Tag Archives: books about rehab

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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Where there is hierarchy there is violence (part two)

 

…Which means there are casualties. They are victims, if you’re feeling sympathetic and outraged. They are losers, if you’re not. Chris Leavitt, my protagonist from Crystal From The Hills, is not much of a victim, but he is much of a loser. And I write that with love. In a way, I prefer losers to victims, though they are in some respects the same. Losers lack the hubris of victims, mostly because they haven’t the fortitude to call themselves victims. So Chris Leavitt is a traumatized individual; a casualty and a loser, not a victim: he is privileged, free for the most part but wary of his onlookers–his shadows, both real and not. Ironically, he pays more attention to the less than real shadows, which render him paranoid yet oblivious to what’s right beneath his nose. He is innocent in so far as he is uncalculated, uncensored and anarchic. Whether too impulsive enough or just lacking in political savvy, he is unequipped for any tight, hierarchically-driven order.

There are hierarchies all around: some are tacit structures, governed by race, class, gender, philosophy, religion–prejudices of various kinds. This is not original, but then neither is the hand-wringing that surrounds public controversies. It’s not nice to judge people for being different, people say on camera. But they do. Of course they do. It’s the correct thing to aim for the center (“the center holds” our President tells us), but all around us (and him), splitting, the thoughtless, triage-like division of life into “good” and “bad”, right and wrong, is occurring, and meanwhile, we are all shepherded into cliques, nurturing our prejudices and providing succor within echo chambers. I was once clique-bound at Thunder Road, the workplace that employed me for fifteen years, and which I depict in another book, Working Through Rehab: An Inside Look at Adolescent Drug Treatment. Contrary to my younger observations, Thunder Road is just another typical hierarchical system governed by shadows who determine who fits and who doesn’t; whose turn it is to be in charge, and whose turn it is to go…what works and what doesn’t. Leaders use corporate tools for the most part: manuals, handouts, HR policies, lawyers and spreadsheets, to create order. Meanwhile, the world they govern is an inchoate mass driven by an oral tradition, and the unconscious.

My turn on the rollercoaster lasted longer than most, though it was never my goal to merely have my turn. It was my pretension to do more, and now I have, only from the outside looking in. The point of my book is that taking a turn is not enough. Being politic, fitting in and censoring dissent may suit a hierarchical system, but it is psychological death to the conscious individual, the growing professional. I could avoid hierarchies, mess with hierarchies, dissent and maneuver only so much until shadows converged and told me that if I was to continue avoiding the trappings of leadership and compliance, then it was my time to leave. Cohesion: it means togetherness, which is good, sort of. But coherence, which is like music, is superior. I remember being told once by someone in charge that if I was to really take a turn being in charge, then I’d have to assert just that, regardless of what is right. The decisions were mine, I was told: ultimately, what I said prevailed, not because I was right, but rather because I was in charge. Reluctant leadership. I nodded compliantly but remained slippery, thinking this a dangerous, undemocratic idea, this thing about being right because it was necessary to be so. The problem with equating rightness with being in charge is that being in charge doesn’t last.   

One of my favorite passages of literature reminds me that the exiled exist in numbers, are neither contained nor containable, even if they’re not in charge. Even if they’re not right. This is John Self from Martin Amis’ Money:

“I hate people with degrees, O-levels, eleven-pluses, Iowa tests, shorthand diplomas…and you hate me, don’t you. Yes you do. Because I’m the new kind, the kind who has money but can never use it for anything but ugliness, to which I say: you never let us in, not really. You might have thought you let us in, but you never did. You just gave us some money.”

 

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