n 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 almost certainly otherwise never have met any of the many urban inner-city men and women 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, what I learned 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. This series will focus on life at The ReHab, and issues of drug addiction and drug addiction treatment in America. For interested readers, part 1 and 2 can be found here (http://www.dailykos.com/...).
(http://www.dailykos.com/...)
The Rehab where I worked is one of a number of facilities owned and operated by a large non-profit parent organization. That parent organization is headquartered in a large metropolitan center on one of the left coasts, and operates multiple rehab facilities across the country, and a growing number of sister organizations overseas. The sole mission of the parent organization is to provide compassionate family-oriented substance abuse treatment for adults and teens.
The parent organization was started by a young catholic priest (who we will call M.O.) in the 1960s. He was responding to the appeals of some of his parishioners to address a growing gang and crime problem in the neighbor hood. After a series of meeting and community organizing (there's that word again) events with the locals, including some gang members themselves, the priest came to understand that addiction was a common element in gang violence and crime problems in his native city. He also understood that in the early 60's, addiction treatment was mostly non-existent. M.O. felt that the most important contribution he could make to combating gang violence and crime would be to advocate and promote greater addiction treatment, and he set himself the goal of improving treatment for drug addiction.
It wasn't long before M.O. met a couple of refugees from a place called Synanon. Synanon was an early Californian experiment in a community approach to treating drug addiction. The founder of Synanon, Chuck Dederich, was an alcoholic and drug addict who was dissatisfied with his many failures to make Alcoholics Anonymous (AA) work for himself. So he borrowed some of the ideas of AA, and a bunch of other practicing addicts who disliked AA, and formed a community of drug addicts devoted to resolving addiction problems. Mr. Dederich and his followers felt that the larger society in many ways fosters addictions, and therefore addicts could only get better if they left that society behind permanently. Addiction treatment at Synanon relied on the concepts of self-help, personal growth, group treatment, and community participation. Synanon was both commune and therapeutic community: a community devoted to helping health problems in which each member is both the sick person needing treatment and a healer providing it. Members lived and worked in the community, and all treatment was done inside the community, provided by the community members themselves. The concepts of therapeutic communities, self-help groups, and drug addicts providing treatment to other addicts were radical ideas at that time. And indeed, Synanon eventually collapsed from financial pressures, infighting, scandal, and legal problems. Today, Synanon is remembered (if it is remembered at all) as the fabled inspiration for The Eagle's hit song “Hotel California”. But the idea of a therapeutic community survived, and Synanon provided some important lessons that fueled the later success of drug rehabilitation organizations everywhere.
M.O. opened a live-in drug treatment center in 1963. He took in 22 probationers facing drug charges from the local courts. The basic principles of the treatment were group therapy sessions, community work responsibilities, behavior modification, all overseen by a hierarchy of peers. Addicts who remained in the community took on more duties and responsibilities, and earned greater privileges. Newer community members could see others like themselves acquiring leadership positions and gaining respect. More importantly, newer community members could see other like themselves getting out from under the yoke of the criminal system, and living and succeeding free and independent of drugs and crime. An important aspect of this treatment was it's voluntary nature: there were no locks or bars, and participants were allowed to leave at any time. And a second important part of the treatment was, in contrast with Synanon, re-intergrating the addict back into the larger society.
And things grew from there. Demand for drug addiction treatment remained great, and M.O. opened more facilities, and incorporated his outfit to become the parent organization. Today, the parent organization operates scores of rehabilitation facilities in New York, New Jersey, Connecticut, California, and Texas. They operate residential treatment programs modeled on the concept of therapeutic communities, out-patient treatment programs, separate programs for teens with addiction problems, specialized treatment for women addicts, programs for addicted veterans, and support groups for the family members of addicts. M.O. runs the parent organization independent of the Catholic Church, though he maintains the honorific Monsignor. Treatment is offered without regard to race, religion, nationality, or ability to pay. No religious instruction or guidance is offered at The ReHab, and the practice of religion is left to the residents' individual discretion. The only “higher power” requiring observance is that of the hierarchy of peers within the community.
Additionally, M.O. founded an international organization devoted to the advancement of therapeutic communities as a treatment modality for drug addiction around the world. The parent organization offers training here in America to those overseas who are interested in using the therapeutic community as a treatment for drug addiction in their own countries. Trainees spend months at a time at one of the residential facilities, seeing how drug addiction treatment and therapeutic communities function from the inside. The parent organization says in their literature that training in running a TC (therapeutic community) is “experiential”; what that means in practice is that trainees live and work in the community just like all the other residents. Which is how the two Vietnamese counselors came to stay at The ReHab.
The taller one, Loc, was the director of a drug treatment center near Hanoi, and Bang was his assistant director. They were both older: in their fifties or maybe even sixties. They had just traveled halfway around the world to come to America for the first time to receive training in the running of a therapeutic community from some of the world's foremost experts on treatment in a TC modality. I didn't want to rain on their parade, especially after they had come so far, but at that time in my life, I felt like I was first-mate on a ship of fools, about which any expertise seemed to me of very dubious value. And after their initial interviews (in which Bang admitted he has been in prison for some period of time as a young man), they were welcomed into the community and handed a mop or a broom and told they were now members of the TC and had to follow rules. Rule number one: do as you are told. Rule number two: clean that floor. I wondered to myself how the director of a drug rehab in Hanoi felt about coming halfway around the world to receive training in cleaning the floor. It must be quite a come-down, I thought.
It took some time for them for fit it. First of all, there was a bit of a language barrier to overcome. Both Loc and Bang spoke some English. But fast-paced conversational English is another matter, to say nothing of the TC patois of inner-city street and prison slang that is a pervasive feature of conversations at The Rehab. Basic expressions like “shit” and “fuck” had to be explained, as did “yo, hold up!” More complex concepts like “dope-fiend” (a person hungering for drugs and/or related drug-seeking behaviors), and “kicking up my shit” (negative behaviors that bring to mind how I acted in the streets) took longer. The street-wise residents had a lot of fun with Bang's name, signifying for them as it does both a sexual activity and a way to administer their favorite drugs. Of course, you had to explain the joke to him, which took all the fun out of it.
But the addicts at The ReHab are a friendly and welcoming bunch when they are not dope-sick, and with their advanced hustling skills many know how and when to turn up the charm. For their part Loc and Bang were smilingly deferential to all, even the most unrepentant, unfriendly sick and suffering addict. Within the forced intimacy and shared hardship of The ReHab, the two Vietnamese counselors, who had never seen a do-rag or a crackpipe in their lives, found themselves members of a tight-knit family beyond their wildest imaginings. They had come for the training, and training they were getting in spades.
But I and the other counselors noticed that Loc and Bang seemed to be fighting amongst themselves a lot. They would argue together in Vietnamese, so no one knew what the arguments were about. Both appeared to be upset by these disagreements. Their counselors addressed them individually without making much headway. We made sure they got into the same Encounter Groups (twice weekly group sessions in which residents were allowed the opportunity to publicly say to each other whatever they refrained from saying during the working day and hash out their differences, typically at top volume). And while they made a go of it, yelling at each other in English, and accusations of “You-a dope-fiend!” were tossed back and forth, the cause of the tension remained a mystery and it continued unabated.
During one lunch-time conversation, Bang told me he had lived in Saigon as a young man. “Were you involved in the war?” I asked. Yes, he told me; he had been a member of the South Vietnamese Air Force. I murmured something about how difficult that time must have been for him, feeling ashamed for my rich and soft life in the land of plenty, and about how little I could really appreciate the pains and difficulties he had experienced. And something clicked inside me as well. Later, Loc confirmed to me that he had proudly served as an officer in the North Vietnamese regular army.
And here they now were, thirty years later, boss and subordinate. Apparently, citizens who fought for the losing side would never attain the position of director, but would always play an inferior second fiddle to the former officers of the NVA. And now, ten thousand miles away from their upbringings in a culture of reserve and reticence, and confirmed members of a TC that encouraged out loud expressions of their inner pains and frustrations, the two Vietnamese counselors had encountered an aspect of training in TC life that they could not have anticipated. The ReHab makes running from yourself impossible, and now Loc and Bang were forced to confront some difficulties that had been kept hidden for decades.
As counselors, we had seen this before and knew the next step: throw it back on them. “What do you two plan to do about this situation? You are both committed to a fight against a powerful enemy: drug addiction is eating the young people in your country and ravishing the countryside. You are leaders in this fight, yet you can not resolve the antagonism that exists between you. You are adults. What are you going to do about it?” The arguing seemed to subside.
Later, as their six month stay at The ReHab was coming to a close, I asked Bang if he would have a chance to see any sights here in America. He told me he was going to New York City to see long-lost family members. With his shy smile and soft steady voice, Bang told me that when the war in Vietnam was winding down, he knew that as a member of the opposing armed forces he faced retribution after the war. He manged to secure passage for his young pregnant wife to come to America, and somehow convinced her he would follow shortly. He spent many years after that in various re-education and labor camps, and was not able to get word to his wife that he was still alive. She eventually remarried, and Bang had only recently been allowed to finally exchange letters with his former wife. Now, thirty years later he would at last see the women he had once married and lost, and for the first time, his only child, now all grown.
As they say at The ReHab, Bang gave me good treatment during his stay at The ReHab, a powerful walking, talking lesson of humility and grace in the face of overwhelming hardship. And how fortunate I am that an accident of birth has given me so much that even my worst day at The ReHab was better by orders of magnitude than Bang's best day as a soldier in South Vietnam. My self-pity seemed impossibly petty measured alongside Bang's strength and endurance.
And how for over forty years and against impossible odds, The ReHab continues to reunite families.