Starting a Mandated Client on the Road to Recovery
By Dr.Fourkan
Ali
Was Sam
addicted to K2 or suffering from “cell phone preoccupation” disorder?
Some are tired of a life full of
arrests and incarceration, but others... Sam believed that cell phones
were his problem, not K2.
Although often maligned as a
sub-optimal environment in which to establish a healthy recovery, many clients
in mandated treatment do find the traction they need. Mandated treatment for
airline pilots and physicians, for example, is often very successful.
Obviously, such clients can be assumed to have a higher level of motivation to
return to their previous high levels of functioning than clients who enter
mandated treatment as an alternative to incarceration, but the good outcomes with
these populations support the fact that mandated treatment in and of itself is
not necessarily a barrier to beginning an intrinsically-motivated
recovery…Richard Juman, PsyD
“Sam”
entered our treatment center like so many others—mandated by his county’s probation
department. He had been in jail for several months, so had agreed to 90 days of
chemical dependency treatment in order to get out early. Upon his admittance to
our facility, Sam stated that his drug of choice was K2 spice—synthetic
marijuana. Many users view “spice” as more natural than marijuana and therefore
less harmful. In reality, some users report psychotic effects like anxiety,
paranoia and hallucinations. K2 spice, often with unknown ingredients, has also
been known to cause brain damage.
I’m a
counselor at an inpatient men’s unit. Although I am only able to work with our
clients for 90 days, the maximum length of treatment in our program, I feel
privileged at the deep level that I am allowed into my clients’ lives on a
daily basis. We have 39 beds, with most of them being occupied by men who have
been mandated to treatment by parole, probation or drug court. Every now and
then we get someone who is self-referred, but that’s a rarity. As you can
imagine, the motivation for treatment for most of our clientele is mixed. Some
of them truly want to be clean—tired of a life full of arrests and
incarceration. But most...most aren’t sure what they want. They are so
entrenched in a life of crime and drug use that abstinence and recovery
behavior is a foreign concept.
I
greeted Sam when he arrived on the men’s unit after going through the intake
process. I stood in the office, screening his belongings. He didn’t have much.
Like others, his time in jail had made him quite resourceful. Sam had playing
cards in plastic soap containers. He had made bracelets by stripping cloth from
bedsheets and pillow cases. He had gauge earrings made of caps from water
bottles. The tops of his ears were pierced with the teeth from a hair comb. He
wore a long beard, telling me that he was a Mennonite and wore a beard to
signify that he was married...I thought he looked like a white supremacist.
Here’s
the other thing that Sam had amongst his belongings: picture after cut-out
picture of cell phones. It was mind boggling. He also had a cell phone amongst
his belongings, which I had to promptly confiscate. It was actually just a
display model, not able to work, but important to Sam nonetheless. With his ear
gauges and piercings removed, Sam and I sat down to review his intake assessment.
When we
got to Sam’s drug using history, Sam had a confession. He really didn’t think
K2 was a problem for him. In fact, he told me, he believed his addiction was to
cell phones and not to drugs. Sam proceeded to tell me how much he loves cell
phones. “It’s all I think about,” he said. He knows every brand, every model
and, until the time he got locked up, simultaneously owned several different
models. He told me of his dream to build a coffee table made of cell phones.
His obsession with cell phones was so profound that one day when I had my
personal cell phone on the desk and walked to my doorway to take care of
something, Sam told me that he had to bow his head to avoid looking at my
phone. The arrest that brought Sam to jail, and subsequently to my facility
was, you guessed it, retail theft of a cell phone.
I had
never really heard anything quite like Sam’s story. I understand people are
attached to their cell phones, myself included, but this was like nothing I had
ever heard of. I had to tell him, “Sam, we’re not a cell phone addiction
treatment center. You need to think about why you’re here and what you’re here
for. This is not a shelter or a ‘get out of jail free’ card. This is chemical
dependency treatment center.”
My
first order of business was to come up with Sam’s first treatment plan. Before
I went any further with treatment, I needed to establish whether Sam understood
his dependence on K2 as a problem, or if Sam was really appropriate to be at
our facility. Certainly I didn’t want to waste my time with someone who was
just occupying a bed. The vast majority of our clients are heroin dependent.
The next most common drugs of choice are alcohol and cocaine. Occasionally we
get someone who is strictly dependent on marijuana, but for many of our clients
marijuana is a here or there thing, and mostly something that they’ve let go of
in lieu of their current drug of choice.
I could
tell from the beginning that Sam was having a difficult time adjusting to the
program. After all, living day in and day out with 30-plus strangers with a
strict group schedule and facility rules can be hard to adjust to for some. My
office sits right across from one of the large treatment rooms. One day, while
sitting at my desk, I see Sam reading a magazine with ear plugs in his ears.
Not exactly the most inviting way to make new friends! I had to pull him aside
to tell him that, “Nothing says ‘don’t talk to me’ like ear plugs in your ears.
What are you doing?” Sam’s reply: “There’s too much talking.” Hmmm. Was this a
person who had difficulty with sober socializing, or was this someone just
trying to bide their time and avoid as much interaction as possible?
With
treatment plan in hand, Sam spent his first week in treatment attending groups
and listening to didactic lectures. In the course of this first week or two of
treatment, I heard from several of my fellow counselors wanting to talk about
Sam and his preoccupation with cell phones. He had been asking everyone in
treatment what type of cell phone they own, and trying to guess before they
tell him. According to Sam, there’s a personality type that tends to go for a
particular cell phone model. He had pegged me as an Apple iPhone carrier long
before he laid his wanting eyes on it. Not a tough guess, I suppose, but oy vey this
guy is killing me!
Sam and
I sit down to review his treatment work. “You know,” he says, “listening to all
these other guys makes me think I might have a problem with K2. I figured
because they’re all shooting up heroin, my problem wasn’t anything compared to
theirs. What I realize is I’ve had a lot of things—bad things—happen to me, and
every time something bad happens, I’m high on K2.” And there we had it: Sam is
beginning to make some movement from pre-contemplation to contemplation. This
pleases me very much. I don’t expect to “cure” anyone while they’re in a 90-day
treatment, but if I can plant a seed that may resonate at some point, I feel
I’ve done my job. Sam was beginning to realize that his K2 use, and perhaps his
preoccupation with cell phones, were ways of distancing himself from his inner,
genuine experience of the world and of other people.
Fast
forward about 10 weeks and Sam has made several friends, serves as the lead on
the kitchen crew and has moved his preoccupation with cell phones down to what
seems like a much healthier “hobby level” interest. It’s also noteworthy that
he shaved his beard. He’s now decided he wants to be Methodist.
Sam is
someone I’ll never forget. He left our facility with what seemed like a new
zest for life. He didn’t have many belongings, no family support, but what he
did have was enthusiasm for moving into the action stage of change and turning
his life toward a healthier direction. He also decided getting a job in a cell
phone store was probably not a good idea!
Update: Shortly
after his discharge I hear through the grapevine that Sam is back in jail,
serving time for some outstanding charges. Hopefully when he gets out, he’ll
keep heading down the positive path he seemed to be heading down at discharge.
Carolyn Bloom Hakes, BS,
CADC recently moved from the suburbs to the city and left this position soon
after being promoted to Senior Counselor in order to be closer to her new home.
She now works in DUI counseling and greatly misses the challenges and rewards
of traditional treatment.
The
writer Teacher & Columnist
8801611579267
dr.fourkanali@gmail.com
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