Addiction Specialist Says Recovery Industry Is Failing Lindsay Lohan

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Tony Bevacqua, Psy.D. from Summit Malibu says Lindsay Lohan's underlying issues and lack of coping skills are not addressed by the treatment programs she has been exposed to four times in four years because the recovery industry is still dominated by the disease model, which despite decades of research that shows these approaches to have limited effectiveness, they are still used and mandated by the court. He states that on the one hand, she must admit to being powerless and diseased for which she has no control, and on the other hand, she must responsibly behave appropriately according to court order and remain abstinent by treatment standards as the only measurable marker for successful rehabilitation. This may be contributing to her problems.

Now that Lindsay Lohan has failed her drug test just weeks after being given an early release from yet another rehab facility, a big question looms: Do these facilities really help those struggling with addictive behaviors--or actually contribute to their problems? Tony Bevacqua from Summit Malibu, says that undoubtedly, Judge Fox was well-meaning when creating consequences for her non-compliance with the terms of her release from jail and from her latest rehab stint. Indeed, since the 1950s, well-intentioned judges have been mandating legal offenders to Alcoholics Anonymous (AA) and other related 12-step recovery programs. However, he cautions people to keep in mind that if you believe that addiction is a biological disease and that the brain is disordered, then how can you expect a person with a disordered brain to consciously choose to stop their behavior or else be considered a failure? He suggests this would be akin to calling a cancer patient who does not go into remission responsible for the failure of their treatment. "If you label Lindsay Lohan's problems as biological and that she is powerless, then why would you send her to jail for being incapable of controlling herself? In essence, she is being asked to take responsibility for her recovery but she is told that she is not responsible for her affliction because she is diseased," states Bevacqua.

Bevacqua suggests that the problem with these programs is that they often create the conditions for non-compliance because they subscribe to the disease model of addiction and indoctrinate the suffering individual with the idea that only abstinence is the solution. Bevacqua says, "since rehabs take no responsibility for treatment failure, the suffering individual who is unable to remain abstinent is considered a failure and led to believe that this inability to completely stop their use is proof of a biological disease, and in the case of Ms. Lohan, a violation of her court ordered mandates." Yet, common to most 12-step programs are two assumptions about the cause and treatment for alcoholism, drug abuse and other types of addictive behavior.

Over 50 years old, both claims are long outdated scientifically--and often produce ineffective, even counter-productive treatment. Unfortunately, they continue to dominate the recovery industry forced upon Lohan and countless others.

First, these programs proclaim a unitary disease model of alcoholism: namely, that the majority of individuals with alcohol difficulties has the same chronic, lifelong illness, and that for them, moderate consumption is forever impossible. As E.M. Jellinek famously asserted in 1960 in his book The Disease Concept of Alcoholism, the condition is a disease that is “progressive, transmitted through heredity, and by a loss of control over consumption once drinking begins.”

Jellinek had little scientific proof to support this contention, but that didn’t seem to matter. Already basic to AA’s view of alcoholism as a disease, his notion was enthusiastically promoted by America’s growing rehab industry--and then expanded in the 1960s and 1970s to address a variety of individual problems ranging from drug addiction and gambling to overeating and sexual adventurism. Consider Tiger Woods’ stay at the posh Pine Grove rehab facility, which is run by medical doctors, who treat--as their website announces--“those suffering from sexual addiction, relationship addiction, and sexual anorexia.”

Yet, for over 25 years, the unitary disease model of alcohol dependency has been found scientifically shaky--with even less data to support its extension to other areas of personal life difficulties. As Stanford University’s acclaimed psychologist Albert Bandura declared in a major research review, “alcohol abuse is not a monolithic condition with an inevitable progression” but rather, “a multi-determined pattern” varying from person to person in its severity and causation.

Secondly, most 12-step programs share a one-size-fits-all approach to treatment. They’re rooted in the 1935 “conversion experience” of AA’s chief founder, stockbroker Bill Wilson, as he bitterly struggled with alcoholism--and can be aptly summarized as: “You’ve got to hit rock-bottom and admit you’re powerless” to overcome alcohol or any other source of dependency. This message is central to all 12-step programs, and was undoubtedly impressed upon Lohan at her first AA meeting.

But is it scientifically true?    

Hardly, says Bevacqua. He explains that even the National Institute on Alcohol Abuse and Alcoholism (NIAAA) after years of research, stated that we need to rethink what we know about alcoholism. They found that many who met the criteria for alcohol dependency, no longer met the criteria one year later, despite receiving no treatment and many of whom continued to drink in moderation. In fact, over the past 30 years, research led by Dr. William Miller at the University of New Mexico has analyzed 381 clinical trials involving 48 treatments for alcoholism. Miller’s team found that existing court-mandated approaches to addiction treatment rank among the least effective regimens. Even more strikingly, his group found that clients who view their alcohol-dependency as an all-powerful disease are more likely to relapse than those rejecting this basic 12-step notion.

Bevacqua says that the research critiques of Drs. Bandura and Miller fit well with his own professional experience. He states "alcohol’s misuse has many different causes and simply isn’t a single “disease.” Effective treatment must build on personality strengths and skills--not encourage a sense of powerlessness."

Bevacqua says Lindsay Lohan needs to address her underlying issues. But the dominant recovery approach to which she’s been subjected seems to be neglecting this. Let’s hope she finds the alternatives while still young and teachable. If so, her personal struggle may some day truly benefit others.

Tony Bevacqua, Psy.D., is an addiction specialist at Summit Malibu. His article on celebrity addiction culture, "A dangerous infatuation," appears in the Addiction Professional Magazine, and he co-authored William James' "Sick-Minded Soul" and the AA Recovery Paradigm: Time for a Reappraisal in the Journal of Humanistic Psychology.

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