Treatment communities and Twelve Step communities have completely mucked up my drinking and drug use. When I first relapsed after my first treatment, I had the nagging suspicion that ‘picking up that first drink’ was going to be a really bad idea and could end disastrously. During fleeting moments of consciousness I recall desperately wanting to be a part of the community that I’d so abruptly left after my decision to pick up the first drink. I no longer wanted to be isolated and full of pain and misery. De Leon (2000:18) states:
115 Both [Synanon and AA] shared the premise of self-help recovery, a belief
that the capacity to heal and change lies in the individual, and that healing occurs primarily through the therapeutic relationships with others….For the TC, however, the power of change primarily resides within the individual and is activated through his or her full participation in the peer community.
Ting (1988:104) asked why community was the bedrock to treating addiction and not society. She argued that society is ‘too remote to remedy any personal problem’. I’d seen many of my peers going through treatment feeling alienated from society. Ting then maintained that there’s ‘immediacy’ with being involved in a community, and that communities change through collective efforts, through the mutually implicated personal growth of its many individuals. This, she argues is where the therapeutic effect should be grounded – through the promotion of personal growth. Today we see motivational interviewing as one of the principal methods of addiction treatment.
De Leon (2000:87) sees the use of community differently, one which ‘fosters change in the social and personal elements of identity’ based on participating in the community they’re a part of and being ‘mutually responsible’ for one another. Caring for someone else provides an opportunity to take risks and share your stories with someone similar to you. Hinshelwood (1999:42) maintains that therapeutic communities must influence clients in some deeply personal way, and that this is achieved through insight – using the community to take away a new understanding of the self. Kathy Mildon from Higher Ground (personal interview, Auckland, 28 August 2012) sees the community approach working in treatment because ‘addicts know addicts very well. So it’s that level of realness. They get it. They get what’s going on for the client…the authenticity. What you see is what you get, you know, working in the safety of an alcohol and drug free community. It’s safe. Nothing’s going to happen to them in here.’
Antze (1987) likens modern day recovery communities to Victor Turner’s (1957) observations of the Ndembu of Zambia, where victims are initiated to a specialised community
116 of ‘former-sufferers-turned-healers’ and lasting bonds are made with people who are suffering the same affliction. Antze (1987:151) quotes Turner (1957:302) who states ‘[t]he affliction of each is the concern of all; likeness of unhappy lot is the ultimate bond of ritual solidarity. The adepts have themselves known the suffering the candidates are experiencing.’ One of the reasons community works as a method, according to Brett George (personal interview, Auckland, 17 September 2012) is:
We relate to being in groups. You know, we’re born into groups. We live in groups. Um, there’s something inherently organic about that experience that is just intrinsic to being a human being. So I think that’s what tends to replicate…so when we go into a therapeutic community, a lot of those family of origin issues get unconsciously or consciously resurfaced. Whether that’s in a group or with your fellow resident, or with a supervisor, whoever it happens to be.
Wilcox (1998:61) sees the recovery self-help community as one which ‘shares a common world view that is learned, expressed, transmitted, practiced, and perpetuated in the specialised language of unique speech community. The construction of this shared reality through language fosters a human view of existence on this planet that is very familiar to anthropology and to traditional human social organisation. Responsibilities and duties are shared by members and structured by an egalitarian ideology.’ Wilcox maintains that reciprocity in the form of one addict or alcoholic helping another, defines the human relations of the self-help communities. The key philosophy behind this construct is that members get to keep what they have (their sobriety) by giving it away (the knowledge and experience they have gathered in staying sober). Thinking about someone else stops them from thinking obsessively about themselves. The Twelve Step meeting is the space that provides ‘the foundation for the shared belief and action of the community, which in turn provide the foundation for healing’ (ibid).
In writing this section on ‘why it works’ I saw an interesting ‘trend’ in addiction and recovery-based research. There’s a vast amount of research on how people become addicted, what can be done to treat them and what the outcomes are. There’s a disproportionately
117 smaller amount of research that reviews how and why it works, and what the addicts put into practice in the wider community once they leave treatment. Moos (2004:132) states:
Although clinicians have employed modern therapeutic community-based treatment modalities for almost 60 years, we know very little about how and why therapeutic community treatment does or does not work.
My participants feel strongly in their knowledge and belief that what they do works, however telling that story qualitatively and quantitatively can be difficult. One of my participants said, “I know we do really well and we’ve got different tools we’re using and finding the best method to prove what we do sometimes gets a little difficult.’ So what are the opportunities for future research?