One Grain of Sand Beit T’Shuvah Best Practices for Integrative Treatment Under the Direction and Guidance of Harriet Rossetto, LCSW & Rabbi Mark Borovitz Prepared for Beit T’Shuvah by Dr. Charles Blakeney & Dr. Ronnie Frankel Blakeney BTS HANDBOOK EDIT APRIL 7.indd 1 8/26/13 1:41 PM BTS Publishing A Division of Beit T'Shuvah BeitRecover Your PassionT’Shuvah Discover Your Purpose 8831 Venice Blvd. Los Angeles, CA 90034 Copyright © 2013 by Beit T'Shuvah All rights reserved, including the right to reproduce this book or portions thereof in any form whatsoever. For Information, address: BTS Publishing Subsidiary Rights Department, 8831 Venice Blvd., Los Angeles, CA 90034 Beit T’Shuvah Best Practices for Integrative Treatment Under the Direction and Guidance of Harriet Rossetto, LCSW & Rabbi Mark Borovitz Prepared for Beit T’Shuvah by Dr. Charles Blakeney & Dr. Ronnie Frankel Blakeney Designed by Creative Matters Manufactured in the United States of America 2 BTS HANDBOOK EDIT APRIL 7.indd 2 8/26/13 1:41 PM Acknowledgments This Handbook is the fruit of many years of labor and love. Its roots go deep. It represents the evolu- tion of the treatment program at Beit T’shuvah begun by Harriet Rossetto, and shepherded by her and her husband Rabbi Mark Borovitz for the past twenty-five years. The Handbook is based on systemat- ic observations in groups, therapy sessions, services, meetings and informal gatherings. The data that we gathered includes formal and informal interviews with staff members, residents and alumni, as well as surveys conducted with residents and staff members over the course of ten years. We wish to thank the counselors, spiritual counselors, therapists, interns and supervisors for their generosity, openness and helpfulness in gathering and analyzing the data that support this Handbook. The Handbook represents the culmination of 12 years of scientific exploration into the recovery of Developmental Integrity among chronic alcoholics, drug abusers and gamblers by the authors. Beit T’Shuvah’s Board of Directors sponsored the first stages of the research twelve years ago, and the completion of the handbook this past year. We are honored by their trust. This handbook presents a developmental approach to recovery and builds on the authors’ work begun at Harvard three decades ago. The authors wish to acknowledge their mentors in this process: Lawrence Kohlberg, Carol Gilli- gan, Robert Selman and Robert Kegan. Director Harriet Rossetto and former Clinical Director, Kathy Marks, are the fire under the Beit T’Shuvah Handbook. They knew that Beit T’S huvah had a successful approach to treatment and they wanted to be able to share what we do and how we help in a more systematic, comprehensive, useful and user-friendly format. Rabbi Borovitz and the Board of Directors agreed. We are grateful for the oppor- tunity to be of service. We wish to thank, as well, Yeshaia Blakeney, our son, who is Rabbi-in-training at Beit T’Shuvah and Beni Warshawsky for their helpful insights into the program (YB) and how to organize the data into a succinct Matrix (BW). Lastly, we would like to acknowledge our granddaughters Eden, Noà, Stella and Ida, who remind us every day about the importance and joy of sharing what we’ve learned, and of being open to learning from them in turn. Beit T’Shuvah is a Jewish spiritual community, and this Handbook describes, in part, how a spiritual community heals. As members of this Jewish spiritual community, the program directors and authors encourage others to join us on this path to recovering integrity, passion and purpose. 3 BTS HANDBOOK EDIT APRIL 7.indd 3 8/26/13 1:41 PM "We don’t expect you to be perfect. We just expect you to be one grain of sand better each day." —Rabbi Mark Borovitz 4 BTS HANDBOOK EDIT APRIL 7.indd 4 8/26/13 1:41 PM “You don’t come here to get sober, you come here to become your best self.” This Handbook introduces the reader to the Integrative Treatment Program at Beit T’Shuvah Synagogue and Recovery Center. T’Shuvah means repentance, return and new responses. T’Shuvah is the essence of recovery. We’d like to welcome you, too, as our Rabbis welcome new residents each Friday night during Sabbath evening services. Welcome to Beit T’Shuvah “We want to welcome you in. And the first thing I want to tell you is that Beit T’Shuvah is not a rehab. It’s a community. We’re a community. You come into a rehab to get free of drugs, alcohol, gambling, eating disorders, i.e. addictive behavior. You come to Beit T’Shuvah to become a better person…the best “You” you can be. When you come to a rehab, they tell you the rules about how to behave: Do not touch alcohol, drugs, your cell phone, your roommate or the front door. We have those rules, too, mostly. But in other programs, in rehabs, depending on their theory of recovery, after 1, 2 or 5 rule violations you get kicked out. At Beit T’Shuvah, whether you stay, and how long you stay, depends on you; it depends on how you are working on how to be a better you…one grain of sand at a time. It’s an individualized program, because it’s about you being your best You…not some cookie-cutter sober alcoholic, drug addict or gambler. The one thing you have to do, that everybody has to do, is HOLD ON. It’s going to be a wild ride, and nobody does it perfectly. When you come in here trying to be perfect, then we can’t get to know the real you: the part of you that hides in the closet or under the rug—that sleeps in your car and runs from the light. The part of you that takes over and whispers in your ear that you’re not good enough, that you’ll never make it, that you don’t matter. In Hebrew it’s called the Yetzer Ha’ra, the evil inclination. Everybody has one, just as everybody is a pure soul, with good inclina- tions, the Yetzer Ha’Tov. We all have (at least) two voices, chattering in our heads—a voice that urges us to take the easy way out, that tells us to hide our shame from G-d and other people, a voice that tells us we can’t make it, so why try—that we’ll never be lovable, that we’ll never belong, that we’ll never be worthy or rich enough or thin enough or powerful enough. And there’s a voice that tells us that we, too, are a child of G-d, and that the world needs us, needs our talent, needs our good heart, needs 5 BTS HANDBOOK EDIT APRIL 7.indd 5 8/26/13 1:41 PM the contribution we can make, and that we are good, and that we are enough, and that we can be who God intended us to be, and this next step is the next step on our path, and that when we stumble, it reminds us that we, too, are human, a part of the whole, and that we can learn to walk our path, to get up when we fall and to walk through pain and shame and fear and sadness. That when we stray, we can return. That How does Beit T’Shuvah help we can let go of frustration, disappointment, anger and rage, lost, stuck, broken souls to re- turn, heal, grow, discover their and not follow it down the rabbit hole, because we matter. purpose, recover their pas- You matter. And each of is obligated to do our part, to be the sion and their integrity, and rejoin the larger community letter of Torah we were made to be.1 as fully participating mem- bers? At Beit T’Shuvah, the path to recovery is through the doorway of a Jewish spir- itual community. Beit T’Shuvah is the House of Return. This Handbook guides the reader through the recovery program at Beit T’Shuvah. Part I relates the history of Beit T’Shuvah, our philosophy of addiction, recovery, In- tegrated Treatment and Jewish spiritual community, and the Core Values that guide our practice. Part II: Menu of Services, orients the reader to the components and structure of the Integrated Treatment Program. Part III: Five Recovery Tasks, illumi- nates Beit T’Shuvah Best Practices for working with people at each of five empir- ically derived Recovery Tasks: Sanctuary, Awakening, Moral Engagement, Recov- ering Integrity, and Covenant. We present these tasks in a “typical progression” in full recognition that recovery doesn’t proceed in a straight line, and that Beit T’Shu- vah’s Integrated Treatment Program is individualized. People come into the program with different experiences, different patterns of being “split” and “stuck” and “dis- engaged.” Addiction is a chronic relapsing condition, and people work on the tasks of recovery in different ways, have different needs, make use of different aspects of treatment at different times—they have to go backward to go forward, and so on. In Part IV: Tailoring Integrative Treatment, therefore, we describe four regenerative pathways people take as they find sanctuary, awaken, engage with the program, and recover their integrity, passion and purpose. In Part IV we conclude with a summary of the research on which the program and this Handbook are based. Each Section includes extensive reference notes that explain, account for, validate, complement or extend the annotated theme. 1.