Lemonade Skies and Bluebell Woods 3
Chapter Three — In which I reminise
We were standing in a circle on the hard wet sand while the restless Pacific, dark grey and foaming, roared behind us. There were 20 of us all together; a few Certified Counselors, this graduating cohort of Interns, me and our trainer for the weekend. The Wounded Warrior was teaching us how to address burnout, move our Chi, breathe deeply and reenergize ourselves. Preventing or salving burnout is a very real need in the line of work for which we were preparing the Interns. It was also relevant for the current Counselors.
The Interns sacrificed a year of salaried employment to work and train at my treatment facility. They’d all done well. I felt they deserved this training as a treat. It wasn’t on the regular curriculum/ A last hurrah if you will, because two days later I’d be on an international flight that would literally drop me off the edge of my world. I looked at the faces with their eyes closed and smiled inwardly at the peaceful happiness that was evident there. It was a good thing.
I’d done everything I could and I had every confidence that the greatest majority of this group of interns would ace their State Certification examination and become full-fledged counselors, Certified Alcohol and Drug Counselors — CADC-I. The bosses had already gleaned the best of the best for the hospital and treatment center I worked for. Some of the others already had job offers at other sites, including our own outpatient sites. Everyone who passed their exam would have work offered them — because they’d been trained by me.
Years before I’d gone through the year-long, unpaid Intern Program myself and noted its discrepancies. I passed my State Exam for the CADC-I, one of the 68% of my cohort to do so. I was one of a handful that was offered paid work as a Certified Counselor at the Treatment Center.
Then I went on to get my CADC-II before it was ‘authorized’ for me to do so. It seemed that being better qualified meant that they’d have to pay me more and that didn’t make the bosses happy.
Much of what I was to do over the next several years didn’t make them happy. Let me explain. First of all, I was a woman in a facility founded, run by and catering to men even when it was half-full of women.
I was an intelligent and diligent worker. I wrote reports and notes that made sense. Pointing that out should make it clear that not every Counselor’s notes made sense. One of the things I did when I became the Intern Coordinator (Intern Training Manager) was to introduce a course of note/report writing that improved our record keeping throughout the center. This was a change. Change was not encouraged. I was expected to just keep doing what had always been done and no more.
I spoke to my bosses about the woeful state of treatment for women. Women’s needs in treatment are different than men’s needs. They didn’t believe that and challenged me to prove it. In my spare and personal time I did my permitted research and presented evidence based on a number of record trawls, published research and Journals. I found that while men entering treatment overwhelmingly had the support of their families, particularly their wives and mothers, women more often did not. Women reported they were motivated to get treatment by the threat of losing their children but their husbands and fathers were usually already missing. So too, surprisingly, were many of the women’s mothers. Instead, the support network that women were often forced to count on were friends, many of whom were still admitted users. Right away, it can be seen that this is a problem.
Most often the motivation for men to enter into addiction treatment came from their bosses and included the potential loss of work and salary. Rarely was it because of the threatened loss of family. The treatment center acknowledged this with programs that were meant to connect the men with their bosses, educate the worksite about what was needed to support their recovery and teach their work how to hold the recovering man accountable. There was no such program built in to help women connect with parenting classes, other sober and recovering mothers or even to help them retain or attain paid employment that could support their families and their recovery.
There was a family day, one day during the whole of the inpatient cycle for any individual but children were discouraged from coming. It was a day meant to increase the motivation for the inpatient and often included guided confrontations. But while this appeared to help the men maintain their focus on recovery, it appeared to increase the sense of shame women felt which very often led to relapse. This was reported over and over again by those counselors who recorded the actual words of their patients in notes.
These realities and others, including the differing ways that substances affected the physiology of men versus women, were not acknowledged by my bosses as important. In something of a mood of defiance I instituted a training in which I addressed these differences. I ensured that the interns I trained understood that women had different needs in recovery such as connecting with a sober, woman-focused support network and that they were helped to re-establish relationships with their children and with their partners. Today it seems obvious. Twenty years ago it was cutting edge and not welcomed at the treatment center where I worked.
My treatment center was 12-step based, male led and ‘good enough’ for anyone who was properly motivated to get into recovery. It had a reputation of being one of the ‘best 100 treatment centers’ in America. However, the people running it did not want to admit that the treatment and recovery landscape was changing even twenty years ago.
The bosses there did introduce acupuncture for people with opiate addictions. This was considered quite revolutionary. But what they really thought was that all anyone with addictions needed was the Big Book, AA and the 12-steps. They refused for a very long time to believe that the acknowledgement let alone the concurrent treatment of depression and other mental health issues was necessary. Dual diagnosis was an annoyance, not something that they wanted to touch with a ten-foot pole. Before I left though, they’d finally hired two psychologists one of which was a woman. I like to think I had something to do with the shift of thinking.
While I worked at the treatment center I also completed my Masters Degree in Social Work.
There was a medical Social Worker present at my mother’s death. She was there to support us, insure that my mother was well cared for and to answer any questions. When my mother seemed to be struggling I asked this Social Worker, “Is she in pain?”
“No,” she said to me gently. “She is negotiating with the angels.”
I never forgot that exchange and the manner of this Social Worker. She was part of my motivation for continuing my education.
Reluctantly, my bosses at the treatment center allowed me to complete my Masters Degree. However, they assured me that they would not be increasing my salary as a result of my education. I wasn’t doing it for the money but this showed me once again evidence of their lack of respect for me. They wouldn’t have said this to a man. I wasn’t going to forget it.
I continued to work and rewrite the Intern Program training manuals. I continued to provide the best training I could to the two cohorts a year that we accepted. I increased our interns from a low of five when I originally took over the program to between 35 and 40 in any given year. I improved their percentage of passing the State test from around 65% to a whopping 95%. I was particularly proud of that. The measure of success for the Intern Program was not provided by me but by the State.
I was also developing a bit of reputation in treatment circles. I was being invited to teach seminars, speak about my research, advise on other training programs and other outside activities, all of this was actively discouraged by my bosses. It was clear to me that I couldn’t grow in my role there. I thought about leaving all the time.
I had another motivation for leaving the country. I needed to end my relationship with the person my daughters called “The Nasty Little Man”.
When I first met Sam I was charmed by him. He was intelligent, lively, a sometime musician and he wasn’t afraid to be silly. We talked about everything. At first. Then his addictions began to get in the way. He liked to drink, a lot. I didn’t drink at all.
I met Sam prior to entering the intern program. I chose to do the year-long program because my dear long-time friend Max had gone there, got sober, went through the internship program himself and was now a well-respected Counselor there himself. At least that’s what I told myself. If I’m honest, a large part of the motivation was Sam. I wanted to ‘save’ him. Obviously, I couldn’t save him because he didn’t want to be saved. Now, I really had to save myself.