Rehab, Is It Always Helpful?

A Healthy-Looking Amy Winehouse

The death of Amy Winehouse has produced such a landslide of tosh I hesitate to add anything, but so much of what has been written has been wrong, and in some cases positively dangerous I feel I must contribute.  There have been comments based on her biggest hit along of 'she should have gone to rehab' - rather missing the point that she had in fact just left yet another residential rehab days before her death.
There is the obvious question, does rehab work?  The answer is at best mixed:  as this report in Scientific American shows.  Most drug and alcohol treatment is not evidence-based:  it is faith based.  Once one walks through the looking glass into treatment alternative medicine is the convention. Acupuncture is pushed everywhere even though it just does not work.  Though only as an adjunct to the central treatment, the 12 Step Programme.  A serious contender for the most ridiculous statement on the subject came from Tanya Gold in 'the Guardian':  only the most enlightened doctors will recommend Alcoholics Anonymous or Narcotics Anonymous, self-help groups that sometimes get results, although no one knows why.   Well, in a word, no.
Virtually all rehabs fall into one of two groups:  those which call themselves 12 Step based or "Minnesota Method" (which is virtually identical) or those which say they are not but put in the small print "all clients are expected to attend 12 step meetings while resident and after care consists of 12 step meetings".  Ms Gold states that 12 Step programmes "sometimes get results".
They do if you use the alternative medicine tests of having testimonials:  anecdotal evidence.  When things are tested scientifically things are rather different.  A good summary of scientific studies can be found (along with much else of interest) at The Orange Papers.  Within that page the results of Prof George E Valliant are worth particularly close attention as it follows proper scientific practice in having control groups and Prof Valliant is a firm believer in AA.  Yet his study shows AA performing worse than nothing in many ways.  Especially, as we began with Amy Winehouse with the tendency of those who have undergone AA treatment to be more likely to binge afterwards and the higher mortality rate, which Valliant himself admitted was "appalling".
Another look at AA's effectiveness presented amusingly  can be found here:

If you don't want to watch the whole video (though why anyone wouldn't want watch Penn & Teller eludes me) there is a helpful summary at the end:  if you only remember one thing from this programme you just need one figure: 5% - that's the amount of drinkers who quit with AA and it's the number who quit by themselves.  So if you compare a random guy getting drunk in a bar one day with a guy who has been drinking but decides to turn over a new leaf and goes to his first AA meeting that day there's exactly the same chance of either being sober a year later.
That contradicts one of the AA core beliefs, that alcoholism a "progressive, incurable disease" which inevitably ends in prisons, institutions or death but the facts are that many alcohol and drug abusers do stop; indeed most of those who stop do it without outside intervention.
(Penn & Teller Part 2 & Part 3)
There is a widely-held view that alcoholism is a disease.  This did not originate with AA but it is largely because it has been repeated so frequently by AA that it has become so widely accepted.  The philosopher Herbert Fingarette, isolated the treatment paradox: "If the alcoholic’s ailment is a disease that causes an inability to abstain from drinking how can a program insist on voluntary abstention as a condition for treatment?" His book Heavy Drinking, the Myth of Alcoholism as a Disease is essential reading for anyone interested in the subject.
Somehow AA, its siblings, NA, Al-Anon and all the others have managed to establish themselves as the ultimate authority on addiction without their tenets being checked. The image presented is of benevolent self-help groups deliberately down-playing the cultish aspects and purpose of the 12 steps being to induce a religious conversion.  There is a lot more which could be said on this subject, but for now I would recommend browsing the Orange Papers subtitled 'One Man's Analysis of Alcoholics Anonymous and Substance Misuse Recovery Programs, and Real Recovery. An Online Book.'
Instead let's return to poor, talented Amy Winehouse.

A more recent picture.

She was a woman with problems.  In addition to her abuse of alcohol and other drugs she self-harmed, some would say the tattoos were as much self-harm as cutting herself, she had eating disorders, clearly she had great problems with self esteem and how she saw her own body, she was involved in at least one highly destructive relationship.
Some of the things AA teaches include.  "You are powerless over alcohol and drugs, have one glass of wine and you will automatically be back to the worst you've ever been, so there's no point stopping after one glass of wine, you may as well be injecting speedballs, in fact you will because you're powerless."  And "It's not your fault, it's a disease and you're powerless" but later "it's sin which can only be removed by God".  And to get God to forgive you you have to do your Step Four, where you confess all your moral shortcomings and defects of character and resentments, reliving all the shittiest moments of your life.  And everything is your fault.  Something bad happens to you, say you've been raped, you're supposed to look for what you did wrong.
Part of the AA programme is destroying the individual's sense of self worth, because AA   founder Bill Wilson reckoned all alcoholics were the same, full of grandiose inflated opinions of themself.  Bill Wilson may have understood himself, maybe he did need bringing down a peg or two in order to help himself, but I'm not sure the frail girl in the picture above needed it.
I'll end this on a personal note.  A few years ago I was in a detox unit and the scheduled event for 11am was a walk in the park.  On that day I was the only inmate who was physically fit enough to walk any distance and had been in long enough to be trusted not to make a run for it as soon as I got outside, so I ended up having a one to one chat with one of the staff.  She was a psychologist, we were about the same age, had some common experiences and it turned into something more akin to a chat between friends than formal therapy.  So when we were talking freely I asked her about how poor the measurable success rate for treatment was, and was told, honestly but 'off the record': "the problem that everyone involved has to face up to at some time is that nothing:  detox, rehab, treatment, 12 steps, makes any difference at all".

Hackgate: where are we?

Now we’ve gone a day or two without major resignations and other matters are beginning to appear on the serious papers’ front pages it seems like the time to attempt rough summary of where we stand.

Was there widespread illegal behaviour in tabloid newspapers?

So far only two tabloid employees, Paul McMullan and the late Sean Hoare have said so on the record.  McMullan memorably in the conversation recorded by Hugh Grant and published in the New Statesman on 12^th April 2011, said this:

Me Ah . . . I think that was one of the questions asked last week at one of the parliamentary committees. They asked Yates [John Yates, acting deputy commissioner of the Metropolitan Police] if it was true that he thought that the NoW had been hacking the phones of friends and family of those girls who were murdered . . . the Soham murder and the Milly girl [Milly Dowler].
Him Yeah. Yeah. It's more than likely. Yeah . . . It was quite routine.  Full Text

This was almost three months before the Guardian printed the allegation that Millie Dowler’s phone had been hacked and the affair entered the stratosphere.  Though this was certainly not the first time such allegation had been made, such as this from the legendarily meticulous New York Times on 1^st September 2010.

When the New York Times investigated phone-hacking they found a dozen journalists who confirmed this, but only one, Sean Hoare, who was prepared to speak publicly.  Mr Hoare died in the midst of the furore.

While there is a temptation to think that is just too convenient before jumping into conspiracy theories it’s worth recalling that Mr Hoare had said that “my doctor has said that with the state of my liver I ought to be dead,” a few weeks earlier.  A man whose body had been wrecked by substance abuse but was still drinking found himself under intense stress:  in those circumstances death is not really surprising.  It would really help resolve this if one of the reporters who spoke to the New York Times (or anyone else who worked there at the time) were to have the courage to take Hoare’s place by speaking publically.

Perhaps the best lead we have today is the Harbottle & Lewis emails, which News Corp claimed supported their “one rogue reporter” response in 2007 to the jailing of Mulcaire and Goodman.  While Lord MacDonald, former Director of Public Prosecutions has said that he found evidence of serious criminality within three to five minutes of looking at those emails.  Perhaps we shouldn’t be too surprised, after all Neil Innes tweets, Harbottle and Lewis were my lawyers when the Rutles "arrived". I was left with no copyright, no writing credit and no producers royalties.

Another possible obstacle to discovering what exactly happened is the names of the police investigations, Operation Weeting into phone hacking and Operation Elveden into Police corruption set up by former Chief Constable of Norfolk, Andy “Don’t You Dare Call ME Bent” Hayman.  This is why.

And then there’s the Champney’s connection.  Sir Paul Stephenson has, of course, announced his resignation as Metropolitan Police Commissioner, in part because of his £12,000 worth of hospitality there, the ubiquitous Neil Wallis found time to work for them, as well as the News of the World and the Metropolitan Police, and Rebekah Brooks’ husband Charlie has his “kriotherapy” spa there.  But the Parliamentary Home Affairs Select Committee will no doubt sniff out any wrong doing, under the chairmanship of the scrupulously financially correct Dr Keith Vaz, who just happens to be a business partner of the owners of Champney’s

A couple of essential documents if anyone wants to understand the sordid state of the UK popular press in the early part of the last decade is the Operation Motorman report, WhatPrice Privacy, which includes details of how personal details were “blagged” and even a detailed price list and the follow up report, What Price Privacy Now which has a fascinating table of how many times publications employed private detective.  Interestingly the News of the World was way down in fifth place behind the Daily Mail where 58 journalists paid for 952 transactions, with the People, Daily Mirror and Mail on Sunday all above it.

Though if this report of the long-rumoured "Black Ops" room at Fox News checks out Murdoch's British travails may seem trivial.

It's not all Murdoch's fault:  those who buy the tittle-tattle help create the environment in which it flourishes.  An important point from an Aussie competitor.

And finally, if anyone has persevered this long they deserve a laugh:  Jon Stewart's take on the scandal.
PS Breaking as this was being written, did James Murdoch mislead parliament on Taylor payoff?

How's That for Power

14.41 Mary Ann Sieghart tweets Will someone please ask Boris whether he still thinks #hacking is a load of codswallop?
Telegraph Live stream:
14.51 Reporters repeatedly challenging Boris Johnson over dismissing the hacking scandal as "codswallop" in September 2010. He insists he made the decision on the information he saw then. He is asked to apologise for mocking those who pursued the matter and refuses.
14.54 Boris Johnson appears to have lost his temper at a question from Jon Snow, answers in raised voice. Starting to look more flustered than usual; fiddles with his tie. And to another question - "Come on, be fair".
Finally, challenged again on dismissing hacking as codswallop, says: "I misunderstood the severity of the allegations." Blames poor information he was given.

How to Leave Twitter by Grace Dent

This morning I received a tweet from someone calling them self @gracedent telling me that the book rabbit has done a big word poo this morning in your device, and, sure enough: How to Leave Twitter: My Time as Queen of the Universe and Why This Must Stop was lurking in my Kindle.


It changed my life. Previously if I had come across the characters, LOLZ, CUTE KITTENS DOING STUFF ROFL!!! I would merely have thought, "don't you know what the shift key is for, moron?" Thereby cutting myself off from the myriad delights of abbreviations, excessive capitalisation and pictures of kittens being cute in less than 140 characters.
How wrong I was. I see now that if Proust were alive today he wouldn't bother with seven volumes of À la recherche du temps perdu when he could shown us all he was a catty old queen with a simple "Rhianna's arse looks huge in that," and have space left over to link to a picture of a manatee.


I did learn one essential thing from this book; while I had spent the last week convincing myself that I was following current affairs by avidly keeping abreast of the latest revelations of the latest naughtiness from Murdoch's playthings in Wapping what I was really doing was sinking ever-deeper into 'the desktop multi-application spiralling circle of hell syndrome'. It's real, it happened to me, even down to having both Tweetdeck open and a browser window open on www.twitter.com and flicking between them as if I'll somehow miss something if I only have one open. Oh and I've never, ever got 'remnants of an internet porn foray' on my computer. Ever. It must have been the cat walking across the keyboard which typed in THAT address.
Even as a relative Twitter novice there was much that had me nodding in recognition, 'the twaddlings of egomaniacs, A-grade inanity, adverts, charity begging, tedious social climbing.' - oh yes, I've seen that. But there was one thing she bangs on about which I hadn't noticed. People having a laugh? Fun? Not really concepts I'm with which I'm altogether au fait, I'm afraid.
Perhaps if I followed cool people like Grace Dent and Caitlin Moran I'd get all the fun she's always going on about. Ah. Right at the end there's several pages of 'why important people like me simply don't have time to reply to all the plebs, sorry.' Maybe she could give me the addresses of @josiedrivel, @suziecamel or maybe even '@SamCram, secretly very boring man. I'd have a lot in common with him.
Or maybe this is the secret of twitter after all that it's a way of being ignored by celebrities in real time. Oh dear, that sounds bitter. I've got to go, Tweetdeck just bleeped, bound to be something important.

PS.  Argh.  One thing I do have in common with Ms Dent: leaving blog posts with broken HTML.  It's not all supposed to be double spaced but I can't figure out how to cure it.

Serendipity

After the mishap of using a manatee as my avatar on Twitter and being followed by 'Weightwatchers Deals' (it wasn't really me.  12 stone something, honest.) I picked out the naked mole rat to represent my quirky, enquiring nature.

Aah, isn't he sweet?

Only to find out, the naked mole rat lives for ages, shrugs off chemical stings and never gets cancer. No wonder scientists are keen to learn the secrets of this small, bald Methuselah.  (New Scientist).
And even more exciting is the source who pointed this out, none other than a Notting Hill neighbour of mine, Ms Nicola Bryant, the woman whose chest spared an 80s viewer from having to look at co-star Colin Baker's costume.

Well, it's better than...

Missing the Point

Pleased to see Prof Wiseman's book. Paranormality is doing well as self-published in the US after failing to find a mainstream publisher. One publisher did apparently suggest they might take it on if it were re-written to suggest ghosts and the like do exist.  Which reminded me of the story of Alan Bennett reading his first draft of Prick Up Your Ears to an American film producer who said he loved it, but could they make a couple of changes, like making this Orton guy American - oh yes, and heterosexual, of course...
PS.  A response to US publishers' failure to pick up Paranormality for Stevyn Colgan.

Swimming with Sharks

1:  Spare Some Change

1pm 2/7/11

There’s always someone after your money.

Very specifically there’s always someone outside Sainsbury’s in Westbourne Grove collecting for charity or selling the Big Issue though the problem is by no means confined to that one spot.  Maybe it’s an official collecting area or perhaps just a profitable pitch but there’s always someone there.  I try not to look at them.

“Collecting for disabled children,” rasped a Belfast accent from somewhere near my right knee.  It was surprising as the slumped posture and elderly clothes of the speaker had suggested that she was more likely to be collecting for a can of Special Brew.  Whatever the cause her aggressive tone and refusal to look at me would have stopped me donating, and the events of the previous day had not put me in a generous mood.

Far too much of it had been spent on the telephone.  I can remember when, in general, the telephone was a nice thing; before interminable menus, recorded announcements and call centres in Bangalore turned it from a way people talked to each other into an instrument of torture.  The phone would ring and I would think cheerily to myself, ‘ooh I wonder who this will be, another party invitation, mayhap, or could it be Ms Ciccione pleading with me to road test her new rubberware’ as I skipped to answer my wall-mounted trimphone. Nowadays the phone ringing elicits high-pitched whimper as I place a cushion over my head.

9am 1/7/11

The first call had gone quite well.  A few weeks earlier my utility company had sent me a letter telling me that my existing tariff was about to expire and that I need not do anything, they would simply transfer me to their Super Easy Bonus Save Tariff  (trans. Very Expensive Mug’s Rate).  All it had taken me was to go to a comparison site, find out the cheapest rate available, the ‘Bet You Won’t Spot This Small Print #22’ from the same company, a couple of soul-crushing conversations with the comparison site, (No. 1, ten minutes of asking me to repeat the same details over and over again then them saying it was too early to do anything and to call back on exact day the existing deal expired, No. 2 they called me back a few days later to ask me to repeat everything I’d said in call No. 1 another half dozen times until I hung up) and  then I was able to call the supplier, give the secret code for the lower rate and, Viola! I had reduced next year’s Gas and Electricity bills by £77.  Don’t let them screw you.

2:  Robbing Banks

 

The next bit of business wasn’t quite so simple.  I had tried to transfer money between two bank accounts.  Everything clickable on either website had been clicked in every imaginable permutation and nothing was happening.  It was time to brave the phone.  After hearing for the 98,738^th time that my call was being recorded for security and training purposes (yes I had gathered that) and why not save yourself time by going to our website, www.gnawyourownfingersoffinfrustration.com, where you can quickly and easily do lots of things (but NOT what I’ve wasted the last hour trying to do, which is why I’ve resorted to the phone) it was  time for the ever popular ‘key in lots and lots of numbers game’.

After keying in your account number, sort code, 2^nd. 5^th and 4^th digits of your password you’re allowed to negotiate a few more menus, key in your telephone number, date of birth, mother in law’s date of birth (Argh, I’m not married, snake; back to square 1) ages of Brad and Angelina’s kids and then you’re finally put in a queue to speak to a human being.  When one eventually answers they ask your for name address, date of birth, account number (by which time the website which you had open earlier to remind you of this has helpfully logged you out for your safety and security).*

After the sweating and shaking had subsided enough for me to speak coherently I learned that the reason I had been unable to transfer money from Bank A to Bank B was that my account with Bank B was an ISA, a long term savings instrument, and Bank B had hit on the money making wheeze of giving you a different account for each tax year.  All I needed to do was open another ISA for this new tax year and they would consent to take my money.

Fortunately I have learnt to treat banks with just as much trust as I would give a tiger with toothache which hadn’t eaten for a month.  “So what happens to all the old accounts you build up,” I asked?  It turned out Bank B offered a decent rate on the current year’s ISA but all the old accounts dropped to 1% after a year.  Now I may not be a qualified accountant but even to the barely financially literate me this spells ‘Rip Off’.  No thanks, Mr Bank.

So, the phone call to end all phone calls.  Go to the paragraph above marked with an asterisk, repeat (except this time add keying in the ages of all Mia Farrow’s offspring except the ones by you-know-who).  And repeat again.  Extra, super-duper long wait before a helpful person answers who says, “No Bank A don’t pull that trick, and we’ll pay the same rate on last year’s deposits as on this year’s ISA”.

“Could I open one,” I whimpered, between sobs.

“I’ll just transfer you to our ‘Opening an ISA’ department.”

A mere five minutes or so later someone answers, I only have to key in a few dozen more digits.  “I’ll do it,” I mewled.

“There is a bit of reading I have to do.”  Page after page of incomprehensible gibberish comes back at me.  Much of it seems to be the same paragraph, over and over again with a single word changed.  It’s like listening to Ed Milliband. 

“Yes,” I moan during pauses.  There are lots of pauses where I’m expected to assent. Finally, unbelievably, it ends, and I’m still conscious.  “Now about transferring the money from my Web Saver Account, like you said we could?”

“Ah.  That will mean transferring you to the ‘Closing Down Internet Accounts Department:  I’ll just put you on hold for a moment.”

The minutes dragged by.  Pressure sores were forming on my ear, and I began to wonder if I’ll end up in A&E having an ingrowing telephone receiver surgically removed.  Silence mounted, I had long ago exhausted all possible interest in the game of ‘keep all the bank tabs open by clicking them before they log you out’.  After a few plaintive calls of “is there anybody there?” I could take no more and hung up.

When the pain began to subside I did a rough calculation. I had stopped Bank B ripping me off.  Good; it’s a matter of principle, don’t let them rob you by inertia.  But this hour of agony has gained me less than forty quid in interest over the next year.

3: Night Life

3am 2/7/11

The doorbell buzzed.  And again.  And again.  Long, long rings.  Angry-sounding rings, or, more likely, desperate ones.  I lay in bed.  There is no point shouting at a person ringing your door in the middle of the night to go away:  that’s opening a channel of communication, “please, please let me in, I’ll explain, just let me in, I’ve got a good reason, please,” and it would go on much longer.

The writer William Donaldson once said (approximately, I’m quoting from memory) “I’m the kind of person who will always answer the phone at one am because it will be a drug dealer or prostitute rather than a bank manager.”  (For more on Donaldson’s louche life his Wikipedia entry is here or read the fascinating biography You Cannot Live As I Have Lived and Not EndUp Like This: The thoroughly disgraceful life and times of Willie Donaldson. ByTerence Blacker.)

I used to live something like Donaldson.  Which is probably why the door still occasionally rings at absurd hours, it’s an echo of more reckless days. Things have changed now.  I’ve got more possessions that I care about, more to lose, and rather less in the way of libido that I used to have. I don’t want to seem like some fuddy-duddy old materialist but I’ve paid for my laptop and Kindle and DVDs and I’d rather I had then than anyone else, that’s all.  Plus I’ve acquired a liver which couldn’t endure a third bout of Hepatitis, the rest of my body couldn’t take a second course of Hep C treatment and perhaps I have gained some common sense.

I remember one occasion when one of the night people I knew brought round a friend, much to my annoyance.  When the one I did know was out of the room her friend said to me, “you have to be careful with these people:  they mistake kindness for weakness.”

The biggest thing is; it’s no fun when you’re constantly watching your back.  No matter how many drugs you take the need to be constantly watching out destroys the buzz.  So no more 3am visitors, though if it were a choice between that and spending my days saying my prayers and “Working the Steps” pass the syringe.

 

4:  Spare Some Change 2

1.30pm 2/7/11

I had bought my lunch and was almost home.  A tiny voice appeared by my right knee, “anything for two pounds.”  There was an absurdly-pretty little girl, maybe three years old, standing in a doorway with a couple of picture books and small toys laid out on a toy chair beside her.  A huge, involuntary “Aahh” formed in my mind:  she was so irresistibly cute.  But I really didn’t need a picture book or a stuffed toy, and it dawned on me that she might be cute now, but this was precisely the sort of behaviour with which the crazed-eyed business-speak-babbling sociopaths on the Apprentice started and therefore definitely not to be encouraged. 

A few steps down the road a man spoke to me.  He had a thick beard, looked a little older than me, though that was probably the beard and the lifestyle:  being homeless adds a good ten years to your appearance:  no smell of booze at all, unusually.  He started to give me his spiel about how he’d been to ‘the Centre’ nearby (whatever that was) but they had run out of sandwiches and he was hungry.

I’d run out of resistance.  Keeping hold of money is just too much hard work.  “I don’t need the story:  Have a couple of quid.”

“No, honestly, they had run out of sandwiches…”

L'esprit de l'escalier:  at the time I couldn’t think of anything to say and just walked away, but afterwards I realised what I had wanted to say was “have a good fix”.  You can’t keep holding on tight all the time.