Analysis of Quotes - Stage A
In Stage A the residents are busy with coping with the here and now.
They still have not decided if they are staying in Malkishua to complete therapy, and have ambivalent feelings regarding the program. Most of them are having new and unfamiliar experiences. They are aware of the power of the community, but this power also scares them. The residents in this stage begin to change, each according to their personal situation.
Abraham:
Abraham is 16 years old. He came to Malkishua without any court intervention. The main reason was his mother's involvement in the process. Abraham addresses the encounter group as a significant tool:
"They put things in your face, in front of our eyes. I like this group".
Abraham describes the process through which the group takes place: "You put a person on a chair in the middle of the circle and one person comes and reflects his behavior and his patterns".
Apparently Abraham is excited by the ritual nature of the community. In general, he cooperates. Using the term "I like the group", is not so suited to the process that occurs in it, but it is typical of the unconsolidated stage that Abraham is in.
Abraham understands that in general, the change process depends on him:
"It depends where you come from. If you want them to help you then you will take the help. AS hard as it is, when they present the truth, you want to receive help. I really like it and value it".
Abraham addresses the report notes: "Not too long ago I realized. I just understood that it is not snitching. I wasn't willing to write and I made fake notes (I did as if). At some stage, I understood".
Abraham, who came to Malkishua of his own free will, had difficulty understanding the aims of the model's tools at first, particularly the report notes. Often, these notes are perceived as "snitching" by members on other members, because they report deviations of others. This report is passed on to the staff. In essence, the report notes create a "backwards backwards" effect. If in criminal society on the street the youth used the
"you watch me and I'll watch you" approach, i.e., never snitch on one another, then in the community, the opposite is the case. Writing and speaking about other members aims to help him. The role of setting
28 Explanation of each tool in the chapter on Coordinating the Model (pg. 82).
boundaries is not to harm but rather to help so that the youth will understand that their behavior is dangerous and its implications are severe:
"If on the outside someone would bother me, I would give them a shove and solve the problem. Today I understand that there is a better way without a mess. You don't hurt the person, you help him and you don't put yourself in a problem situation".
Individual therapy: Abraham differentiates between inside and outside within the community. Outside is public ground, where the therapeutic community model operates along with all its tools. Inside is individual therapy in the therapy room, with full discretion: "Individual therapy is a place of quiet. In the room there is a feeling of safety, even though all types of difficult things arise sometimes". Abraham understands that despite the silence in the room, the residents go through a deep therapeutic experience: "Even though all kinds of difficult things arise, whether it was that you were raped when you were 6 or you mother is crazy, etc.". Here too, we see Abraham's ambivalence. On one hand, the therapy room is inviting and calming, but on the other hand, it is threatening and scary and difficult and painful issues may be raised.
Family therapy: Abraham's mother did not give up and came from Holland once very two weeks. Abraham is aware of the significant place of his mother in his life and therefore he cooperates, and even more so:
"Family therapy is something that I cannot stay clean without".
Regarding the "Wall", also, Abraham presents ambivalence regarding this therapy tool: "The wall depends on how you look at it. It can be very degrading for someone, that someone of your age or younger than you reflects something to you and the entire community sees. You have to just stand there quietly. It can be very degrading. But if you come with a different mindset, and tell yourself think that it is someone coming to reflect to you and he wants to help. But it depends where you're coming from… Sometimes it is really hard for me. I don't have patience, it is like a feeling of helplessness… it seems as if I am saying things about all of the tools in the community. There is no tool that I have a problem with".
Abraham shares with us his understanding of the therapeutic community.
He is an intelligent youth who understands the rationale behind the community. Yet, he is at the beginning of the road and sometimes has some despair, expressing a lack of agreement with some of the tools.
Apparently Abraham is holding himself back and not allowing himself to flow. His head says make a change, but inside it is still difficult for him.
Abraham empowers the tools. In this way he convinces himself of their importance. For example: "Diving is a privilege. It is like being a monk without any stupid music, computer, etc. If you have the approach of soul
searching then it is something that is like no other". Apparently Abraham must be in this position because at any stage of difficulty he has the option to get up and leave, unlike the others who came with a court order and stay because of an external threat. Therefore he empowers the tools to convince himself of the importance of the community.
Yitzhak:
Yitzhak is at the beginning of therapy after going through 3 months of therapy somewhere else. He relates to the wall and the bench as the most effective tools. These are concrete tools, daily tools that show the boundaries of what is happening and do not allow the youths to deteriorate. Yitzhak calls these tools "warning signals": "The tools that help me the most are the wall and the bench. The wall gives you the barrier, the stop, the warning signal".
Yitzhak addresses individual therapy, also: "The best is individual. There is nothing better than that. I think that it is because the social worker does not judge me, but on outside they did. I am not sure I'm right. I believe that it is not right".
Yitzhak also differentiates between the "inside" and "outside" of the therapeutic community. "Outside" means the paths of the therapeutic community with a rigid model, where every event has a response. Yitzhak perceives this as a sort of judgment. But inside, in the therapy room, there is a different dynamic, a different rhythm. Less judging. Yitzhak is careful in his diagnosis, even though this is how he feels. He concludes:
"That's what I think. But I'm not sure I'm right. I believe that it is not right". It is clear that this is what he feels right now. It is a feeling that suits his stage, but because of the power of therapy and the model he is scared to make such statements.
Yakov:
Yakov immigrated from Ethiopia at a young age. He also was involved in a severe accident. Yakov has been in Stage A for a long time. He has difficulty becoming organized to move to Stage B. He still opposes the therapy process. When he addresses the wall, he says: "When I am at the wall I think about what I did and how to accept the shaking up… Don't look at the person but listen to what he says, even if it is not right. I oppose. I don't open up at the wall, but I don't always internalize it either". From his words we understand that he is still in an oppositional stage and concerned with the external facet of therapy. He cannot understand that the tools are only a means through which he can begin to change.
Regarding the report notes, Yakov also is in opposition: "It's a tool that I don't use. I am for setting boundaries inside and not in writing. On the outside there are no reporting notes. If I don't know how to set boundaries inside, I won't do it at all". What Yakov is doing is rationalization of faulty function and of a lack of desire to barely cope with the difficulties of therapy. In his situation, he cannot allow the community tools to impact him. Diving: "I did 9 divings and the longest was for 11 days". Regarding the question of what happens in diving, Yakov answers: "Actually, I did not work in this diving. I was busy with thoughts of outside and was not open to therapy. I thought about drugs, freedom, family, I am locked up and don't get from anyone".
Regarding the deal group: "It is scary. It is stressful to open up about friends. I have often been afraid to lose my relationship with youths who open up deals, but now I am connecting to it and I open them myself".
Yakov is therefore oppositional, typical to stage A. He is afraid to open and to lose what he has become familiar with throughout his life. The change process is slow and full of opposition.
Joseph:
Joseph is in the initial stages of moving from beginning Stage A to advanced Stage A - a stage in which youths begin to look at the community differently. There is still ambivalence but there is more openness and a positive attitude regarding that which occurs in the community: "The tools that I connect with most and help me are the
"emotion jump". I yell and it makes room inside. It is more than conversation. In a conversation you get less help. You come in full of results, full, and interpret things in an incorrect manner, and then you do an emotional jump, and scream from your soul. You feel relief. You don't care about anyone and yell, and feel confident".
Joseph has found a way to share his difficulties with friends by releasing pressure. He understands that it is best not to keep the difficulty and distress alone inside of you, and there is power in the support of friends.
Regarding the therapy group, he says: "The therapy group helps me. I speak about things that bother me. A week ago I was very helped by the therapy group. I exposed myself. At first it was hard. I was embarrassed, but I got confidence. Even when things come up anew, it gets difficult, but it still helped me. My contact with my father, I didn't want to touch on, but I got confidence and it helped me understand things a lot".
There is a therapy stage in which the resident gets the courage to allow himself to be dedicated to therapy. He is less busy with defense and allows his friends and the staff to touch on sensitive issues, which until
now he had repressed inside. In Joseph's case, it is his complex yet important relationship with his father.
Regarding the report notes: "At first I did not believe in them. I felt it was snitching. Today I understand that there is something protecting me".
Here too, is Joseph's ambivalence, typical of the stage.
When Joseph is asked his opinion on the wall and shaking up, he answered: "I haven't connected with the wall. It doesn't always stop me.
Many people don't get out of their place". Regarding diving: "I am degraded by the apron. I feel degraded that someone tells me to clean or when families come to visit and see me cleaning". Joseph is still oppositional, at least regarding some of these tools. Some of his opposition is strong. Joseph has been degraded, particularly when using the diving tool. There are tools that are implemented "in public" so that everyone can see what the youth's status is. The community does not allow the youths to run away and fake. Transparency is complete. The role of friends in the community is to reflect the youths' situation 24 hours a day. This is in contrast to the period of drug use where the youths were continually running away from themselves and their environment. Drugs helped them detach on a physical and emotional level. In the community, there are no drugs and the role of friends is to place the youth in the center, to support him and set boundaries at the same time. Joseph is very concerned about how things look on the outside. The look of the apron (worn during diving), and families coming to visit make him feel degraded. During a "result", there is a chance that he will be perceived as weak and helpless, and this makes him uncomfortable because of the public nature of it.
He also feels the same about "Chair facing Chair". He addresses this tool, saying: "I would get rid of it. It only makes the situation worse. In a face to face confrontation we just get more angry. This tool is more suited to Stage B when you are more advanced and can cope with criticism without any ego". Joseph understands his situation and why he may be open better at a more advanced stage with the model's tools and get much more out of them.
Regarding the "deal group", Joseph also uses the concept "I like it".
Therefore Joseph is busy getting rid of emotional baggage, and any tool that lets him do that, he connects to more.
Regarding individual therapy: "Individual therapy, at first I blew it off.
Now I use it for help. It is quiet there. More pleasant. There is someone to talk to". Joseph perceives the therapy room as a safer place: "…It is cold and scary outside".
Sarah:
Sarah is the only female that I interviewed in the study. At the time there were three girls in the community. Sarah was at the beginning of her stay in the community. She was still busy with the question of whether she was in the right place.
Regarding the tools of the community, Sarah differentiates between therapy and the model's tools: "… in the therapy group and in therapy I feel safe. I feel more protected".
Regarding the bench: "I personally don't understand the sentence - here is the bench, outside is use". This sentence is on the wall near the bench.
The intent of the writer was to illustrate to the community members the importance of the bench which is a warning signal: "Let's stop ourselves before we reach bottom". The bench is a means for stopping. Sarah is asked about other tools within the model:
She doesn't connect to the "emotional jump". The deal group: "A group of snitches". But despite her negative attitude towards some tools, there are tools that Sarah manages to connect to: "Regarding diving, until now I went through diving without connecting to its significance. But in the last long diving I connected. I asked the social worker to bring me a question, a question I could focus on and think about. The question she gave me was, what do I want from myself? Where do I want to go in my life? The process I went through in diving was this: You don't connect immediately, on the first day you start to connect. On the second day you deepen your connection to yourself. On the third day, when you feel you can't connect any more you begin to slack off".
Although Sarah is only at the beginning of her journey, she began to understand that it is for her own good, and that it is possible to get something out of being in the therapeutic community. At her stage, it is easy to connect to her personal coping with herself, and it is more difficult with the group.
Analysis of Quotes - Stage B
At Stage B, the youths are in a state of making a decision whether they are to stay or go. At this stage they are a personal example, because they manage the community and are big brothers for those who have just arrived. They are responsible for the daily schedule of the community. At this stage, they also begin to go on vacations and begin to encounter the outside world - a complex encounter that raises many questions. It may be said that this is a stage where there is a transition from "external police" to
"internal police".
Aaron:
Aaron chose concrete tools such as tasks. Tasks are results, and their goal is to reflect the youths behavior, sometimes symbolically. For example, walking around with a lemon all day. The lemon is a fruit that is squeezed so that the juice will come out. Aaron has a problem that he is
"emotionally squeezed" by his friends. The lemon is supposed to remind him of his weakness. There are others who walk around with a bag on their backs, which illustrates that they are mobile. It is a statement that you have not yet decided if the therapeutic community is the right place for you to be now.
There are youths for whom the concreteness of the symbols help them make a change. They need a continual reminder, which is the goal of these types of tasks.
Another tool that Aaron chose to discuss was group work, which is mainly a group confrontation. Use of confrontation techniques is an important and central work in the varied work methods in the groups that are conducted in the therapeutic community.
The leaders of the groups are already familiar with the fact that only few addicts come freely to therapy. As a result, when these residents come to therapy, they are usually under external pressure by family, courts etc.
We know that the addicts do not give up use of drugs unless the pain they feel is greater than the enjoyment of use. In the early stages, the addicts' involvement in therapy is motivated by feeling bad and a desire to prevent criminal conviction, more than by a desire to learn ways to ensure successful therapy. As a result, the staff and the community have a difficult task when coping with the opposition of residents on different levels, both active and passive. If the members of a group do not actively rebel against therapy, they generally invest much effort to make the impression that they are actively involved in rehabilitation and therapy.
This presents a difficulty to the staff and the community. In order to cope with this situation, the staff or the group must confront the resident with his situation, because if his manipulation is not exposed, the residents in the community will not be able to make the transition to levels of personal responsibility that are required of them to prevent use of drugs in the future (internal police). As Aaron said: "At first they would yell at me. I got angry and was degraded, but when some of my friends did it to me, it woke me up and led me to think about all kinds of things".
Aaron addresses another area of the group aspect, which is the "emotional jump". This is a group that aims to support a youth when he is in a bad emotional state. He can gather a number of community members and share his emotional state with them. At the end of the "jump", he gets a