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The Multidimensionality of “Pains of Imprisonment” Among IncarceratedWomen in IsraelMichal Soffera; Mimi Ajzenstadtb

a College of Law, Burton Blatt Institute, Syracuse University, Syracuse, New York, USA b Criminology,Faculty of Law and Paul Baerwald School of Social Work and Social Welfare, The Hebrew University,Jerusalem, Israel

Online publication date: 27 October 2010

To cite this Article Soffer, Michal and Ajzenstadt, Mimi(2010) 'The Multidimensionality of “Pains of Imprisonment”Among Incarcerated Women in Israel', Women & Health, 50: 6, 491 — 505To link to this Article: DOI: 10.1080/03630242.2010.510388URL: http://dx.doi.org/10.1080/03630242.2010.510388

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Women & Health, 50:491–505, 2010

Copyright © Taylor & Francis Group, LLC

ISSN: 0363-0242 print/1541-0331 online

DOI: 10.1080/03630242.2010.510388

The Multidimensionalityof ‘‘Pains of Imprisonment’’ Among

Incarcerated Women in Israel

MICHAL SOFFER, PhD, MSWCollege of Law, Burton Blatt Institute, Syracuse University,

Syracuse, New York, USA

MIMI AJZENSTADT, PhDCriminology, Faculty of Law and Paul Baerwald School of Social Work and Social Welfare,

The Hebrew University, Jerusalem, Israel

This study re-examined Gresham Sykes’s initial conceptualization

of ‘‘pains of imprisonment’’ as it applied to women inmates. It

contextualized these pains within the women’s social experiences

both inside and outside the only women’s prison in Israel. Semi-

structured interviews with 42 female prisoners were conducted.

Two counter-themes emerged from our analysis. The first one por-

trayed prison as punishment, a ‘‘painful condition,’’ a stressful

event that included deprivation, negative meaning, suffering, and

pain. The opposite—and more dominant—theme framed incarcer-

ation as a positive experience, during which the prisoners received

nurturing, care, and treatment, which they had not been afforded

in the outside world. We found that ‘‘pains of imprisonment’’

was a multidimensional and complex phenomena that included

contradicting emotions, thoughts, and behaviors. ‘‘Pains of im-

prisonment’’ was part of a larger group of pains that extended

beyond the time and place of prison.

KEYWORDS women prisoners, pains of imprisonment, positive

accounts of imprisonment

Received March 18, 2010; revised June 7, 2010; accepted July 12, 2010.

Address correspondence to Michal Soffer, PhD, MSW, College of Law, Burton BlattInstitute, Syracuse University, 900 S Crouse Avenue, Crouse-Hinds Hall, Suite 300, Syracuse,

New York, 13244-2130. E-mail: soffer.michal@gmail.com

491

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492 M. Soffer and M. Ajzenstadt

INTRODUCTION

Although the prison population consists primarily of men (more than 90% ofthe overall population), data from various Western countries show that thegender gap has significantly decreased over the years (Chen, 2009). In theU.S. for example, 9.1% of the inmates are women, while the female prisonpopulation grew by 832% from 1977 to 2007 (Women’s Prison Association,2010). Women prisoners consist of merely 1.8% of the Israeli’s prison pop-ulation.

The most recent data (special analyses of the Israeli Bureau of Statistics,personal correspondence) have shown a stability in the number of sentencedwomen offenders over the last decade. However, data from the Israeli PrisonAuthorities (2010) have indicated that the number of overall women prison-ers has increased over the years, which has suggested that the increase islargely attributed to other reasons of incarceration (i.e., illegal immigrantsand security prisoners; concerning the latter see Ajzenstadt & Ariel, 2008).Nonetheless, data from Israel and the U.S. have shown that about 80% ofwomen criminal prisoners served time for drug-related offenses (Shamai &Kochal, 2008).

Prisons are total institutions, in which time, space and movement areultimately controlled and monitored (Goffman, 1962; Scott, 2010). Througha process of ‘‘prisonization,’’ the prison’s norms are assimilated into theinmate’s thinking habits, emotions, and behaviors, and he/she becomespart of a group, no longer an individual (Clemmer, 1958). ‘‘Prisonization’’decreases the prisoner’s physical and psychological functioning over time, asprison is a continuously stressful situation, demanding a restructuring of one’sidentity and social roles (Haney, 2008). In his work ‘‘Society of Captives,’’Gresham Sykes (1958), built on Clemmer’s work (1958) and coined the term‘‘pains of imprisonment,’’ arguing that ‘‘life in the maximum security prisonis depriving or frustrating in the extreme’’ (p. 417). Following Sykes’s (1958)work, other scholars have stressed that life in prison is mainly a negativeexperience and prison is viewed mainly as a destructive, brutal, and in-humane environment or a stressful—sometimes traumatic—event, includingthe emotional and mental cost to prisoners (Haney, 2003). Sykes (1958)described five ‘‘painful conditions’’ which accompany prison life: the depriva-tion of liberty, autonomy, goods and services, heterosexual relationships, andsecurity. ‘‘Pains of imprisonment’’ are perceived as the core of prisonizationand the prison experience, and central criminological and other theoriesassume that incarceration is the ultimate and severest form of punishment,taking for granted the notion that prison is the most dire mechanism for theinfliction of pain (Haney, 2008).

Research has shown that, while all inmates are subjected to ‘‘pains ofimprisonment,’’ women prisoners are more vulnerable to them, and sufferthem to a greater extent as well as more intensely, compared with men

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prisoners (Collica, 2010; Moore, 2008). The psychiatric and psychologicalliterature has reported that a high percentage of female prisoners in Israeland other Western countries were victims of abuse; were more distressed;suffered from a higher prevalence of mental illness and psychiatric symp-toms, such as deep depression and anxiety disorders, in comparison withmen prisoners, other women, and general society (c.f. Binswanger et al.,2010; Bloom et al., 2003). Furthermore, due to the association betweenmental illness and suicide, compared with incarcerated men, incarceratedwomen are more likely to attempt suicide and to turn to self-harm and theabuse of drugs (Binswanger et al., 2010; Bloom, Owen, & Covington, 2003;Moore, 2008). Life in prison may trigger ‘‘re-traumatization’’ of childhoodtraumas and provoke psychological mechanisms and emotional reactionsthat were developed during childhood to adjust to disturbing events, mainlyexperiences of abuse and neglect (Dirks, 2004; Haney, 2003).

The central type of a ‘‘pain of imprisonment’’ experienced by femaleprisoners relates to their children. Many female prisoners are mothers, andthe pain of losing their children due to their incarceration as well as fearfor the children’s destiny have been found to be a major concern for thesewomen and to affect their mental well-being (Chen, 2009; Collica, 2010).Koban (1983) found that imprisoned women reported greater difficultiesin adjusting to the separation from their children, in comparison with im-prisoned men. Moreover, compared with men prisoners, women inmatesreported more hardships in maintaining contact with their children, as wellas a greater decline in the number of children’s visits over time (Tuerk &Loper, 2006).

While most studies have focused on ‘‘pains of imprisonment’’ and thenegative experiences of incarceration, examining stress, mental illness, andother negative accounts, very few studies have shown that women’s ex-perience of imprisonment may include positive aspects. For example, in astudy of female prisoners’ adjustment to a maximum security prison, Warrenet al. (2004) found that the majority of the women reported having ‘‘worseproblems with feeling angry, having heated arguments, getting involved infights, being injured, getting sick, and fearing an attack’’ when living in theoutside community than in prison (p. 640). Fryer (2005) reported that some ofthe prisoners perceived their lives in prison as satisfying. Similarly, Ferraroand Moe (2003) showed that many female prisoners, especially batteredwomen, consider their lives in prison to be better than their previous lives.

Following these preliminary studies, we conducted an exploratory study,which re-examined Sykes’s (1958) initial conceptualization of ‘‘pains of im-prisonment’’ as it applied to women inmates in Israel. Although statisticson the nature of crime and personal characteristics of women inmates areseldom collected or available to the public in Israel, evidence suggests thatwomen offenders in Israel share many similarities with their counterpartsin other Western countries including the U.S., i.e., low involvement in vi-

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olent offenses, while property crimes (fraud and theft) and drug offensescomprise the central types of crimes women commit (see the only recentstudy conducted in Israel by Erez, Hassin, and Rahav, 2000; see also Bureauof Justice Statistics, 1999; Belknap, 2007). Hence, Erez, Hassin, and Rahav(2000) suggested ‘‘that feminist insights and explanations provided in otherWestern countries equally apply to Israeli women’s criminality. Notwith-standing differences in the social and cultural history between Israel andthe countries : : : ’’ (p. 72).

METHODS

Population and Sample

This study was a part of a larger research project in which we examinedwomen prisoners in Neve Tirza, the only female penitentiary in Israel, amaximum security prison for 220 women prisoners, which at the time of thestudy housed criminal inmates, immigrant detainees, and women securityprisoners. For the purpose of the larger study, we interviewed 42 criminal in-mates, ten members of the staff, and studied prison files and documents. Thefindings in this article relate to the aforementioned sub-sample of 42 womeninmates. The eligibility criteria for the sub-sample of criminal inmates were:being able to communicate in Hebrew and having children. These criteriafit 85% of the prison’s population at the time that the study was conducted.Prison social workers from all units recruited inmates on the basis of theaforementioned eligibility criteria as well as availability, i.e., a conveniencesample of prisoners who were not engaged in any prison activity at thescheduled time of the visits. The recruiters were also instructed to approachwomen who varied by type of offense, age, and ethnicity. All the recruitedwomen fit the eligibility criteria, this was confirmed by the researchers priorto conducting the interview. Only three of those approached refused toparticipate in the study.

Data Collection

Data were collected over two consecutive years by the researchers who vis-ited the prison twice per month. After signing an informed consent, indicatingthe voluntary participation and ability to refuse or withdraw with no conse-quences, prisoners completed semi-structured person-to-person interviewswith the researchers and trained research assistants in the staff offices. All42 women completed the interviews, which were audio-recorded and latertranscribed. The average length of each interview ranged between an hourand an hour-and-a-half. A closely-followed interview protocol consisted of25 open-ended questions, concerning the women’s history and prison expe-rience, for example, ‘‘tell me about your childhood,’’ and ‘‘describe a typical

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day in prison’’ (for the detailed list, please contact the authors). The study wasapproved by the institutional review board (Hebrew University Jerusalem).

Data Analysis

We used qualitative research methods to understand women prisoners’ worldsand their personal stories of incarceration. This method was chosen as it isparticularly suited for exploratory studies in understudied areas and serves asa ‘‘catalyst for conceptualization’’ (Strauss & Corbin, 1990: 19). Data were an-alyzed by three analysts to assure reliable results, according to the followingstages: First, each analyst randomly selected three interviews and indepen-dently searched for emerging categories relating to the study’s aim (Ryan &Bernard, 2000). A discussion among the analysts of the identified categoriestook place in which the analysts summarized the content of each category,established category boundaries, and searched for negative evidence. Datathat could not be classified were identified and analyzed later to determineif they represented new categories or subcategories. The data analyses wasrepeated several times until all categories were agreed upon by all threeanalysts (i.e., 100%); in the first round 70% agreement was achieved, in thesecond round 10% of the remaining categories were agreed upon, and soforth, until we have reached 100% agreement between the analysts (see,e.g., Ajzenstadt & Steinberg, 1997). Second, each analyst randomly selectedthree new interviews and systematically assigned data segments from theseinterviews to the categories formulated. Comparing the data assigning resultsamong the analysts confirmed that the application of the 15 categories wasconsistent. The transcripts were independently coded by the three analysts toassure quality control of the coding. Finally, the 15 categories were groupedinto a smaller number of meaningful thematic clusters (Coffey & Atkinson,1996) according to identified recurrent themes across the texts. The cate-gories were compiled into two overarching themes: prison as punishment(the deprivation of liberty and autonomy, and the loss of contact with thechildren), and the ‘‘mothering role’’ of prison—the provision of care andtreatment (prison as a provider of physical, psychological, and social needs,and prison as a safe haven). This formed the basis for the structured analysisof all the interviews. Peer debriefing and audio-recording of the data analysisprocess were used to assure the trustworthiness of the themes constructed(Johnson & Waterfield, 2006; Morse et al., 2002).

RESULTS

The women were sentenced for the following offenses: the sale of illegaldrugs (13 inmates), theft (10 inmates), armed robbery (7 inmates), white-collar crime (4 inmates), inflicting severe injuries (2 inmates), attemptedmurder, abduction, and pimping in the context of the trafficking of women

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(1 inmate each). Punishments ranged from three years to life imprisonment.Ages ranged between 21 and 48 years. The majority (70%) were born toJewish parents who immigrated to Israel, 20% of the sampled women wereArab, and 10% were immigrants from the former Soviet Union. All of thewomen were mothers; the majority (84%) were single mothers.

Prison as Punishment

The image of prison as a polluted, evil, and morbid place was constructedin descriptions of specific types of ‘‘pains of imprisonment’’ which are ad-dressed below.

The deprivation of liberty and autonomy. Two major ‘‘pains of impris-onments’’ originally described by Sykes (1958) were evident in the women’snarratives: the loss of liberty and autonomy. G. verbalized the constant agonyof being imprisoned and denied her freedom: ‘‘Every single day for mebehind bars, being locked is like two years. It’s not easy being in prison. Iam not willing to repeat this experience again. I will never forget this foras long as I live.’’ Many of the women complained about the suffocating,painful feelings that surrounded the constant control and observation thatwas part of the prison routine. Thus, R. described prison surveillance as:

You get up to work : : : it’s hard for example, now it’s time for the nooncount; now it’s time for eating lunch. There comes a time when you’refed up, you hate being controlled. ‘‘Now, stand up and wait for a minute,now it’s an emergency, step there, etc.’’

S. expressed feelings of being controlled:

It is my body which is being controlled by others all the time, theyconduct urine samples by surprise.

B. portrayed her body as an object bearing ‘‘corners’’ which were reachableand could be violated at any given time:

Only here I appreciate the autonomy I had while I was outside. They getinto every corner of your body: they take urine samples without notice,they watch you all the time, you cannot move without being observed.

Thus, while medical examinations may have served as a means to correctand control deviant behaviors in prison, both punitive and medical controlsserved as mechanisms of discipline and reform (Bosworth, 2007). The ‘‘painsof imprisonment’’ of loss of liberty and autonomy were reflected in descrip-tions of multiple surveillance mechanisms that exercised power and controlover the prisoner and ‘‘prison becomes a site of perpetual surveillance,subjecting women in prison to a paradox: a visibility within invisibility’’(Wahidin & Tate, 2005: 63).

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The loss of contact with the children. The major source of pain, stress,and adversity for all the women we interviewed involved restricted con-tact with their children. One of the women told us that on her daughter’sbirthday, ‘‘I was with her in spirit.’’ The children of the prisoners becamea theme for fantasy and dreams. Even simple tasks that give substance tomotherhood—but which the prison denied—became a subject for yearn-ing. M. confessed that ‘‘I dream about dressing them : : : I wake up withtears every morning. I want to see them myself.’’ Some of the women weinterviewed claimed that their restricted contact with the children was dueto their dependence on people from the outside, including other familymembers, for maintaining contact with their children. For example, one ofthe women was heartbroken and helpless when ‘‘on his birthday, I sent myson a present. The father returned the present by mail. It was worse than adeath sentence.’’

Prison distorted the mother-child relations especially when the mothersbecame dependent on their child. Often this led to role-reversal, when themother became a ‘‘child’’—infantile, dependent and needy: ‘‘It is impossibleto be a mother in the prison. You must be careful not to annoy your childwhen you talk to her because you are dependent on her: : : : I am the childand she is the mother.’’ Some of the women we interviewed felt that theywere robbed of their mothering role by their total dependence on peopleon the outside to care for their children. M. said:

My sister comes, and my youngest calls her Mom. The first time I heardthat, I shed tears of blood. He only wanted my sister, and he calledher Mom. I felt so bad about it. That’s the hardest part, it always hurtsso much when he wants my sister: : : : I hadn’t given it much thoughtbefore, that she is actually raising him; it’s good that there is someone tocall ‘‘Mom’’ but it tore me apart.

The ‘‘Mothering Role’’ of Prison: The Provision of Care

and Treatment

In contrast to the image of ‘‘prison as punishment,’’ a more dominant de-scription of prison experience that the women voiced portrayed it as a timeduring which they received care and treatment.

Prison as a provider of physical needs. In contrast to Sykes’s (1958)conceptualization of the ‘‘pains of imprisonment’’ due to the loss of goodsand services, the interviewed women emphasized the fact that their basicneeds were taken care of during their incarceration. For example, one inmatetold us that in prison ‘‘You get food, milk, fruits; I don’t see it as a punishmentat all; it is like being in boarding school with other girls.’’ Other descriptionsportrayed the prison not simply as a place in which the inmates were notmaterially deprived, but rather as one that provided ‘‘luxuries.’’ H. said:

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498 M. Soffer and M. Ajzenstadt

I went up to the ward. It was very nice: good girls, okay people. I startedwalking and said to myself: ‘‘Am I truly in prison? This looks like a threestar hotel in Egypt or Jordan.’’ I looked around—wooden doors and aTV, a large, beautiful and tidy dining room, chairs. I entered the room,saw beds made up, everything, nothing missing, TV, hot plate, kettle,you’ve got everything in your room.

Prison as a provider of psychological and social needs. The womendescribed prison not just as providing their physical needs, but also as a placethat addressed other profound psychological needs, such as self-esteem andautonomy. This stands in stark contrast to Sykes’s (1958: 418) argument that‘‘pains of imprisonment’’ ‘‘pose profound threats to the inmate’s personalityor sense of personal worth.’’ J. described the effect that prison had on herself-esteem: ‘‘I did not taste the meaning of life yet, only suffer. Now, herein prison, I started to feel good—to love myself.’’ M. portrayed prison as the‘‘freedom’’ to stress the magnitude of inner emancipation she felt:

: : : I feel freedom inside. Even though I’m in prison, I’ve got freedom.No-one can pester me. No-one has a right to touch me. I’m free. I feelas though I’m blooming. They even tell me that I’ve got color in myface: : : : I feel free. I’ve got courage to speak out. I’ve already learned tosay no: : : : I’ve learned to stand up for my rights. I’ve learned so manythings in prison: : : :

While Sykes (1958) mainly addressed the prisoner’s actual confinement,the perception of ‘‘prison as freedom’’ implied a more profound freedom,i.e., of inner liberty, which is not influenced by prison walls. As was alsoevident from M’s story, prison was constructed not merely as allowing aninmate to fulfill her psychological needs, but also as a place that enabledtransformation, personal growth, and change. R. said, ‘‘The change in me isreal. I told you that my perception of the world has changed, that I see thingsdifferently today. It’s prison; it gave me a chance to look at other peopledifferently.’’ Viewing prison as a place that allows inner growth may seemsurprising at first; however, contemporary theories in psychology suggestthat even extreme situations, such as illness, can result in positive change.Linley and Joseph (2004: 11) call this ‘‘adversarial growth’’—changes thatincrease the person’s level of functioning after the event in comparison withtheir pre-event functioning. Thus, borrowing from this framework, womenprisoners may also experience adversarial growth inside the prison walls,which may explain their positive descriptions of the prison experience.

In contrast to Syke’s (1958) description of deprivation of autonomy,some women perceived prison as a place in which to exercise personalchoice. The women’s creation of arenas of choice regardless of the prisonwalls should be viewed as a reflection of strength and resilience. The descrip-tion of ‘‘prison as an arena of choice’’ was further constructed by comparing

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the women’s former, deviant lives and a ‘‘normative’’ way of living while in-carcerated. L. described the two options she would face once she is releasedfrom prison:

: : : I’m afraid to be released because, from the moment that I’ll be outthe last door, I’ll have two ways to turn. The first one is a staircase: it’shard to climb, there are various obstacles. The other one is going down,slippery and easy; you don’t even have to walk, you slide with it, butyou slide down. This road is the road of prostitution, of conning. Goingup is a way of living I really want to try.

L. constructed her options in the picturesque religious symbols of hell andheaven. On the one hand was the easy, slippery and sinful way that threat-ened to pull her down to hell; on the other was a less-traveled road, thedifficult journey that involved climbing up but is perceived as a worthwhileodyssey, because it symbolized the road to heaven. While many womendescribed the meeting of salient psychological needs and social needs inprison, some whom we interviewed regarded their therapeutic experiencesinside the prison as the source of these profound changes. L. told us abouther therapeutic relationship with a student of social work: ‘‘The therapy I get: : : This girl helped me a lot and I wait for these sessions because only thesesessions can help me.’’ T. spoke about her positive experience while she wasundergoing rehabilitation from drug abuse: ‘‘: : : in the treatment ward youlearn how to cope with life in different ways, not through drugs. How to copewith life in general : : : ’’ She referred to her learning to cope better with lifeon the outside. In a study of male inmates, van Harreveld et al. (2007) foundthat engaging in an emotion-focused coping strategy—sharing one’s feelingswith others and positively reframing the prison experience—was associatedwith improved well-being. These findings are consistent with studies onpositive outcomes of stress in relation to illness (such as caring for a partnerwith HIV/AIDS), which also indicated that these ways of coping facilitatedpositive emotions during stressful situations (Folkman & Moskowitz, 2000).

The experience of sharing one’s feelings with someone who listenedand cared was prevalent in the women’s therapeutic experiences. It seemedthat—maybe for the first time in their lives—they were able to connect, toexpress their inner feelings and share their unspoken life experiences. A.talked about her experience in relation to her participation in a parentingskills group in prison: ‘‘: : : I eagerly wait for these meetings: : : : I felt lonelyall of my life—until I started to participate in the group. Suddenly I was a partof a group. Suddenly A. is cooperative, becomes the star of the group: : : : ’’

Other women also expressed this personal view of prison as a fulfillerof social needs. The main imagery that they used to describe this experienceportrayed the ‘‘prison as a family.’’ One of the inmates told us that ‘‘for thefirst time in my life I feel part of a family, people care about me. They willnot let me die’’ and, similarly, another prisoner said that ‘‘I am happy with

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the other girls, they help me, not like the friends I had in the past.’’ Hence,the women felt that they were part of a wider community, of similar ‘‘others,’’that accepted them. E. said: ‘‘All my life I was an outsider, never belongedto anyone: in the family, school, reformatory, I was alone, and here I ampart of the society of prisoners. We share so many things.’’ The image of‘‘sisterhood’’ enabled greater adaptation to prison. The prisoner perceivedherself as having much in common with the other inmates, as being similarto them (Veysey, 2010).

Prison as a safe haven. In contrast to Sykes’ (1958) description of theloss of security, we found that—at times—prison was portrayed as a safehaven. A. described prison as a ‘‘wake-up call,’’ a pause that allowed her tostep outside the vicious cycle of her pre-prison life that was dictated by heraddiction to drugs: ‘‘It’s hard to step out. It takes a ‘bang’ like prison or deathfor a person to escape.’’ R. perceived death and prison as the only ways outof her previous life. Similarly, L. claimed that prison saved her life fromdeath. Thus, prison life was constructed as the complete opposite of thesewomen’s pre-incarcerated lives; while life on the outside was equivalent todeath, prison was a safe haven. This notion of prison was further stressedin descriptions of it as a place in which one could rest and heal. Thus, ‘‘theoutside world gives you the feeling of a rat trap. You need to run and neverstop; here you can make up for lost time. This means that I am calm, atrest,’’ said one of the women, while another told us, similarly, that ‘‘Thisimprisonment—yes, inside I felt that I came here to rest, that I’m not goingback to drugs and prostitution. I’m clean now : : : I felt as though I’m resting,that I just came here to rest: : : : ’’

DISCUSSION

This study re-examined Sykes’s (1958) initial conceptualization of ‘‘pains ofimprisonment’’ as it applied to women inmates in Israel. We found thatprison was oxymoronically experienced by the women as both a negativeand a positive experience. As a negative experience, and in accord withSyke’s (1958) conceptualization and ample research from the U.S. and else-where (see, e.g., Bloom, Owen, & Covington, 2003), prison was describedas restricting the liberty and autonomy of the inmates. The experience ofconstantly being watched, monitored, and controlled has been described byFoucault (1977) as part of the new mode of punishment, designed to punishmore effectively. As a part of this punitive gaze, the physical body of thewomen served as an arena for surveillance and control. Dirks (2004) arguedthat such assaults on the body are rationalized in ‘‘the name of security’’(p. 106).

Similar to other studies on women prisoners in the U.S. (c.f. Shamai &Kochal, 2008), we found that the loss of contact with the children was a

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central source of pain for the women we interviewed. Studies have shownthat approximately 75% of the women inmates in the U.S. and in Israelare mothers (100% in our sample; see Shamai & Kochal, 2008). Medinaand Magnuson (2009) discussed the widely culturally entrenched ‘‘intensivemotherhood’’ ideology which postulates that mothering is a full-time jobwhich entails logistic and emotional responsibilities. Failing to meet thishegemonic concept of motherhood may indicate that a woman is not a ‘‘goodmother.’’ Feminist theories on self have argued that a woman’s self-worth isperceived as based primarily on her relationships with others and her abilityto care for them (c.f. Gilligan, 1982). Motherhood, therefore, is embedded inpractice; it is a role that is claimed and constructed by performing culturally-expected acts. These rituals of motherhood are denied the female prisoner,as she cannot fully care for her offspring. Her motherhood is confined tospecific times and places.

While the loss of contact with the children as a source of pain wasreported in other studies, we found that the loss of contact with the childrenwas engaged in the notion of ‘‘un-motherhood,’’ the symbolic death of asalient feature of the women’s identity. The magnitude of pain expressed bythe Israeli inmates (M. told us that she shed ‘‘tears of blood’’), is perhapsa culture-bound phenomenon. Israel is family-oriented and strongly pro-natalist at both institutional and normative levels (Ivry, 2010). Grounded inthe Biblical commandment to ‘‘Be fruitful and multiply’’ (Genesis1:28), inIsrael, motherhood is highly valued and is considered both a public role anda national mission (Remennick, 2008). Motherhood assigns a social statusto Israeli women: it is central to the definition of their gender identity andpersonal integrity. Motherhood and the requirement of full devotion to one’schildren shape the ways in which most adult women in Israel conduct theirlives in various spheres; they also shape social attitudes toward them. Most ofthe interviewed offenders had internalized this gender role and had adoptedthe dominant moral imperative assigned to it: they attempted to fulfill theideological expectations of them and carry out the requirements associatedwith motherhood (Remennick, 2000). In such a value-laden socio-culturalclimate, the women not merely felt the pain of separation; they felt that theywere worthless as human beings because they cannot adhere fully to theideal of hegemonic motherhood.

Unlike our findings, Ferraro and Moe (2003) noted that prison wasalso a dangerous place for women. Similarly, Pogrebin and Dodge (2001)found that the prison experience for women consisted of ‘‘[a]n atmosphere ofbedlam,’’ (p. 535) that is of consistent violence and noise. These differencesin findings might stem from differences in the prison’s size, surroundings,regime, and policies, that perhaps influence the degree of safety, support,and most of all individuality that the women feel in each country.

Although few studies conducted in the U.S. have reported positiveaccounts of imprisonment, their findings have been to a modest extent,

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comparable to ours as well as different in nature. The women we intervieweddescribed prison as providing for their physical, psychological, and socialneeds. Fryer (2005) reported satisfaction among women inmates. Ferraroand Moe (2003) showed that for many women prison was a better alternativeto their pre-incarceration lives, particularly women who found refuge fromtheir abusers and, therefore, perceived prison ‘‘as a retreat’’ (p. 23). Theimages of prison as a salvation, a place that cures and contains, whichwere found in our study as well as to a lesser extent, the positive accountsof incarceration found in the aforementioned U.S. studies, emphasized theunbearable conditions that characterized these women’s lives on the out-side. Prison was not a safe haven per se, but rather, as was evident in thewomen’s stories, a far better alternative to their former dire lives markedby abuse, violence, poverty, rejection, loneliness, prejudice, stigma, moraljudgments, and other means of suffering (see also Ferraro & Moe, 2003).Warren et al. (2004) argued similarly that better adjustment to prison thanto life outside among women inmates measures ‘‘the instability and chaosof the inmates’ pre-incarceration lives rather than any degree of comfortafforded to them by the prison environment’’ (p. 640). However, it is alsoplausible that the prison experience is not a negative one-dimensional ex-perience as suggested, but rather a personal and complex phenomenoncharacterized with an array of emotions that at times are contradicting.Future research should examine positive outcomes of imprisonment andtheir meanings.

We note several limitations to our study. Our convenience samplingmethod and the relatively small size of the sample limit the representativenessof the sample and thus the generalizability of the findings. Furthermore, ourresearch measurement was not validated nor was its reliability tested in sta-tistical means. Last, due to the self-report, social acceptability bias may havebeen introduced. However, despite these limitations, the study examined anunderstudied phenomenon, offering some further understandings of womenprisoners’ pains and health needs. In addition, the similarities between oursample characteristics and those of women inmates in the U.S. in termsof types of crimes that were committed as well as personal history (seeBelknap, 2007; Bureau of Justice Statistics, 1999) strengthens our ability todraw more general conclusions rather than contextualized ones regardingthe studied population. Nonetheless, future quantitative research needs toassess the types and extent of pains of imprisonment among women, andtheir implications for health in Israel and in other countries.

Our findings have implications for women’s health. The positive ac-counts of incarceration we identified suggest that ‘‘pains of imprisonment’’are located on a continuum of pain, belonging to the inmate’s past as wellas to her future life once released from incarceration. These past and futurepains include, for example, stigma, economic and social hardships, and mayhamper her health and wellbeing. This frame has implications for practice

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and research as it suggests that women offenders suffer from enduring healthdisparities.

The pains we identified are strong indicators that prison is an extremelystressful situation and as such poses a risk factor to women inmates’ health(see similar findings by Douglas, Plugge, & Fitzpatrick, 2009). Ample researchhas shown that stress is a key risk factor to morbidity, and that womenreport more stress than men (see Soffer, 2010). The findings point to twospecific and main sources of stress in prison among women: the deprivationof liberty and autonomy and loss of contact with the children. While theformer is an inherent characteristic of the prison, the latter is perhaps amore controllable factor and emphasize the need to facilitate and nurture themother-child relationship during incarceration (see also Covington & Bloom,2007; Lewis, 2006). Children as a means of social support, at times the onlymeans or the major means, can act as buffers of stress that might hamper theinmates health and wellbeing (Bloom, Owen, & Covington, 2003; Callaghan& Morrissey, 2008).

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