Home » Blogs » Trauma Informed Systems » One Heartbreaking Way Treatment Centers Incentivize Illness

One Heartbreaking Way Treatment Centers Incentivize Illness

Carrott.StickA few weeks ago, I had the privilege of teaching at an organization that is named a “treatment program” for addicted women who live there with their children.  I met with the staff in the chapel where the chairs were predictably lined up so that everyone looked at the back of everyone else’s head.  Soon, though, the chairs we had replaced the chairs with a bunch of square luncheon-like tables with seats pointing in at all of our faces. Now there was a place to put food, drink, papers, elbows.  Especially elbows.

The service providers wanted to know the causes of addiction: some believed addiction was a reflection of a woman’s character; others believed it was the product of the chemical soup in addicts’ brains, all called it an illness.  And they wanted to know how to treat these women’s illnesses – these women who with their children had all come to love the facility and the service providers along with it.  They wanted to know how to help these women struggling with the illness of addiction.

“So,” I asked, “this is a treatment program for women and their children, right?”

“Yes,” they said.

“And the women and their children love you, and love being here, right?”

“Yes,” they said proudly, “many of them come back often!”

“And to be here, receiving this love, they have to be in active addiction, correct?”

There was a long silence.

If a woman must be an addict to have a caring and supportive relationship, and if living somewhere where she can have that love includes the entry requirement of addiction, then these women must relapse in order to earn love, and you can see how the treatment program will always be a revolving door.  Does anybody see how (ahem…) crazy this is?

The program wants women and their children to come in, get clean, learn how to stay clean, and return to the community as examples of better health and healthier living.  This is the definition of “successful treatment“.  The paradox is that in the time women and their children are at the center, they form bonds they can’t find outside. A woman who is loved and cared for—and who must be addicted to access that love—is in a heck of a spot.  To give up addiction means to give up love.

So the women “get better,” leave the facility, leave the relationships they created, and then the pain of whatever happened to them that got them using in the first place returns in an environment where they are perhaps not as loved as they might have been in the “treatment program.”  What do you think happens then? Can it be anything but relapse?

So what’s the answer? Certainly it’s not to avoid forming loving relationships in treatment! No, the answer is dealing with trauma. Trauma is the driver that causes people to need relief.  When the world is too big and overwhelming, when the big people around you can’t help you find relief, you find whatever you can.  Dissociation, drugs, sex, work, money, pick something, anything that makes you feel better (or not feel at all).  When the goal of treatment is disconnection from a group where one experiences connection, love, and caring, the result is often relapse.

But if the goal of treatment is the real processing of the underlying trauma, then people struggling with addiction may be more equipped to find the connection they need in the world outside treatment. Only by equipping people with the skills to look beyond trauma can treatment programs prevent relapse.

– Please join me on Facebook to discuss personal and organizational trauma, healing, ethics, and innovation.

One Heartbreaking Way Treatment Centers Incentivize Illness

Elizabeth Power, M.Ed.

Elizabeth Power, M.Ed., CEO of EPower & Associates, Inc. is a sought-after speaker, facilitator, teacher, and consultant. Her firm's specialty is helping organizations make and manage change through learning and doing. Her mastery of diverse interests and innovation has been recognized worldwide through awards and publications across a wide spectrum of disciplines. Her firm provides services in the mental health and disability communities and to early childhood educators, families, parents and teachers.

9 comments: View Comments / Leave a Comment



APA Reference
Power, E. (2014). One Heartbreaking Way Treatment Centers Incentivize Illness. Psych Central. Retrieved on September 29, 2020, from


Last updated: 6 Apr 2014
Statement of review: Psych Central does not review the content that appears in our blog network ( prior to publication. All opinions expressed herein are exclusively those of the author alone, and do not reflect the views of the editorial staff or management of Psych Central. Published on All rights reserved.