(page 3)What does Bob Forrest’s ideal rehab look like?
I just know my patients. I know what they’re willing to do and what will probably be the best experience for them. Rehabs should all provide the exact same service: containment, accountability, and structure. That’s all. It doesn’t matter whether you’re in a California king-sized bed with 640-ply sheets or not. Our rehab was a pretty traditional Minnesota model. We were like, “If you don’t want to be here, go home.” We weren’t punitive, but we weren’t accommodating. Just straight down the middle, like Hazelden or Betty Ford—though Betty Ford’s a little more punitive.
What an addict needs is love with boundaries. What an addict needs is compassion.
There is footage in the film of you as a guest on Dr. Drew’s “Loveline” from back in the day. It’s a quirky foreshadowing of things to come: You’re talking to Dr. Drew, and you’re very earnest about addiction. Yet you were still so far from your own final recovery. Do you remember that conversation?
Yes. They would bring me on a lot because of that ability—that compassion. That conversation in the movie is just straight Hazelden. I had just got out of Hazelden like six months before. I knew about addiction because Hazelden is the greatest rehab center you can go to, and you’re treated like an adult, with respect, and it’s relatively cost effective because it’s a not-for-profit. So that was Hazelden talking.
That’s one thing I’ve learned—you just have to be inherently compassionate and have this people-focused mentality. I’ve always had it. People call it codependency. But I don’t think it’s destructive to care about other people or want to help other people. I try to mentor counselors, and they’re taught in chemical dependency school that caring is a negative, that it’s codependency. They learn to just do reflective listening and constantly be breaking down denial. That just doesn’t work. As soon as you alienate the patients, they’re done with you. They’re shattered people, and if you try to shatter them again, they just become guarded. That’s how I was. That’s how thousands of addicts are when they’re brutalized by this archaic old-fashioned idea of what an addict needs.
And what do you think an addict needs?
What an addict needs is love with boundaries. What an addict needs is compassion. Bill Wilson had this right from the very beginning: love and tolerance. Nowadays, a lot of addicts meet their counselors in the rehab center. Those people have a very powerful effect on the addict. If the counselors are sarcastic or mean-spirited, it’s unprofessional and it doesn’t help anybody. Bill Wilson used to constantly talk about that. If you read his writings in the ’60s and ’70s, he could already see that AA wasn’t working that well. He was like, “What are we doing wrong? What do we need to do better?” Everyone else was like, “Shut up, Bill. It’s working just fine.” That’s what goes on in the rehab centers: “It’s working just fine.” No, it’s not.
I have a feeling that a lot of people who work in chemical dependency couldn’t get a job anywhere else—because of a personality disorder, because of their employment record, because of their education. You need an industry where people choose to be in it, because they have a passion for it, they’re well-educated about it, and they have just a tremendous drive about it. That’s what I have. For me, it’s an obsession.
Sacha Z. Scoblic is the science writer at The Fix, the author of Unwasted and a Carter fellow for mental health journalism.