Deal says she’s been having nightmares. Linda had asked if she’d been getting any rest, and Deal had to shake her head no, no, because she’s been having these nightmares and they’ve been keeping her up. Last night, Deal says, she fell asleep for a while, but it didn’t last. “One of the girls woke me up,” she says, “’cause I was screaming in my sleep.”
Deal says she’s been trying to relax, but she’s been having these nightmares since she was a child. That’s why she started using drugs in the first place: they let her sleep. But now she’s off, just on a small dose of methadone, and she can’t sleep again. She’s been depressed, she’s been tired, she’s been sick, and her food won’t stay down. She feels good some days, bad the next, she’s confused, and her wallet was stolen two nights ago. She has liver cancer. Her eyes point in two different directions, and they are glazed, still, as if they wish they were blind and couldn’t see what they see. Deal wants to talk to the other girls at her shelter, but if she does, she’ll get teary-eyed, and they’ll call her a crybaby.
The six other women around the table are quiet for a moment after Deal’s speech, and then they are all responding. “If you want to talk to me, I ain’t gonna call you no crybaby,” Linda says. “I probably cry with you.” Everyone else calls out approval, but Deal seems unconvinced. She slumps in her seat and says nothing, so Linda moves on with the meeting.
“Go to Hebrews 11,” she says, turning the pages of her bible. “Who wants to read?”
Rosalind, sitting to Linda’s left, opens her own bible and begins: “Now faith is the substance of things hoped for, the evidence of things not seen.”
Linda looks up over her reading glasses and asks who can explain the passage. Yvette volunteers right away. “It means faith in God first,” she chirps. “God goes before everything and everybody.”
“Mmm hmm,” Linda hums.
But Deal looks more confused than she did before. Linda notices and asks her what she’s thinking.
Deal shakes her head, her cross-pointing eyes and pinched face expressionless except for a wrinkled brow. “I believe but… how come when addicts get clean they start going to church and they get this whole holier-than-thou thing?” she says. “How come they talk about God so much?”
I have to stop my pen when she says that. I have to look up from my notes and look into her eyes because now Deal is asking them the question I had been trying to ask them myself.
Village of Power is a day program for African-American women recovering from drug addiction that sits in the basement of a health center in New Haven, Connecticut, two blocks down the beleaguered Dixwell Avenue, two blocks from Yale. In the newly-proliferating world of community substance abuse treatment centers, Village of Power in many ways stands by itself. Unlike many other programs, it is primarily staffed by former drug abusers, women who can sympathize with their clients on more than a theoretical level. Unlike many other programs, it has a workshop devoted to sewing, where clients can make ponchos, hats, and scrunchies, piecing together their lives while they cut out their addictions. And unlike many other programs, the core of Village of Power’s treatment — beyond the usual focus on self-esteem, impulse control, and relationship stability — seems to be religion. Tucked among the program’s group therapy sessions on “Relapse Prevention” and “Recovery Skills” are at least three meetings every week focused specifically on spirituality. Village of Power brings in community ministers to talk to its clients, shows evangelical videos of inspirational preachers, and organizes a weekly Rapha class, which is a combination Bible study and therapy group named for Jehovah Rapha, God Our Healer.
Far beyond therapy groups, religion is ever-present at Village of Power. Clients mention God at every hour of every day, at every group they attend. In the sewing room, they make pillows embroidered with “I love Jesus” or vestments to give to the pastor at their church. And all over the walls of the maze-like center (painted a feminine purple to make the women more comfortable) clients can find posters and paintings and tapestries referencing the Lord, from a woven rug displaying a biblical scene to a simple sign proclaiming “God Bless!”
But most importantly, unlike many other treatment programs, Village of Power works. According to Ed Matison, a New Haven alderman who runs South Central Behavioral Health Network, the umbrella organization for many substance abuse and mental health clinics in South Central Connecticut, Village of Power has an impressively low relapse rate. Many of its former clients go on to become counselors and social workers, and one has even started her own design label. Women who attend Village of Power say they love the program and often will do anything to get there, a stark contrast to the typically reluctant relationship between drug abusers and rehab. According to Matison, Village of Power’s success is tied up with its reliance on religion. While the use of religion in substance abuse treatment (once discouraged or even banned) has become more common in recent years, few groups use spirituality as explicitly as Village of Power, and that’s why, Matison says, the clients keep coming back.
I call it Bible thumping,” Deal says, looking at Linda nervously.
Linda, who is large, square-faced, and at this moment, fire-eyed, snaps back: “I call it grasping onto life!” Everyone else is silent at Deal’s statement. This is Rapha, a time for peace. One girl gets up and leaves as if to escape the storm she knows is coming.
“I don’t understand why…” Deal says. “Addicts… they talk about God a lot… it’s constant. It’s constant.” Deal speaks searchingly, leaving long pauses between her words. She doesn’t mean to be antagonistic. She’s struggling, and she really wants to know why God, why… but Linda is taking this as a challenge.
Everyone starts to answer Deal. Linda reads out the Lord’s Prayer and says she’s going to get Deal a walkman and some spiritual tapes so she can get some inspiration. Rosalind starts going on about how God is sinless, how he is “the Father, the Son, the Holy Spirit. Always in three. The trinity.” Johnnie-Anne’s gravelly voice cuts above the growing din: “God gave you eyes to see,” she says, gesturing to herself and then to Deal. “Ears to hear. Heart to love. Faith to heal.” The room is loud now, everyone talking at the same time, then looking at Deal, who is crying.
“I know that!” she says. “You’re not understanding what I’m saying.”
Everyone quickly quiets down. Johnnie-Anne, who is sitting next to Deal, slowly hands Deal a tissue and puts an arm around her shoulders.
“I didn’t mean to get deep,” Deal says, “I just had a question. I believed all these years, but my liver hasn’t gotten better.”
Linda counters, “That’s because of your faith,” but Johnnie-Anne looks at Deal and shakes her head. “You gotta put all your trust in God and he will heal you,” she says. “He’s seeing you right now, through me, you crying. We’re not saying things to hurt you; we’re saying things because we love you. It’s just you have to trust in our Father. He’s our Father and our daddy.”
Deal wipes her eyes and brightens a little.
“It ain’t your time,” Johnnie-Anne says, “so you might as well turn it around.”
Sue Feldman, the founder of Village of Power, gets it, but only to a point. She understands the importance of spirituality to her clients’ recovery, to be sure. She understands that for the African American women she treats, faith is an avenue back to their communities, that reading the Bible improves clients’ literacy, and that saying a prayer is eminently soothing. She understands that the women at Village of Power love the spiritual aspect of her program, but she doesn’t quite understand, as Vivian would tell me later, that they long for it.
“We kind of buck the system, push the envelope,” Sue says, smiling. Unlike almost all of her clients, Sue is white, her hair styled in a lemon-yellow puff, eyes ringed in black eyeliner, lips painted hastily in coral. Twenty-five years ago, she says, when she was first starting out as a social worker, the theory was that a person’s religion was an element of the personal domain that had no place in the world of public healing. Fifteen years ago, she says, people studying behavioral health started to focus on culturally sensitive treatments that often forced providers to recognize their clients’ ethnicities and specific spiritualities, but still, treatment programs did not often include “spiritual modalities.” But six years ago, she says, she helped to develop the pioneering Amistad Program for drug abuse recovery, which, like Village of Power, is located in New Haven. Amistad offered spirituality-inspired classes, and now, so does Village of Power. That whole New Age thing, she says, the spiritual centering and calming, didn’t really touch the African-American population. It was primarily a white, middle-class movement, and African-Americans just never really identified with it. “Their pathway to self-actualization has remained the extended family, the community, and the church,” she says, nodding her head sagely in a very new-agey way.
“Other programs see spirituality as exclusionary,” Sue says. “They are afraid they are going to be perceived as pushing religion.” That’s not a problem at Village of Power. “We just provide what the clients ask for,” she says with a smile, and then it doesn’t really matter if she gets it or not.
This morning Deal is tired, slumping in her chair as she was in Rapha, chin on her chest and eyes closed. As everyone gathers for the Monday morning meeting, chatting and laughing and exchanging weekend stories, Deal stays slumped, still. She looks like she’s in pain.
The meeting is held at 9:30 a.m. in a low-ceilinged room ringed with black plastic chairs. Sue sits resplendent in her lipstick and eyeliner and a black pinstripe pantsuit in one of the chairs while about 15 clients settle themselves into their own and quiet down.
“Good morning everyone!” Sue says, and some of the women chorus back “Good morning, Sue!” Sue and Josephine, one of the case managers, give some announcements and then Sue has everyone stand up for a morning stretch. “Sue, you alright!” one woman laughs, as Sue wiggles her skinny hips. Other clients whirl their arms or dance, but Deal doesn’t stand up. Her eyes are open now, but she is clearly not feeling well.
“OK, let’s go around, say your name, and we’ll all say hello,” Sue says as everyone sits back down. Sue works her way around the room, asking each client their name (“Who are you?” she says, though she clearly knows) and the women respond with an account of their weekend that varies from the admirable (“I went to church on Saturday night. The spirit was very high.”) to the unfortunate (“I did smoke marijuana. I didn’t smoke nothing else.”) When Deal’s turn comes, the room gets quiet.
“Hi, I’m Deal,” she says slowly.
“Hi Deal,” Sue says, “How was your weekend?”
Deal’s face is crumpled. “I don’t know… I was sick. I didn’t feel well.”
“Did you see a doctor?” Sue says. “How did you spend the weekend?”
“Throwing up,” Deal says, lowering her eyes.
“Throwing up?” Sue answers, grimacing slightly. “Well, let’s all say something to Deal — that we are hoping that she feels better.”
A woman named Edith volunteers. “Deal, I hope you feel better and I hope you still come to Village of Power because I really like you.”
“Aw, that’s sweet,” Deal says, sounding genuinely touched.
“We’re praying for you Deal,” Johnnie-Anne says.
Near the end of the meeting, a woman tells a story about how over the weekend, she found a boy in her teenage daughter’s closet, “buck naked with his hands covering his privates,” and in explaining her reaction she, like so many of the other women, comes back to her faith. “My faith,” she says, “that’s the only thing that kept me calm.” God is always good, she says, and always working. “See, he sent us this guest to get the message out.” Once again I have to look up from my notes, out from my seat in the corner of the room, because this time she’s talking about me. “You don’t know it,” she says, “but you’re being used right now.”
Josephine turns around and looks at me. “In a good way,” she assures me.
“In a good way,” the woman repeats.
Traditionally, says Art Margolin, a professor of psychiatry at the Yale School of Medicine, addiction therapy was negative. The addicts had to hate themselves before they could be reborn as clean. A spiritual approach is a positive approach. “In the spiritual self therapy we assume that the person has falsely identified themselves with their addict self, and they are truly their spiritual self,” he says. “What we have to do is help them reveal this Buddha nature to the world.”
Margolin and his wife, Kelly Avants, who is also a professor at Yale Med, are in the final stages of developing a substance abuse treatment with a Buddhist foundation called The Spiritual Self Schema Development Program. This “non-theistic philosophy” is accessible to people of all faiths, Margolin says. The core idea of the intervention is that when people are addicted to drugs, they are living as their “addict self.” The intervention attempts to make its clients recognize that they also have a “spiritual self,” and then through meditation and visualization, over the course of three months, develop the spiritual self into a full-blown self schema that the addict can inhabit. Although the program sounds far removed from the type of traditional spirituality that characterizes Village of Power, Margolin says it’s not. “We let patients define the spiritual self in terms that are meaningful to them,” he says. “For Christians, that’s in terms of God.”
How successful is the spiritual self schema? As successful as Village of Power, Margolin says. “We found that the patients absolutely love the therapy and want to continue receiving it,” even after the required course of treatment, “which is somewhat unusual in drug addiction treatment.” Programs like Alcoholics Anonymous have made reference to spirituality for years, Margolin says, but the incorporation of personal spiritual beliefs into a clinical setting is definitely something new and definitely something good.
But what about Deal’s complaint that when addicts talk about God, “it’s constant, it’s constant,” as constant as their drug use? “If a person is reducing or transferring an addiction from something that causes them psychological and physical harm to something that may not,” Margolin answers, “then I would say that may be a step in the right direction.”
Vivian’s office is as small, quiet, and spare as the cell of a monk, and her large purple windbreaker drapes around her shoulders and forearms in a way that cannot help but suggest a minister’s robes. Eyes closed and hands clasped, she looks like an angel as she leads the morning prayer, even if she’s really just Vivian Fripp-Elbert, an elder at her church and the director of the sewing program at Village of Power.
“So we’re gonna open up with a prayer,” Vivian says to the group assembled in her office, which includes two other women, Rosalind and Georgia. “Heavenly Father,” she begins quickly, “we just thank you for your goodness, your mercy…”
Vivian, like her office, is small and quiet, with a voice like milk and honey. She is about sixty but still beautiful, her delicate skin gently tacked over prominent cheekbones, the corner of each eye dotted with small black moles. As she prays, she keeps her eyes closed and her voice glides out questions like, “How to run this program in the name of Jesus, oh Lord?” Her voice goes up and up in pitch and volume, and Rosalind and Georgia start responding more and more, with echoes of the prayer or simply “Amen.”
Vivian’s morning prayer group is organized casually, its attendants the most faithful of Village of Power’s clients and often the most successful. Rosalind is a model client who has been clean for over five months and got so good at fixing the program’s sewing machines that she recently got a job with their maintenance company. Georgia is a Village of Power graduate, once a drug addict, now a student interning at the program as part of her training to be a social worker. When Vivian prays, Rosalind and Georgia open their hands, palm up, and hold them at their sides, shaking them slightly at moments of particular intensity, then shaking them harder.
You see, Vivian says after the prayer when we walk out of her office and into the sewing room, the church is everywhere believers are, so we here are the church. “You have faith in God, right?” she asks me.
Without a moment to think I mumble “Mmm hmm.” I don’t know exactly what my answer would be if it wasn’t Vivian asking me, or if I wasn’t in this sweet-smelling room at Village of Power, surrounded by a feeling of Vivian’s grace.
“You’re part of the church!” Vivian says.
Vivian’s idea of why spirituality helps her clients overcome their addictions has the same philosophical underpinnings as those of Sue and Art, but she far outpaces her peers in depth of feeling. “People need to know that they are powerless,” she says. “Because addiction has a name and it has a voice. So they need to believe in something that has a greater power than the self to bring them out of their addiction, and so they need to come to know that there is a God that is greater than their addiction and that is able to deliver them, and to keep them from harm.” Substance abuse and the depression that so often accompanies it is a state of hopelessness, Vivian says, and God gives clients the hope to stop abusing. “They think that their drug is gonna bring them a high, you know, get rid of their problems, but it’ll only get rid of your problems as long as you’re high, and you can’t stay high forever.” But if you believe in God, she implies, then you can.
For Vivian, clients who hesitate to embrace the role of religion in their recovery — clients like Deal — just need a little more time. “One thing that we always say is that you don’t have to come to prayer, you don’t have to come to Rapha,” she says. It’s totally OK for clients to say, “I’m just not really ready for that yet.” Vivian smiles and toys with the “I love Jesus” lanyard hanging around her neck. “And I say, all right, because we’ll pray for you.”
This time, Deal is sitting in a chair at the back of the circle, across the room from me. She still looks tired, but she has headphones looped around her neck, and I’m almost positive they’re hooked up to the spiritual tapes Linda offered her during the Rapha group.
Sue begins the Friday morning meeting in her soothing tone. “Now let’s go around the room,” she says. “On Friday — what do we do on Friday?” The women in room mumble answers. “What we accomplished, right? We reflect on the positive things we accomplished so we don’t forget them or minimize them,” Sue says emphatically.
The Friday meeting works a lot like the Monday meeting, with everyone introducing themselves, detailing their troubles (“I did smoke yesterday because my daughter didn’t show up.”) or successes (“And this Saturday, I start my job.”). When Deal’s turn comes, she straightens, her voice surprisingly energetic.
“Hi, I’m Deal,” she says.
“Hi Deal,” everyone echoes.
“Um, I got some good news yesterday,” Deal says. “My doctor, he wants me to have surgery, and he told me I was a good candidate for a liver transplant.” At Deal’s announcement, Sue cheers, and the room breaks into applause. It seems like this is something everyone has been waiting for. “So, I’m going for a lot of blood work,” Deal says. “The surgeons are going to take me because I’m clean.”
Sue beams. “How are you feeling about that, Deal?”
“I was very happy. Even the doctor hugged me,” Deal says. “I’m gonna be on the transplant list.”
Despite the drama of Deal’s announcement, Sue sticks to the goal. “So I think staying clean and sober was a prerequisite, right, for getting on the transplant list,” she says. “So how have you been staying clean and sober?”
“Uh, I’ve been coming here,” Deal says. “I’m getting more support from the staff and the ladies and everyone else. There’s more prayers being put out and more time that I do what I have to do.”
“So you’re feeling that the support from your sisters here is helping you have strength and hope?” Sue asks, and Deal nods yes. “Wow,” Sue coos. From anyone else, the tone would almost be mocking, but from Sue, it is undoubtedly sincere. “Now let’s all look at Deal and say ‘We’ll continue praying for you,’ ” she says.
Immediately, enthusiastically, the room choruses, “We’ll continue praying for you Deal,” and breaks into applause again.
When the applause dies down, Sue finishes up the session. “And I know you’ll be praying for us, too,” she says to Deal.
Deal’s crinkled face breaks into a peaceful smile. “Oh yes,” she says, and for this moment, I have no questions.