Tribal Transplant

– Marcus Shumate, LPC, LCAS,

The topic of “tribalism” has been the topic de jour in various arenas of conversation over the last several months. The focus of these various conversations often appears directed towards discussing the dangers of tribalism. Perhaps it is a good idea to define terms and clarify what tribalism means in the context of this blog. Tribalism, as its being used in this blog, refers to the notion that people are prone towards forming insular groups that they ardently seek to remain in; regardless of that group’s net benefit. The conversations that are happening around this tend towards discussing the negative and harmful components of tribalism. I tend to think this limits an interesting conversation that can be pushed into some novel territory.

If the pursuit of a “tribe” is an inherent psychological drive for humans, why fight it?  After all, it certainly seems to fulfill some of our baser needs. Without common pursuits with others life is much more lonely and insignificant; at least it is for me. It’s also clear that getting stuck in an unhealthy tribe can be difficult to escape. This is due to the insular nature that asks its respective members to abandon any rhetoric or behaviors that threatens the cohesiveness of the tribe. However, what if we accept that our pull towards tribes is something to be embraced and directed towards the good? This is the approach we’ve taken in developing our Young Men’s Extended Care program.

It’s fair to say that most of our patients in the Young Men’s Extended Care program belong to groups that are oriented towards substance use. For most people this is normal and poses minor problems, but our patients are different. They arrive to Pavillon needing treatment for substance use disorders. Their relationships with substances have demonstrated to be problematic. The fear of the repercussions of their substance use often drive families and patients into treatment, but that fear can begin to erode and, in the case of most young men, be replaced be a more primal fear: expulsion from his friend group. It’s almost without fail that at some point in the context of treatment the young person begins to take inventory of his respective friends and recognizes that they may pose a danger towards his recovery efforts. Despite this recognition it may not dissuade him from returning to the friend group. An even more discouraging notion is that he may return to this group because of a sense of hopelessness regarding his recovery efforts. After all, why get sober if you are destined to be lonely or isolated from your peer group?

A major driving force behind the reason we approach young men’s extended care in the way we do is because we know that this question permeates so much of the young patient’s mind, and, rightfully so. As providers, we owe it to our patients to address these questions in an authentic and empathetic manner. We can’t simply dictate that they not return to the group and hope that they listen to us. We all understand how great edicts from an authority figure work on changing human behavior…sarcasm is most certainly intended to be read into that claim. If we intend to address these questions it’s probably a good idea to apply a strategy in the way we do it. In developing our program we have sought to create a culture that embraces tribalism; just, its tribalism to the good and it’s not top-down. We want it to be organic and authentic or, we suspect, it probably wouldn’t work as well. For example, instead of chemical dependency techs, we use recovery guides and this isn’t simply a double-speak. We mean it. Our recovery guides function as an organic representation of a happy and vibrant recovery and as a person that can help guide our patients into a new tribe. In keeping with this ethos, we have our young guys working with a trainer that creates intense and personalized work out program. This trainer forms relationships with our patients and creates a cohesive and physical struggle for the patient’s new tribe to organize around. This fosters a sense of common and shared positive, healthy, fun, and adaptive experience for the guys to organize around. In addition to all of this, the guys get to have an experience in which their sense of confidence grows through overcoming arbitrary limitations that they have placed on themselves. This cultivates a level of intimacy and vulnerability that greatly enhances the clinical work they do in other groups. It is through these various processes that they patients begin to get a sense that there is a hope for forming a new tribe and that they are free to abandon old and limiting tribes. With this hope they can begin to push themselves through the discomfort of forming new and adaptive tribes.

In our thinking, this is what we want. Treatment is a sliver of time that will pass quickly and when the patient is done here he must launch into developing a life that takes into account recovery-management. If he finds a new group that is conducive to his recovery-management then his chances of remaining in recovery or returning to a state of recovery are enhanced.