Going crazy in solitary

Heavy-set, with a soft-jowled face, King has a distinctly ursine air about him. We first meet at a Wendy's in downtown Brooklyn, his teddy-bearishness rounded out by a plushy layer of cocoa-colored velour tracksuit with a matching hoodie, T-shirt, and beanie hat. He is a garrulous, flirty raconteur. When he talks about his three-decade long "bid" in various upstate correctional facilities, punctuated by periods of isolation in "the Box" — a solitary confinement cell — he gets quieter, and stares away, distracted and angry.

In 2007, King spent 75 days in the Special Housing Unit (SHU) of Fishkill Correctional Facility in upstate New York. "Some rat told a correctional officer I was selling weed," he recalls. "So they gave me...75 days in the Box." He found himself in a 7-by-10-foot concrete cell with a small bed and toilet. It had a solid metal door with a small window made of hard plastic, out of which he could see a catwalk. A few times a day he saw correctional officers walking past, and once a day, a nurse dispensing medication.

Every morning, for an hour's recreation, a door at the back opened out on to a "recreation cage": a slightly bigger Box with a tiny, barred window. He had been in the Box a couple of times before, but these 75 days were the longest he'd ever been stuck there.

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"All day, every day in the Box," he recalls, staring down at the table, "people go off. They yell, they scream, they talk to they-self. They cuss the police out, call them all types of names: 'Cracker!' 'Incest baby!' At 2 or 3 in the morning, somebody starts screaming, 'Aaaaaa!' You don't do nothin', you shake your head sayin', 'Another one.'"

King has been out of prison for four years. But he's traveling within a lonely Box wherever he goes. "I still don't meet people. I'm alone," he says. "I got my back to the door when I take the train. I can't have anyone behind me. I hate being in crowds." He struggles with paranoid fears — of being cut in the face by an assailant, of a policeman spotting him and deciding, for some occult reason, to beat him up.

In 2005, there were an estimated 81,600 prisoners in solitary in the U.S. That's 3.6 percent of the 2.2 million presently incarcerated, many of whom, like King, were put in there for acts of nonviolent rule-breaking. Some, like him, shuttle in and out of solitary; others remain locked up for decades. Prison authorities in every state are running a massive uncontrolled experiment on them. And every day, the products of these trials trickle out on to the streets, with their prospects of rehabilitation professionally, socially, even physiologically diminished. The Box, as psychologists and psychiatrists have been saying for decades, damages the mind. But evidence from neuroscience increasingly suggests that it is irrevocably harming the brain, too.

In 1982, forensic psychiatrist Stuart Grassian visited Walpole State Penitentiary in Massachusetts. He spoke to 14 young men who'd been in isolation for several months, each in a 6-by-9-foot cell. Grassian expected to hear fantastically exaggerated claims from prisoners looking to dupe their way out of the unit, but each vociferously denied that anything was the matter. "Solitary doesn't bother me," one told him. "Some of the guys can't take it, I can," said another. With close questioning, Grassian wrote later, the second prisoner "came to describe panic, fears of suffocation, and paranoid distortions while he had been in isolation," while the first had recently slashed his wrists because he "figured it was the only way to get out of here."

They suffered a range of symptoms: stupor, delirium, hallucination, and a loss of "perceptual constancy" — the ability to recognize the sameness of things when viewed from different distances and angles. Many had painfully sharpened senses. One lived in dread of prisoners on the tier above turning on the faucet. "It's too loud, gets on your nerves. I can't stand it — I start to holler," he told Grassian. "Are they doing it on purpose?"

Half of them hallucinated constantly. They heard whispers and muttered sounds, which took on menacing meanings: prison guards conferring about amputating a prisoner's leg, someone getting beaten up with sticks. Four had extended bouts of amnesia. They said they felt narcotized, and couldn't concentrate on anything.

"These people were very sick," recalls Grassian. He thought it resembled anoxic brain injury — the result of an oxygen-starved brain — or delirium tremens. But the symptoms also recalled a curious set of Cold War–era experiments that Grassian had read about years before.

Through the 1950s and '60s, researchers in America and Canada were investigating the effects of "sensory deprivation" or "perceptual isolation," both analogues of solitary. This work was largely bankrolled by the CIA, which was interested in developing more efficient techniques of interrogation and "mind control." Canadian neuropsychologist Donald O. Hebb proposed that dramatically reduced stimuli — such as in narrow windowless cells with single beds — might be one way to impair a prisoner's alertness, and lay the ground for "the implantation of new or different ideas."

To test this hypothesis, Hebb's colleagues at McGill University confined college students to isolation units, where ear pillows muffled their hearing and plastic visors restricted their sight. Within 24 hours, they couldn't think or concentrate, and experienced powerful sensorial hallucinations: They had strange visions of rocks, eyeglasses, babies; their skin crawled; and they heard choirs trilling in "full stereophonic sound." They experienced spatial disorientation whenever they left their cell.

Does solitary draw in an especially vulnerable subgroup of prisoners? Does isolation damage or transform the brain? Or both? Grassian is convinced that both are true — the first, from his research, and the second, from his experiences visiting hundreds of prisoners in isolation units across the country. "Punish him, punish him, punish him: That's the only thing the correctional system knows to do," he told me. But the kind of prisoners who tend to be in solitary don't respond to a rational calculus of means and ends. His research and observations have lent strength to several important federal court decisions, including Madrid v. Gomez, in which the court called for the removal of prisoners with psychiatric problems from isolation, and the judge conceded that the conditions in SHUs "may well hover on the edge of what is humanly tolerable for those with normal resilience."

You are where you live. How you live shapes who you are. We owe a debt to Hebb for proving these aphorisms right down to the neuron. In 1947, Hebb took a few rat pups home for his children to play with. When these pups grew older and hairier, and were less welcome darting about the furniture, he brought them back to his lab, where they outsmarted cage-reared rats in problem-solving tests. They were also visibly well-adjusted, unlike cage-bound compatriots who groomed themselves until their whiskers dropped off, and had balding patches all over their bodies.

During the 1960s and '70s, researchers at the University of California, Berkeley, followed up on Hebb's observation. The neuroscientist Mark Rosenzweig showed that, when compared with rat packs that roved in rodent McMansions filled with ladders, tunnels, and toys, animals that languished in spartan cages had fewer connections between neurons and thinner cerebral cortexes. Marian Diamond, a colleague of Rosenzweig, showed that various types of enriched or impoverished environmental exposures could alter the dimensions and even the cellular content of the cortex at any age from newborn to elderly. Even four days of impoverished environment could have an impact on the physiology of the cortex and its ability to navigate the world.

These were stunning discoveries. The cerebral cortex is the part of the brain that makes us most human. This dime-thick, intricate surface runs across the two hemispheres of our brain. It's where we make our plans, guide our movements, and consciously respond to social cues. It's where stimulus turns to perception, where the neural nuts-and-bolts of language reside. The Berkeley experiments showed that, at least for rats, social interactions and surroundings are inscribed in the neurophysiology of the brain, and not just during the early part of life.

But what was it about isolation and confinement that caused the brain to become impoverished? In 2004, Princeton researchers Elizabeth Gould and Alexis Stranahan inadvertently stumbled upon a clue while investigating a paradox: Exercise was known to release stress hormones that should tamp down on neural growth. Yet a raft of studies consistently showed that exercise was a fail-safe way of enhancing the growth of new neurons in the adult brain.

To investigate, Stranahan and Gould took adult rats, housed separately, and had them scrabble around running wheels. Then Stranahan killed the rats and examined their brains under the microscope. She was dismayed to find no increase in neurogenesis in spite of the exercise. "Not only that, she saw an opposite effect," Gould told me. "The running animals were showing a reduction in neurogenesis." When Stranahan consulted the studies she'd been trying to replicate, she saw that all prior test subjects had been group-housed.

On closer scrutiny, Gould and Stranahan found that when the adult rats who'd been isolated ran, their brains were flush with elevated levels of the stress hormone corticosterone — the rodent analogue of the human stress hormone cortisol, produced by the adrenal gland. Isolation had caused levels of the hormone to spike so high that, instead of proliferating, neurons were dying off. "It shows that when animals live alone, they're not very good at coping with a challenge [such as running] to the system," says Gould.

A little stress-induced cortisol is actually good for you. It reins in the immune system, controls inflammation, and keeps you alert and energized in the morning when its levels are naturally high. But when stress is chronic, the ebb and flow of stress hormones becomes a steady, unceasing seep. The hippocampus is not able to shut down the stress response, leading to weakened immunity, demineralized bones, clogged and narrowed arteries, obesity, impaired memory and cognition, and a susceptibility to psychological problems. Chronically depressed people are likely to have too much cortisol sloshing around their brain through the day, while sufferers of post-traumatic stress disorder (PTSD) — and residents of the Box — likely owe their constant state of hypervigilance to overpowering doses of noradrenaline.

Craig Haney, one of the leading correctional psychologists in the U.S., has testified to the psychological impact of solitary confinement on prisoners numerous times, including in a 2012 Senate hearing in Washington, D.C. In the course of his work over two decades, Haney has found that isolation puts prisoners at risk of a range of adverse symptoms: appetite and sleep disturbances, withdrawal, hypersensitivity, anxiety, panic, chronic tiredness and depression, rage, loss of control, paranoia, hallucinations, self-mutilation, and suicidal ideation and behavior.

And every year, inmates leave solitary cells to join the ranks of parolees outside prison, their minds altered by an experience so fraught with risk that scientists require special dispensation to do it to animals.

This article was originally published in Aeon Magazine, a digital magazine or ideas and culture. Follow them on Twitter at @aeonmag.