‘The Recovery Revolution’

Claire D. Clark’s The Recovery Revolution traces the history of therapies that help drug users recover from addiction, sometimes with contradictory and controversial practices, Scott McLemee writes.

October 11, 2017

Not long after moving into the building I’ve called home over the past 20-odd years, I heard that it had once been occupied by a cult. Longtime residents soon confirmed it, but they were hazy about the particulars. No one could remember the name of the group, only that its members were strange and menacing. Nor could my neighbors recall the circumstances under which the cult had departed. The latter struck me as a potentially important piece of information: if reclaiming the cult’s old property was part of an apocalyptic scenario, I wanted plenty of notice.

The millennium ended without incident, and in time the mystery slipped my mind entirely -- until just a few years back, when the solution turned up one day by surprise. It came from a book about Synanon, a drug-rehabilitation program that started in California during the late 1950s. It was inspired by Alcoholics Anonymous, as the name suggests, although Synanon went off on very much its own course by taking in heroin addicts and the abusers of other hard drugs. In handling such tough customers, Synanon modified AA’s therapeutic methods considerably. Another difference was that Chuck Dederich, the founder, was as eager to encourage publicity as Bill W. was to avoid it.

By 1965, there were two books about Synanon by academics as well as a Hollywood film (starring Eartha Kitt as a junkie) along with an enormous amount of print and television coverage -- all highlighting Synanon’s remarkable success in turning self-described “drug fiends” into sober, productive citizens. Just when and how the group went off the rails is a difficult question. But it did, and the effort to establish an East Coast headquarters by taking over my apartment building (noted in Rod Janzen's The Rise and Fall of Synanon: A California Utopia, published by Johns Hopkins University Press in 2001) was not even the most bizarre and disturbing thing Dederich and his followers did in 1978. That distinction would go to the attempt to silence one of the group’s critics in California by placing a rattlesnake (its rattle cut off) in his mailbox.

Synanon’s multifaceted and highly successful public-relations efforts during its first dozen years are recounted in detail in the first two chapters of Claire D. Clark’s The Recovery Revolution: The Battle Over Addiction Treatment in the United States (Columbia University Press). Clark, an assistant professor of behavioral science at the University of Kentucky, leaves no room for doubt about the depth of Synanon’s influence. The group has been defunct since the early 1990s and is long since forgotten for the most part -- except for the rattlesnake incident, perhaps.

The group’s spectacular degeneration is incidental to Clark’s interest in it. She places Synanon in the wider history of American attitudes toward dependency on highly addictive substances -- swinging between framing the problem in terms of morality or of physiology, to be addressed as a crime or as a matter of public health. To simplify a bit, the high rate of relapse from medical treatment tends to bolster the sentiment that the one sure way to minimize addiction’s social cost is to lock addicts up, while the general effect of locking them up is to reinforce the subculture of addiction. (Another by-product of incarceration: addicts who leave prison with stronger criminal skills and connections.)

The genius of Dederich in creating Synanon was that it combined the therapeutic promise of Alcoholics Anonymous with his firsthand knowledge of addicts’ deviant socialization. Joining meant moving into group housing and entering “the Game” -- marathon therapy sessions in which participants ruthlessly challenged one another’s pretenses and defenses. For hours and sometimes days at a stretch, ex-addicts tore away the lies, rationalizations, self-pity and anything else that they recognized, from experience, could lead back to using. And it worked.

“The longer residents stayed in Synanon,” Clark writes, “the less likely they were to drop out: the dropout rate fell to 40 percent for those who stayed three months, 32 percent for those who stayed six months and less than 25 percent for those who stayed a year or longer. As of 1964, of the 1,180 members who had joined Synanon since 1958, 463 (39.3 percent) were in residence or had graduated in good standing. By the standards of Synanon’s contemporaries, that cure rate was more than respectable.”

Public attention to Synanon was not a result of its success rate alone -- or even of the founder’s willingness to let journalists, celebrities and the occasional sociologist sit in on the confrontational Game, though the voyeuristic appeal must have been a factor. In analyzing Synanon’s development from its founding in 1958 through roughly 1970, Clark brings into focus how the group exemplified, and sometimes anticipated, the cultural themes of the period. It was a counterinstitution, run on a principle of anti-expertise, without input from the medical or judicial professions, and the implication soon became clear that the Game was radically antiestablishment in spirit, demanding greater honesty and authenticity of participants than was the social norm.

At the same time, Synanon advanced what Clark identifies as a “retrograde moral philosophy” -- dedicated to hard work, frugality, self-control and maturity -- against the supposed “new morality” of the period, with its countercultural and consumer-society values.

It was quite a contradictory package -- and as such almost perfectly suited to meet, in the author’s apt phrase, “nonaddicted spiritual seekers’ seemingly conflicting desire: to transform society by dropping out of it.” Perhaps the least bizarre thing about Synanon’s course after 1970 (the point at which Clark rather abruptly drops the subject) is that it attempted to claim tax-exempt status as a religion.

The “second generation” of therapeutic communities -- as Clark calls groups that borrowed from the Synanon model without copying it exactly -- was more open to involving medical professionals; some combined group-therapy techniques with methadone treatment or other pharmacological interventions, while Dederich had insisted on a total break from substance use. A few post-Synanon therapeutic communities sustained the outlook at the American society was sicker than any junkie. (Some forged ties with the Black Panthers; at least one sounds like it might have joined up with the Weather Underground sooner or later, if not for attracting the attention of the FBI.) But other groups developed working relationships with judges and prison wardens, feeding into what is now an established if underfunded system of drug-treatment and mental-health centers.

As The Recovery Revolution's final pages suggest, it is possible to overstate how well-accepted or mainstream therapeutic communities have become. As the number of drug overdoses has spiked over the past 20 years, the rhetoric of punitive drug policy is always easier to generate than funding for treatment. The history Clark records is of an alternative that has inflicted some black eyes on itself over time, but that has also proven itself in practice and saved lives.


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