In the search for addiction treatment you may find a wide variety of treatment approaches, and several definitions of what actually constitutes (a) an addiction and therefore (b) a relevant treatment.
One model is the Behaviour Modification Model. According to Wikipedia ‘The first use of the term behavior modification appears to have been by Edward Thorndike in 1911. Through early research in the 1940s and the 1950s the term was used by various research groups. The experimental tradition in clinical psychology used it to refer to psycho-therapeutic techniques derived from empirical research. It has since come to refer mainly to techniques for increasing adaptive behavior through reinforcement and decreasing maladaptive behavior through extinction or punishment (with emphasis on the former). Behavior modification is a form of Behaviour Therapy now known as Applied Behaviour Therapy.
Whilst The Bethesda Addictions Treatment and Rehabilitation Programme strongly promotesBehaviour Modification for certain aspects of its graduate’s life style after treatment, like how to address conflict or how to create a new social life, our programme does not concentrate its focus uponBehaviour Modification.
Another approach to addiction and therefore to its treatment is the Disease Model, from which we see all 12 Step Treatment Centres promoting personal application of the 12 step recovery programme. Experience is teaching us how this model of addiction treatment is by far the most successful throughout the world. At Bethesda Addictions Treatment Centre, our approach is rooted in the central ethos of the disease model but only in as far as it relates to the principles of the 12 Step Recovery Programme, we are not entirely sold at this point that (a) addiction is a disease or (b) a treatment centre can be a 12 Step Treatment Centre.
We have complete faith in the 12 Step Recovery Programme and its promises of freedom from the bondage’s of self within the programme, but only as and when it is applied with a heart of complete surrender.
It is our continued experience that many men and women relapse either in treatment or shortly after leaving treatment, because they really believe that they are on the programme when in actually fact they are only on a ‘version’ of the programme which is developed in a Group Think environment – the practice of thinking or making decisions as a group in a way that, knowingly or unknowingly discourages creativity or individual responsibility..
In reality, there can never be a 12 Step Treatment Centre. In the addiction culture the nature of the addict is to become like the people they mix with, and this dynamic does not go away when the clients enters out facility, it continues, in order to survive, in treatment.
- Everyone is clean, so I get clean
- If everyone relapses, I relapse
That is not how an authentic, lasting recovery programme works
The 12 Step Recovery Programme breaks down into 3 phases:
Step 1 to 5 are The Foundational Steps
- We admitted that we were powerless over our addiction, that our lives had become unmanageable.
- We came to believe that a Power greater than ourselves could restore us to sanity.
- We made a decision to turn our will and our lives over to the care of God as we understood Him.
- We made a searching and fearless moral inventory of ourselves.
- We admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
It is our belief that most men and women begin their relapse back into active addiction during the process of Steps 1 to 5 of the recovery programme, even whilst they are in the sanctity of a nice warm treatment centre. We very rarely hear anyone who is coming out of an addiction, question the truth or the wording within the step programme that they are introduced to, they generally take it as solemn because that’s what everyone seems to believe.
As Bethesda’s Clinical Director, my personal belief is; if we follow the step programme to the letter, we may well relapse. Here’s why: Much emphasis is placed upon Powerlessness and Unmanageability in the first step, and invariably during the process of analysis, clients start to see how the problems of feelings management, attitude accountability and behavioural waywardness were firmly in place before the drugs even became an option. So to drive home the principles of Powerlessness and Unmanageability, followed by promotion of a need to believe that we can be ‘restored to sanity’, is for many, a very subtle but nonetheless cancerous contradiction in terms. In and of itself, this is not such a bad thing, but for the client, it could be the conception of a relapse in that they start, or in actually fact continue, to believe one thing about themselves whilst something else is actually true – and that’s the road to nowhere.
They then give this second-hand identity over to the care of God as they understand Him in Step 3? They have a false understanding of who they are, and they are then encouraged to create a god for themselves.
By the time clients get less than half-way though the riggers of Step 4, their version of treatment becomes a reflection of their version of the programme; naive, vulnerable, insincere and compliant.
Bethesda Addictions Treatment Centre is a Five Step Treatment Programme.
To allow our clients to go any further than this before thay have been properly grounded in their foundations will be the eqivalent of building a recovery version of the leaning tower of Pizza – attractive, for a while, but destined to fall.
Steps 6 to 12 must only begin when the foundations are secure, so our clients do not enter that section of their recovery programme until they graduate and return to living in society, life on life’s terms. Our clients do not celebrate clean time during treatment, they only start that once they leave, or the cycle back to addiction begins again. Each of the following steps are deeply personal and progressively developmental, but only in reality.
Steps 6 to 9 are the Developmental Steps
- We were entirely ready to have God remove all these defects of character.
- We humbly asked Him to remove our shortcomings.
- We made a list of all persons we had harmed, and became willing to make amends to them all.
- We made direct amends to such people wherever possible, except when to do so would injure them or others.
Steps 10 to 12 are the Maintenance Steps
- We continued to take personal inventory and when we were wrong promptly admitted it.
- We sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
- Having had a spiritual awakening as a result of these steps, we tried to carry this message to addicts, and to practice these principles in all our affairs
Our understanding and definition of an addiction is as follows; it is a polluted (diseased) relationship with the deceptive influences of an addictive substance, from which the individual recieves:
- Temporary and false sensations of individual significance
- Temporary and false sensation of anti-social security
- Temporary and false sensations of acceptance and belonging
The goal of our treatment approach therefore is to escort each client deeply into the first five steps of the recovery programme as a means of revealing and exposing the deadly unfaithful nature of the chemical and its corresponding culture, with gentle encouragement towards faith in a God whom they will never really understand, but whom thay can have faith in.