5.3 Quantitative Study Analysis and Discussion
5.3.4 The Recovery Process
The following results establish the general attitude towards the therapies of attending meetings and rehabilitation centres and the ways in which rehabilitation centres may be improved. The information describes what is currently believed to be lacking in current recovery therapy offerings and the potential improvements from the perspective of the end- users.
5.3.4.1 The Social Perception of Addiction and Recovery
Social stigma and prejudices about the disease of addiction and addicts suffering it, are some of the major obstacles to solving the problem in South Africa (Adrie Vermeulen, 2013, pers.
comm. 25 April) as there is often a substantial lack of community and family support (Jackson Mutie, 2013, email comm.). However, the survey results suggest the opposite is true, with few respondents (14%) feeling they did not have the support of their communities and families (6%). One hundred percent of respondents stated that fellowship was important to their recovery process suggesting that regardless of whether recovery is through a meeting or a rehabilitation centre, the essential element of belonging to a community is instrumental in sustaining recovery. These figures are welcomed in the debate on the efficacy of current treatment methods which are further enforced in the discourse on shame and pride in addiction. A staggering 92% of respondents claimed that they did not feel ashamed to be seen attending AA and NA meetings and rehabilitation centres.
" My ego was a surfer, I was perceived as a surfer but now I am happy to be me."
(Simon, 2013, focus group. comm. 16 May) The perception of shame is a recurring theme in the discourse on how human beings maintain their interconnectedness and is described, through the research, as a primary source of
103 | P a g e addictive mentalities. The focus group discussion on the shame results attribute the absence of these feelings as an indication of the success of the programme. Recovering addicts are so intensely grateful and 'delighted' about their freedom from the unbearable physical and mental confines of active addiction, that they are happy to be seen going to meetings and to a rehabilitation facility. They are aware of how difficult recovery is to sustain every single day and are grateful for their still being in recovery.
5.3.4.2 A Spiritual Solution
Of the 86% of respondents who said they had experienced a definitive liminal moment during their recovery process, 96% stated it was spiritual in nature. Distinct from the religious profile of the recovering addict, the spiritual nature of the treatment of the disease is central to the true cognition of the 12 steps.
"The disease of addiction is a spiritual thing and I think these other rehabs are trying to deal with a spiritual disease in a worldly way. Like beat it out with a
kind of a different approach to what it actually is. You've got to deal with it spiritually if it's a spiritual sickness."
(Simon, 2013, focus group. comm. 16 May) The focus group discussion expanded on this sentiment of the disease of addiction being a 'spiritual malady' not curable by psychological therapy or psychiatric drugs. The approach is reminiscent of Carol Gilligan's work on a more feminine approach to medicinal care that is more subjective and aware of the emotional frailties in the diagnosis. Although the underlying illness may be a type of insanity in that one repeats the same actions expecting different results each time, the cure to addiction is spiritual (Nick, 2013, focus group. comm.
16 May).
5.3.4.3 Suggested Improvements
Most of the respondents believed that rehabilitation centres would benefit from the introduction of training facilities (84%) including occupational training such as computer and trade skills development as well as life-skills psychology and addiction counselling.
Respondents were also largely in favour of parenting and family skills education (82%), reiterating the opinion of addiction counsellor, Judith Gordon-Drake that addiction is a family
104 | P a g e disease that affects the whole system and of the importance of stable family structures and home life in defence of addictive tendencies. In keeping with the current offering, the majority (52%) of respondents would prefer a rehabilitation centre located in the country.
The halfway house model as an integrated part of the rehabilitation centre model with skills development that equips a person with the skills needed to become financially and then emotionally self-sufficient thereby mitigating the chances of relapse on return to the person's previous lifestyle on leaving the centre. This is one of the major obstacles to sustained recovery and often affects single mothers who are unskilled and will do any job to provide for their children.
"A lot of the people have got something...but they go back home to their families and communities where people are using all around them; you'd have to be
literally super-human not to start using again."
(Aldine, 2013, focus group. comm. 16 May) These facilities however, should be separated from the primary care portion of treatment to not dilute the impact of the cognitive behavioural therapy of the 12-Step programme which is imperative in the initial stages of recovery. It was suggested that a central educational facility, could serve many rehabilitation centres in instances where resources are more limited. These central zones of community empowerment possibly funded by businesses in the community could encourage community participation and investment as suggested in the theory of Placemaking. Community participation is also central to the idea of a Kibbutz-like system for a rehabilitation centre, where the recovering addicts residing there contribute to making the centre self-supporting by including a commercial element as a public interface and tending urban farmlands to decrease the drain of a percentage of food costs on the centre, thereby freeing up a portion of financial resources for offering subsidized treatment over and above what the government offers.
In terms of location, the group cited the need for a direct connection with nature and an adequate amount of outdoor space for physical exercise, as the two main reasons why a country location was preferred by the majority of respondents. However, there were concerns raised about accessibility, most notably for those homeless and without transport. In this case
105 | P a g e centrally situated easily accessible centres were proposed, on the periphery of urban areas so as to cater to both outdoor space requirements and public transport routes. In terms of specialized facilities, most of the focus group members expressed an interest in having guided meditation classes in a dedicated sacred and silent space.
5.4 Potential and Actual Behaviour Settings - An Intuitive Response