Monthly Archives: June 2015

The Reading

I was ready for my reading. The first of its kind was to take place before a private little gathering in a semi-lit room, with an overhead projector not working because my friend, a confirmed techno-specialist, didn’t have the right cord to fit my computer, my less-than-a-year old computer. We could head down to the Radio Shack to get the VRG-DHR cord (I don’t know—I can’t remember its actual name) cord that we needed, he offered with enthusiasm.

“Forget it,” I said with mine draining from me.

Whenever I invite friends or family to show up for me, whether it’s for a public event or not, I find that I have to fight impulses towards the negative: a sour, ill-humored cloud that creeps over me, threatening to douse energy and kill joy at the first sign of a setback. It wasn’t so much that I needed the damn laptop presentation anyway. It was leftover from the workshop I’d given six months ago, and was a supplement to a reading of about half a dozen passages from my non-fiction, Working Through Rehab, which I am occasionally hawking to would-be readers through…anyway, I didn’t need the laptop. That was the point. So I had to coach myself to breathe, or more specifically, to issue forth a gust of breath that would dislodge the wad of resistance that would soon form a mass and block my voice. I had to, as they say, get over it. “Whatever,” I said aloud to no one, dismissing early interpretations: that this was a harbinger; a symbolic alert, signaling me to stop what I was doing, sneak out the back door, leaving a note with apologies for everyone’s inconvenience. For the next few minutes, the lull prior to my beginning, I fought gravity’s tug upon my lips, that smile that was turning upside down. People started to arrive, greeting me with pleasure, eager to support this writing thing I did on the side.

“How’re you doin’?” asked my best friend, seeing a cloud over my face.

“Nervous,” I said.

“Drink water,” he advised.

I did. Throughout the talk, whenever I paused to field a question or a comment, I stole a sip from my bottle, and felt buoyant, if nearly drowned after an hour. There weren’t many there—maybe a dozen people, total. But it wasn’t so much how many were there, or even the fact that I was speaking before an audience, sharing passages from my book, and breaking to make comments in between. It was the who that mattered. Speaking to family, friends, plus a crossover of collegial knowing, I imagined deeper judgments, more fraught investment, and a more rigorous, concerned critique: speak louder, someone whispered ironically after five minutes. “You should look at your audience more”, someone else remarked afterwards. I nodded politely and took it in. How do I do that and read? I thought churlishly. The positives made it through the blockade, however. Gathered around me in a circle, the assembled uttered their “good job” pronouncements, their gentle congratulations and other good wishes. One person left early, without comment, which nagged at me for the rest of the evening. “Sorry I had to go,” he texted later. “Had to pick up my kid. Good job.”

You’d think the event was about me, and it was. The book is about drugs, adolescents, their parents, and the people who work with those suffering from drug abuse and addiction. If you check out the image which is the cover of the book, take note of its artful rendition of drug treatment, milieu therapy, and community mental health. Up front there’s me, the author, sat on a time-out device, having left the field, but now raising a thumb in accordance with an old protocol of rehab expression, indicating that I have something to say. To my left is a doctor, or psychiatrist, holding a clipboard, observing from an aloof position the goings on, wondering what prescription(s) may be best. Over my right shoulder, there’s an officious-looking floor counselor, a fledgling member of the mental health army, not yet working with kids in the manner of his/her choosing, monitoring an affectless, acting out, poorly attached and difficult young person who will nonetheless touch hearts. With his back to all of this is a man busy at a console, producing a report, maybe of numbers. But he’s not an accountant. He’s a therapist, or a case manager, as they are euphemistically called in such places. Tellingly, his back is to the scene, thought it’s not by choice. It’s by necessity. This is the business of mental health that I’m talking about, and writing about, and reading aloud. In public.

Meanwhile, that review came, the one I moaned about in my last entry: it arrived finally, and it was pretty good, sort of. The reviewer read between the lines, observed the melancholy, and something of the humor. He or she (it’s not clear) wrote that I was cynical and bitter, though the comment was not a complaint necessarily. This reminds me of something I heard recently and have recycled for patients: if you don’t complain how do you know there’s pain? I don’t mean it to sound like a rap, but there is pain. That’s the melancholy truth of Working Through Rehab. From my point of view and that of other veterans of drug treatment, there isn’t a happy plan in place for the consumer; no all-conquering model for the professional to embrace. Once, there was a working idea: treat the adolescent more or less as an adult, and certainly as an addict. Operate as if a compulsive pattern has gained a foothold, and that strategies for using other human beings in a human way were profoundly offline. Those who thought this weren’t wrong, and most agree the attachment disorders of those in treatment seem pervasive. But disagreements abound as to solutions. Containing the drug user’s behavior is one thing; aiming for motivation, and assessing capacities are the other great tasks, and this is where drug treatment with adolescents–with everyone, frankly–has gotten tricky.

Why? Because increasingly, kids, old and young, think that using drugs, sex, video games, and cell phones are acceptable tools for soothing the attachment disorders which they may agree are present and ongoing. Don’t see this? At least as far as drugs are concerned, read the latest statistics released by The National Institute of Drug Abuse (NIDA) about the opinions of high school seniors. Only 16% consider that use of drugs constitutes an unhealthy risk, compared to 27% who thought this just five years ago. Wake up: self medication is being normalized. This is why treatment centers like Thunder Road are at risk of being closed down; it’s why places like it have already closed down, and why public officials are reaching out to the media, bemoaning the impending lack of options for at risk youth. It’s why drug treatment as it once was may be a thing of the past, except for the wealthy. It’s one of the reasons my book is a little melancholy, and just one of the reasons my reading of it might stir the nerves.

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The Submission

When I first submitted Working Through for review at the The Therapist, I waited. I waited patiently. Over the previous year, I’d been writing prolifically, completing two books, one a novel whose basic plot I strain to describe in less than a paragraph, but whose themes cover the bases of a therapist’s sphere of influence: addiction, depression, psychosis, and most crucially, the good news: empathy. My other book, my expose of drug treatment and adolescents, fully entitled Working Through Rehab: An Inside Look at Adolescent Drug Treatment, is an ambitious, sprawling memoir cum essay that has been variously thrust at agents, publishers, and indulgent peers, though getting people to read it feels a bit like peeling wet leaves off a driveway in the dead of winter. I take my readers one at a time.

A colleague, a good friend whom I do not shame into reading my material, suggested I take advantage of membership in the statewide association of Marriage and Family Therapists, and submit my non-fiction to its flagship journal, The Therapist. The magazine, which is published quarterly, or thereabouts, features a section in which members can volunteer to read submissions and then provide a review. It seemed like a good idea to take advantage of a service that is a privilege of membership. My friend is good at having ideas that obscure his lack of effort. Anyway, what could I lose? I thought, especially after I’d just waiting six months waiting fruitlessly upon a publisher to study WTR, express enthusiasm for its content, but ultimately reject its content. They don’t publish memoirs of non-famous people, said an executive editor, gratuitously pointing out that I wasn’t famous. Fair enough, I thought. However, he could have told me this earlier, rather than having me wait with bubbling hope that a fantasy writing contract was forthcoming. In the end it was a flat e-mail that delivered the publisher’s verdict—an afterthought, really—by a deputy editor who had forgotten to reply to my last message. A flattering response, “well-written and compelling”, was quickly followed by the word, “unfortunately…” rendering the compliment a consolation.

So I submitted WTR to The Therapist in January 2014, thinking it might be advertised in the next issue, and possibly reviewed in the issue following that (as suggested by the editor). March was the next issue, and my fresh-looking book was there in print, alongside several other titles, looking eager like playful children, but also like bags on an airport carousel waiting to be collected. I was pleasantly anticipating, thinking my book an important work. As far as I could tell, no one else was writing about what really happens in drug treatment, and I feel in my gut that there’s a readership for subject that’s slightly off-center: it’s comprised partly of parents concerned with the impact of drugs upon kids, which is what publishers might presume the book is about. There’s a faction of society that is more broadly concerned with mental health, and with the problems of poorly attached individuals, the famous and non-famous, who are collapsing around us, killing themselves with addictions, violently attacking others in schoolyards and movie theaters, or just plain killing themselves. And there’s a faction of workers in this field, who aren’t necessarily readers, who are slated to work with all these people and somehow help figure out all of their problems: they are therapists, social workers, drug and alcohol counselors, for the most part, and they—not the adolescents or their families, actually—are the heroes of my story.

At least some of them are, and that’s what’s potentially controversial about my book, because it’s not exactly a tribute. You see, I write about some of the things people expect to learn about drug treatment: like what leads kids and their families into drugs and addiction, and how treatment and therapy can help claw them out. But I’m not writing a how-to guide for parents, or any other consumer of the industry. I’m more of a critic of the process; the only kind of critic this business could really have: that of an insider, versus, say, a peripheral insider, such as a policy maker, or even most physicians. I’ve worked several positions within a hospital-based treatment setting, as a counselor and later as a supervisor of therapists. I was a manager of a six-bed group home for teens for three years; a leader of an intensive outpatient program for another three, and have seen patients across several divides in private practice for about twenty years. I’ve tracked the dialogues between the addicted and their families. I’ve been a part of and witnessed the back and forth arguments between patients and helpers, administrators and clinical professionals, and I understand the context of treatment’s limited resources, the conflicts many do not understand. I know the Gordian Knot that is drug addiction and the continuum of drug treatment, and the strained efforts to untie it.

As for the feedback process: I’d written the book, had it appear in black and white, and learned that it was selected by a volunteer to read. Again, I waited. When it didn’t appear in the next issue I sighed and reasoned that the book was long (350 pages) and dense, and was perhaps demanding more time and effort from a committed reader than I’d accounted for. But when a review didn’t appear in the issue after that (another two and half months on), I wondered what was happening. I e-mailed the magazine’s editor, a man who had cheerfully written that WTR had been selected six months earlier, and asked the question. Seeming like the deputy editor of that unnamed publisher, he wrote back that he hadn’t yet received a review from the volunteer, and didn’t know why. With curious incuriosity, he added that I might re-submit a copy such that the book could be advertised again as available for review, and that I might implicitly begin the cycle of waiting all over again. It was: oh yeah, I forgot, followed by an attempt to sweep the matter aside. Waiting and writing: years ago, when I started practicing this pleasing craft, I had no idea there would be this much waiting. What was I submitting myself to? Coolly, I replied to the editor, modeling the curiosity the situation compelled: Was there a problem? Is the volunteer no longer willing or able to provide a review? Did they get bored after reading a chapter and burn the copy? Or were they so engrossed that they couldn’t take their eyes off the material, even when driving, and thus died in a fiery crash. The sheepish editor, to whom I did not share these fantasies, wrote back that he’d pursue my inquiries. A week later, after I again solicited information, he replied that he still had none to give. He vaguely apologized on someone’s behalf, perhaps his own, for being inattentive. He excused the magazine by pointing out that this event—this phenomenon of neglect—seldom happens, and once again invited me to re-submit a copy.

Which I have done, and I am waiting. It is June of 2015: enough time for topical subjects to come and go; happily, or not, addiction isn’t one of them. And as I wait, I will continue to ruminate on my work, and perhaps inflate its importance, thinking that someone is out there waiting to snatch up another copy for review, but then blocking its exposure by abandoning the task. Or maybe I’ll be rewarded for my patience, and my raw message on this subject will be read, perhaps even in numbers, and a fair critique will come back at me finally. In the meantime, I will remind myself that while the culture continues to seek and develop tools for immediate gratification, the writer must endure the slowest, most excruciatingly elusive feedback system ever known.

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