S02E12 - In treatment
I feel like an alien who has just crash landed into a completely foreign galaxy. This is my first full day in rehab and spending time with the other six men who are also in treatment with me.
I sit silently in a creaky old chair that surrounds a large rectangular wooden table and I eat my hot breakfast. I would soon come to understand that this large table would serve as my main dining space, workspace, and community gathering space for the next 30 plus days. Looking around the table at these strangers quietly eating their breakfast while furiously writing notes into their binder, I wonder how I might find anything in common with any of these obviously heterosexual men.
‘What to expect in treatment’
So much of my life has been about hustling for approval, competing, performing, and pleasing and yet, here in rehab, I can already tell that none of these strategies were going to help. I open up the binder that I started to put together during my intake sessions and flip to the ‘What to Expect in Treatment’ page so that I’m not the only person sitting at the table doing nothing but eating.
“Everyone’s experience here is unique but there are some things you can expect to happen during your time. You have already completed the lengthy intake process, settled into your room, and hopefully met your new community. The first few days may feel overwhelming with the new rules, new environment, and new faces. Everyone in your community has already experienced this process and can empathize with how you may feel, so consider them a resource during this period of transition. Here’s what you can expect to happen from this point forward.”
While reading my binder I try to pay attention to the words, but I’m also dragged into the dialogue going on inside of my head.
“Who are these men? Will they like me? What do I have to offer in a space like this? I’m different from all of them. There is no way that I’ll feel safe opening up about my life with these straight men. Their problems and issues aren’t anything like mine. We are so different. Why didn’t I do more research and specifically search out a program that catered exclusively to gay men.”
Realizing I’m not paying attention to my reading, I try my best to focus back on the words in my binder
- You will have regular meetings with your individual therapists and 1st step counselor. You can expect to meet with your individual therapist for at least one hour every week, but please feel free to talk to any staff or therapists at any point during the week.
- You are also assigned a family therapist who will meet with you to review your family history and current family dynamics. They will work with you on who to invite into family sessions.
- You will work with your 1st step counselor to better understand the 12 steps, especially the 1st step, and related concepts of recovery, sobriety, and relapse prevention. You will have at least two meetings with your 1st step counselor.
- You will attend 12 step meetings six days per week.
- You will complete a Sexual Dependency Inventory (SDI), which will help you and your therapists better understand your acting out, addiction history, trauma, and other areas of concern.
- You are asked to write and present your Life History in an Addiction and Trauma group within the first 7 to 10 days of your stay. This will be your first major assignment and official introduction to the community. Your story is important for the community to hear.
As I try to focus on the words in front of me, instead of the voices in my head, the ‘bus driver’ for the day screams out,
“Ten minutes before ‘Good Morning’ group starts.”
Yesterday I was informed that everyday one of the men in treatment assumes the role of ‘bus driver’. The bus drive is responsible for running the daily good-morning and good-night groups, keeping the house on-time for all daily therapy sessions and group outings, preparing for and chairing in-house 12-step meetings, updating the house assignment board, and giving constructive feedback about any broken house rules.
‘How do they expect me to be the bus driver by the end of the week? There is no way that I’m going to fit in here. I’ll never be able to lead this group of guys.’
Even though everything around me is new, I’m surrounded by a very familiar and ever-present fear of impending doom that has haunted me and kept me company for most of my life. This fearful part of me is constantly whispering in my ear.
‘Something is about to go really wrong. What are you doing to protect yourself? You’re never going to be able to figure this out. Don’t let your guard down, the other shoe is about to drop. Never, ever trust anyone. These people aren’t safe.’
From my spot at the table, I have a clear view of a blackboard that houses a large grid of our rehab assignments. This grid tracks the individual progress of every man in-treatment across the month of their stay. The bus driver has done his job and my name has been added to the grid. I can immediately see that I’m in last place with zero assignments, projects, or milestones completed.
Slowly I read over the tasks and assignments in-front of me:
- Life History assignment
- discuss SDI results with therapist,
- discuss Post Traumatic Stress Index with therapist
- OCD profile
- Victim’s list
- Statement of Responsibility
- List of Rationalizations
- Letters of Atonement
- Empathy letter
- Grief and Loss assignment
- Offender’s cycle
- Relapse Prevention Plan
- Graduation Presentation
As I sit silently and try not to let my anxiety show, I tune back into the dialogue of torment that is growing louder inside of my head.
‘Everyone else in the house is way out in front of me. There is absolutely no way for me to catch up or win. All the other guys have been here for weeks. They’ve all bonded and I can tell they don’t want to have to deal with any of my ‘gay sob story’. What a stupid way to design a program. Why did they design this program with a rolling admission? They should start all of us at the same time so that we could all go through these steps together. Here I am again, the outsider who has to go it alone.’
As I listen to the conversation going on inside of my head, I remember a worksheet on the dissociation that I was tasked to complete during my intake sessions. I found the ‘About Dissociating’ worksheet curious but didn’t think it applied to me since I wasn’t a ‘trauma survivor’.
The worksheet explained that when children experience the world as unsafe, they do many different things to adapt, cope, and survive. It went on to explain that one of the more common ways children deal with the unbearable experience of being severely abused is to flee from the experience by dissociating.
Dissociation in its milder form, means that someone lives exclusively on a mental level, in their thoughts, and they aren’t fully present. Dissociation in its more extreme forms has individuals feeling like they are literally leaving their body. Since children cannot physically run away, they leave their bodies.
The worksheet described the dissociative experience of some survivors as a sensation of floating above themselves, looking down at their body from the ceiling. Other survivors go somewhere they cannot identify. Some survivors consciously choose to dissociate, but sometimes dissociating happens spontaneously when you don’t want it to.
Part of me recalled this worksheet, while other parts of me observed the anxious thoughts of overwhelm. As these thoughts happened almost simultaneously, I start to wonder,
‘Maybe I do dissociate. But doesn’t everyone go inside when their scared and just try to pretend like nothing is going wrong? Isn’t that what ‘fake it until you make it’ means?’
The rest of the guys start to pack up their belongings and Steve comes over to ask if I’ve filled out my ‘Good Morning Group’ sheet.
He must have seen the panic in my eyes because he didn’t wait for me to reply before he took an empty group template sheet out of his own binder and handed it over to me. He explained that we fill out these sheets every morning and every night and use these sheets during our group sharing time.
Rules of engagement for group sharing
He also helped me flip to the page in my binder that shared some of the expected skills or rules of engagement when sharing with the group.
- BE HERE. Stick with the present. As much as possible, stay in the boundaries of the here and now by describing present experiences
- BE AWARE OF FEELINGS. Try to express them. Because we are used to stuffing our feelings, give special attention to how you feel and use feelings statements like “I feel sad,” or, “I feel afraid.”
- USE “I” STATEMENTS. Rather than using “we” or “you” speak for yourself. “I feel comfortable.”
- SPEAK DIRECTLY TO ANOTHER PERSON. Instead of “Mary seems angry”, speak to her. “Mary, you seem angry to me,” or, “I imagine you are angry right now.”
- SPEAK FREELY AND OPENLY. People do not need to ask permission to speak, intervene, or contribute in any fashion. However, it is easier if only one person speaks at a time.
- ANY PERSON MAY “PASS”. If someone is uncomfortable with an activity or question, they have the right to say “I pass.”
- AVOID QUESTIONS. Before asking a question or answering one, consider the statement behind your question and try to express the direct statement. For example: Instead of asking “Why are you looking at me?” try, “I’m not comfortable when you look at me like that.”
- AVOID “WHY”. Why leads to analyzing, mind-tripping, and often leads one away from the full experience.
- AVOID JUDGEMENTS; BE DESCRIPTIVE. Describe the person’s behavior and your response to their behaviors. In this way you do not accuse someone else and you take responsibility for your own reactions. For example: Instead of ‘You’re really off base,” try “When you ramble on I lose a sense of where you are going and I start to feel anxious.”
- CONFIDENTIALITY. What happens in the group stays in the group. This refers to all personal sharing, names, occupations, or group interactions
- LEVELING. Leveling is stating what you experience of yourself and others. Leveling is being honest with yourself and the group. Leveling is a risk-taking behavior about information that you consider a key factor in your behavior or in the group. Instead of feeling angry at someone in the group for several nights and avoiding them, try saying “John, Tuesday night you said XYY and I have been angry since that time and wanted to avoid you. Avoidance is an old pattern of mine and I’m working on it.”
- CONFRONTATION. Confrontation is a non-abusive process of letting others know how you’re experiencing reality, expressing your feelings, and asking for what you need. A sample confrontation model is three statements and one request
- When I hear you say… (basic facts)
- What I make up is… (share your thoughts)
- About that I feel… (use a feeling word)
- In the future I would like… (be as specific as possible)
As I read this list of 12 straightforward rules, something inside me shifts and almost jumps with excitement.
‘Where has this single piece of paper been for my entire life? Using these skills would dramatically change how WE… sorry I… show up and interact in relationships, with my family, at work, and with friends. Why are these rules not shared with every single human before every single relational interaction… these skills would dramatically improve how we connect and relate with each other. Could this be what was printed on the flip side of the tablets containing the 10 commandments?’
Good morning group
Before I could continue mind-tripping with my WHY based question and analyzing the power of using these skills the bus driver yells.
“Good morning group is starting in one minute”.
I clear my plate from the table, walk over to the main group therapy room, and sit down in one of the empty chairs. The bus driver starts the meeting and I quickly start to scribble in my own answers to the ‘Good Morning Group’ template as the other men start to share.
Good morning, my name is James
My addictions are: sex, love, and drugs
My bottom lines are: drugs, cruising, anonymous sex, hook-up apps
Affirmations: I am worthy. I am strong. I am lovable.
Feelings: Physically – okay, Emotionally – good, Spiritually – fine
Highlights of the day – meeting the others in the house yesterday, smooth intake process, brief call with my parents during the intake call, OREO ice cream bars that I found in the freezer.
Contracts broken: none
Desire to leave program: no
Desire to hurt myself: no
Optional 30 sec share: thank you for being so welcoming and showing me the ropes yesterday.
I was thankful to get all my sections filled in before it was my time to share. As I read off my form, I could feel the eyes of all the other men zeroing in on me. Their presence was intense, and I couldn’t tell if that made me feel comfortable or uncomfortable.
I finished reading off my sheet and was happy to be done and was looking forward to shifting the focus off me and onto the man sitting next to me.
Before I had the chance to take a sigh of relief the bus driver for the day spoke up.
“Thanks for sharing, James, good job with your first Good Morning group share, are you open to some feedback?”
“Umm, sure, of course.”
“I noticed that you were writing while the others were sharing. What I make up about that is that you didn’t prepare things in advance. That makes me feel discouraged and insignificant. In the future I’d like to request that you prep in advance so that you can be present for all of our shares.”
“I’m so sorry. You’re right. I won’t ever do that again.”
“Don’t worry about it bud, it’s not about scolding, we’re just trying to be as present to everyone in the group and I wanted to check-in to see if you were aware of how you are showing up.”
I started to panic but before I could escape back into my head, one of the other guys spoke up.
“I also have some feedback from your share. When you were talking about your feelings, I noticed that you didn’t share any actual feelings. You mentioned feeling okay, good, and fine. I had trouble identifying my actual feelings when I first arrived. I use this feelings wheel to help me identify what’s actually going on inside my body. Maybe it would help you too?’
As he handed over his worksheet, I didn’t really understand what was going on. Parts of me felt shamed for screwing up such a simple assignment but other parts of me felt safe and comforted by the help and feedback that the others in the house offered me.
I feel physically
I feel emotionally
I feel spiritually
This was only my first full day, I hadn’t even met any of my therapists, but I could already tell that this type of treatment was going to be life altering.
How do you define strength?
Learning to surrender
You have been designed to be deeply known.
You experience that knowing when you surrender and safely open yourself up with others and allow yourself to be seen.