I worked 20 years in Rehab, and for a long time, I saw it do a lot of people a lot of good. As rehab has evolved over the years, it has moved from an introduction into the Twelve Steps of Alcoholics Anonymous into a medical, medication, and mental illness model of treatment. The old model was “one drunk helping another over a cup of coffee.” I remember when there was a sign at the admissions entrance of my old rehab that said “AA Members Always Welcome”. I remember when my first morning staff meeting would tip the phones off the hook so they wouldn’t ring. We would shut the door and spend 20 minutes in prayer and meditation for the spiritual well-being of the unit. We would read from “Twenty-Four Hours a Day” and “As Bill Sees It.” The unit supervisor used to say “The patients will always reflect the spiritual well-being of the staff” and “They won’t get better than we are.” We thought of our unit as one recovering community.
Rehab has evolved. Now most rehab staffs do not ever reveal whether they are in recovery or not. Staff are defined as “well” and patients as “sick.” Patients are given multiple diagnoses and complex treatment plans. Patients are rarely just alcoholic or addicted. They are sick in many different ways, and need to be rehabilitated in a complex matrix of medication, group therapy, counseling, and alternative therapies of unproven effectiveness.
Having observed equine therapy and hot stone therapy, I am tempted to invent “feline therapy”, with cats. Just as with equine therapy you don’t actually get to ride the horse, in “feline therapy” the patient would try to get the cat to move from point A to point B without feeding it or playing with a cat toy, just by “relating” to the cat. It would be a Step One exercise in powerlessness.
The trouble with rehab is that it is passive. The patients are defined as defective and the responsibility for treatment is on the rehab provider. If the patient drinks or drugs again, we say that “treatment didn’t work” and the answer is more treatment or rehab.
In Alcoholics Anonymous, I am responsible for my own recovery, even though I am powerless to achieve it. Knowing that, I go get more power from God and from a group of sober men who are taking these steps together. I stop asking what the world is doing for me, and start seeking what I can contribute to life. The Steps invite me to believe in a Higher Power, to do my own inventory, to make amends, and to carry a message of hope to the alcoholic who still suffers.
I’ve been working at The Retreat just over four years now. The Retreat cannot make anyone well. What we can do is introduce our guests to the program of Alcoholics Anonymous in an authentic way. What we have is a residential Big Book study. We have a staff and a community of volunteers who are living out the Big Book every day. We take people who need recovery, and put them with people who have recovery, so that they can learn how to do it.
A few of our guests misunderstand, and behave as if they were still in rehab, rebelling against the system, as if we were trying to make them change. We know we can’t make anyone change who doesn’t want to. When I see a guest carrying on with “street behavior” I just say “If you don’t want what we have, go have what you want.” We don’t have the fantasy that we can force people to get sober.
We are not rehabilitating people. We are inviting people to join with us in a community of recovering people who are having the greatest adventure and the greatest happiness of our lives.
John MacDougall is the Spiritual Care Coordinator at The Retreat,
And author of “Being Sober and Becoming Happy”, available from Amazon.com.