Sunday, August 27, 2006

Our Addiction Has Consequences for Others: Half Nelson, the Movie

Half Nelson is the story of a young white junior high school teacher in a black working class school and of a 13-year old girl student, Drey, who discovers that he is a crack addict. The screenplay, by Anna Boden and Ryan Fleck, is refreshingly free of the racial cliches that pollute most black/white dramas and sitcoms.

Dan Dunne, the teacher, has the split personality typical of many functioning addicts. In class, he is direct, honest, and empathetic with his students. He poses as something of a Marxist radical, teaching his history class “dialectics” and reviewing highlights of the civil rights, anti-war and other struggles of the past 50 years. You can see that the students, when they are not bored, like him and respect him.

But as soon as school is over he becomes a different person, scoring drugs, hanging out in clubs, lying to his family and friends, and living the life of the lumpenproletariat. It’s clear that the dialectic of life and death is at work within him, and life is losing.

When Drey finds him out, a very complicated dance begins. She has been trying to live a straight life. Her older brother is in jail for drug dealing. Her dad uses drugs and is not supportive. Her mom is clean but locked into a dead end low wage job that keeps her away from home too much. Drey tries to stay clear of the friendly neighborhood dealer and keep focused on school. The discovery that her admired teacher is a user has a powerful impact on her feelings and her life choices.

It would be unfair to give away the rest of the plot. The acting is first rate. Shareeka Epps as Drey is totally believable and honest throughout. Ryan Gosling as the young teacher turns in a devastating portrait of a manipulative addict in the grip of self-deception and on his way to self-destruction. His radical political posturing in the classroom is only a figleaf for his sick personal life and his destructive impact on the community. If you needed reminding that our addictions have consequences for other people, Half Nelson is a powerful statement, all the more so because it avoids all moralizing.

Half Nelson movie web site.

Sunday, August 20, 2006

Spinning Mel Gibson's Relapse (2)

Einstein famously defined insanity as doing the same thing over and over again and expecting different results. Judge Lawrence Mira, who on August 18 gave Mel Gibson a slap on the wrist and sent him to a year’s worth of AA meetings for his drunk driving offense, should have his head examined. Mel Gibson, whose anti-Semitic, obscene, sexist, arrogant, and bellicose outbursts during his July 28 arrest on the Malibu Highway made world headlines, has been attending AA meetings for more than fifteen years already. Not only attending them, but making others attend them on the film set (see blog below). “Sentencing” Gibson to AA is a little like throwing Brer Rabbit into the briar patch. What made the judge think that another year of the Same Old Same Old is going to make any difference?

Maybe the judge is a victim of the U.S. press, which somehow managed to “miss” the fact of Gibson’s long-time AA participation almost entirely. While readers in the UK, Australia, India, and even Thailand learned of Gibson’s 15-year AA participation at the same time as they learned of his arrest and his drunken outbursts, American readers have been fed the line that Gibson is a recovery virgin and that sending him to AA will be a New Thing for him and will Make a Difference. One would like to think that the judge was better informed, but maybe prosecutors played along with the game and kept him in the dark.

Even the L.A. Times, one of the only two American print organs that noted Gibson’s prior AA participation a few days after the arrest, seems to have forgotten about it in its coverage of the hastily-called courtroom event where Judge Mira disposed of the case. The Times’ staff writer Andrew Blankstein quotes a lawyer who specializes in DUI defenses, who claims that sentencing Gibson to AA is somehow outside of standard court procedure. Source. (Where has this guy been?) But Blankstein doesn’t dig any deeper.

So, instead of stories that ask, “What do you do with an alcoholic after AA has failed him?” — a question with broad public health implications — you get pablum like this:

  • An op-ed in the Baxter Bulletin (Arkansas), has Gibson’s arrest serving as the lead for an infomercial promoting the local 12-step meetings. Source.
  • A guest op-ed writer in the Roanake VA Times expresses optimism that Gibson will become clean and sober now that he’s been referred to “the one program we knew worked” — Alcoholics Anonymous. Source.
  • Postcards from a Pug Bus (Source), a supposedly satirical, dig-behind-the-scenes blog, indulges in an imaginary monologue in which Gibson “takes the first tottering step” on the twelve-step recovery journey. Duh.

And much more of the same.

Hats off to whoever is spinning the Mel Gibson story in the U.S. media. You’ve managed the next thing to a media miracle: turning Mel G.’s ugly recovery failure, after 15 years of AA, into a tidy advertisement for the organization. It’s like turning Chernobyl into a promo for nuclear power.

Friday, August 11, 2006

An Effective Choice-Based Treatment Approach

A client-centered recovery program that designs services to fit “clients’ individual experiences, perceptions, and needs” and where staff works with clients “on learning choice-making skills as an essential part of recovery” has scored impressive outcome improvements with a challenging dually-diagnosed populations, says an article in the July issue of Behavioral Healthcare (www.behavioral.net). The choice-based program, called CHANGES, targeted a high-risk population with multiple psychiatric hospitalization histories, including jail time. As a result of the program’s individualized approach, “clients previously considered ‘treatment avoidant’ became treatment receptive.” (p. 36)

This finding will not surprise savvy LifeRing participants (or other readers of the Recovery by Choice workbook). The traditional mental health and substance abuse approaches too often are designed to serve the interests of the providers and payors, rather than clients. Providers frequently assume as rock-bottom truth that clients are incapable of making choices, and therefore must have prefabricated solutions rammed down their throats. Instead of learning to make choices, clients are made to dwell on their moral defects and to affirm their powerlessness to change. Why are people surprised that this kind of approach produces “treatment avoidant” clients and has a dismal outcomes track record?

Millions of taxpayer dollars are wasted every month on treatment programs that are ineffective and in many instances abusive. Lonny Shavelson’s “Hooked” details many of the absurdities in the system. The CHANGES program — embodying some central tenets of the LifeRing philosophy — not only showed significant outcomes improvements, it yielded substantial cost savings. The CHANGES approach deserves consideration and creative emulation by other professionals in the mental health / substance abuse fields.

Tuesday, August 01, 2006

Spinning Mel Gibson's Relapse (1)

In case you’ve been on another planet, Los Angeles County sheriff’s deputies stopped actor/producer Mel Gibson’s Lexus at 2:36 a.m. last Friday going 87 in a 45 mph zone on the Malibu highway. Gibson had an open bottle of tequila on the front seat. He apparently attempted to escape, made anti-Semitic and obscene remarks, swung from the bars of his cell, and boasted that he owned Malibu and would f**k the arresting officers.

The story of Gibson’s DUI bust, first broken by the celeb-watch website tmz.com, scored more than four thousand hits in Google’s index to the world press. Gibson produced and directed the controversial religious blockbuster Passion of the Christ, which made him very rich. Many critics at the time objected to what they saw as the film’s anti-Semitic message. That background, plus the current Mideast conflagration, made Gibson’s drunken tirade newsworthy. After he sobered up and huddled with his agent and his PR people, Gibson issued an apology and checked himself into rehab.

When I entered “Mel Gibson Alcoholics Anonymous” in Google’s News search a moment ago, up came a mere 49 hits. ABC News reported that one of Gibson’s neighbors in Malibu, Chris Prentiss, said that “The center that I’ve heard he’s checked himself into follows the Alcoholics Anonymous 12-step program. And I don’t believe that will help him.” Prentiss owns a competing celebrity treatment center. The Chicago Sun-Times, the Philadelphia Daily News, and the Boston Globe carried the same bit.

The Los Angeles Times has so far been the only American print source to dig a little deeper. In a July 31 story, staff writers Robert Welkos and John Horn say, “One source said the star had already begun rehabilitation, noting that Gibson had long been a member of Alcoholics Anonymous.” Source. In other words, it appears that Gibson is not just beginning to attend AA, he is a long time AA member experiencing a spectacular relapse.

Print media outside the U.S. have been much less delicate in handling Gibson’s long time AA membership. Compare the Glasgow Daily Record’s coverage:

Recovering alcoholic Gibson was stopped on Friday on suspicion of drink-driving on the Pacific Coast Highway in Malibu, California, near his luxury mansion.

The director and actor was allegedly driving at 87mph in a 45mph area. The Alcoholics Anonymous member had a bottle of tequila in his car.

The London Daily Mail details Gibson’s background and notes that Gibson already joined AA in 1991. Source. In other words, the current relapse — the paper says it is only the most recent of many — came after fifteen years of AA membership. The Adelaide Advertiser in Australia says flatly “that Gibson has been attending meetings of the 12-step Alcoholics Anonymous program since 1991.” Source. A dozen other Australian, British, Indian, Thai, and other world press sources consider it relevant and newsworthy to print Gibson’s long-time record of AA participation.

As a recovering alcoholic myself, my heart goes out to Mel Gibson in this relapse. I don’t share his politics or his religion, but I know what addiction is and I don’t wish relapse on anybody. I hope that with the benefits of 15 years of hindsight, Gibson stops repeating the same recovery experiment expecting different results, and finds a program that will work for him.

I also wish that the U.S. press would take a hint from the world press and stop treating AA like a sacred cow. When a long-time AA member in the public eye has a spectacular relapse, the person’s membership is relevant and newsworthy. People in recovery, the general public, and lifestyle gurus like Dr. Phil and Dear Abby should become aware that no recovery program is guaranteed, that they all have their failures, and that what the recovering person needs is choices.

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PS Aug. 3: Today’s Google News search on “Mel Gibson Alcoholics Anonymous” yields 138 hits … but the spin in the U.S. Press continues.

Fox gives a perfect specimen of the pro-AA media whitewash with a story today that focuses on Gibson’s selection of outpatient rather than inpatient 12-step treatment. Fox’s writer issues the usual bland promotional yadda-yadda about AA and then quotes an “anonymous” AA spokesperson stating “We only say we have found a solution that works for many of us and we are happy to share information about it with any person interested in not drinking.” Source.

As if Gibson were a newcomer to the AA concept! Not a word in the Fox story about the fact that Gibson has been attending the Malibu AA meeting since 1991 and has been following the 12-step recovery path for 15 years. The “many of us” for whom the solution works, on the evidence, doesn’t include Mel G. Fox deserves a booby prize for shutting its eyes to the obvious. (The same story is now on the AP wire and the Washington Post, which ought to know better, ran it verbatim.)

Oh, and in case you were thinking that Mel G. was just a casual AA participant, sitting behind a pole in meetings and not really working the program, consider this letter printed in the London Telegraph:

A Scottish actor who worked on Braveheart once told a director friend of mine what it was like working with Mel Gibson. “He’s off his head,” alleged the actor. “We’d all be standing there in kilts and with blue woad painted on our faces, ready to do a shot, when suddenly Mel would announce to the Alcoholics Anonymous members among us - a healthy number - that we had to have a meeting. So there we would be, behind the catering van with painted faces, reading from the Big Book and sharing our experience. You know, ‘My name’s Mel and I’m an alcoholic,’ then we’d all go back to the set and get stuck into the English.” Source.

As if to prove that some of the UK press can be dumb, too, the London Daily Mail has a story today that plays along with the wink-wink nod-nod game from America: “According to U.S. reports, Gibson, a recovering alcoholic, will now embark on the Alcoholics Anonymous 12-step programme.” Source. Will now embark! Hello!

So far, the only U.S. print media source that is filling in the background of Mel G.’s AA membership, following the L.A. Times, is the Miami Herald, which on Aug. 2 wrote, “Gibson has been a member of Alcoholics Anonymous for years.” Source.