View attachment 50209 A prescription painkiller overdose had nearly killed Victoria Gonzalez Vega, but the 61-year-old American was hopeful she’d get a second chance at life—at Retorno, an inpatient addiction program near Beit Shemesh, a desert town near Jerusalem.
The rehab’s brochures and website painted Retorno as “a paradise,” with horseback riding and mountain hikes. They said nothing of the full days spent peeling potatoes or shoveling horse manure. They didn’t mention the use of humiliation as a punishment, or the strange “therapy” where addicts were screamed at and insulted by their peers until they broke down. And though Gonzalez had signed up for the English program, very few of the other women or counselors ever spoke it.
But it was the silence that still haunts her.
“I wasn’t allowed to speak to anyone. No one was allowed to speak to me,” Gonzalez said, describing one of the treatments she received at Retorno. “There was a lot of grunting to ask for things I needed, like a glass of water or something.”
For Gonzalez, who had been sexually abused as a child by her father, that silence and the guttural sounds were triggering. During group therapy, she began screaming, then howling. Soon some of the other women in her group started to scream, too. The next day, Gonzalez says one “sadistic” counselor told her, “We liked what happened to you yesterday. We’re doing it to you again today.”
Speaking from a New York coffee shop—five months after she finished the program and left Israel—Gonzalez says such treatment is commonplace at Retorno. She says it’s a place where participants work long hours, learn what the rules are by breaking them, and are handed down peculiar punishments including timeouts, isolation, and being forced to dress like a baby for “immature” behavior. And now, the therapeutic community, which practices a self-described “tough love” philosophy—one that American mental-health experts label ineffective and possibly detrimental—is making a concerted push to recruit more American addicts for its programs.
At 62 years old, Gonzalez—a lawyer by training and an artist by nature—was 40 years older than her nearest peer at Retorno. Before she entered the facility in 2015, she was living with her then-boyfriend in Tel Aviv; when the relationship went sour, Gonzalez became depressed, living most days locked in her bedroom, high on Klonopin, Valium, and alcohol. One day her boyfriend’s son came to get her for dinner and found her unconscious in a pool of her own vomit. When she woke from her coma months later, her boyfriend told her he didn’t want her to come home. He suggested a place for disturbed artists, then, she says, he found out about Retorno, for people with addiction problems.
“And I certainly have an addiction problem,” Gonzalez says.
Though she wasn’t technically committed, Gonzalez had run out of options and was taken to Retorno “not entirely voluntarily,” according to the rehab’s director. Still, hearing that she had been accepted to Retorno, Gonzalez wrote to her boyfriend, “I feel hope—something always beyond my reach since I was 18. Before that, survival itself was all I could hope for, dream of. Now it may be possible to exorcise the demons.”
But Gonzalez says she never got the treatment she needed.
“You know sometimes where you have to give a speech or something, you have a knot in your stomach?” she said. “I had that feeling for five months. I didn’t have a moment of rest from it. I was frightened the entire time.”
Because she couldn’t understand Hebrew, group therapy was ineffective, and she didn’t know what the rules were. For taking a cookie at 3 p.m. instead of the 4 p.m. snack time, she was sent to the outside “punishment bench,” where she would sit dozens of times over the course of her stay at Retorno. Sometimes forced to sit there for hours in the desert heat, she could neither speak nor be spoken to.
There was also “anger therapy.”
“They would ask a woman to come forward and say what she hated about the woman in the center [of the group therapy circle],” Gonzalez said. “They would come up to my face, red in the face, spitting, screaming in Hebrew, ‘I hate you’ or ‘You remind me of my mother,’ just screaming and screaming at me.”
A counselor both translated into English and urged the other women to use stronger language and scream louder, to show “real” anger. Meanwhile Gonzalez couldn’t answer back. The woman receiving the treatment could only hang her head, clasp her hands behind her back, and reply, “thank you.”
Gonzalez isn’t the first person to speak out about Retorno. One former client who went to Israel for treatment in 2003, started a now-expired website to anonymously tell his story and warn others. “While outreach (or marketing) staff may have been well intentioned, my family and I were grossly misinformed about the nature of the program,” he wrote, calling the treatment “humiliating,” and claiming Retorno had “short-change[d] individuals seeking to be healed.”
Three other former clients of Retorno confirmed its controversial practices to The Daily Beast. Even Retorno’s director, Rabbi Eitan Eckstein, acknowledged the harsh conditions at his center, offering as explanation: “In order to stop suffering, one has to suffer.” Nevertheless, in several interviews with The Daily Beast, Eckstein and his assistant, Shoshana Schwartz, mostly discounted Gonzalez’s claims, saying they were the complaints of someone with an axe to grind against her ex-boyfriend. Further, Eckstein said that privacy laws had tied his hands, alleging that if he could open Gonzalez’s file to the public, it would “without a doubt,” explain the motive behind what he called her “smear campaign” against Retorno. Gonzalez’s request for a copy of her own file was not returned.
Eckstein and Schwartz denied some of Gonzalez’s specific allegations, and qualified others: The manual labor is not intensive; anger therapy trains addicts how to deal with anger in a healthy way; silence teaches addicts to think before speaking; the bench is a helpful place where addicts think about their actions; and English is spoken sometimes, but “experience has taught us that the best recovery happens when the English speakers remain connected to, and identify with, the larger group,” Schwartz said.
Isolation, silence, and anger therapy were all treatments approved by Israel’s Ministry of Social Services, Schwartz said. In fact, she said, their entire program is under the watchful eye of the Social Services. “If anything was amiss, if any abuses were taking place, they would not tolerate it and would shut us down.”
Rabbi Eckstein, 57, started Retorno (“U-turn” in Spanish) in Mexico City in 1990 after realizing that “good kids from good families” were using drugs and alcohol. Eckstein, a commander in the Israeli army turned social worker, took the rehab back to Israel in 1997 to Beit Shemesh. At Retorno, started with Orthodox Jewish patients in mind, being Jewish isn’t a requirement but clients have to observe the Sabbath and abide by religious dietary and clothing restrictions. Contact between men and women is forbidden.
Today, somewhere between 50 and 60 patients, a third of whom are women, occupy Retorno’s inpatient adult program at any given time. It costs around $400,000 to run Retorno every month, Eckstein said. Some of this money comes from the state, which pays for treatment of Israeli citizens. (About one-third of Retorno’s clients are in the program because of a court order.) But foreigners pay full price—$8,000 a month for the English program, (not counting advertised discounts)—a point that’s no doubt appealing both to Retorno, and to people struggling with addiction in North America, where even the most basic treatment centers start at $10,000 and can reach four times those rates. The center also relies on donations, many of which come from the charity American Friends of Retorno. Formed in 2003, the group, which lists only three unpaid officers—including Rabbi Eckstein himself, who serves as president—sent $1.8 million to Retorno between 2003 and 2013, according to its tax filings.
Outside charities also contribute to Retorno’s mission. The International Fellowship of Christians and Jews (IFCJ), for example, which raised over $1 billion in donations from evangelical Christians for Jewish causes, provided a $40,000 grant to Retorno in 2015 for a program to treat soldiers with PTSD and is considering another proposal for Retorno this year, according to emails between Gonzalez and an IFCJ employee reviewed by The Daily Beast. Several messages left for IFCJ’s media representatives went unreturned.
Retorno claims to be able to treat any and all addictions, but according to former residents, most people who come to Retorno are there for drug, alcohol, or sex habits, and their stays are long—between six to seven months for men and eight to nine months for women. The treatment at Retorno, as Eckstein explains it, is guided by two philosophies. The first is a 12-step program, created and popularized by Alcoholics Anonymous, wherein addicts confront their addiction, surrender to its power, and make amends for the havoc it has wreaked. The second is the idea of a Therapeutic Community (TC), a place where addicts live together and help each other.
“Therapeutic communities were created in the U.S. The first one was Synanon, created by a guy, Chuck Dederich, in California. Look it up,” Eckstein said.
If Retorno is indeed based on the methods used at Synanon, perhaps it’s telling. Founded by Dederich in 1958, Synanon was the first to offer a brand of tough-love treatment for addicts by addicts. The signature technique at Synanon was “The Game,” later known as “attack therapy”—in which a small group of players would sit in a circle and lob verbal assaults at an addict in the center, sometimes for hours, the idea being to release pent-up aggression.
In their book One Nation Under Therapy, Christina Hoff Sommers and psychiatrist Sally Satel relegate the practice to one of the “bizarre expressive therapies” from the ’60s that have, with the Primal Scream and the Nude Encounter, “gone the way of the Nehru jacket and love beads.” Yet “anger therapy” is alive and well at Retorno. Still, former clients, including Gonzalez, will admit that Retorno wasn’t all bad—though the best of Retorno, they say, was usually found in the relationships formed with their peers. The gong—used to wake clients up at 6 a.m. and signal meals—could also be rung by someone in distress, day or night, and everyone who heard the sound would come to offer support and hugs.
A 2012 qualitative study of 10 clients receiving treatment at Retorno reported in fact only positive experiences. Counselors were described as “empathetic, flexible, containing, and accepting,” and the therapeutic community’s elements of “unconditional acceptance, identification and reflection” were counted as the keys to Retorno great success. That success rate varies from year to year, but has reached up to 80 percent, according to Retorno’s website. Eckstein said the inpatient program’s success rate is more like 50 or 60 percent. Retorno claims to keep in touch with all of its former clients years after treatment—but some former clients, as well as experts like Haim Mell, at the Israel Anti Drug Authority, said such a high rate seems suspect.
“That’s pretty bold to say,” Jacob (not his real name), a Canadian and former client of Retorno, told The Daily Beast about the stated success rate. Jacob was at Retorno for six months in 2003, and relapsed briefly, but has been sober for years. In AA, which Jacob credits with his sobriety, he says the success rate for the first couple of years is around five or six percent. Jacob’s experience mirrored Gonzalez’s in many ways. He said the facilities were run-down, the “English program” was nonexistent, and the main benefit Retorno offered was “complete powerlessness,” (one of the 12 steps) which actually helped him in the end.
“I know this wasn’t by design on Retorno’s part. It is an environment that simulates the worst conditions, brings out our worst character defects. I had no way on anesthetizing my feelings.” And finding that proverbial bottom, is what Jacob says saved him.
“Retorno was so hellish I swore I would stay sober, just so I didn’t end up in a place like that ever again.”
“We don’t have punishments, we have natural consequences,” explained Shoshana Schwartz, Rabbi Eckstein’s assistant and the person in charge of recruitment, in a phone interview with The Daily Beast. Isolation, confrontation, and humiliation for someone who wakes up late or eats a cookie outside of the designated time may sound harsh, but it’s a means to an end—and for addicts who have never taken responsibility for their actions, Schwartz says it works.
“We’re teaching these people who are living in a dream, they’re living in a movie,” she said. “We try to duplicate life. There are other places where they try to make everything nice and sweet, where you might leave clean, but our goal is to try and make you clean in the real world. That’s our job.” But, she concedes, “Just because something works really well doesn’t mean Americans can stomach it. Americans like it to be soft and sweet and cushy. But everything that we do, it’s always coming from a place of love: ‘We love you and this is what you need.’”
As for Gonzalez, Schwartz says, “Victoria is clean. It worked for her.”
Nevertheless, when The Daily Beast spoke with six American addiction experts about Retorno’s tactics, they said without exception that the treatments sounded extreme—and possibly unethical.
“First, these sound like rather drastic practices,” said Richard Clayton, a professor at the University of Kentucky College of Public Health who specializes in drug abuse research. “If Israel has in place processes for accreditation, site visits, and accountability, I can’t imagine those processes have not been implemented.
“I am fairly confident the evidence supports the efficacy and effectiveness of positive reinforcement rather than negative reinforcement,” he added. And while it’s not unusual for alumni of programs like Retorno’s to give glowing reviews, this is not always evidence of how well a program works, said Bill Miller, a University of New Mexico professor who has studied addiction for decades.
“It sounds like the philosophy is that if you can just make people feel bad enough, ashamed enough, humiliated enough, they will change, and there’s no evidence of that in the addiction field,” Miller said. “And if you did that with any other disorder in the DSM, it would be blatant malpractice.”
There are three non-medical therapies that have been proven to work on addiction—cognitive behavioral therapy, 12-step programs, and motivational interviewing—as well as medical interventions, Miller said. But in all cases, he said, a provider should be open to the idea that a given approach may not work for a client, and they might have to refer him to another method.
“The good news in addiction treatment is we’ve got a variety of things that work,” he said. Meanwhile, at least one expert warned that Retorno’s approach could be actively harmful—especially if the program doesn’t tell participants what the rules are.
“That’s really also mirroring kind of the alcoholic family, where you don’t know what the alcoholic is gonna do and when you’re gonna be in trouble and when you’re not,” said Deni Carise, the Chief Clinical Officer at Recovery Centers of America. “It really can be kind of re-traumatizing for people.”
While therapeutic communities were the first kind of treatment available to addicts in America, Carise said that further research found some of their techniques to be harmful later on. Even the punishment bench—a central feature at Retorno—has been done away with in most American therapeutic communities. Many of them used to focus, as Retorno still does, on shaming people, but backed away when it became clear that addicts in therapeutic communities have the most acute problems.
As these centers are often run by alumni, “sometimes the therapeutic point [of the punishments] is, ‘It happened to me when I came here, so it’s gonna happen to you too,’” Carise said. Yet many of Retorno’s graduates—while acknowledging the harsh style of treatment—say the program helped them get their life on track.
Shaindy, a 19-year-old British woman who asked The Daily Beast not use her last name because some relatives don’t know she was in rehab, entered the program at 18 with no knowledge of Hebrew. She says she learned the language in a matter of months, and ultimately found that the program’s strict methods worked for her. “It was one of the hardest things I did in my life, to go there,” she said. “But it ended up being one of the most important times in my life.” At first, the program was so hard on her that Shaindy says she was kicked out—but she asked to be allowed back in. At times, she wouldn’t see the direct reason for some of the punishments, but it would dawn on her months later. She clashed wildly with one of the counselors assigned to care for her.
“Now, that counselor I hated, I speak to her all the time on the phone,” Shaindy said.
Shira Chrysler, 22, spent eight months in Retorno in 2015 for addiction to drugs, alcohol, and issues with codependency. Chrysler was there during Gonzalez’s stay and conceded that while the program worked for her, it was “horrific” for Gonzalez “because she didn’t understand what was going on. She spent most of her days so confused and in shock, living in fear.
“To bring an English speaker into rehab like that is crazy,” she continued.
Chrysler acknowledged her own “breakdown” at Retorno, attributing it to the shortage of staff, the complete lack of translators, and overall disorganization at the time. Since Chrysler was from South Africa and spoke English, she was given the job of interpreter for the small group of English speakers—a task she said interrupted her own treatment. “I was making sure everyone was sticking to rules, explaining what the rules were, I had to be there for the girls. I took too much upon myself,” she said. But it wasn’t just the language barrier that made the rehab so difficult. “[Retorno] is for Israeli girls who are used to living in a caravan outside and cleaning and working with horses. For an older woman coming from New York, a lawyer, it’s completely different.”
Chrysler did get art therapy, acupuncture, horseback riding, and daily counseling in addition to the more punitive practices, which she acknowledged were “crazy.” For example, she explained, if one of the women acted in a way a counselor deems “immature,” she would be forced to dress like “a baby”—in a child’s dress or pajamas—and do “baby” things all day, like watch cartoons, drink out of sippy cups, eat baby food, and be read a children’s book by one of the other women before she could go to bed.
“The whole point is to change the way you were,” Chrysler explained. “They do this until you break. That’s the whole point. I’m not saying it’s a paradise, but it is for someone who is willing to give up everything and put her head down. So for me it was a dream. Even though it was hard, it was a place I could get better. And that’s all I wanted.”[IMGR=white]https://drugs-forum.com/forum/attachment.php?attachmentid=50100&stc=1&d=1462996211[/IMGR]
Shoshana Schwartz at Retorno denied the “baby” punishments as well as another client’s claim that men who did not “act like men,” were forced to wear an apron all day, “like a dunce cap.”
“There are no punishments in Retorno at all,” Schwartz said.
Positive reviews like Chrysler’s are what Retorno’s administrators are banking on to get more English-speaking addicts into the program. Former clients are encouraged to leave positive reviews on the website ConsumerAffairs.com. Currently five of the seven ratings are positive. Someone from Retorno responded online to Gonzalez’s one-star review with “We’re sorry you had a bad experience. We don’t offer Jacuzzis; we offer a new life!”
Her review was followed by “Esther of Jerusalem,” who writes, “The way it was done 7 years ago was so degrading and made me feel even worse about myself. Lack of slow integration into society like a halfway house cause me to relapse.” Those who go to Retorno’s website are welcomed by a video invitation to “Rehab in Paradise,” backed by New Age music and a sprawling aerial view of the compound. A banner carousel flips through advertisements to prospective clients, including one in bright pink that reads: “New! Detox/Rehab for American Girls click here!”
In addition to online marketing, Gonzalez says she was asked to recruit Orthodox Jews from Williamsburg in Brooklyn. “Maybe in your search to bring in some money you’d like to revisit the idea of bringing clients to Retorno or donors to help others,” Shoshana Schwartz wrote to Gonzalez in an email reviewed by The Daily Beast. “On a percentage basis, it’s not bad.”
When asked about Retorno offering kickbacks to former clients for referrals, Schwartz clarified that “we often offer graduates employment, based on their particular skill set.”
What Retorno doesn’t advertise is what can be a harsh reality once inside the compound’s gates, though it’s one Rabbi Eckstein doesn’t dispute. “It’s a really tough program. It’s not for everybody,” he said.
“When you go to ski, you see ‘It’s beautiful, it’s paradise, come to Switzerland to snow ski. Well the first time I went, I broke my leg. Nobody told me that you can break your leg and nobody told me to wear a sweater out because I would get cold. I had to practice,” he explained of what one former client called Retorno’s “bait-and-switch” style of addiction therapy.
“What do you want me to say? Do you want to say that there are 30 percent of people who hate us? It’s true. But they don’t hate us, they hate themselves because they couldn’t go through the treatment. It was too hard for them.”
By Brandy Zadrozny, Katie Zavatsky - The Daily Beast/May 11, 2016
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