley and her colleagues at the Institute of Criminology painted a similar picture. "Many... told us that they had undergone significant and sometimes wholesale personal transformations," the researchers wrote in 2015.

The prisoners described a process of "emotional numbing". "It does harden you. It does make you a bit more distant," one said, explaining how people in jail deliberately conceal and suppress their emotions. "It is who you become, and if you are hardened in the beginning then you become even harder, you become even colder, you become more detached." Another prisoner stated: "It's... I, kind of, don't have feelings for people" any more.

In terms of the Big Five personality traits, one could characterise this as a form of extreme low neuroticism (or high emotional stability or flatness), combined with low extraversion and low agreeability - in other words, not an ideal personality shift for the return to the outside world.

That is certainly the concern of Hulley and her colleagues. "As the long-term prisoner becomes 'adapted' - in the true sense of the term - to the imperatives of a sustained period of confinement, he or she becomes more emotionally detached, more self-isolating, more socially withdrawn, and perhaps less well suited to life after release," they warned.

The interview-based studies so far involved long-term prisoners incarcerated for many years. But an exploratory paper published in February 2018 used neuropsychological tests to show that even a short stay in prison had an impact on personality.

The researchers led by Jesse Meijers at Vrije Universiteit Amsterdam tested 37 prisoners twice, three months apart. At the second test, they showed increased impulsivity and poorer attentional control. These kinds of cognitive changes could indicate that their conscientiousness - a trait associated with self-discipline, orderliness and ambition - has deteriorated.

The researchers think the changes they observed are likely due to the impoverished environment of the prison, including the lack of cognitive challenges and lost autonomy. "This is a significant and societally relevant finding," they concluded, "as released prisoners may be less capable of living a lawful life than they were prior to their imprisonment".

However, other findings offer some glimmers of hope. For another recent paper - one of the few to apply the Big Five model to prisoner personality change - researchers compared the personality profiles of maximum security prisoners in Sweden with various control groups, including college students and prison guards. They found that while the prisoners scored lower on extroversion, openness, and agreeableness, as you might expect, they actually scored higher on conscientiousness, especially the 'sub-traits' of orderliness and self-discipline.

The researchers, led by Kristianstad University's Johanna Masche-No, don't believe this was due to a social desirability effect - that the prisoners were trying to make a good impression on the team asking them questions - because the results were confidential and the prisoners described themselves in unflattering terms on other traits like agreeability.

Instead, the researchers think their findings may reflect a form of positive personality adjustment to the prison situation: "The environment in a prison is very strict with respect to both regulations and norms, and private space is limited," they concluded. "Such an environment places demands on inmates to acquire order to avoid both formal punishment and negative acts from co-inmates."

In other words, it can help to be conscientious to stay out of trouble.

Although these findings from Sweden seem to contradict the Dutch research, it's worth noting that while the Dutch prisoners became more impulsive and less attentive, they also showed improvements in their spatial planning abilities, which could be seen as related to orderliness (Meijers and his colleagues did not read too much into this improvement because they said it could just have been that the prisoners scored higher on the test the second time round because they'd had more practice at it). Another possibility is that the high conscientiousness seen in the Swedish prisoners is specific to their country's prison system, where there is a greater emphasis on treatment and rehabilitation than in many other countries.

Also hopeful, and somewhat in line with the Swedish findings, two recent studies involved prisoners playing financial games that are often used to study cooperation, risk-taking and punishment (one of the games is unrelatedly called The Prisoner's Dilemma). These showed that prisoners engaged in normal or even heightened levels of cooperation.

The findings have implications for debates about the reintegration of criminals into society, says

Sigbjørn Birkeland at the NHH Norwegian School of Economics, who conducted one of these studies with colleagues. "A common perception... is that criminals are bad guys who lack prosocial motivation and this perception may potentially be used to justify harsh sentencing of criminals," they wrote. Their results show, they said, that criminals can be just as "equally pro-socially motivated as the general population."

As awareness grows that personality is malleable, hopefully this will lead to greater efforts to consider how the prison environment can shape an inmate's character. This clearly could affect their return to society.

There is currently a dearth of existing research with this explicit aim. For now, the evidence we have suggests that prison life leads to personality changes that are likely to hamper a person's rehabilitation and reintegration. To one extent that may be inevitable, given the loss of privacy and freedom.

But that said, the research findings regarding prisoner conscientiousness and cooperation show all hope is not lost, and they highlight potential targets for rehabilitation programmes.

These are not merely abstract issues of concern to scholars: they have profound implications for how we as a society wish to deal with those who break our laws. The current evidence suggests that the longer and harsher the prison sentence - in terms of less freedom, choice and opportunity for safe, meaningful relationships - the more likely that prisoners' personalities will be changed in ways that make their reintegration difficult and that increase their risk for re-offending.

Ultimately, society may be confronted with a choice. We can punish offenders more severely and risk changing them for the worse, or we can design sentencing rules and prisons in a way that helps offenders rehabilitate and change for the better.

--
Dr Christian Jarrett Join 800,000+ Future fans by liking us on Facebook, or follow us on Twitter. edits the British Psychological Society's Research Digest blog. His next book, Personology, will be published in 2019.
If you liked this story, sign up for the weekly bbc.com features newsletter, called "If You Only Read 6 Things This Week". A handpicked selection of stories from BBC Future, Culture, Capital, and Travel, delivered to your inbox every Friday.

# data[].attributes.attachment_link.description
Day after day, year after year, imagine having no space to call your own, no choice over who to be with, what to eat, or where to go. There is threat and suspicion everywhere. Love or even a gentle human touch can be difficult to find. You are separated from family and friends.

# data[].attributes.body
St. Nicholas, Sinterklaas, and Italy’s La Befana are all different variations of the idea of Santa. In all of their stories they leave something out as a warning to bad children. While Santa leaves out coal, the others have also been said to leave bundles of twigs, bags of salt, garlic, and onions.

# data[].attributes.attachment_link.readable_text
The tradition of giving misbehaving children lumps of fossil fuel predates the Santa we know, and is also associated with St. Nicholas, Sinterklaas, and Italy's La Befana. Though there doesn't seem to be one specific legend or history about any of these figures that gives a concrete reason for doling out coal specifically, the common thread between all of them seems to be convenience.

Santa and La Befana both get into people's homes via the fireplace chimney and leave gifts in stockings hung from the mantel. Sinterklaas's controversial assistant, Black Pete, also comes down the chimney and places gifts in shoes left out near the fireplace. St. Nick used to come in the window, and then switched to the chimney when they became common in Europe. Like Sinterklaas, his presents are traditionally slipped into shoes sitting by the fire.

So, let's step into the speculation zone: All of these characters are tied to the fireplace. When filling the stockings or the shoes, the holiday gift givers sometimes run into a kid who doesn't deserve a present. So to send a message and encourage better behavior next year, they leave something less desirable than the usual toys, money, or candy-and the fireplace would seem to make an easy and obvious source of non-presents. All the individual would need to do is reach down into the fireplace and grab a lump of coal. (While many people think of fireplaces burning wood logs, coal-fired ones were very common during the 19th and early 20th centuries, which is when the American Santa mythos was being established.)

That said, with the exception of Santa, none of these characters limits himself to coal when it comes to bad kids. They've also been said to leave bundles of twigs, bags of salt, garlic, and onions, which suggests that they're less reluctant than Santa to haul their bad kid gifts around all night in addition to the good presents.
Have you got a Big Question you'd like us to answer? If so, let us know by emailing us at bigquestions@mentalfloss.com.
Subscribe to our Newsletter!

# data[].attributes.attachment_link.title
Why Does Santa Claus Give Coal to Bad Kids?

# data[].attributes.attachment_link.description
The tradition of giving misbehaving children lumps of fossil fuel predates the Santa we know, and is also associated with St. Nicholas, Sinterklaas, and Italy's La Befana. Though there doesn't seem to be one specific legend or history about any of these figures that gives a concrete reason for doling out coal specifically, the common thread between all of them seems to be convenience.

# data[].attributes.body
The idea of punishment is engrained into children's heads from a young age to discourage them from acting immorally. We can see the effects of lax punishment in children who's parents let them get away with bad behavior. Often these children are not taught skills like sharing or being kind. It is also unpleasant for the child as they do not know why it's harder to make friends.

# data[].attributes.body
This set of type made with someone's body would be good for exploring the idea of a freak show as commonly they had contortionists who would bend themselves into shapes like this.

# data[].attributes.body
I like Annie's work as its so unique and playful. This branding for a cosmetics brand is based off circus aesthetic. The curved type with the fancy detailing is my favourite detail. It reminds me of the typography from the old freak show posters I researched.

# data[].attributes.body
This is her design for a book cover. Her illustration style gives it a whimsical touch. She doesn't use straight lines so it looks very hand drawn. The colour scheme makes the type pop which is good for the purpose of the design.

# data[].attributes.body
Another of her works for The Grand Budapest Hotel is this prop box that was used in the film. This has the same lavish detailing around the type as the cosmetics design. This is the sort of style I'd like to try when designing based on Bedlam.

# data[].attributes.body
"Having worked in newspapers for the past 10 years, I wanted to reflect how so much of my time is spent designing both on a screen and also with halftones in print. The base letter is from Austin News Headline, the font I commissioned for the Telegraph, designed by Paul Barnes at Commercial Type."
I really like this letterform. The halftone effect is interesting as it's an unconventional way to blur something. I think it works well because Q is a circular letter, so making it out of small circles is visually pleasing.

# data[].attributes.body
I was inspired by this cutout design by Louis Reith. I thought I could do a similar thing but using pictures of patients from Bedlam with the cut out area forming a B.

# data[].attributes.body
Inspired by Louis Reith I made a B out of pictures of patients from Bethlem. This was a quick first try so I just did it on photoshop instead of actually printing them out and collaging them. I think the photos are a good visual tool to represent the whole hospital because by seeing what they look like you can begin to try and understand what they went through. While I am pleased with the outcome of this piece I would like to make something with more emphasis on Bedlam and the chaos that ensued there. For an outsider looking in at this piece it would not be obvious what my theme is.

# data[].attributes.body
These ideas all follow the theme of deviancy:
In Bedlam, the mentally ill people were seen as deviants because they didn't behave in a socially acceptable way.
In prison, the inmates have committed deviant acts to end up there.
The children who get coal for Christmas have behaved badly, meaning they are deviant.

# data[].attributes.body
https://thepsychologist.bps.org.uk/volume-29/march-2016/understanding-experience-imprisonment

# data[].attributes.attachment_link.readable_text
One of the students I teach told me that she had recently visited a police station to observe a mental health team. The police sergeant asked whether she'd like to go into the police cell for a short period of time; she agreed. She told me how struck she was by this experience, one she will never forget. Perhaps it would be valuable for psychologists working in prisons to have an experience like this, of spending some time in a prison cell, in order to get a sense of this day-on-day experience of prisoners. Of course, I doubt that a short stay would come close to capturing what it is actually like to be locked in a small space, unable to ask someone to let you out when you want. But from my experience as a prison researcher and then as a psychologist in prisons and other secure settings, it has long struck me that in order to practise effectively as psychologists, we must at least try to acquire a detailed understanding of the daily lived experience of prisoners.

Such attunement to prisoners' unique experiences would help us to direct our practice to promoting recovery in a meaningful way. In their 2012 book Secure Recovery, Gerard Drennan and Deborah Alred usefully summarise the principal spheres of recovery for people with mental health difficulties as clinical, functional, social and personal. They also add to that list 'offender' recovery, which they define as 'coming to terms with having offended, perceiving the need to change the personal qualities that resulted in past offending, which also create the future risk of reoffending, and accepting social and personal consequences of having offended' (p.15). I would suggest that in order to help prisoners recover from their past experience of offending and prevent future similar experiences, we must first understand their current experiences, psychological and social, of imprisonment.

Before I trained and worked as a clinical psychologist in forensic settings, I spent time as a criminologist and prison ethnographer. The ethnographer watches what happens, listens to what is said, and asks questions, in order to understand those people's experiences holistically (Hammersley & Atkinson 1997). The ethnographer aims to develop a 'thick-description' (Geertz 1973) of the subjective lived experience of the group with whom she or he has spent a long spell of time. Ethnography involves learning from people rather than studying people (Spradley 1980), so the ethnographer does not come in to a culture taking an expert position.

This was my initial experience of working with prisoners, during my doctoral research on the psychosocial experience of prison for young adults aged 18-20, when I spent a year at HMYOI Feltham (Harvey, 2007). I interviewed young people and staff, and carried out social network analyses of the relationships between prisoners. But also, as part of my ethnographic approach, I was given a set of keys and spent a substantial period of time observing the practices of everyday life, shadowing, observing and interacting with staff and prisoners. As a student and ethnographer, rather than a practitioner then, my reason for being there was to understand - to capture the detail of life there and to witness the ebb and flow of social relationships.

That experience has shaped my later practice as a psychologist in secure settings: I have continued to try to comprehend the lived experience of prisoners in these confined spaces. In my practice (and in this article) I continue to draw not only on some of the findings from my doctoral research but also on some reflections on the process of carrying out such an ethnography.

So what do we know about the experience of imprisonment? There is a wealth of studies of prisoners' culture and the psychological experience of confinement (Liebling & Maruna 2005). Research has explored what prisoners import with them into prison, the deprivations of the prison environment and the interaction between the individual and their environment (Toch, 1992). We know that prisoners import with them a range of psychological and social difficulties and that being in prison presents further challenges or 'pains of imprisonment', a term favoured by Gresham Sykes (1958) in his classic text The Society of Captives. Sykes identified these pervasive pains as the deprivations of liberty, goods and services, of contact with family and friends, of autonomy and of security.

Of course, while the pains of imprisonment are well documented, it is important to note by contrast that, for some people, imprisonment might feel like a relief from a difficult life outside and that some prisoners become attached to the prison. That said, a person's life outside prison must be very difficult, if prison, with its controls and deprivations, is preferable. And even if a person is more attached to the institution and has learned to navigate it, the experience of imprisonment is still full of difficulties.

In the prison, there are specific dangers, from increased prevalence of bullying and high rates of self-harm and self-inflicted deaths (Ireland 2002; Liebling, 2007). There are also more general difficulties: experiences of 'fear, anxiety, loneliness, trauma, depression, injustice, powerlessness, violence and uncertainty' have been identified as common to prison life (Liebling & Maruna, 2005, p.3). Irving Goffman's classic study also reminds us of the profound impact that imprisonment can have on a person's basic identity: he describes the process of entering the 'total institution' as a 'mortification of the self' (Goffman 1961, p.25) and 'personal defacement' (p.29).

I too was interested in the entry point into custody and, in my ethnographic study, examined how young men adapted to the first month in custody. Some common themes emerged about their experience: a preoccupation with safety, a sense of losing control and freedom, feelings of uncertainty, and separation and loss. I interviewed the young men longitudinally after 3, 10 and 30 days in custody and found that the young men who had the most difficulty regulating their emotions and had higher level of psychological distress after three days still found it most difficult to adapt to life in prison after 30 days as well.

In my study, the variables that significantly accounted for variance in psychological distress for people after three days in custody were their locus of control and their perceptions of their own adaptability. Their sense of safety also showed a significant correlation with their levels of distress. Individuals with an internal locus of control were able to find ways of achieving at least some sense of autonomy within this limiting environment, and did not feel completely determined by their experience. These young men were able to find jobs in prison or take up the education on offer. However, those who scored higher on an external locus of control were more distressed. Perceived adaptability, that is, the young men's own sense of whether or not they would be able to cope with prison life, also significantly predicted variance in psychological distress. Those who reported that they found it difficult to adapt to life in prison, or could not cope with the experience, were more distressed. Safety also appeared as an important variable. How safe a young person felt in this environment had profound implications for his wellbeing and ability to engage in interventions that were on offer. Such differences have significance when thinking about what might be needed to help a prisoner along the journey of recovery.

Why, though, do we need this understanding of the experience of imprisonment as a prerequisite to our practice? First, there are ethical reasons for improving our knowledge of the pains of imprisonment and the process of adaptation. If we are not thinking fully about the painful nature of secure confinement, we are then not validating, or indeed are invalidating, the experience of the thousands of people who are locked in our prisons today.

Moreover, if we as practitioners do not place their experience at the centre of our thinking about psychological provision, then we are not going to contribute to the amelioration of the potential harmful effects of imprisonment. The daily experience of life in prison should be considered throughout our assessments, formulations, interventions, evaluation, audit and research, training and consultation. Recognising the pains of imprisonment would ensure that we tailor our services to the needs of prisoners and to the amelioration of the pains of imprisonment. Consider the construct of psychological distress, and my measure of it in my past study. Can conventional, standardised notions of depression or anxiety aptly capture psychological pain that might be, in some part, induced by the prison itself?

When developing therapy provision in prison (Harvey & Smedley, 2010), context should be uppermost in the mind of the applied psychologist. If we were to focus solely on the delivery of specific interventions for specific psychological difficulties, then we might risk our interventions being too atomised and attending to individual factors at the expense of attending to systemic factors. A detailed exploration of the pains of imprisonment should be routine practice. Such a contextual understanding of the client's current experience might also inform interventions focused on specific offences. For example, the first place to start might be on helping prisoners cope with being locked up and separated from loved ones, before considering their offence. We might even ask whether we should be offering more interventions that centre on coping with imprisonment, alongside offence-focused work?

Finally, we might recognise that the very environment where psychological provision is being offered has the potential to do harm. We need to ensure that we deliver interventions that are safe and bear in mind individuals' responses to imprisonment. For instance, there are significant ethical and practical challenges in carrying out trauma-focused work in an environment that might be perpetuating the trauma. How do we ensure that the client is able to cope following a psychology session when they then might be locked up for a substantial period of time? Moreover, we might make more central to our practice the task of working closely with prison staff to help staff understand how an individual's presentation might result from what the individual has brought with them into the prison, so pre-existing vulnerabilities, but also how the environment itself interacts with the individual.
Image: Therapy Chair, HM Prison Grendon. Courtesy of the Koestler Trust.
But how, in practice, could we go about understanding the pains of imprisonment, or making them more central to our work? First, we might think differently about preparing psychologists for work in prisons. Induction programmes for new staff could include time to focus explicitly on the effects of imprisonment. Such programmes could make time to think about the psychological effects of imprisonment for prisoners, but to consider the impact on the psychologist too. It might be useful for some of the findings on the effects of imprisonment to be shared. Importantly, it might be useful for former or current prisoners to talk about their experience, although this would require careful thought in order to ensure that the space felt safe and contained. Likewise, it is important for psychologists to be oriented to the demands in the role when working in prisons and for there to be a space to allow new psychologists the opportunity to voice their hopes and fears and to be offered support. Of course, the role of ongoing clinical supervision is also paramount.

Second, I am wondering whether it would be useful to borrow some of the methods of ethnographic research for use in psychological practice. As mentioned above, at the heart of ethnography is the attempt to understand and learn from the particular group of people. Could psychologists from time-to-time adopt the role of the 'participant-observer' and be freed from routine assessments and interventions, actively to observe and reflect on micro-moments of prison life, as an ethnographer might? This could yield useful reflections that might be helpful for practice. Psychologists, normally presenting themselves as 'scientist-practitioners', could develop themselves also as 'ethnographic practitioners' when working in prisons - or indeed in other social contexts - and have at least some time to use the method of ethnography in their practice (Harvey 2015). Such moments could include shadowing staff, carrying out detailed observations of social interactions on the wing, attending adjudication meetings, spending time in different areas of the prison and absorbing and making sense of the culture.

For example, when I carried out my ethnographic study at HMYOI Feltham, I was able to walk around the prison and observe what was going on without being there as a practitioner with tasks to do. I was able to spend time in the visits hall and observe the young people before, during and after visits. This gave me some insight into the complex emotional experience of a visit and the ways that emotions shift during this process. Learning from such observations could be a useful complement to hearing clients' reflecting on their responses to visits in a psychology session. When a prisoner says that he no longer wants his loved ones to visit, say, a psychologist would be better attuned to what might prompt such an assertion.

Finally, in our practice, we might consider the 'pain quotient' which has been conceptualised by O'Donnell (2014, and this issue, p.000) in his writing on the experience of long-term prisoners. He identifies two variables that affect this quotient: the time the person has left to serve in prison and the likely lifespan remaining to a person of this age after the sentence. I think a broader conceptualisation of the 'pain quotient' could be useful when working clinically with prisoners to ensure we are thinking about their level of potential pain, as it might inform our contextual understanding of their experience. Of course, prisoners vary in length of sentence, and their age, but they also vary in the personal and social resources they bring with them into the prison. Such personal and social resources could impact upon the level of pain experienced. Furthermore, we know that prisons themselves vary in their 'quality of life' (Liebling, 2004), and some prisons might be experienced as more painful than others. It would be useful to measure pain at both an individual and prison community level, and consider the interaction between the two. Perhaps we need to capture the notion of pain in those micro-interactions, and an ethnographic approach might help us do so. Through developing such a detailed 'thick description' of the prison, we could then develop deeply contextualised interventions aimed at reducing the experience of pain.

Of course any such work in assessing and formulating the prison, as well as the prisoner, is limited by the finite resource of time; but such time could be useful if reflections from these observations and interactions were fed back to inform practice. Considering the prisoners' experience with an ethnographic attitude could open up different avenues of discourse with our clients, and help us to develop psychological services that are truly attuned to their needs.
Meet the author
'My own interest in tracing the experience of imprisonment stems from time spent as a criminologist and prison ethnographer, before I trained and worked as a clinical psychologist in forensic settings. The practice of ethnography, which was developed by social anthropologists, involves spending time with a group of people in order to understand their experience.
I now firmly believe that ethnographic processes of understanding prisoners' experience will be useful for improving psychological practice with them.'

- Joel Harvey is a Lecturer in Clinical Psychology at the Institute of Psychiatry, Psychology and Neuroscience.
[email protected]

Image credit: Demon in Solitary, HM Prison Littlehey, Grayson Perry Bronze Award. Courtesy of the Koestler Trust.
References
Drennan, G. & Alred, D. (Eds.) (2012). Secure recovery. Abingdon: Routledge.
Geertz, C. (1973). The interpretation of cultures. New York: Basic Books.
Goffman, E. (1961). Asylums. London: Penguin.
Hammersley, M. & Atkinson, P. (1997). Ethnography. Abingdon: Routledge
Harvey, J. (2007). Young men in prison: Surviving and adapting to life inside. Cullompton: Willan.
Harvey, J. (2015). The ethnographic practitioner. In D. Drake, R. Earle & J. Sloan (Eds.) The Palgrave handbook of prison ethnography (pp.390-402). Basingstoke: Palgrave.
Harvey, J. & Smedley K. (2010). Introduction. In Harvey, J. & Smedley K. (Eds.) Psychological therapy in prisons and other secure settings. Cullompton: Willan.
Ireland, J. (2002). Bullying among prisoners. Hove: Brunner-Routledge.
Liebling, A. (2004). Prisons and their moral performance. Oxford: Oxford University Press.
Liebling, A. (2007). Prison suicide and its prevention. In Y. Jewkes (Ed.) Handbook on prisons. (pp.423-446). Cullompton: Willan.
Liebling. A. & Maruna, S. (Eds) (2005). The effects of imprisonment. Cullompton: Willan.
O'Donnell, I. (2014). Prisoners, solitude and time. Oxford: Oxford University Press.
Spradley, J.P. (1980). Participant observation. Orlando, FL: Harcourt Brace Jovanovich.
Sykes, G. (1958). The society of captives. Princeton, NJ: Princeton University Press.
Toch, H. (1992). Living in prison. Washington, DC: APA

# data[].attributes.attachment_link.title
Understanding the experience of imprisonment

# data[].attributes.attachment_link.description
One of the students I teach told me that she had recently visited a police station to observe a mental health team. The police sergeant asked whether she'd like to go into the police cell for a short period of time; she agreed.

# data[].attributes.body
This artist was treated at Bethlem

# data[].attributes.attachment_link.description
Discover artworks, explore venues and meet artists. Art UK is the online home for every public collection in the UK. Featuring over 275,000 artworks by over 50,000 artists.

# data[].attributes.body
So was this one

# data[].attributes.attachment_link.readable_text
Art UK has updated its cookies policy. By using this website you are agreeing to the use of cookies. To find out more read our updated Use of Cookies policy and our updated Privacy policy.

Close

(b Chatham, Kent, 1 Aug. 1817; d Broadmoor Hospital, Berkshire, 8 Jan. 1886). English painter who murdered his father in 1843 and spent the rest of his life in Bedlam and Broadmoor asylums. Before his mental breakdown he was considered one of the most promising artists of his generation (his friend Frith called him 'a man of genius that would assuredly have placed him high in the first rank of painters') and after his incarceration he was encouraged to continue painting. Although most of his work before the murder had been fairly conventional, he had begun to paint fairy and fantasy subjects and in the asylums he developed these along highly imaginative lines: The Fairy Feller's Master-Stroke (1855-64, Tate, London) is probably the best known.

Read more

Text source: The Oxford Dictionary of Art and Artists (Oxford University Press)

# data[].attributes.body
Louis Wain was a patient at Bethlam being treated for  schizophrenia. This collection of artworks by Louis Wain shows his mental deterioration over time and how that affected his artwork. I think this visual timeline of his mental decay is perfect inspiration for my project. I could do 6 letter Bs and they slowly become less recognisable as a B and more surreal.

# data[].attributes.body
A similar thing is seen in Picasso's self portraits, as he battled with depression and allegedly schizophrenia his sense of self is seen deteriorating, by the last painting his face is unrecognisable as being human.

# data[].attributes.body
I want to create a 6 versions of the letter B inspired by Louis Wain and Picasso. I want to show the decaying of the mind through my piece to highlight what it was like for the patients at Bethlem.

# data[].attributes.body
This artist created art based on his time in prison. He wanted to highlight how isolating it was for him.

'Nardone is uniquely gifted at conveying the warmth that surrounds memories when they are recalled from the grimness of prison, while also capturing the hallucinatory, time-stopping atmosphere of prison itself.'
https://www.themarshallproject.org/2019/04/22/drawing-from-memory-a-former-prisoner-creates-art-from-pain-and-loss

# data[].attributes.body
I like this style of stop motion animation. I think I could make a compilation of different Bs in this style.

# data[].attributes.attachment_link.embed_code
View this post on Instagram

A post shared by Patrick Thomas (@xpatrickthomas)

# data[].attributes.body
The first B is just the plain letterform as I wanted a clear starting point for the letter's journey.

# data[].attributes.body
I wanted the next one to have more detail to show there had been more thought put into it. I was also inspired by Annie Atkins' work. The typography is meant to look a bit like the type used for freak shows because of Bethlem's links to them.

# data[].attributes.body
I wanted this to look like the memory of what a B looks like was fading away. I was inspired by Jon Hill's Q letterform. I used the liquify tool to distort the letter, then I added a gaussian blur. To get the dotted look I used the halftone effect on it.

# data[].attributes.body
I wanted this B to show fear or panic. The cuts are meant to look like it has been dropped and smashed. I thought this could be a good representation of a breaking points for many patients at Bethlem.

# data[].attributes.body
This letterform is an adaption of my first attempt. I started by using black eyeshadow to mark the shape of a B. I used eyeshadow to look similar to coal because of its links to my project. Then I cut out various images to do with Bethlem such as:
- pictures of the patients
- leeches, because a common treatment there was bloodletting by leeches
- barred windows, to show they couldn't leave

# data[].attributes.body
For the final letterform I decided to rip up the previous one and photocopy it. I wanted to show frustration that the patients may have had about the hospital and about themselves. I thought it would be a good end to the journey of the letter because it ends up being destroyed, just like the patients.

# data[].attributes.body
I'm pleased with my final outcome as it encapsulates Bethlem and its patients well. I think it also represents mental illness well. I enjoyed the journey I went on with this project as I got to learn about the interesting history of the word 'bedlam'. If I had more time for this project I would have done more exploration into prisons and coal as well as spent more time perfecting the Bs. However, for the time I had I think I completed the project accurately.

# data[].attributes.body
When I presented my final piece, the critisism I got was that the timing was too methodical and that the patients would not have had this type of rhythm in their lives. So this is the final outcome where some of the letters stay on screen for a shorter or longer amount of time.