I make mistakes. However, after 20 years of acupuncture detox work I have learned a few things, mostly the hard way.
Every teacher tries to mitigate mistakes, and it is important to note there are things that can be taught, but to truly understand certain things, you must experience them first hand.
The Enabling Mistake
To do this work you have to care, but you can easily fall into enabling. This isn't just a rookie mistake. My first job doing detox was in a methadone/community clinic. One of my NADA trainers got a request from a clinic for NADA services and forwarded the information to me. I went to the clinic to discuss acupuncture detox services. In retrospect, I can't believe my naivete, but I was new and too excited to think negatively. Good thing too, because it worked out and the acupuncture part of the clinic still exists. I am proud of that. I think it is a testament to NADA that I could go from training to setting up a program in a few months.
Setting up the physical aspects of a clinic is easy. It's the hustle to get clients to try acupuncture that is difficult. I really wanted this clinic to work. I made information flyers and stood at the methadone line every morning passing them out and talking to clients. Right from the start I got lucky. Two clients had moved from the city where I had trained to this clinic and remembered me. One came to acupuncture.
Within a few months the clinic had hired another acupuncturist because it was so busy. I wanted this program to succeed so badly that sometimes I lost sleep. Whenever someone did not come back, if I saw them in the methadone line or anywhere else in the building, I would ask them if there was a problem. One day my need to succeed overcame my better sense.
An intermittent client came in to get a treatment and before either of us could get needles into him, he turned and left. I told the other acupuncturist I would be right back and left the building to catch him on the street and ask him what the problem was. He was shocked that I would do such a thing and kept saying, "You came to get me?" He wouldn't or couldn't tell me why he had left and eventually stopped coming to acupuncture all together. I am going to guess a little now, but he certainly acted embarrassed whenever we saw each other. After a while, I didn't see him in the building anymore. His counselor told me he was out on a "mission" (slang for going back to using). She and I talked a bit about him and I began to see my first lesson unfold. You, the practitioner, cannot care more about clients' sobriety than they do. You offer the services and encourage participation. You can even use a tough love approach when necessary, but the client has to want to get clean; that is the only way it works.
Caring Too Much
In lesser degrees I have allowed myself to occasionally get sucked into the "caring too much" mistake. It can be destructive because it can lead to clients "splitting." Maybe you know what that means, but I am going to define it anyway. It is when a client plays one staff member against another or the rest of the staff. We used to have a staff member who was fond of saying, "I care about my clients," the implication being that the rest of us did not. This staff member would get too involved, too closely entwined in the lives of his clients and lose sight of the goal. The staff member was putting his need to be "liked" or to be superior to the other staff above the needs of the client - enabling. Many clients manipulated him like clay.
One of the biggest mistakes that I made and the greatest lesson I learned was before I worked in any detox clinic. It was during the short period that I did private practice. I could not afford to let go of my day job, which was working in a hospital storeroom part-time. The rest of the time I did private practice as much as I could. One of my co-workers in the storeroom referred a friend. The complaint was stomach problems and insomnia. During the intake I asked about drug and alcohol consumption. She stated she drank a little.
Everything I did helped for a while and then stopped working. Finally she admitted that maybe she underestimated her drinking. Maybe she didn't just drink two or three beers a day maybe it was more like a six-pack. Then later she disclosed that maybe it wasn't just regular beer, maybe it was fortified malt liquor. In short, she was an alcoholic. So, I had relearned to keep asking the questions if things did not seem right. We kept treatment going for a while, but it just never worked. I would ask every week about her drinking and she became more and more angry. She was angry that I kept asking that question and talking about quitting and that the treatments were not working. One day she said she was drinking less - by her assessment a case of regular beer was less than a six-pack of malt liquor. I was aware that none of it was good. Eventually I got it - I was keeping her just healthy enough to keep on drinking, to keep up her addiction. I was helping her to remain just above her "bottom" as in "you have to hit bottom before you can climb back up." I was enabling her in the worst way.
When I told her we could not continue treatment and why, she was livid. The worst of it for me was a couple of drunken 3 a.m. angry calls.
I formed a belief that nothing in the last 20 years has changed - acupuncture alone cannot deal with addiction. It is not to say that there is not someone, somewhere who got clean by just going to acupuncture, but in general, it is my belief that acupuncture works best as adjunctive treatment in a detox program.
