What Is Rehab?

to be real clear about what this podcast is intended for it is intended for entertainment and informational purposes but not considered help if you actually need real help and you're in need of help please seek that out if you're in dire need of help you can go to your nearest emergency room or you can check into a rehab center or call a counselor like me and talk about your problems and work through them but don't rely on a podcast to be that form of help it's not it's just a podcast it's for

entertainment and information only so let's keep it in that light all right have a good time learn something and then get the real help that you need from a professional I'm going to rehab that's the word you say either because you voluntarily said you were going to do it or because somebody talked you into doing it because you just heard it enough but in any case you're going to rehab and Let's just say it's your first time. First time rehab ideas and misconceptions. What is it?

And what isn't it? How do I know if I'm doing the right thing or what can I expect? And what can I not expect? What is the purpose of rehab? How long do I have to stay? And what am I going to accomplish? And what's the point? See, these are all very good questions that you can ask yourself, but unless you have the answers, you're never going to know what it all means. So you need to go so you can get the answers.

And so I'm going to explore ideas about rehab and share some stories from people who have gone to rehab for you to understand what to expect and what not to expect. So that's today's show. rehab and questions you may have about it and what it is and what it means to really start working on getting clean and sober the right way. So first of all, let's talk about what rehab is. What is a rehab? Rehabilitation center. A place you go to get a start at getting clean and sober.

And I want to stress that point because I really think you need to hear that. It is a start to getting clean and sober. It is not getting clean and sober. It's not some magic pill or formula or experience that's going to make you sober. It's the start. The very beginning.

And that's where most of the people that I work with who are starting to work on recovery really they lose their place at that point because they think that going to rehab is the cure and it's not it is the start to the cure so you're figuring out what it is it is a start it's a place where you can get some distance between you and your dealers you and your get high buddies and you and your drugs of choice And successfully getting a physical barrier is probably the biggest obstacle you have in

your recovery. Because everybody I've ever worked with, that was the biggest issue they had, was they could not get enough distance between them and those three things, their dealers, their get-high buddies, and their drugs of choice, to really have much of a chance to clear their head long enough to start to think correctly. You know, an addiction is a... brain disorder that impairs the brain's ability to think clearly. And when you are using chemicals, you are impaired.

And I can't stress that enough. It's an impairment. And you know it. You know what I'm talking about. If you're using, you're impaired. And you're not thinking straight. So to be able to be not impaired is going to greatly In a positive way, affect your ability to think and to reason. So that's why it's so hard to get you to go to rehab in the first place is because you're so impaired. Your thought process is so impaired that you really don't want to get clean and sober.

And so then you don't because it's easier to get high to escape from your thoughts about your problems than it is to use something else. So what is rehab? Rehab is a place where you go where you can't use your drugs of choice and you learn how to do simple things like sleep regularly, get up at a regular time, bathe, self-care, bathe, brush your teeth, put on deodorant, the things that you typically don't do when you're just high and drunk. You don't do those things.

It's also a place where you get to eat. Like a regular person. Like three times a day. And food that you chew. Seems like a very simplistic thing, but a lot of people don't. If you're a tweaker, you are not eating at all. I mean, it's a great weight loss program, right? Unfortunately, you get to where you're really unhealthy with very low weight. Same thing with cocaine. So, learning how to eat and sleep regularly. And take care of yourself, your physical needs. That's what it is.

I'm not going to kid you. The first two, three weeks of rehab is just hell. It's hell. The things that you go through, the dysregulation, the emotion, all the thoughts, all the opposition. You just want to get out of there. You want to get out of there and get high. Those first, I'm going to say, one to five days is probably where most people walk out against medical advice or against staff advice. And there's a distinction there.

AMA means that a doctor has said, if you do this, you have the potential of dying. If the staff is saying it against staff advice, ASA, which is different, is not as medically important. But in either case, it's not good. So if you leave in those first one to five days, you're going to have a hard time realizing that you need to go back. And a lot of people do. They walk out. I don't need this. I'm not going to listen to you. You've got too many rules. I can't stand it here.

I don't like the people, the other addicts. The staff is horrible. This place is horrible. I'm bored. In other words, you just want to go get high. That's what that means. And you're not kidding anybody. We all know it. All of us who work in the field, we know that.

I had one client on an earlier episode she worked in the field for quite a while and she said that there was like one client they called Goldilocks and he would just stand around outside the facility and would smoke cigarettes and would not go in that day and so they called him Goldilocks because he was waiting for everything to be just right and they would go out and talk to him and he'd say yeah yeah I need to go I need to go but then he wouldn't go that day he eventually did go but it took

like I don't know two weeks I think she said Kerry Zoo has some really great stories. So finding a way to be able to get in the door and then stay. And those first five days are critical. And I'm talking about after detox because you've got to go through a detox first. Medical detox is anywhere from five to ten days depending on the drug of choice and how bad it is. So withdrawal is not even counting withdrawal.

part of the rehab so you can take 30 days and you can add five to ten more days on top of that just for detox and so once you get through detox and you walk in the door you got you know one to five days and you're gonna want to bolt you're absolutely gonna want to bolt but don't and and so the question about how long do you stay how long do you stay you stay until you're done you know facilities that detox and is is a limited amount of time and you can detox and you can walk out of detox and go

back out but you're going to pick back up as soon as you walk out the door because that's what everybody does i don't know anybody who goes through detox and magically they're clean and sober but you got to stay till you're done you know uh till you're done you got to stay in that oven till you're fully cooked and how do you know when you're done Well, when you stop resisting the idea of working on getting clean and sober. And that's what we look for in rehabs.

We look for patients to come in and when they start to agree, and we can see their whole mindset change. You can feel it too. You feel better. In that safe cocoon of an environment that you're in, in rehab, it's awesome when you're there for 45, 60, 90, 120 days because you really do feel like a different person. And it feels very safe, right? Because your dealers can't get to you and your get-high buddies can't get to you.

And so any urges you have, they get met immediately in that treatment center with a dose of reality and being able to talk to somebody. Because you're surrounded in that cocoon. There's a drug counselor. There's a mental health counselor. There's a psychiatrist. Maybe they have a social worker. There are other people you're working with. Maybe they've even hooked you up with one of the NAA type meetings and you've got sponsors. You've got tons of people to talk to.

And you know because you can rely on that safety of being in the safe place all the time where it's safe. It's when you get out that it's not safe. So the trouble is when you get out, unless you have a good aftercare program put in place, you don't have a chance of really good sobriety, getting clean. You really don't. And depending on how hardcore you are, you know, are you a wake and bake pot guy? Are you a drink first thing in the morning because you go into DTs?

If you don't, are you, you know, are you shooting up two times a day, three times a day, sucking on the pipe? You know, are you doing that?

multiple times a day well and you've been doing it for a long time so that's pretty hardcore you're gonna it's gonna take you a while to to get to the point where you're agreeing to some cosmic seismic shift in your thinking to um to engage in aftercare so you're done when you feel that change and we know because we we know it as professionals when we see what we're seeing is a change and they have a chance for survival out in the wild so you're done When you feel like you're done and when

you're told that you're done. And that's the other part of this. People go into rehab and they are all about running their own programs. I'm generalizing to everybody. A lot of people who check into rehabs, they think they know how to get clean and sober. Maybe they've been to rehab before, but maybe not. But they know what they need to do. So they don't listen to the staff. They dismiss the staff in a very arrogant way. They think that they know better than the staff, which is interesting.

Because when people come into my room here in my private practice, I tell them two things. One, you're an expert at being an addict. And two, you are not even an amateur at getting clean and sober. So why don't you leave the direction... to getting clean and sober to me as your primary therapist, and you just participate. And that kind of goes with that saying that we have in recovery, that you have to do things that other people tell you, even when you don't want to do them.

And that is a rock solid truth that will get you way further down the path of getting clean and sober than you trying to run your own program, either in a rehab or out. So when you get out, you gotta have to have an aftercare. So what can you expect from from the rehab when you check in? Well, it's real simple. You're going to expect structure, rules, boundaries, and they're going to expect of you compliance, right?

So you can expect that you're going to see a lot of rules and structure and boundaries and compliance. You get up when they tell you. You go to sleep when they tell you. You eat when they tell you. You go to meetings when they tell you. You talk to the counselor when they tell you. You go to the yoga or the mind-body expansion class or the neurofeedback at 10 o'clock on Wednesdays or whatever it is. They expect you to follow the schedule. Because if you're not, then you're not in compliance.

And they're going to discharge you. If you're foolishly going in thinking that, oh, I don't like yoga. I don't like feedback. I only eat this. I only eat at this time. I don't like getting up before 10. I don't like going to sleep before 3. You're just going to get discharged. Because you're not ready. Because, see, you're running your own game. That's you trying to run your own recovery program. So what can you expect from a rehab is boundaries, structure, and rules.

and expectations of compliance. That's what you can expect from a rehab. Now, how do you know when you're in a good rehab? Well, they have a lot of those things, but they seem to know who you are. They connect with you. And it's really all about the counselors, the drug counselors, mental health counselors, because they're really the ones that you're going to want to lean on pretty heavily and emotionally.

So you can expect that that's going to be a good sign that you're in a rehab that's a good one. If they won't put up with your crap, that's actually a good rehab. Let me say that again. If they don't put up with your crap and they call you on it, You're in the right place. Some people would say, oh, no, I'm not in the right place because I couldn't, you know, they wouldn't listen to me. It's really funny when I look at reviews of treatment centers that I know are really good treatment centers.

And I look at the reviews and I'll see one that's a real negative review. And I look at it and I think, well, what did you expect? Like you went in there, you didn't like this, you didn't like that, you didn't like this, you didn't like that. Well, you had different expectations then because I know what's really there and I know what goes on because I know those people that are the counselors and the psychiatrists and the people on staff. I know them.

And you didn't like what they were telling you. It's not that you didn't. It's a bad facility. You didn't like being pushed around. You felt or told what to do or, you know, you're not ready. You're not ready because you're not going to surrender, right? And it's that step one, wildlife's becoming manageable. And then you move towards step three and you turn yourself over to higher power. And the 12 steps, it means to God. But the higher power is the rehab and the people there.

So is it a good experience? It depends on who's there and depends on, you know, what you're going to get out of it. But there's no such thing as a total failure of a rehab, you know. There are some ones that at times are not that good because the staff is not that good. But that's what you can expect going in. Now, what do they expect of you? I already talked about this a little bit previously. They expect you to comply and cooperate.

And they really do want you to feel some suffering, of course, because you're not using your drug of choice to cope with your stuff, right?

So they, of course... are going to expect you to be emotional be upset be angry be sad be depressed but that's okay that's where you're supposed to do it it's safe in that treatment center to be be that but they expect you to be that they also expect you to be honest and that's that's that's a thing that a lot of people that i've worked with over the years man oh man they are just not honest And it's really interesting, when you go to see somebody for help, for emotional support or help, because

you have a problem, and you walk into that appointment, be it an individual counselor or a psychiatrist or a rehab or an IOP, and you go in and you make up a bunch of crap. Or you just don't disclose, like they ask you how you're doing and you just don't, you know, you make up some story about how you're doing. You're not helping yourself. You're not even helping them. You're just fooling yourself and making it almost impossible for anybody to help you.

So you are trying to protect yourself with all kinds of nonsense. And that's the wrong place to do it. You really need that moment, that epiphany, that time when you can... really expose what's really going on with you. So what they expect you to do is to be open and honest, and they know that you're not gonna do it right away. They know that you've been traumatized. Most facilities that I've ever worked with, that's what they know, right? So they know that you have issues.

Now, does the counselor that you're working with, and hopefully you're in a place where you check in, and this is an important thing to ask them, is do you have an individual drug counselor? and an individual mental health counselor, and how many times a week do I see those two people? I prefer that there be a minimum of twice a week with the mental health counselor and twice a week with the drug counselor.

Cost savings and volume, the number of people at the facility, if it's large, that's going to be tough. If it's small... That can be tough too, but probably not as much. If you only have 8 or 10 or 12 people in the treatment program that you're in, and there are those that are that small, you're probably going to get more individualized attention than a larger one, just by sheer numbers. It's difficult to do that if you've got 150 to 200 people in there.

To see 200 people, that's 400 sessions a week. You've got to have a lot of counselors to do that because there's only 40 hours in the week, right? So you've got to have quite a few, the ratio of available therapists. And I know there are some treatment centers, and I'm not going to label them, but that really try to cut costs. And so they'll only have one or two mental health therapists, and they only see those patients in the treatment program that are critical.

And so if they are in a critical status, they will see them more frequently. But once they start to stabilize, they kind of back off of those sessions. Anyway, I'm kind of going down a rabbit hole here. But anyway, so what do they expect of you? They expect you to be honest and to comply and to cooperate. Now, you may not like it. You probably don't. Because you can't get high and you're going to be a little oppositional.

But, you know, just even saying, hey, you know what, I really feel like I'm oppositional to this whole idea of recovery. Even that's honest, right? And they can work with that. But if you're just in non-compliant mode, that's tough. They also expect you to be able to get along with the other patients that are in the treatment center. And that can be an issue. Because everybody, when they check in, they're all dysregulated. So that makes it so you're emotionally all over the place.

And it also makes it difficult when you're using that as a manipulation tool to get out of treatment, basically. That's really a difficult one. So, you know, cooperation and getting along with other patients. When you're there, you know, we lean on each other. Drama, drama, drama. Everybody who works in a treatment center, they know that. There's drama, drama, drama, drama. Every time. However, when you go to a treatment program, let's keep the drama to a minimum.

Because in many ways, the people that you go through treatment with, those people that are your peers working on recovery, you're probably going to run into them or you're going to want to keep touch with them. And, you know, that's great because that's your peers, right? That's peer support. I even know facilities where, because it was small and it was local, that they go to treatment and then they end up being in the same area geographically, so they'll go to meetings together.

They kind of partner in their recovery and that's awesome so trying to figure out a way for you to be able to establish you know good solid relationships with people not everybody but some people in the treatment center is a very supportive thing and helpful and you'll meet some people and you know what's interesting is the people that I work with in my practice when they get out of rehab They'll tell me stories about somebody that they kept in touch with or a couple of people.

If you've been there for 45, 60, or 90 days every day, 24 hours a day with somebody for that long, you get to know them and you know their story. And they get out and then they keep in touch with each other and maybe they even live on the other side of the country. But they know when the person relapses, which is quite interesting. And it has a very negative effect on my client because who's sitting there telling me that, and they say, yeah, Tim, you know, got out, and he's back at it again.

I'm like, how do you know? Well, he told me. Do you talk to him anymore? No, he won't respond. You know, and it's hard when you have a peer that you connected with, and they relapse, and unfortunately it happens frequently. So... Relationships are important, so getting along when you're in treatment. The experiences that I have, I wanna talk about just a couple minutes here about what happens when things go wrong in residential treatment.

When I send somebody to treatment for their entrance into the beginnings of recovery, I'm expecting them to go and to engage in the treatment program. So I try to match the program with the person the best that I can. So I try to get to know them. The only time I don't really is when I'm doing an intervention and it's kind of tough for me. I'm taking a stab in the dark based on the stories of the family around them that has employed me to do the intervention.

But when people... uh go they're trying to match them to what they think works and uh sometimes it's a mismatch so sometimes you go to that residential treatment program and maybe the good counselor is left because there's some you know business structural change in the program and the good people the good counselors a good you know clinical staff they're starting to leave and unbeknownst to like me, as a professional, I didn't know that. So when the person goes to rehab, it's a bad experience.

What I really want my clients to do, or even people I do interventions with, is I want them to tell me, hey, this is not working, and I like those conversations. Call your therapist on the phone and say, hey, you know what? Here's the reasons why it's not good. Be honest. Don't just make up a bunch of crap because you want to get out because you're wasting everybody's time by doing that. But just really be honest about what's going on.

It's like, yeah, I haven't seen my mental health counselor in a week and a half. Or the drug counselor went on vacation for two weeks and I haven't seen anybody. Those can be bad experiences. So you say that. Because what you need to do is be in rehab because this is your entry into recovery, right? So you got to get to where you are still in some kind of a rehab. So you got to tell people so they can... Me as a professional, I will find another one for you. I'll do a bed-to-bed transfer.

Okay, you don't like that rehab? Awesome. I understand. Give me a day. I'm going to reach out to some other people and I'm going to find out what... what the good one is that you need to go to. And so you go to the next rehab. I'll send you there. That's what I'm going to try to do, right? Because I'm your primary counselor.

I'm the one that really cares about whether or not, you know, you're successful with the clinical experience that you have because I got a vested interest in it because you're going to come back to me, hopefully. at the end of it, and I want you to be able to complete it. So if you're having a bad experience, you gotta make sure you say something to your counselor, right, or whoever it is that was helping you get into rehab.

Be honest, and you didn't waste time by going for two weeks or three weeks and it turned into a big mess. You go to the next one, right, and trust me, there are tens of thousands of rehabs out there, and a lot of them you're not gonna know. Because you're the amateur at recovery, right? So you go to the experts. So if things are not working well, sometimes they don't, then you reach out so you can go to another one and get you into one that will work for you. Don't just give up.

So there's a lot of expectations on both sides when you go to rehab. The number one thing that can't be an expectation is this is the cure. 30 days, I'm out, I'm cured. No, you're not. It's a year and a half to two years before you can say that. And those of you who are listening who have gone through recovery, perhaps in the past and you've tried, you know exactly what I'm talking about. So, it is not the cure. It's not the end. It is the opening of the door to recovery, literally.

You're just crossing the threshold to that long journey to recovery. And I hope it's a good one. And it's, you know, statistically, The odds are against you getting clean and sober with a single residential stay after two years. The long-term recovery, not using for five years after successfully getting clean and sober, you may go through two or three. Statistically, with opiate drugs, it's six times of completion of rehab before you get clean.

With alcohol, my own personal experience is Two and a half to three times. I keep leaning towards three, but it seems like the numbers are not quite there for three. I know that's anecdotal, but for me, that's what it is. And so, you know, you may not be successful that first time and it's OK. It's OK. I think that the conversation about rehab and what to expect and how to get through it is. would be helpful if you had some individual experiences relayed to you.

So on the next podcast, I'm going to be having some people give me their input so you can hear it from them firsthand about what rehab worked and didn't work and experiences for them individually in their recovery were good or bad. And maybe you can learn from that. So it would be helpful, I think, to learn that part of it. So... I hope you tune in to the next podcast, which is a follow-up to this one, which is what is rehab or how does it work from a firsthand experience from storytellers.

who have gone through rehab. Well, thanks for listening to this podcast of Doc Jock, Your Addiction Lifeguard. And as always, if you found this helpful and useful in your journey towards recovery, or if you had questions about recovery because you're trying to help somebody who's a loved one in recovery, I hope this information was helpful to you. If you need help, please contact me, jockdebruker.jock, at wellspringmindbody.com.

And reach out to me by phone or email, text message, however you want to do it. And let me know what your needs are. Because living a life that's clean and sober, stable, is awesome. So go out and get it today. Be sane, stable, and sober. Save your life. Get into recovery. And thanks for listening to this episode of Doc Shock, your addiction lifeguard. See ya.