Chapter 3. Treatment for Crime
3.1. From alcohol to dangerousness
Scandinavians have severe problems with alcohol. We do not consume great quantities according to international standards, but we consume it in situations and ways that enable drinkers to evade the usual forms of social control. It will therefore be easily understood that drinking, and control of drinking, have been topics of focal concern within our societies. It has been an important and difficult problem: important through the many and highly visible signs of misery. Difficult because we want to get rid of the problem, but not of the alcohol. Therefore we could not, as with heroin for example, outlaw the whole substance. Vis-à-vis most drugs we apply an official policy of teetotalism. Except in situations governed by medicine-men we decree the drugs unsuitable for everybody. When it comes to alcohol, that type of control seems impossible. Here we operate with the idea that the problems are not in the substance, alcohol, but in certain categories of users. We have of course also a vast number of rules and regulations concerning the sale and serving of alcohol. But in addition to the partial control of the substance, we do attempt to control some categories of those who cannot hold their liquor.
It was particularly the skid-row population we made the first attempts to control. Drunken people in the streets were a distasteful and unaesthetic nuisance. Teetotallers used them as pedagogical examples, the alcohol users found them embarrassing. Drunkards therefore should be kept out of circulation. It was not easy, however, to regard their behaviour as so disgusting that they deserved a punishment which would keep them away for a sufficiently long time to create a real improvement in the renovation of the streets.
But what could not justly be done in the name of punishment could not be objected to if it were carried out as treatment. Treatment might also hurt. But so many a cure hurts. And this pain is not intended as pain. It is intended as a cure. Pain becomes thus unavoidable, but ethically acceptable. The idea was formulated at a major meeting of the Norwegian Association for Criminal Policy in 1893, and it took only a few years until a law based on this principle was passed in Parliament. The law authorized the crime-control system to put people away for treatment if they had been arrested several times for drunkenness in the street. Instead of fines for drunkenness, they should, since they were not deterred by the fines, receive a long period of treatment. The original idea was that the period for which people should be put away would be completely indeterminate. At the last minute, however, a limit of four years was decided upon. This was to be spent in what turned out to be the most severe prison in the country, situated on a flat and dull piece of land so windy that, according to one of the directors, the hens had to be tied to the ground so as not to be blown away. Recidivists were given another four years, and then followed as many four-year periods as needed, until the cure was completed.
Similar measures were also installed in Sweden and Finland but not in Denmark. Denmark has always coped with alcohol and alcohol-problems in ways more similar to those common in Central Europe. In Finland the measure was particularly useful, because it was combined with an arrangement whereby those incarcerated could apply for deportation to Siberia instead. Many did.
But not all sickness can be cured. The concept of the "non-treatable" is the logical extension of ideas of treatment. Some sick people cannot be helped back into ordinary life. They have to be kept, as old people in nursing homes, or as the completely disabled in their special units. It would not be fair to expect complete success within the crime-control system either. Therefore, this system would also be in need of more permanent units for the hard core, particularly since this system would also be confronted with people diagnosed as dangerous criminals. Again, it might be experienced as painful to live in such an institution. But so was also often the fate of the old or permanently disabled. And in the particular case of the dangerous criminals, pains of potential victims were prevented.
This whole development reached a climax in Sweden just after the Second World War. A penal law committee proposed the complete abolition of the old penal law and of the concept of punishment. Sweden should have a law of "measures" for social defence, not of punishments. The proposition was defeated.
3.2. The great explorers
Last century was the age of voyages of discovery. Livingstone explored Africa for the white man, sociologists were investigating the situation of the lower classes in the European cities. Machines grew bigger and more powerful. They demanded more hard- working hands in the towns and fewer in the country. It became more difficult to control the masses in the towns. The operators of the machines drew physically nearer and yet, at the same time, they became more remote. August Strindberg, describing the Stockholm of the last century (The Maid-Servant's Son 1878), tells us how the civil servant, the burgher, the worker and the whore at one time lived together in the same building, though not in similar apartments. Gradually, however, their ways parted. Valen-Senstad (1953) describes how in Oslo no policeman in his right mind ventured alone into Vaterland. It was like Harlem today, enemy territory, or at any rate the territory of the aliens.
Working in Italy at that time was a young military doctor, Cesare Lombroso. He himself tells of the breakthrough he made on one occasion in the 1860's.
Suddenly, one morning on a gloomy day in December, I found in the skull of a brigand a very long series of atavistic abnormalities ... analogous to those that are found in inferior vertebrates. At the sight of these strange abnormalities, - as an extensive plain is lit up by a glowing horizon - I realized that the problem of the nature and generation of criminals was resolved for me. (Radzinowicz 1966, p. 29).
Recently questions have been raised as to the nature of these "brigands". Were they plain criminals, robbers? Or were they farmer-rebels? Was the question of the nature and cause of criminality solved on the basis of the skull of a political enemy? In any case: the causes of crime were firmly placed inside the body. Criminals were different from most other people. And they had to be met with scientific methods. They had to be dealt with either through internment or by treatment, in accordance with the needs of the particular criminal.
Lombroso was the flagship. In his wake came Ferri in Italy, von Liszt in Germany, Bernhard Getz in Scandinavia - and then all the special regulations and measures relating to the particular circumstances of the individual lawbreaker. We acquired preventive detention, remand in custody, indeterminate sentences and experts to decide the moment of discharge, institutions for psychopaths and special institutions for alcoholics. The liberal state was not all that liberal when it came to the establishment of the external conditions for the free flow of economic entrepreneurship. Roads, railroads and regulating the poor became essential. An army of experts evolved. Deviance control became essential for industrial development. The intellectual foundations for this way of thinking were established in the nineteenth century. Tove Stang Dahl describes this development in two important works (1977, 1978). Ignatieff (1978, p. 215) comes to the same conclusions: "The intensification of Labour discipline went hand in hand in hand with the elaboration of the freedom of a market in Labour, . . . ."
3.3. The downfall of an empire
During the last ten years, these measures have nearly all vanished.(1)
The skid-row population was allowed to remain on the streets in my country from 1970. Special measures against psychopaths are increasingly going out of fashion. Denmark and Finland have dropped the system altogether, Norway and Sweden are soon to follow. Borstal institutions and special youth prisons have been abolished everywhere, except in Sweden. The remaining major exception has to do with the so-called "dangerous criminal". Denmark had 20 persons classified as such in 1978, Finland 9. Norway will probably find a solution corresponding to Finland's when we abolish special measures against psychopaths. A recent Swedish committee has proposed to drop the category "equal to insanity". By and large we are back to a system with definite sentences decided by the courts.
To a large extent, this was bound to happen. First: The hypocrisy of the system soon became transparent. One study after another indicated that the treatment centres for criminals were not hospitals after all. They were suspiciously similar to ordinary prisons, the "treatment" staff similar to prison staff, and the supposed patients were equally similar to the old prison clientele, only with an even more negative attitude towards what was happening to them than that which ordinary prisoners used to express. Indeterminate treatment for crime was obviously experienced as considerably more painful than old-fashioned intended pain.
Secondly: It was also shown that the system of treatment did not successfully treat. Treatment ideology was based on concepts of utilitarian and scientific thought. The protagonists of treatment made claims to be useful for the patient, and were at the same time open to research. But, as efficiently demonstrated in the literature on the effects of treatments for crime, the claims of usefulness have not been substantiated. Except for the death penalty, lifelong incarceration, and possibly castration, no cure has proved more efficient - as a means of preventing recidivism - than any other cure. Even in the few cases where there have been realities behind the terminology of treatment, no reduction in recidivism rates has been substantiated. The unanimity on this point just now is deafening, to an extent that makes it necessary to add some words of warning: what has been attempted has all the time been within the limits of available resources. Massive economic and social action has never been undertaken. Poor people have not been made rich, workers have not been given middle-class jobs, youth without anchorage has not been helped to realize hidden dreams, lonely people are not effectively given lasting new social relations. Of course they are not. That would demand social reorganizations far beyond the power of criminological research workers.
Thirdly, the concept of "dangerousness" was scrutinized. As von Hirsch (1972) summarizes in an excellent article, study after study had documented vague usage of the concept, low predictive ability when it comes to selecting the supposed dangerous ones, and the usual lack of treatment success. Scandinavian studies, Christiansen and others (1972), Dalgard (1966), and Stang (1966), fully agree. The endless row of scandals popping up around the few remaining special institutions (in autumn 1980 Reitgjerdet, in Norway, and Rampton in England) illustrate the impossible moral compromises built into them.
Science provided the arguments. But arguments are not sufficient to change social life. This brings us to a fourth point in the explanation of the defeat of the treatment ideology. In the 1960's, Labour had gained some power, or at least respectability. Spokesmen for the working class - but of course not necessarily coming from that class or belonging there except through ideology - were upset by the exposed inequalities and abuses disguised as treatment. It did not exactly strengthen the credibility of these measures that most receivers of this type of treatment for crime turned out to belong to just those classes supposed to be in political power. In addition came the fact that alternative measures of control seemed to be within sight. The concept of the welfare state had arrived. Poverty and misery ought to be handled by pensions and social assistance, rather than by prisons.
1. The story of the heyday and later demise of "treatment for crime" has been told by so many and in so much detail, that I can make my coverage very short. Some early Scandinavian works with a critique of treatment ideology and its results can be found in Aubert (1958), Christie (1960 a and b), Aubert and Mathiesen (1962), Børjeson (1966), Eriksson (1967), Anttila (1967) and Bondeson (1974).