Further Reading

Should I go along with a treatment philosophy I dispute after I have relapsed?

Dear Stanton:

I am aware that you are a very busy man so I will get right to my situation:

38 year old male. Problem with alcohol. Legal problems. Sober almost 4 months again. Had 5 1/2 years sobriety. Got sober in AA. Hurt at work. Put on prescription pain killers. Off to the races from that point. CIT, worked in treatment field in some capacity for @ 8 years. Very uncomfortable with a lot of treatment philosophy. Anyway.......

While back out I received 4 DWI's and a 5th degree felony charge for attempted theft. Currently on probation, attending Drug Court. If I satisfy the court—group therapy, AA attendance, remain clean—record expunged in 15 months.

Problem: Have to attend a relapse prevention therapy group using Terrence Gorsky's model. I don't agree with the philosophy at all. This is not an uneducated conclusion. Come to the conclusion that I have several options.

  1. Make it known that I do not agree with this philosophy, which opens the door to the therapist claiming that I am not "amenable to treatment." Experience has shown that when I disagree with a particular philosophy, then "I am in denial" or "trying to manipulate my treatment path." This can lead to negative reports to my probation officer and the Judge.
  2. "Play the game." I did, after all, set up this whole scenario with my drinking. The idea that these are the consequences of my drinking comes to mind. I feel that I could get away with playing the game, as I do possess enough treatment knowledge to do such. Yet, that feels dishonest to me. But then again, why make waves? Can you help me come to some sort of cathartic realization here?


Dear Allan:

Well, the question of playing the game is a deeply felt personal one. Some might say that, in your case, being able to go along with with flow is a sign of improved adjustment and less likelihood of incurring more life damage. Others would say that people don't sacrifice their intellects, humanity, or civil rights because they have a substance problem, and that to do so is not a way to improve people's self-image and ability to function.

If you're asking me for my judgment, I'd say, go along, and then when you've shown the ability to function independently, safely, and soberly, voice your opposition strongly and confidently and say how you could have gotten to where you are more quickly and in a better state if you had been offered an alternate route.

Here's how I see the issues: It's denigrating to listen to people spew bullshit, and to know better than they — at least as far as you're concerned — what works and doesn't work in your life. But you've failed as a spokesperson — both for yourself and for others — for the alternate route for the time being.

Best wishes,