The Recovery Revolution

The Battle Over Addiction Treatment in the United States

Claire D. Clark

• Publisher: Columbia University Press
• Year: 2017
• Topic: History
• eBook ISBN:
  9780231544436
• Subtopic: North American History
• Index: History

In the 1960s, as illegal drug use grew from a fringe issue to a pervasive public concern, a new industry arose to treat the addiction epidemic. Over the next five decades, the industry's leaders promised to rehabilitate the casualties of the drug culture even as incarceration rates for drug-related offenses climbed. In this history of addiction treatment, Claire D. Clark traces the political shift from the radical communitarianism of the 1960s to the conservatism of the Reagan era, uncovering the forgotten origins of today's recovery movement.

Based on extensive interviews with drug-rehabilitation professionals and archival research, The Recovery Revolution locates the history of treatment activists' influence on the development of American drug policy. Synanon, a controversial drug-treatment program launched in California in 1958, emphasized a community-based approach to rehabilitation. Its associates helped develop the therapeutic community (TC) model, which encouraged peer confrontation as a path to recovery. As TC treatment pioneers made mutual aid profitable, the model attracted powerful supporters and spread rapidly throughout the country. The TC approach was supported as part of the Nixon administration's "law-and-order" policies, favored in the Reagan administration's antidrug campaigns, and remained relevant amid the turbulent drug policies of the late twentieth and early twenty-first centuries. While many contemporary critics characterize American drug policy as simply the expression of moralizing conservatism or a mask for racial oppression, Clark recounts the complicated legacy of the "ex-addict" activists who turned drug treatment into both a product and a political symbol that promoted the impossible dream of a drug-free America.

PART I

REVOLUTION

1

SELLING SYNANON

Synanon pioneered the hippie business,” said its founder, Charles Dederich. The group modeled communal living before it became fashionable. Yet Dederich viewed latter-day hippies as hypocrites who “took what they liked from the established world and then tuned in, turned on, and dropped out.” Their communes were not self-sufficient; their righteous spirituality disguised immaturity. “What’s holy about getting loaded to your eyelashes and leaving your garbage to pile up and breed flies while your plumbing goes out of whack and your girls get babies and the clap at the same time?”1

That was the sort of no-nonsense language residents could expect at Synanon. Like a stern father, Dederich promised to create an orderly residential environment that would teach drug users to behave responsibly. Run entirely by reformed addicts, the Synanon group soon billed itself as a “tunnel back to the human race” for heroin addicts trapped in a degenerate subculture. Synanon’s recovering addicts opposed AA’s gentle method of group “sharing”; they preferred to use “attack” therapy to force each other to confront their sins and defects. The confrontations took place in an intense, rule-governed familial environment that apparently altered the habits of the most hardened addicts. For the early residents who recovered there, the experience was revolutionary. “What I want to point out you,” said one ex-addict advocate in the 1960s, “is that what happened [to me] at Synanon did not happen at the Menninger Clinic in Topeka; the Institute of Living in Hartford; three times in Lexington, Kentucky; New York; Metropolitan Hospital; Manhattan General; the Holbrook Sanitarium; or the Westport Sanitarium.”2

This ex-addict’s litany of institutional failures was comprehensive; drug addicts in the late 1950s and early 1960s had few treatment options. The Victorian-era sanitariums that emerged to treat the disease of “inebriety” collapsed by the early twentieth century. A few hollowed state asylums, hospital detoxification centers, and therapeutic federal penitentiaries remained, but by the 1960s patients and the public had come to view these facilities’ treatment offerings as futile. Dederich saw the crumbling treatment system as ripe for disruption. Struggling addicts, desperate for a treatment alternative, helped Dederich create one at Synanon. Together, they successfully marketed the organization as a radical and glamorous new form of addiction treatment.

Dederich described his therapeutic experiment as “a new form of communication, a new trade, a new kind of people, a new branch of knowledge, that would possibly have as great an impact on the world as Freud’s discoveries in psychoanalysis at the end of the nineteenth century.”3 In Dederich’s lifetime, the influence of psychoanalytic ideas expanded beyond the realm of mental-health services to the business world. Marketers appealed to Eros in advertising campaigns; executives applied Carl Jung’s Myers-Briggs Typology Index to workplace management. Although Dederich would gain notoriety as a cult leader by the end of the 1970s, his decisions were usually the result of managerial, rather than divine, inspiration.

After helping journalists uncover Synanon’s most problematic practices, the sociologist Richard Ofshe concluded that Dederich’s management choices drove the organization’s development.4 Synanon first began as an AA-influenced fellowship of recovering alcoholics and addicts (January–September 1958), quickly established a residential TC (September 1958–1968), expanded into a self-declared social movement (1969–1975), and, finally, devolved into a controversial, corporatist new religion (1976–1992). In the last phase, Synanon also came to symbolize the excesses of experiments with spiritual exploration and alternative living in the 1960s and 1970s. “A once-respected drug program turned into a kooky cult,” reported Time in late 1977.5 Synanon leaders ordered residents to enter into open marriages, undergo vasectomies, and prepare for battle against the organization’s enemies. Professionals warned that Synanon’s fate should serve as a “signal for caution” to addiction-treatment centers based on its model.6

While scholars and critics fixated on Synanon’s connection to cults or communitarian religious movements, generations of treatment centers that followed Synanon sorted out the mixed blessings of their therapeutic inheritance. Early critics argued that the hierarchical treatment model prevalent in TCs, “while freer than many custodial facilities,” still presented ample opportunity for the coercion of residents through “ridicule, abrasive encounters, social ostracism, stripping of defenses,” and so on.7 Yet TC proponents ultimately provided evidence that an intense social environment, if managed appropriately, improved clients’ outcomes.8

Synanon’s new therapeutic model directly challenged the drug-treatment status quo. The few recognized drug-treatment facilities—however dubious their cure rates—were authorized by a bureaucracy of medical professionals, criminal-justice referrals, and government funders. In contrast, Synanon’s quest for legitimacy initially relied on charismatic leadership. The organization’s growing membership of drug-free former addicts congregated around Dederich and gave his treatment methods credibility. Had Dederich’s community been unable to attract the interest of establishment figures such as government officials, researchers, reporters, and business leaders, Synanon’s early members might have lost interest in the movement. Had he been quick to offer the treatment model to the authorities who wished to modify it, the recovery revolution may have been moderated—or, as sociologist Max Weber put it, “routinized.”9 It instead took more than a decade for TC treatment to become routine.

Until then, treatment radicals’ integrity correlated with their leader’s charisma. Dederich’s business plan shaped Synanon’s treatment structure. His personality inspired a provocative new way to think about addiction and its treatment.

Charles E. Dederich was born in Toledo, Ohio, in 1913 and was fatherless less than ten years later. Dederich’s mother married a well-off engineer soon after her husband’s death, altering the family’s financial circumstances and Dederich’s status in the household. They moved into a large Victorian house, and Dederich was sent to private Catholic schools and briefly to college at Notre Dame. He had difficulty adjusting to Notre Dame, and his grades were poor. He returned to his hometown, found work at Gulf Oil’s office, married, and had a son he named Charles Jr. As a traveling salesman for Gulf, Dederich became a heavy social drinker, and for a time cocktails capped off his business deals. In 1944, he contracted meningitis and fell into a coma that lasted two weeks. He survived after doctors performed a mastoidectomy that left him with facial deformities and tics. A droopy eye, partly paralyzed mouth, and brush with death sent Dederich into a deep depression; his habitual alcohol abuse progressed to alcoholism.10 Seeking renewal, he moved his wife and son to Los Angeles, California, where he divorced, remarried, and had a daughter, Jady, by his second wife. His increasingly problematic drinking made it difficult for him to maintain employment.11 In 1956, Dederich’s second wife left him, and—taking her parting suggestion to heart—he attended his first AA meeting. “Once she was sure that I had a fighting chance of taking care of myself, we divided everything up,” said Dederich. “She took the inside of the house, and I took the outside.”12

Dederich’s wit made him a sought-after AA speaker. He maintained his abstinence from alcohol by attending an AA meeting each day. He landed an office job at an aircraft-manufacturing company in Santa Barbara but quickly grew restless. Citing a new revelation from a tattered copy of his favorite essay, “Self-Reliance” by Ralph Waldo Emerson, Dederich quit his job, returned to Los Angeles, and dedicated himself to creating a new enterprise that would cure other alcoholics. Emerson was a leader of the mid-nineteenth-century transcendentalist movement, which advanced the idea that the cultivation of the individual mind and spirit was the best route to the divine. Emerson’s essay urged readers to be skeptical about living according to traditional belief structures and societal constraints.13

Dederich offered an alternative to square, Salvation Army–style evangelism. He tried to convince a local AA clubhouse to transform the meeting space into a kind of “way-out hep jazz AA club” that would cater to a younger demographic and welcome addicts as well as alcoholics.14 The AA stalwarts rejected Dederich’s proposal. By 1957, however, he had nevertheless gathered a small fellowship of recovering alcoholics and addicts in a dilapidated storefront in Venice Beach. They paid the rent with one member’s disability pension. Although Dederich’s group continued to attend local AA meetings, privately their rollicking, confrontational arguments evolved into a distinct form of therapy. In 1958, Dederich pushed the members of his group to formalize their association. The alcoholic members, in keeping with AA tradition, wanted to maintain an informal, nonproprietary, voluntary association and resisted Dederich’s plan to incorporate.15 The AA traditionalists, said Dederich, were “gumming up my deal” with their emphasis on God and gift economy. “They still thought it was an AA club and they would come in and put a dime on the counter and drink 30 cups of coffee and use our shower.”16 The addicts followed Dederich, and, together with four other members, he drafted an organizational charter and filed the necessary paperwork. In 1958, the Venice Beach flophouse became a nonprofit corporation. Dederich originally called the organization the “Tender Loving Care Club” but soon changed the name to “Synanon”—a brand that brought to mind the old-fashioned concept of “sin,” the twelve-step precedent of “anonymous,” and the group’s therapeutic “symposiums”—because he had a vision of the group’s logo “in print, on letterheads, and on our literature.”17

At first, members subsisted on donuts and stale sandwiches donated by local vendors.18 Gradually, the organization attracted new members, positive press coverage, and bigger donors. After Dederich’s split with alcoholic members, Synanon became focused on courting heroin users. According to Synanon’s press coverage and internal bookkeeping, residents in the early 1960s were prototypical hipster heroin addicts: they were mostly working-class white men from traditional immigrant communities in urban centers. Enamored of jazz and cynical about their futures, they had started using drugs in adolescence and entered Synanon in their late twenties.19 Synanon also admitted a smaller number of women and African Americans, and Dederich believed that “hustling” for funds and attention taught all the organization’s addicts—regardless of race, gender, age, or addiction history—to channel their survival skills into a responsible enterprise. By 1968, Synanon had more than one thousand residents and locations in San Francisco, Santa Monica, New York, and Detroit.20

Dederich initially claimed his entrepreneurial vision was equal parts Emerson and lysergic acid diethylamide (LSD). In the 1950s, several human experiments demonstrated that LSD, a derivative of a grain fungus with hallu...

Table of contents

• Cover
• Title Page
• Copyright
• Dedication
• Contents
• List of Illustrations
• Preface
• Introduction: The Roots of Revolution
• Part I: Revolution
• Part II: Co-Optation
• Part III: Industrialization
• Conclusion: The Revolution’s Aftermath
• Acknowledgments
• Appendix: Historical Actors
• List of Abbreviations
• Notes
• Bibliography
• Index