A sample text widget

Etiam pulvinar consectetur dolor sed malesuada. Ut convallis euismod dolor nec pretium. Nunc ut tristique massa.

Nam sodales mi vitae dolor ullamcorper et vulputate enim accumsan. Morbi orci magna, tincidunt vitae molestie nec, molestie at mi. Nulla nulla lorem, suscipit in posuere in, interdum non magna.

The Recovery Industry

I’ve writ­ten else­where about the fact that I am a sur­vivor of child­hood sex­u­al abuse and have been treat­ed for depres­sion in the past. As a result, I had an extend­ed expe­ri­ence with the recov­ery indus­try in the Unit­ed States. I have real prob­lems with many aspects of that indus­try.

I would hate to see any­one read my con­cerns about the recov­ery indus­try use those con­cerns as anoth­er excuse to delay get­ting help for men­tal health prob­lems. Please don’t. I do hope that any­one read­ing this essay will be a more informed con­sumer and sim­ply be more aware and proac­tive in seek­ing men­tal health care.

When I first sought help in 1988, I sim­ply went to a prac­tice rec­om­mend­ed by oth­er peo­ple in the orga­ni­za­tion for which I worked. The par­tic­u­lar psy­chol­o­gist I hap­pened to see in the prac­tice was deter­mined by the fact that he was the one who had a week­ly slot avail­able on his sched­ule. I did­n’t think about shop­ping around or try­ing dif­fer­ent ther­a­pists to see which were best for me. I thought of going in for ther­a­py about the same as going in to a med­ical doc­tor to get antibi­otics for strep throat. Unfor­tu­nate­ly, I had no real rap­port with the ther­a­pist. Going to see him week­ly turned in to just anoth­er thing I had to do each week. It was a has­sle, not a help.

The psy­chol­o­gist referred me to a psy­chi­a­trist in the prac­tice who saw me once, did­n’t take a med­ical his­to­ry of any sort, and pre­scribed an anti­de­pres­sant, a tran­quil­iz­er, and a sleep­ing pill. I lat­er learned from a phar­ma­cist that the three par­tic­u­lar drugs he pre­scribed are coun­traindi­cat­ed if tak­en togeth­er, but obvi­ous­ly I did­n’t have a very atten­tive phar­ma­cist at the time (or a com­pe­tent psy­chi­a­trist). That same psy­chi­a­trist lat­er switched me to anoth­er anti­de­pres­sant that is also used to treat peo­ple with high blood pres­sure, which led to a hos­pi­tal vis­it for dan­ger­ous­ly low blood pres­sure. (My nor­mal blood pres­sure was 90/54, some­thing he did­n’t both­er to notice.) He did­n’t even respond to the calls from my fam­i­ly doc­tor, who admit­ted me to the hos­pi­tal, so I nev­er went to see the psy­chi­a­trist again.

Through tri­al and error, I did learn that I relate best to female ther­a­pists, and that I need­ed one who would be blunt with me if she thought I was avoid­ing some issue. I learned that group ther­a­py is utter­ly use­less for me, because I’m very good at redi­rect­ing atten­tion from myself to some­one else in the group. I learned that I am most com­fort­able with a ther­a­pist who shares, or is at least very sym­pa­thet­ic to, my spir­i­tu­al beliefs, so that I can be open with­out being defen­sive.

I ran into trou­ble as soon as I made it clear that I do not do twelve-step groups. I tried a few meet­ings, found that I have a near­ly irre­sistible urge to make fun of the rhetoric and just about every­thing else asso­ci­at­ed with them when I’m there, and decid­ed that they are not for me. I quick­ly learned that twelve-step groups are tak­en for grant­ed so much by some peo­ple in the recov­ery indus­try that any­one who isn’t a twelve-step­per is regard­ed as being unwill­ing to work on get­ting bet­ter. It does­n’t real­ly mat­ter if that per­son is an addict of some sort, has been abused, or suf­fers from depres­sion or PTSD or what­ev­er. If you’re in ther­a­py, some peo­ple expect you to twelve-step. It’s like always hav­ing fries with your fast-food burg­er. Twelve-step­ping, no mat­ter how use­ful it is to some peo­ple in some sit­u­a­tions, is not applic­a­ble to every­one in every sit­u­a­tion. For those of us who don’t fol­low a tra­di­tion­al (or any) spir­i­tu­al path, the lan­guage of twelve-step pro­grams is trou­ble­some. I per­son­al­ly believe that par­tic­u­lar­ly for abuse sur­vivors, the whole busi­ness of doing a per­son­al inven­to­ry of those we have harmed is ridicu­lous and feeds into the neg­a­tive sus­pi­cion that some­how we deserved to be abused.

Final­ly, some ther­a­pists and oth­ers in the recov­ery indus­try don’t ever fore­see a time to end treat­ment. Even if a patient is func­tion­ing nor­mal­ly and no longer expe­ri­enc­ing the prob­lems that caused her to enter treat­ment in the first place, some psy­chol­o­gists and oth­ers regard any attempt to end treat­ment as signs of ill­ness. Yes, there are peo­ple who end ther­a­py too ear­ly. Once you’re func­tion­ing and don’t have new issues to work out, I think it’s time to end the ther­a­py rela­tion­ship. Yes, you might need more treat­ment lat­er if new issues come up. There is a time to be fin­ished, though, even if the ther­a­pist does still have a high car pay­ment or has just signed a new mort­gage.