Treatment has to change - addiction is a disease and not a moral dilemma.

Man do I get angry at the manner in which people, and more importantly treatment centres and support groups, treat patients with this disease of addiction. I am by no means abdicating any kind of medical treatment approach as this illness requires psychological intervention, and not medication, but I am abdicating that people who struggle with addiction be treated as patients who are ill and not as people who are morally corrupt and incapable of being good. There is this terrible belief that addicts should be punished, they should willingly choose to give up all of their rights and that they should just accept what those “who know better” say without question and certainly without challenging their authority. This is a problem in general society, a problem in support groups and a massive problem in treatment centres who have not changed their approach to treatment for the past two decades. 

Addiction treatment is as much an art as it is a science and knowing who your patient is, and what their needs are, is quite frankly one of the most important aspects to proving effective treatment - if you believe your patient profile has not changed over the last 20 years then you are clearly not understanding the ever shifting norms of society. Addicts are fearful, anxious and riddled with self-doubt and have built up defences to protect themselves from these things. Authority, discipline and forced submission merely trigger all of these flawed defences (especially in the younger generation as I will explain below). The addict becomes defiant and when they revert to old behaviours because their fears have been triggered everyone throws their hands in the air and says “you see they don’t want help”, “they will never change”, “treatment doesn’t work” etc. Perhaps our old ways (which at one stage may have worked) is in fact becoming counter productive as the newer generations enter treatment. 

I have had numerous comments about how nice Jahara is followed by, addicts don’t deserve it, their behaviour doesn’t warrant the reward and so on. This shows the belief in people that addicts should be punished, disciplined and practically told that they are worthless, undeserving and bad unless they submit. The addict gets trapped in a place that unless you listen to what I say and obey my every command they will always be a failure. It is a vicious cycle of reinforcing the very flawed belief that addicts are failures and morally corrupt people unable to live according to societal norms. This is simply not true. Addicts are perfectly capable of change they just need someone to believe in them and guide them. When the world gives up on them they reinforce the flaw in the addict. It is a shame to be finding yourself stuck in a place where instead of helping you are creating deeper beliefs of failure and shame. 

It infuriates me that people comment and challenge the cost of treatment. They decide that it is too expensive and the addict does not deserve it. Many have wasted millions on treatment centres that do not work or do not do the job properly. We get painted with the brush that rehab doesn’t work and the addict does not ever get the help again. Did the centre fail the addict or did the addict fail the addict. Please don’t get me wrong we cannot save everyone and this is not a one size fits all approach but there are so many centres stuck in their old ways, so many centres trying to do a good thing, charging small amounts of money, but taking large amounts of residents and providing a sub standard program. They do not work! That does not mean treatment doesn’t work. That does not mean the addict is beyond help. It just means that perhaps the centres you have tried are not providing a satisfactory treatment program. If we really saw our loved ones as having an illness we would strive to get them the best possible treatment not the cheapest. We are happy to pay for psychiatrists, medication, doctors, surgeries etc but not treatment for addiction. 

Back in the day, and I mean 20 years ago, when those that we treated had been to the army and had grown up in homes where we got hidings and had gone to school where we got caned this old approach of discipline and forced submission may have worked. The older generation responded to such, seeing their ability to comply and endure hard testing as success (and not failure). My ability to behave without being punished was an accomplishment. My ability to submit and surrender was an accomplishment. My ability to be praised for this was what we were taught to strive for. If you could survive such gruelling treatment you had achieved something great and could be proud. The old timers always say “back in my day treatment was tough - we went without - we dug holes - we were given a bible and locked in a room - we were lucky if we got food at all - we survived this and were stronger for it.  They see the younger generation as weak and unable. 

Unfortunately, today’s generation did not grow up that way. They did not grow up in that world. They have grown up in a world where their rights are glorified, there is no punishment and they are encouraged to be different, unique and their own person. Whether we agree with this or not, or believe it is right or not, is utterly irrelevant because that is their norm. Being able to stand up to authority, to question the norm or to be their own person is their form of success. They have been taught to be different, to not take what is said at face value, to mistrust those in authority. That is the norm that they already feel  that they don’t they belong to but so desperately want to belong to. Putting these already hurt and traumatised individuals who believe they are worthless and utter failures into an old regime is never going to work. In fact it is merely going to compound the problem. Addicts already feel different, misunderstood and undeserving of what normal society has. The old system is forcing them to comply with something that is not normal to them. When we do this we are setting them up for failure. 

Inside each addict is a wonderful soft, kind, caring and empathetic individual with tremendous amounts of potential. A treatment centre, a program, a support group and society should create an environment where they feel safe to show this side of themselves and safe enough to express their potential. Yes they need guidance, yes they need to learn what is socially acceptable, yes they need to commit to living a life guided by recovery principles, yes they need to acknowledge their wrongs, yes they need to stop hurting people and be responsible BUT they need to choose to do this because they want the life on offer NOT believe they have no choice if they ever want to experience some form of “freedom” again. Their idea of success is being praised for choosing properly and for following dreams that they have while not hurting anyone - not surviving a gruelling world of discipline. 

The minute we see treatment as a punishment and not a therapeutic process we are merely sending individuals to treatment to learn 1 lesson - you are bad, you better change or you will never be free or accepted by us again. Submit and we will reward you. This change is temporary and filled with resentment and fear. It doesn’t work. When it doesn’t work the addict is blamed, the centre is blamed and the belief is developed that the addict is fundamentally flawed and beyond help. That wonderful saying - he has to want the help to change - is utter nonsense. He needs to be guided to a place of understanding what is available should he change. He needs to want the alternative more than the addiction. He needs to be given the belief that there is more to life than his fears and failures and shame. This is a process, a long process of building trust, of being honest and oozing integrity and more importantly of being the person you want them to become. Show them a life worth living - don’t give them hell until they “surrender” and force them show “gratitude” for the very little you choose to give them. 

Please don’t get me wrong. I come from the old school. I come from the centre of manual labour and punishment. From the super spiritual where God is the only answer. Where psychiatric disorders don’t exist. Where medication is from the devil. Where if you do not comply you will be disciplined. Where if you submit you will be rewarded. It worked! I ran a support group of confrontation, of accountability, of no access to anything for long time. It worked BUT that was 17 years ago. That was when we still had corporal punishment. That was when we still had a school system that rewarded performing students. That was when our parents still spanked us. Times have changed!

The world today is one of instant gratification. Where you can become anyone you want to. Where individuality is praised and not performance. Where Facebook teaches you not to trust anyone. Where politicians and teachers and general society are shown to be without integrity. Young kids have access to the world and not just what their school and parents show them. They live in a world where you cannot exist without a cell phone, where careers change constantly, where education is not the greatest factor but uniqueness and individuality is. 

I worked in a centre of conflict and confrontation for 5 years leaving 4 years ago. I was known as the tip of the denial spear. I was the one on the frontline challenging the addict into submission. It stopped working. It started hurting people. It became a job of war. Everyday was a battle. Everyday was a new crisis. Yes we saved lives and yes people changed and yes there are many still clean today BUT the youngsters did not respond well. 5 years on and the youngsters of that time are now in their early 30’s and still not responding. The new youngsters in their 20’s are definitely not responding to that old school approach. Taking a disciplinarian, critical parent approach as a counsellor to a patient is going to invoke the angry child response in the younger generation. It is going to push them to defy authority and demand their rights. It is going to force them into fear and the need to fight, flight or flee. Surely we have to come to a place where a more adult to adult relationship is seen as more beneficial to all. A nurturing parent approach is better received. Why intentionally set up conflict after conflict? Why intentionally be at war every day? (Please note this is aimed at the treatment centres and support groups not parents - parents in the middle of active addiction need to do whatever they need to in order to protect themselves and survive - professionals in the industry do not and should know better).

I know may people will categorically reject this thought process. It will ruffle many feathers. 6 years ago I was one of the people who would have categorically challenged this line of thinking. I was 100% resistant to changing the old approach that had worked for over a decade. It had worked for me and therefor should work for everyone else. However for the last 4 years I have been blessed to set up Jahara with a brand new approach. I have managed to create a treatment approach that removes conflict and consequence and replaced it with an atmosphere of mutual respect and personal responsibility. I work in an environment where peace and joy are promoted along with laughter and excitement. Yes we hold people accountable or more importantly they hold themselves accountable. Yes we challenge bad behaviour but more importantly encourage good ones. The most important is that we see the people in terms of their future potential and not their past failures. We see them as kind, caring and empathetic people that are fully capable of being very successful. We see the generations that are in treatment now from a different perspective and give them different treatment. 

Sure we do not have 100% success rate and yes people don’t always finish BUT we never give up until we can’t do anything any further. We rarely expel people unless there is no choice because they pose a great risk to the other residents and we hardly have people constantly trying to leave. We definitely still have a 78% success rate. We have manage this approach by focusing on the ones who are working the program and not forcing ourselves into positions where the 10% who are not working the program take up all the time and resources. If we do not give the 10% trying to fight the system attention and do not play into their games we generally win with those too. Previously my time and energy was spent on the 10% who were not willing while we neglected the 90% who were. We used the 10% as examples to the other 90% of what bad recovery looks like. We fought to save those ones and ignored the rest. We worked hard but we did not work smart. Unfortunately the 90% was painted with the same brush and forced to follow the same rules designed to control the 10%. This made their time difficult and for the old generation made them survivors but now for the new generation it just makes them feel trapped and hopeless. Support groups generally work from this premise as well. Treat the 90% with the same approach as we treat the unwilling 10%. 

I was told that the way I wanted to do things wouldn’t work (remember I believed this too 6 years ago). I tried anyway. It worked but I still doubted. I felt that maybe as the resident numbers grow I would be forced back to the old way. I have persisted in maintaining this new approach and it is still working even as our numbers grow. Is it difficult to maintain - yes. When we are tiered and pushed by the minority of individuals it is easy to get triggered by frustration and force the old approach to get submission. We try our best not to fall into the old ways. We keep our eye focused on the success stories. We remember that we are here to provide a life of joy and peace so that addicts in our care may want what we have. We do our best to keep treating them as worthy and we always see them from a place of potential and not failure. 

I fight hard everyday to keep on this path and to keep my staff on this path. Are we perfect? Absolutely not. But we try and we try our best and we hope that those in our care would agree.