Robin Williams, Rehab, and Reorientation
Robin Williams, the brilliantly talented comedian and actor, was found dead in his California home on August 11, the victim of an apparent suicide.
News coverage of his death reviewed his eclectic career, from the 1970's TV hit Mork and Mindy to his Oscar for Good Will Hunting.
However, the media also reviewed his long history of drug and alcohol abuse. That began during his early days of television stardom. Williams reportedly gave up cocaine and alcohol, though, after his friend John Belushi died of an overdose and Williams became a father.
Williams spoke candidly about his addictions in a 2010 interview with the British newspaper The Guardian while on a publicity tour for his film World's Greatest Dad (in which, ironically, he played a writer who fakes a suicide note and journal and attributes them to his late son).
Apparently, Williams quit alcohol and drugs cold turkey in the early '80's, without any professional therapeutic intervention. He reported that he stayed sober for twenty years, but then began drinking again while working on location in a remote town in Alaska. After three years of drinking, a "family intervention" persuaded Williams to enter "rehab" (residential drug and alcohol rehabilitation) at the Hazelden Addiction Treatment Center near Newberg, Oregon, where he stayed for two months. After that, Williams told The Guardian, he continued to attend meetings of Alcoholics Anonymous every week.
Then just last month, news broke that Williams had again returned to rehab, this time at a Hazelden center in Minnesota. A spokesman for Williams said that he had not relapsed into substance abuse, but was "simply taking the opportunity to fine-tune and focus on his continued commitment [to sobriety], of which he remains extremely proud." That was on July 1 — but six weeks later, he was dead.
In the wake of Williams' suicide, many TV commentators and friends of the late star talked about the challenges of mental illness (Williams suffered from depression), addictions — and rehab. I saw comedian Andy Dick say, "I've been to rehab seventeen times."
In light of this history, I have only one question for socially liberal political activists — why aren't you trying to outlaw rehab?
I ask the question because such activists are trying to ban a form of mental health treatment — not drug and alcohol rehabilitation, but "sexual orientation change efforts" ("SOCE"), also known as "sexual reorientation therapy." Such therapy involves assisting people with unwanted same-sex attractions to overcome them.
Why would someone want to change their sexual orientation? Some such individuals are simply disillusioned by their experiences in homosexual relationships. Some have legitimate concern about the well-documented health problems associated with homosexual conduct (especially among men), such as high rates of sexually transmitted diseases, of which HIV/AIDS is only one example. Others may seek help in conforming their behavior and lifestyle to the teaching of the religious faith to which they are committed. Some may aspire to a traditional family life, raising children in a home with both their mother and father present.
Whatever the motivation, there are those who have simply made a choice to walk away from the homosexual lifestyle, without clinical help — much like how Robin Williams simply stopped using drugs and alcohol in the 1980's. Others have sought professional help, perhaps at the urging of family members, in the form of "sexual reorientation therapy" — much like when Williams entered a formal alcohol rehab program in 2006. Whether simply through personal development, religious counseling, or with the help of a licensed or unlicensed counselor, thousands (if not millions) of people have experienced significant changes in one or more of the elements of their sexual orientation (attractions, behavior, or self-identification).
Homosexual groups, however, have successfully pressured professional organizations such as the American Psychological Association to discourage such therapy. More recently, following an example set in California, legislators in several states have introduced bills to forbid licensed mental health counselors from engaging in SOCE with minors at all. Meanwhile in New Jersey (which already passed such a ban), the Southern Poverty Law Center has sued even unlicensed SOCE providers, charging them with "consumer fraud."
Critics of reorientation therapy make two charges — that it is ineffective, and that it is harmful. But they support these charges only by holding such therapies to a standard of "effectiveness" and "safety" that is impossible for any mental health treatment to meet.
Some (but not all) clients of reorientation therapy testify to a complete transformation from homosexual to heterosexual, experiencing a change in their identity, behavior, and attractions. Others may change their identity, control their behavior, and begin to experience heterosexual attractions, but still experience occasional homosexual attractions as well. Still others may change identity and behavior, but continue to struggle with primarily homosexual attractions. Some clients change little with respect to their sexuality, but still find the therapy beneficial in exploring their feelings, family dynamics, etc. Some may seem to achieve significant changes for a period of time, but then suffer relapse. And finally, a few may simply experience little substantial change.
This range of outcomes is no different from any other form of mental health treatment — such as drug and alcohol rehabilitation. Yet critics of reorientation therapy claim that "it doesn't work" because the proportion of clients who achieve complete transformation on a permanent basis is less than 100%. Can rehab live up to this standard?
There is actually no scientific evidence that reorientation therapy is more harmful than helpful. There are, however, anecdotal accounts of people who claim they found it harmful, or who had negative experiences after such therapy, such as depression or even suicide. However, mere chronological correlation is not scientific proof of causation — any more than Robin Williams' suicide was "caused" by his recent return to rehab.
The real reason why homosexual activists object to reorientation therapy has nothing to do with science or mental health. Instead, it has everything to do with politics and ideology. If it is tolerable for some people to try to change from "gay" to straight — and for others to help them with the process — that might imply that it is tolerable to believe that there is something wrong with homosexuality itself. For ideological reasons, that is a belief that homosexual activists want stamped out at all costs.
If we were to apply the same standards to drug and alcohol rehabilitation that the homosexual activists want to apply to reorientation therapy, why not ban rehab? After all, since some people go to rehab and still suffer relapses afterwards, rehab is clearly "ineffective." Robin Williams actually went to rehab, and shortly thereafter took his own life. Does that not clearly indicate that rehab is not only ineffective, but downright harmful? In addition, there are surely people who consume alcohol or use illicit drugs but are still able to function and make productive contributions to society — so there is obviously nothing inherently wrong with alcohol or drugs. Allowing people who struggle with their alcohol or drug use to seek professional help to discontinue them implies there is something wrong with them — thus reinforcing the unfair social stigma which attaches to people who use alcohol and drugs. And surely "family intervention" to force someone into rehab is a violation of their personal autonomy. In light of all these concerns, how can we allow the fraud of "rehab" to continue?
This kind of reasoning, of course, would be clearly absurd. There is no kind of mental health counseling that can guarantee it will substantially change the lives of 100% of its clients for the better. Those who do experience improvement may still struggle with temptation (hence the weekly AA meetings for support). Even among those who succeed in rehab, there can be no guarantee that none of them will, at some time in the future, relapse into the problems which caused them to enter treatment in the first place. Furthermore, the fact that a negative outcome (like suicide) follows a treatment like rehab chronologically does not mean that the treatment caused the negative outcome. It is far more likely that an underlying pathology (in Robin Williams' case, depression) was the cause of both his substance abuse (which led him to rehab) and his suicide.
It would be absurd to ban rehab because it doesn't work for everyone; doesn't work 100% by eliminating all temptation; isn't always permanent; is sometimes undertaken because of family pressure; or because bad things may happen afterwards. It would be equally absurd to ban rehab in order to protect the self-esteem of people who do not consider their alcohol or drug use to be a problem.
But the argument that we should ban sexual orientation change efforts (SOCE) is equally absurd — because it relies on all the same fallacious arguments.
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