In a previous life, I had a job for a couple of years working as a “clinical counselor” at an alcohol and drug addiction rehabilitation facility – to be called The Rehab for the purposes of this article. This can certainly be included in the list of “toughest jobs you've ever loved” category. While I worked there, I was sure I had fallen into some heretofore unidentified circle of hell and I must be the butt of some supreme galactic joke. But at the same time, I would otherwise never have met any of the urban inner-city minorities caught in the web of drug addiction and the criminal justice system, an entire American sub-culture that is publicly reviled when not being ignored and forgotten. Nor would I have come to recognized myself in their painful and desperate struggles. At The ReHab, I faced and conquered challenges far outside my “usual” experience. Perhaps most importantly, my work at The Rehab would later provide the groundwork for some of my greatest professional accomplishments. I now think of myself as uniquely lucky to have had this job.
It is this unique experience I hope to describe with a series of articles I call "Working At The ReHab". If I do my job well, important and far-reaching issues of drug addiction and drug addiction treatment in America will be brought forth. You be the judge.
Once a week, I am scheduled to open the facility. That means I have to get to work at 6 AM, and relieve the overnight guy. He turns over the keys to me, and tells me about any outstanding issues that jumped off overnight, and I count the petty cash to make sure my tally equals the tally of the person who counted the petty cash the night before. Then I collect a coordinator and a chief to do the “room run”. The coordinator and the chief are both residents who have been in treatment for some time and have risen up through the hierarchy: these are positions of responsibility and leadership – or what passes for responsibility and leadership among career drug addicts now with only five months of clean time.
The room run is an inspection of the dormitories. The residents are instructed to leave their rooms neat and orderly, and they get demerits if there are beds unmade and socks not rolled. Yep, we check inside the dressers to see if the clothes are neatly arrayed inside. We also look for contraband: drugs, cash, jewelry, unauthorized cell phones, or anyone hoarding soap or shampoo. Being guys, there is always some debate when I do room runs about whether the girls are allowed to keep six or seven lip glosses or if that reveals some “dope-fiending shit” - the sneaky behaviors drug addicts engage in to get the things they want that they know they are not supposed to have. I myself never felt comfortable looking through the dressers and closets in the women's dorms, especially accompanied by two or more guys whose longest sustained relationship with women until recently was most likely that of pimp. Everyone is supposed to be at breakfast so we are also checking to see who is still in their room and why. Any violations and the room is deemed “out to snacks”, and everyone in that room will held to account. There are roughly 80 beds at The Rehab, so the room run takes about twenty minutes.
One of the most interesting aspects of life at The Rehab to me is the unique language everyone uses – a mixture of street and prison slang combined with the confusions and misinformation that are common among dedicated addicts. “Out to snacks” is part of that slang. I have never heard the term used by anyone except at The Rehab. I think it is a corruption of “out of whack”: it means disorderly, confused , or screwed up. So a room that is not properly straightened out before breakfast is “out to snacks”, as is a resident who constantly breaks the rules. When I say instead that the room is “out of whack”, the residents look at me funny, like I can't get the simplest things right. Rarely will anyone try and correct me, out of respect or more likely sympathy for the pitiful imbecile that is their counselor.
After the room run, I lead the Morning Meeting. The Morning Meeting is mandatory for all residents. It is held in the Dining Room, where all the tables have been pushed to the sides and the seats have been arranged in a large circle. I stand at the head of the circle with the goal of moving the meeting along in the one hour of allotted time. Any new residents are introduced and welcomed. We might play that game where everyone claps and one by one the residents stand up to rap: “My name is Jose. I come for Brooklyn. I am a Virgo. Now sit down, sit down, eat your cookie and sit down.” But mostly the Morning Meeting is about attitudes. The word attitude has a special meaning at The ReHab: it is both thought and an action. To address attitudes we do “pull-ups”. The resident bringing the pull-up will stand and announce to the meeting “Who is the person who forgot to flush the toilet this morning in the Men's room?” or “Who is the person who left their dishes on the dining table?” Then the resident who committed that offense is supposed to stand up in front of everyone (called “copping to the pull-up”) so their lazy, dirty, or thoughtless attitudes can be addressed by the community.
The whole pull-up business is a huge game of cognitive dissonance. Residents are told they have to bring pull-ups in Morning Meeting if they want to advance through the ranks and gain privileges. But this crew have spent all of their adult lives trying to deflect attention from themselves and the things they do, and they certainly don't want to say anything that might be construed as negative about others in public. So no one wants to bring a pull-up. Moreover, the offenses most typically addressed are things that anyone, myself included, does all too often, so the person bringing the pull-up is in all likelihood the one engaging that attitude the day before. It's a toss-up which is more difficult for these addicts: bringing the pull-up or copping to one. Copping to a pull-up means admitting publicly that you have done something you shouldn't have, and standing up in front of your peers to hear them criticize you for it. And given these grown adults have all the maturity of your average 12 or 13 year-old, admitting to even the most benign and common foible is something everyone hates. And of course, the guy bringing the pull-up is the same guy that the community was pulling up yesterday for not making his bed.
So the whole pull-up process is fraught with tension. On some days, there are no pull-ups, or only one ore two. Then I have to harangue them: “You mean to have me believe that you just spent 24 hours surrounded by 80 dope fiends and you never saw any kind of dope-fiend behavior? You see everything on the streets: you know where to find Flocco, which corner the cops are watching, and who accepts ones and who will only take twenties, but now you've gone blind or something, so you don't see shit anymore, right? Who are you protecting here and why?” Sometimes now one stands for the pull-up, which might mean more haranguing: “Smoking is privilege around here. If you can't get your butts in the butt can properly, and can't even bring yourself to stand for a pull-up, you don't deserve to be called a man or a woman. This is candy-assed bullshit, and you people are candy-assed dope-fiending cowards” The worst are the pull-up about masturbation; first off, I don't want to involve the Morning Meeting in a discuss of masturbation; second no one cops to that pull-up; thirdly, every resident is for some reason itching to get in their two cents worth about somebody else's nasty self-pleasure habits; and lastly, most of the talk about masturbation is karroom-shots aimed at members of the opposite sex. (Karroom-shot is another of those slang terms unique to The Rehab: it means to say something to someone that is actually intended for the ears of another – to bounce your words off of someone so they arrive at their intended target). Yes, when I worked there, The Rehab was co-ed..
The Morning Meeting typically ends with some feel-good stuff to lift spirits. Residents recite their poetry, sing songs, tell jokes, etc. Audience participation is encouraged. After a meeting that might include a lot of tough talk from me, the songs and jokes are there to send everyone off with a smile. After the Morning Meeting, the residents go off to their various job functions, which primarily involve cleaning things. I go off to the meeting for the clinical staff..
Every morning the director of The ReHab meets with the counselors. Counting the ADs (assistant directors), there are five to seven counselors, which gives us each a case-load of slightly less than 20 residents. Of course, on any given day, some counselor might be out sick or otherwise excused, so the size of your caseload is always dynamic. By and large, all the staff at The ReHab were at one time residents going through treatment, who stuck around and eventually became counselors. This means the staff know the place, its policies and procedures, and its clientele with intimate familiarity. Even the director, who went from predicate felon serving 6-8 in the state pen to overseeing the operation of an 80-bed residential rehab facility and every person and everything that goes on in it. I am the exception. I was never a client at The ReHab, but heard about the job from a friend, and the director must have thought I could function here, because he gave me the job. I've never been in prison, so that makes me doubly an outsider. The other staff and even some residents remind me of that frequently, mostly with digs at my naivete, and more rarely with complements about how I will give a person a chance to speak and even listen politely. I am also unique in this group in that I have a college degree. I am the only member of the clinical staff, including the director, who does. The only benefit this gives me was a starting salary paid to “senior” counselors: $26k/yr. Other than for writing letters to the courts, the college degree is mostly meaningless here: counseling residents at The ReHab does not require any degrees, only knowledge of dope fiends and their habits, and the willingness to confront both. So my college degree is mostly viewed with some suspicion. Over time, the other counselors have come to recognize that I can treat all with respect, and that I could reliably cop to (admit publicly) my mistakes and short-comings, but even so, I was always the “you” in the crowd of “us”
The clinical staff meeting with the director is so we can plan the “clinical” activities of the day and the week ahead. We are informed which new arrivals will be assigned to which counselor. Problem residents are discussed. New policies are reviewed. Counselors who have fallen behind in their paperwork are called to account. Lately, the director has been on us to do “facility runs” at least once a day. Which means we are supposed to conduct walking inspections of the buildings and grounds, looking for contraband, bad behaviors, and leaking roofs and broken windows. We already have our hands full what with counseling and paper-work, and besides, there is a Maintenance Team specifically tasked with the buildings and their integrity, so none of us like this new duty. But I have on occasion made “facility runs” and even brought up some of the things I found at our clinical staff meeting. The other counselors made sure to remind me privately how my nose might become colored if I kept this up.
Because here “at the TC” (the therapeutic community), we are all both client and counselor, everyone from the “day one” to the director equally capable of lying and dope-fiending and equally capable of helping out another in need. My brown-nosing is no exception. Everyone in the clinical staff meeting is capable of “acting out of their shit” (returning to old and self-destructive negative behaviors for a personal pay-off) as well as providing refuge and salvation, all in the same day. In fact, in the TC, dealing with people acting out of their shit is not only my job, but also a lesson to be learned. For when you can find peace of mind in a roomful of people acting out of their shit, you are powerfully armed. I am here, because there is no refuge from myself.