Just Who Are Our Clients?

You won’t be surprised to read that the majority of our clients are probably a lot like you. Most are well educated, smart, sensitive, generally successful, and whose ages range from early 40s to early 70s with most being between 45 and 65.

The majority of you are Caucasian, next most common is East Indian, then Hispanic, followed by a smattering of Black, Asian, and Native American.

Most of you are married and your spouses may be involved in your work with us to whatever degree you find helpful. Over the years that has ranged all the way from clients whose spouses had no idea they were seeing us to one whose spouse took stenographic notes of every word uttered during every session.

This range is possible because we assume that you know what’s best for you. Imagine that. A program that trusts you to do what’s in your own self-interest.

In addition to these “usual” traits and conditions, there are three exceptions to the foregoing:

  • We do occasionally take clients who are under 40;
  • We sometimes see a parent and adult child together;
  • We have occasionally worked with parents to help them extricate themselves from an exploitive “adult child.”

How do these exceptions play out?

Clients under 40 tend to be smart, successful, and preciously mature and are having problems finding the intimacy they are capable of, but few of their chronologic peers are. This loneliness is exacerbated by not understanding the problem and assuming that there is something wrong with them, rather than the problem being immature “peers.”

In these cases it can help to have a surrogate aunt and uncle to sort out the actual problems and the best options for finding “emotionally appropriate” partners, spouses, lovers, and friends. That’s a much better long term option than drinking one’s way down – alcohol is a regressant, after all – to others’ level in a vain attempt to fit in with over-age adolescents.

Time to “quit fishing in the wrong pond,” as we like to say – or thinking we can change a carp into a marlin, for that matter, though that can happen to all of us regardless of age when loneliness is a primary issue.

The parent/child situation usually involves a young adult who’s afraid to finish growing up and a parent who’s afraid to give up the parenting role as their primary identity. So they help each other and whenever the “child” appears to be escaping a crisis will mysteriously appear – frequently a binge – and the parent will race to the rescue and both will avert growing up for another month or two.

This situation is just another variation on the “dance” routine that all couples indulge in and which have to change if the alcohol abuse is going to end. Again, it’s helpful to examine the benefits each person derives from the drinking behaviors and in this case it’s usually “I don’t have to grow up,” and “I don’t have to grow older.”

Finally there are the older couples who come to us for direction in “fixing” an adult child who is bleeding them dry.

Whatever the “child’s” excuse is, they aren’t going to change as long as parents continue to reward them. One couple was handing their 50 year old son a check for $7,000 on the first of every month and wondering why he didn’t go back to being a lawyer. Really?

Bleeding the parents, annoying siblings who are being ignored – financially and otherwise because they are being responsible – and successfully perfecting a con game they learned at 12 Step rehab, well, why would anyone change that set up?

That’s pretty well covers the people who find themselves in our offices. Do you find yourself among the candidates?

I thought we’d allow two other writers to contribute to this week’s Neswletter with their opinions of 12 Step programs and AA based rehab (so called “Facilitated 12 Step,” or FTS).

The first talks about Bain Capital and why they are buying up 12 Step rehab programs and discusses the 95% client failure rate that makes for a great business model, as places like Hazelden have known for 5 decades.

Click here to read: Bain Capitol’s grip on addiction – The profit behind 12 Step treatment.

The second comes from Ken Anderson, Founder of HAMS – the Harm reduction, Abstinence, and Moderation Organization, as he discusses 12 Step programs and their contribution to adherent suicides.

While Robin William’s death has brought the question up once again, the subject goes back at least as far as Nobel poet John Berryman’s leap off the University on Minnesota’s Mississippi Bridge in 1972.

Click here to read Ken’s take on the subject: Alcoholics Anonymous, Depression, and Suicide.

And one modest disclaimer, we do have a professional connection to HAMs. Mary Ellen is a member of the founding Board of Directors, and I am an advisor on research based alcohol abuse treatment.