Is Scientology's Narconon Killing Patients?
(page 2)While for mental illness, use of punitive measures like restraint, isolation, humiliation and corporal punishment have long been dismissed as barbaric, even late into the 20th century these were regular features of addiction treatment—and some programs still rely on them, particularly those aimed at teens. One reason that they have been so difficult to root out is that faith, not evidence, remains an acceptable basis for treatment models.
If we are to improve addiction treatment, faith-based care should be as unacceptable as the primary treatment as it is for cancer or heart disease. And that means that supporters of twelve-step programs will have to make some big changes. If addiction is a disease, meeting and prayer can be viewed no longer as treatment for it but merely as adjuncts to care—as they are for other medical conditions. If addiction is a disease, twelve-step material cannot be used in rehab itself— referrals to meetings can be made, information can be provided, and even onsite meetings made available, but counseling can’t consist of use of the steps. That’s just not how medicine or mainstream psychology is practiced.
As with other conditions, the spiritual aspects of the problem—for those who find them important or believe they exist at all—need to be kept separate from medical and psychological care. Otherwise, there will be no way to prevent religious ideas from being sold as treatment: if rehabs can sell programs based on the confession, surrender and faith aspect of AA, why shouldn’t they be able to sell Scientology?
There’s no way to set standards when treatment relies on a higher power: if God, why not Xenu?
And if they can sell Scientology, why not any belief about treatment anyone wants to promote? There’s no way to set standards of care when your treatment relies on a higher power: if God, why not Xenu?
Some will argue that twelve-step facilitation—a manualized treatment that involves introduction to the steps and encouragement of participation in the program—has been shown in some studies to be as effective as more standard “evidence-based” programs like motivational interviewing and cognitive behavioral therapy. They will point to research showing that those who do affiliate with AA or NA do better in the long term than those who do not.
But that doesn’t make AA a type of medicine any more than depression recovery through social support is a type of medical care. The mind and body are not separate, and belief certainly can play a role in healing. That doesn’t mean the main medicine for any disorder should be faith. If we continue to allow this, we shouldn’t be surprised when people die in addiction treatment. Medicine itself only advanced and stopped killing more people than it helped when it began to rely on data rather than faith: we need to hold addiction care to this standard, too.
Maia Szalavitz is a columnist at The Fix. She is also a health reporter at Time magazine online, and co-author, with Bruce Perry, of Born for Love: Why Empathy Is Essential—and Endangered (Morrow, 2010), and author of Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead, 2006).