Johanna Martens, PhD. D.
                        Director T.C. DE SPIEGEL
                        BELGIUM

 

THE SITUATION IN BELGIUM.

Belgium is a small country and is divided into three cultural parts with an own language. In the Dutch speaking part there are five therapeutic communities for drug addicts.
Only 20% of the residents of these T.C.’s are women (Noels and Wydoodt, 1996). The T.C. ‘s are characterised by a male life style. There is a lot of hard work, sports and confrontation going on. Because of this situation female residents get little support and lack a role model.
On the contrary nearly 50% of the staff members are women.

POSSIBLE EXPLANATIONS

Different hypotheses can be formulated to explain the low occupation rate of women in the T.C.’s. Some of them belong to the outside world, others have to do with the T.C.’s themselves.
First we have to take into account that women prefer medicine and alcohol rather than hard drugs. The first substances are easier to get, or easily prescribed by medical doctors. They are consumed within the context of a very different subculture or “scene”, and the hard illegal drug scene may frighten a big deal of woman.
Second it is not difficult to understand that a long-term residential programme is hard to enter for women with children. It's painful to be separated and not easy to find a good solution if family members are unable to look after the children.
We have also the impression that addicted women are able to maintain themselves quite well on the drug scene. Usually they have a boyfriend who is also their drug dealer. When they are caught by the police, he declares to be the one who is responsible and goes into jail while she stays outside, visits him and brings him the drugs he needs.
Women earn the necessary money for the drugs rather by prostitution than by breaking into houses. And we know that the judicial authorities are more tolerant towards prostitution than towards burglary. Women also get less pressure by the judicial authorities to enter a T.C.
But the T.C. itself is also responsible for the fact that women have difficulties to enter and to stay in the T.C. As said before the T.C. is characterised by a male life style. Some women may experience sexual danger because of the macho seduction going on, or feel oppressed as a minority group.

WOMEN IN THE THERAPEUTIC COMMUNITY

How can we describe the women who stay in our T.C.’s?
First of all we have to think of people with a character disorder and a traumatised sexuality. (Martens, 1995). Most of the women have been sexually abused during their youth and / or have prostituted themselves during their drug career.
They have a lot of physical problems and tend to neglect themselves on that point. Some have eating disorders such as anorexia and bulimia or eat a lot of sugar.
The psychological problems can be characterised as following. At the behavioural level they are sub-assertive, having difficulties to say “no”, put their limits and accept positive feedback. They are uncomfortable with intimacy without sex and sex without drugs. At the emotional level it is obvious that they have problems with feeling and expressing anger. At the cognitive level they have a triple negative self-image: as a person with a character disorder, with an addiction problem and as a woman in society.

SURVIVAL STRATEGIES

The women in our T.C.’s tend to use typical “survival” strategies that were functional on the drug scene but seem to stay and are very hard to drop inside the T.C. This certainly confirms the hypothesis of a “macho” subculture in the T.C. (and society?).
The two extremes of these strategies can be described as the “macha-rejector” style versus “doormat-acceptor” style. The “macha ” seems to be very strong and able to live by her self. In fact she is only tough and scared of intimacy. The “doormat” can not live by her self and would do anything not to be alone. She seems to be lacking self -respect. Other possible strategies are flirting with all the males or choosing a “pimp” that protects the woman from the other males.
These strategies can be understood as a way of controlling the situation and maintain themselves as a minority of women among men.

WOMAN - CENTRED APPROACH

To be able to do something about the described situation and give the addicted women more possibilities to benefit from a fruitful stay in a T.C., we have been developing a so-called woman - centred approach in the T.C.’s. We decided to pay attention to the female residents as well as to the female staff.
In our work with the residents we give woman - centred accents all over the therapeutic programme and we give the women extra activities and privileges.
On a behavioural level we encourage them to drop their survival strategies, take care of their body’s (hygienics, dentist, gynaecologist), control their eating patterns, being assertive (acquire status and privileges), say “no” (put limits), accept positive feedback, experience intimacy without sex and sex without drugs. At the emotional level we encourage them to express anger, especially within the safety of the encounter group or the bonding-psycho - therapy. At the cognitive level we help them to think about themselves in a positive way.
The “extra’s” that the women get are the following. First of all we take care of the fact that they have a “godmother” among the resident group and among the staff, from whom they can get the necessary support. Secondly we organise a weekly women’s group where the female residents can discuss their problems in a safe way without having to take care of, or trying to seduce men. FORT - techniques can be used and will be explained further in this paper. We also have the monthly inter - TC women’s day. More about it will also be described later. Specific hygienic facilities are taken care of such as more time for private hygiene, accessories in their own toilet and bathroom. If necessary a separate corner is organised in the living room where the women can sit and relax without being approached by the men.
For the female staff members of the T.C.’s we have been organising a training day every year. It is an opportunity to exchange experiences, discuss and get a lecture by some expert.

MONTHLY WOMEN’S DAY

The purpose of this women’s day is to make the T.C. more suitable for female addicts by encouraging the solidarity between them and give support for their minority position in their own T.C. We want them to benefit from the role model function that is available in a bigger group with elder women and women who have been participating in a therapeutic programme for a longer time.
The spirit of the meeting is that the residents choose and organise their own programme of the day and get the necessary support from staff members if necessary. Every T.C. has a turn to be the host. Staff members (one from each T.C.) participate on a personal level as a woman but also watch over the limits of the T.C. programme.
The programme of the day starts with a coffee and getting to know each other. Then follows a discussion group on an issue chosen by themselves. At lunch there is a buffet with food made in the different T.C.’s and much informal chatting. Then follows the activity connected with the issue of the day. Finally the group sits together to evaluate the day and make proposals for the next women’s day.

Most of the discussion issues and the activities can be found in the following list:

issues                                                         activities

  sexual abuse                            creative expression
relationships with men                                 healthy cooking
hobbys                                    swimming
mother and daughter                                  sauna
being a woman in the T.C.                                     visit to the fashion museum
healthy eating and cooking         assertiveness training (2 days)
taking care of your body            baseball
dressing in the T.C.                                        massage
being a parent in the T.C             shiatsu - stretching
assertiveness                           belly dance
spoil your body.                                      african dance
gynaecology                            role playing
agression in the T.C.                                  Santa Claus party
being in love in the T.C.            hair styling
the child within yourselve             visit to a fitness center
feminity and sensuality                                skating
friendship and love                                        horseback riding
the feminist mouvement in Belgium
women with a male job

 

FORT-TECHNIQUES

FORT stays for “Feministische Oefengroep voor Radicale Therapie”. It is a Dutch word for women self help groups. The discussion techniques are inspired by Transactional Analysis and Radical Psychiatry and stimulate the emancipation process of the participants not only on a personal but also on a social level. The techniques are made to address women’s problems here and now in the group (negative self- esteem, difficulties with expressing anger, receive positive feedback etc.).
The FORT-movement has been going on for many years in the USA, Holland, Belgium, and other countries. In the T.C.-work we use their techniques but change the self-help aspect for a staff directed one.
The session generally takes two hours and is divided into different parts. The session starts with several rounds where every woman takes the necessary time to answer the following questions and shares her answers with the other group members: How do I feel here and now? What is recently good and new in my life? Is there anything in the way to have a good group session (negative ideas, resentment)? Then the “personal working time” starts where the women who want, can discuss or work emotionally concerning some problem they may be experiencing. At the end of each personal working time the other group members try to formulate some aspects of recognition from their own situation or experience. The sessions come to an end by giving the opportunity to each group member to gets a “stroke” or complement.
The described exercises may seem easy but in fact they are not at all for the participating women if you keep in mind what was described above as typical female problems. A group member cannot skip her turn as the group is waiting for a good answer.
A female staff member of the T.C directs the group session. She participates also at a personal level as a woman. That means that she answers the questions of the starting rounds and gets a stroke at the end of the group. The personal working time, of course, is left to the residents.

BIBLIOGRAPHY

·        MARTENS, J. (1995). Behandeling van drugsverslaafden. Eerst grenzen, pas daarna experiëntiële gesprekstherapie. In: LIETAER, G. en VAN KALMTHOUT, M.(red.). Praktijkboek Gesprekstherapie, Psychopathologie en experiëntiële Procesbevordering. Utrecht, De Tijdstroom, pp 287-298.

·        MARTENS, J. (1996). Harddrugsverslaafde vrouwen in de therapeutische gemeenschap: specifieke problemen en hun aanpak. In: Verslagboek Studiedag “Vrouwgerichte Verslavingszorg” op 15/03/96 te Brussel. VHV-VAD-IMPULS. VAD, Brussel, pp. 67-71.

·        NOELS, B. en WYDOODT, J.P. (1996). Alcohol, Illegale Drugs en Medicatie. Recente Ontwikkelingen in Vlaanderen, VAD, Brussel.

·        Verslagboek Studiedag “ Vrouwgerichte Verslavingszorg” op 15/03/96 te Brussel. VHV – VAD – IMPULS. VAD, Brussel.

·        WYCHOFF, H. (1977). Solving Women’s Problems. Grove Press Inc., New York.

·        WYCHOFF, H. (1978). Vrouwenpraatgroepen, Feministische Oefengroepen Radicale Therapie. Bert Bakker B.V., Amsterdam.

·        PEETERS, M. (1993). Alledaagse Ongelijkheid. Sekse- en Klasseverschillen in de Hulpverlening. Garant. Leuven-Apeldoorn.