Inmate or Guard?

I got the rarest of opportunities. Something of a fly on the wall in the most delicate of environments. As a kind of underling of a therapy team, an intern in a rehab is a unique kind of nothing; a cipher of experience, neither staff nor patient. Witness to anything with hardly any agency at all. “Inmate or Guard?”I was once asked by someone easing into their long-term stay. In truth, I wasn’t either. I’d find myself continually second-guessing the sense of service in my role. 

One of the organic joys was watching communities form. Total strangers with their poison taken from them, being asked to come together. There is absolutely nothing more harmful to a recovery than isolation. The two pillars upholding any active addiction are isolation and shame. One tends to feed the other in a vicious cycle. Getting to witness people historically riddled with these but now seen and heard, finding a sense of togetherness. was a genuine privilege. Being a trusted presence, fostering a sense of safety where this could happen, was hugely validating.

Yet there was always push and pull. Wanting the best for people and to see their growth could be a difficult thing to regulate. Being the guardrails and not anything more could be a difficult post. So much could be on the line for those giving their stay at the rehab the most long-lasting value. People, who over time and conversations, would come to reveal all that was glowing and admirable in them. Witnessing exactly how communities would form and bond could also be uneasy. What was camaraderie and what was corrosive? What was the place of gallows humor and a visible sense of mischief in an environment designed to bring people to reality?

Nevertheless, reality would arrive to puncture any floating above it all or skirting round the edges. 

Between process groups, therapy sessions and psycho-educational workshops, reality was coming after them day after day. In most cases I would witness, seldom would anybody leave without a sense that they had a problem of greater scale than they’d previously wanted to believe. Those staying had very real circumstances, phone calls could be worth the world, residents had families hanging in the balance.

Bruised and wounded

One of the several psychological interventions offered in the program was a “collateral letter”. The letter was to be read to a person staying at the rehab during a process group and it was to be written by their closest ones back home. Designed to be a confrontation with reality, not a lambasting or shaming. More a form of inventory of how much harm has been caused to those who mean the most.

One Monday, to a vibrant community of incredible lived stories and contagious characters, a collateral letter opened their week. It was thunderously powerful. The words written and read were searingly heartfelt. They were words laden with love, but a bruised and wounded one. The message was clear as day. The person the letter was written for was dearly loved, with children, a wife, a family to hold on to. This individual meant everything, but if they couldn’t leave alcohol behind, the mother of their children would have no choice but to protect the family and leave them behind.

The therapist sitting next to me was clearly moved. Breaths so deep I could’ve credited them to Tony Soprano. I was far from immune, sitting on a bubbling well of emotion that I needed to keep buttoned down for propriety. The person reading the letter was moved to tears and rightly so, she would lead the feedback as well. What she was reading mirrored her own circumstances, she’d spent the last couple of weeks clinging to phone calls on the present danger she could lose her own family. She would be seconded in the feedback. Another individual in the exact same present danger; grasp recovery or risk losing your closest. Soulful and robust, they underscored the gravity of matters to him: get a hold of yourself, get on with your recovery, words aren’t words alone, this is reality.

It was as if just for that 20-minute spell, somebody stopped the clocks. Time paused, reality was here and nothing else mattered. An individual was being handed truth in a form they’d never have again. A phosphorous, molten truth of priceless value. Where else could something with such honesty be handled with such care? 

On that Monday, I felt an immense sense of service. To be sure, I was just a small cog in a much greater machine, but that Monday I walked out feeling a part of something profoundly valuable.

Monday and Friday

The main thing that the therapy team hammered into interns and Healthcare Assistants was boundaries and just how important they are. Maybe I didn’t get that down, maybe I had a degree of personal investment in outcomes I could have handled better. There is always a danger in emotional resonance with matters one can’t control. When I came back that Friday, there was a different feeling around the place. The air was thick and stilted, something was off. Just four days on, from one of their several random drug tests, someone in the community tested positive for cocaine.

The message from the therapy team was clear: when there’s using, there’s no growing. The healing back to square one, the value lost, the formidable message of Monday nowhere to be found. “The Community is Unwell”.  I was gut-punched. The intervention couldn’t have been any more potent, the stakes any higher, yet mere days later we were staring down the barrel of families left in tatters. Addiction blindly bulldozing reality. 

It would be the longest day I’d spend interning at that rehab. It didn’t belong to me. It really wasn’t my hurt but I couldn’t deny the sting of it. I was left with a painful doubt — what use did this work have to these people? What was my service?