Views From A Rehab Counselor

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Views From A Rehab Counselor

By Gayle Saks 09/27/18

No amount of comfort is enough when there is a look of terror on someone admitting to treatment for the first time.

Image: 
girl dancing on dance floor
Photo via Gayle Saks

“I want to be that little girl!”  

A woman in her late 40s is sitting in front of me in my office, sobbing as she stares at a black and white picture of my then four-year-old daughter being twirled on the dancefloor, her white crinoline dress slightly blurred by the movement of her swirl. She has a smile of joy that only a four-year-old can have.  

The woman is a patient I’m admitting to the rehab facility where I’m a counselor. She is highly intoxicated and emotionally distraught. This is her first time in treatment.

I immediately regret having the picture so visible, something I know a lot of counselors and therapists would never do and as I move to put the picture facedown on the window sill, she begs me not to. For some reason she is fixated on my daughter’s image.

In the three years that I’ve been in the field there is something new happening—more and more older men and women—those in their 40s through late 60s—are entering treatment for the first time for their alcohol dependence.  

It’s also happening with people in their 20s—young, suburban, college-educated, fresh-faced young people attempting to stop drinking.

Prior to this job, I worked in an all-male halfway house for 30 men. In the year that I was there, maybe four of the 50 or so guys I had on my rotating caseload struggled with alcoholism. The rest were mostly 20 and 30-year-olds who were addicted to heroin.

This carried over into my current job where initially most of the patients coming in were younger, a little rough around the edges, wanting to detox from opiates and benzos. Then suddenly, just a few months ago, something seems to have shifted.  

I’m stunned by the amount of alcohol these patients have been drinking on a daily basis. I went into my local liquor store to ask the owner to show me what a “handle” is and what a “sleeve” of nips looks like.  

For me, someone who is not in recovery and looks forward to a glass of wine at the end of the day, who stops the second I feel a little buzzed I can’t wrap my head around that desire, that need to completely obliterate oneself to the point of blackout. I can count on less than two hands the number of times I’ve been even slightly drunk and only one time when I actually got a touch of the bed spins. I’ve never thrown up from drinking, never passed out. 

I know enough to realize that a good number of people with substance use disorders are self-medicating for one thing or another, for the pain and anguish, the unaddressed trauma and mental health issues that lurk beneath the surface.  

If a family member accompanies the patient to our facility they will often take me aside and fill me in on some details that the patient wouldn’t necessarily reveal themselves during the intake process. It comes out eventually during the customary 28-day stay, with the gentle guidance of insightful therapists and peers.  

Obviously the hard part, the seemingly impossible task, will be for them to find other ways to cope once treatment is complete.

I have a special fondness for the men and women who arrive to the facility under the influence. I love the rollercoaster ride they take me on with them, the ups and downs, the loop-the-loops, the crying and yelling.  

I’m okay with being told to “fuck off” and then only two minutes later being told that I’m their guardian angel. I was recently told that I was “hotter than a hand grenade” by a man whose blood alcohol level was off the charts.  

I told him that when he sobered up how disappointed he’d be in my “hotness” level. And yes, when I DID see him the next day, he barely remembered me.   

No amount of comfort is enough when there is a look of terror on someone admitting to treatment for the first time. I can only do so much by telling them that it’s going to be okay, that they’ve come to the right place, that they’re so brave for making this first step. I get to go home at the end of the day. I don’t have to be woken up every four hours to have my vital signs taken or worry about who my roommate might be.  

Some time during my intake the woman sitting in front of me looked at the picture of my daughter, put her head down, still sobbing and defeated and filled with shame and said, “I’m NEVER going to be that little girl.”

It was clear that she didn’t think she would ever achieve a moment of such complete joy and freedom, that she would ever be spun around on a dance floor in a twirly dress. It took a couple of hours to complete her paperwork and by the time we wrapped up, she had sobered up quite a bit.  

As I stood up to escort her to the unit, she looked at the picture one more time, some strong and silent resolution having been made, the belief that joy could and would be achieved in her life and said, “I’m GOING to be that little girl.”

I so hope that she has found many joyful and free moments since she left treatment, that she dances in her living room with a smile on her face.  

Gayle Saks has written extensively about her work as a substance abuse counselor from the unique perspective of someone who is not in recovery herself. Her blog, My Life In The Middle Ages, was voted one of the Top 20 Recovery Blogs for 2016 by AfterParty Magazine. She has written on the subject for The Fix, HuffPost, mindbodygreen and Thought Catalog. She has also written about being the daughter of a Holocaust survivor and the eventual suicide of her mother. Her pieces on the subject have appeared in kveller where she is a regular contributor, The Jewish Journal, and MammaMia.

In 2013 she was invited to be on a panel on HuffPost Live to talk about being middle-aged, where her 15 minutes of poignant and intelligent conversation turned into a soundbyte about her having a hot flash at a Justin Timberlake/Jay-Z concert. 

Saks grew up on Long Island, New York, and lives in the Greater Boston area with her husband, daughter, two cats and two dogs or as her husband says, “Too many beating hearts.”

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Gayle Saks has written extensively about her work as a substance abuse counselor from the unique perspective of someone who is not in recovery herself. Her blog, My Life In The Middle Ages, was voted one of the Top 20 Recovery Blogs for 2016 by AfterParty Magazine. She has written on the subject for The Fix, HuffPost, mindbodygreen and Thought Catalog. She has also written about being the daughter of a Holocaust survivor and the eventual suicide of her mother. Her pieces on the subject have appeared in kveller where she is a regular contributor, The Jewish Journal, and MammaMia. Saks grew up on Long Island, New York, and lives in the Greater Boston area with her husband, daughter, two cats and two dogs or as her husband says, “Too many beating hearts.” Follow Gayle on Twitter.

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