November 6, 2002

• The Best Therapy is Group Therapy

  
  

  The therapeutic modality used at Open Door Klinic, with clients and amongst ourselves at staff meetings, was supportive, non-judgmental counseling.  The other time, in the psychicatric ward at Tachikawa Air Base Hospital, the therapy group was likewise low-key.  This set up for me false expectations as to what I’d be getting into in the therapy group Steve recommended to me.  The style of hardcore healing done at Family House heroin rehab center, and at their outreach program, Family Rap, was Reality Attack Therapy.

  
  

  Any defensiveness, evasiveness, denial, hostility, withdrawal or other recognizable psychopathology that a facilitator or group member notices is confronted.  If I say, “You just said that it didn’t bother you, but I think it did,” and you immediately pick up on it and spill the stuff you’ve been stuffing, it’s okay.  If you tapdance, stonewall, try to use misdirection or try to turn it around onto me, then the other facilitator or another member of the group confronts you on that, only not as politely as the first time.

  
  

  If, instead of bigging up and spilling it, you continue to “run” when being confronted (run is one of the words like spin, haircut, sit down, bag, work, etc., that acquired new meaning for me at Family Rap), eventually you may have three or four people yelling your secret truth at you from around the circle.  The only rules are that everyone stays in his chair, and there is  no violence, no physical contact at all until the final group hug.  To work in group, one would end up often with tears and snot dripping from one’s chin.  Gawd it felt good when it was done, though.

  
  

  None of that was known to me when I went for my intake interview.  The interview was in a room at the back of the Anchorage City Gym, once, I think, the City Hall, and then a school.  The room would have made an adequate office, or very small classroom.  We sat in school chairs, writing-desk chairs, mine up against a wall and the two of them facing me across the small room.  It was Theresa, cofounder of this Anchorage branch of Family House Foundation (there was also one in Seattle, from which she graduated), and wife of the executive director; and Craig, a graduate of the program, now working for the foundation as staff at the rehab center.

  
  

  Craig and Theresa asked me questions about my life and work.  They asked searching questions about my stillborn baby and the recent abortion, my two jobs, my marriages, kids, crimes and incarceration.  I gave a few wry smiles and allowed that I’d had some hard times but I was all right now.  Then they asked about my work and my voice broke a few times when they asked about some of my most frustrating cases, but I kept my composure.  Then they asked me about my love life and I said something about Stony.  And that was where they broke me down.

  
  

  I was so in denial about that relationship, so disappointed, disillusioned, broken-hearted and seething with anger over it, that anyone would have seen it.  They were trained professionals.  They needled me in all the right places and I howled, boohooed and blubbered.  They handed me the box of tissues off the floor between their chairs.  Then they started dumping, working, letting off steam about the frustrations of their life and their work.  It was a gracious and obvious quid pro quo.

  
  

  Each of them told me a little of the story of how he or she came to be running a residential heroin rehab program.  And they told me thanks, please come back Thursday evening at seven, room 108 in the basement.  I snuffled and tried to apologize for breaking down, and they told me that was what I was supposed to do, and they were amazed that it had taken so long.  Theresa looked at her watch:  “Twenty-seven minutes.  I’ve never had anyone go that long.”  We all laughed.  It was something I felt I could get into.

  
  

  I got into it smoothly, easily, quickly.  My empathy made it easy to detect running or hiding or spinning or copping attitudes, and I was good at confronting them.  When it was my turn to work, I was willing.  I worked out my feelings for Stony and let that go.  I dumped a lot of frustration and fear from work.  Then I got around to the big stuff:  killing my father.  For the first time ever, I spoke through tears and a throat that kept spasming shut and cutting off my voice, of my anger after a spanking, and the wish next morning after his heart attack, as the ambulance pulled away, that he would die.  BIG, sobbing, shuddering *SIGH* of relief, then I looked up and saw expressions of awe and love all around the circle.  Yeah, I could get into this.

  
  

  Theresa and I started facilitating a women’s group on Saturday afternoons.  When Open Door got another grant and hired three new outreach workers, one of them, Skip, turned out to have been through a program similar to the Family House rehab.  He and I started facilitating a group on Sundays, in the light and sunny upstairs consultation room at the clinic.  Skip was a junkie from New Jersey and a soulmate of mine from ‘way back—Atlantis and Egypt.  He also had the first cat I ever saw that would use the toilet and flush afterward.  Skip’s house became the clinic staff’s party house.  It was on the bluff overlooking the harbor, great views day and night.

  
  

  Skip was an effective counselor, and an especially good choice for his job:  outreach.  He would go to the corners where the hookers hung out, to the places where homeless street people took shelter, to the alleys behind the 4th Avenue bars, and find clients for the Klinic.  Then a close friend of his was murdered in a sleazy neighborhood motel.  Another close friend was present in the motel room, unconscious, when the body was discovered.  He was eventually prosecuted for the murder.  Both men had been clients at the clinic.  Our clients are not supposed to be our friends and vice versa, the rules say, but that one is often honored in the breach.  Peer counselors are, by definition, part of the community they serve.

  
  

  The whole staff was questioned.  Because I had spent hours on the phone counseling the victim, and had known the suspect from his hanging around the clinic, drinking coffee and reading magazines, I was questioned intensively, repeatedly.  Confidentiality was never an issue because the victim had never said anything to me about being or feeling as if he was in danger, nor had he talked to me about the suspect.  I had seen him and the suspect talking to each other at the clinic, but never heard any of their conversation or noticed anything out of the ordinary.  Alcohol and various drugs were involved, obviously, but the motive, as far as I know, was never understood.  With alcohol and an assortment of other drugs, probably no motive would have been needed.

  
  

  Skip started decompensating when the murder came out.  He knew and cared about both men, one dead and the other in jail.  Nobody knew what had happened or why.  Then the cops started grilling us trying to find out what nobody knew.  In group, Skip worked around the edges of his anguish and anger, but danced away from the heart of it.  He’d talk about what was going on, but not about how he felt about it.  He wouldn’t bring up the subject of addiction, heroin, cravings or relapse, although they were hanging right out there and I kept tossing them at him.  He was already back on the needle, and he wouldn’t meet my eyes when I asked him how he was doing with his abstinence and recovery.  Within weeks he was gone from the clinic, and from Anchorage.  Within months, I heard he was dead.

  
  

  I wouldn’t have gotten through it all intact without my Thursday night therapy group.  It gave me just the right balance of a safe place to vent my feelings and plenty of evidence that I wasn’t alone in my troubles.  My associates in that group included a trauma nurse, a psychiatric nurse, a fire department division chief, the parole officer Vicki, and a public defender.  The only thing we all had in common was the mutual need for the process, for the pushing and pulling we did on each other, to work out the kinks.

  
  

  That was where I learned my blunt, direct approach, where I shed my shame, my secrets, and a lot of my fears.  The training and conditioning I got from the give and take of Reality Attack Therapy has been a boon to me, and often a shock to the friends, family members, and clients who have experienced the way I adapted the principles I learned there to other aspects of my life.

  
  

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  • 5:23 pm
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