Who ought to govern those held in custody, and by what right? Democracy in Captivity examines various efforts to answer these questions, centering on two case studies at custodial institutions: the rise and demise of patient self-governance at St. Elizabeths Hospital in Washington, DC, between 1947 and 1965 and the prisoner-organized governance of Massachusetts's Walpole State Prison following a 1973 prison-guard strike. As Christopher D. Berk shows, the promise of these initiatives was tempered by the custodians' backlash to their wards' attempts at self-rule. This backlash arrived not only in the blunt forms of restraint chairs, riot gear, and a surgeon's scalpel but also as more covert measures taken under the cover of so-called democratic management—which in turn entrenched disenfranchisement and naturalized authoritarian rule. Turning from these case studies to a wider consideration of custody and democracy, Berk explores pathologies that have captured the politics of punishment, with pressing implications for the practice of democracy both inside and outside custodial institutions.