Attending to Attachment in the Treatment of Incarcerated Women By Brooke Sheehan, LCSW on 4/5/22 - 2:59 PM

It was a sunny August day when I took a brisk walk across campus to get to the part of the facility that housed the incarcerated women with whom I would soon be working. I remember feeling fully ready for this new endeavor and eager to have a new clinical experience. As I entered the facility, waiting to be buzzed in through the double locked and heavily-reinforced doors, I immediately noticed how bustling the unit was. Looking around, I saw women hustling to their textile-industry jobs, rushing to their various group rooms, meeting for education classes, and heading outdoors to play volleyball. Taking in all of these varied activities, I became poignantly aware of one of the obvious similarities among the residents—most of these incarcerated women were of child-bearing age.

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In my clinical experience with incarcerated men, I have worked with some invested fathers, but the theme around children has tended to be less pronounced than it has been when working with their female counterparts. With the women, I conducted more grief and loss groups than I ever had before, with waitlists that never seemed to get any shorter. In those groups, I became immersed in the nuances of the lives that lead women to lose their parental rights. My heart broke for these women who found themselves in the position where they were perpetuating family traumas despite their best efforts not to.

Jillian, I will call her, was a woman similar in age to myself, whom I worked with up until her release. She and her child’s father both struggled with substance use, having been consumed by the nation’s opioid epidemic. Jillian came from an impoverished family in a rural area that was severely under-resourced, often having to make the decision between paying the electric bill or being able to afford prescription medications. Jillian was very candid that she used illicit drugs, but that she was drawn to selling them because doing so was a direct road to fast money, which in turn allowed her to provide for her daughter in a way that she had not been provided for herself. Jillian and I would meet weekly in sessions that almost always focused on her daughter. She was fortunate enough to have her daughter reside with a family member rather than lose custody of her, but in essence, she was one fragile relationship away from losing that precious custody, and that weighed on her like a boulder. I remember one conversation in which Jillian shared, “I’m so worried about my mother. She doesn’t have enough money for gas, her prescriptions, and the heating bill. If she doesn’t get her prescriptions, she will get sick and could end up not being able to take care of my daughter. If she goes to get the prescriptions, she won’t have money for both that and the gas to get there.”

Jillian is but one representation of the near-constant fear that incarcerated mothers experience. If they have a sentence longer than 15 months, it is completely likely their parental rights will be terminated, and most sentences for drug offenses, which are often non-violent crimes, typically carry more than 15 months. Pair this with the glacially slow legal system which leaves women like Jillian in limbo, waiting for their sentences to be assigned all the while knowing the custody of their children is at risk.

If you are both a therapist and parent, the following is likely not difficult to appreciate. In my clinical experience, mothers who lose custody of their children are at risk to reoffend because they lose what is very often their entire sense of purpose. Oftentimes, although women such as Jillian use and sell drugs—which is obviously an unsafe atmosphere in which to raise children—they engage in far less risky behavior than if they were childless. Not uncommonly, the women with whom I have worked in correctional custody have been victims of human trafficking, sometimes even prostituted by their own family members while adolescents. Many of them grew up in poverty, having experienced horrific abuse, multiple pregnancies, school dropout, addiction, and the absence of their own parents, who were often imprisoned.

To highlight the dark hues of this already bleak picture, I remember a client I will call Mary-Beth, who took a five-year sentence rather than accepting probation so that she would have a chance of being able to spend some quantum of time with her mother, who was also incarcerated and would be released within nine months. Mary-Beth had her own daughter at home, but this did not waive her choice to take a prison bid over probation, because she was that entrenched in trying to have an interaction with her mother.

It has been relatively easy for me to see how the patterns of familial and often multigenerational trauma have played out in Mary-Beth’s life, and the lives of other women who have desperately tried to salvage their parental identities and bonds while behind bars. Had Mary-Beth not spent her childhood chasing her mother out of bars, waiting in cars in the dark while her mother turned tricks, or watching her use substances in between prison bids, Mary-Beth might have been able to develop an identity grounded in secure attachment that could have protected her from imprisonment and resulted in a tangible, rather than ephemeral, relationship with her own child. Now as a young woman, she is perpetuating the same scenario she experienced in the past with her own daughter, which inescapably manifests in pathology around abandonment and paves a direct route to addiction high-risk relationships and self-destruction in seemingly futile attempts to fill the void left by disrupted attachments.


I learned more than I ever would have thought possible from this clinical work with incarcerated women and mothers. Whenever possible, I work on parenting skills and psychoeducation around attachment theory with these clients so that together, we prioritize maternal and self-care skills they can utilize upon release. The additional work of helping promote mother-child bonds, even from behind bars, is critical in helping them break the vicious cycles that will inevitably undermine the attachment security of future generations. The last I heard, Jillian had completed her probation, maintained a job in the community, and was upholding her parenting responsibilities. She seems to be one of the lucky ones, and the implications for her daughter will hopefully be tenfold. The next chapter in Mary-Beth’s story is yet to be written.

File under: The Art of Psychotherapy, Musings and Reflections