Gatehouse Therapeutic Health Services

Gatehouse Therapeutic Health Services (GTHS) operates from a separate but adjacent building to the Gatehouse residence. We firmly believe that the healing that is available in the process of living in a recovery community is as critical as the healing that is available through professional therapy. Because of this, one of the primary goals is seen as coming alongside the Gatehouse community as a whole and helping to maintain its health and sobriety.

The clinical director, Dr. Donald Durham, serves as the primary liaison between the Gatehouse residential community and the professional services of GTHS. In this role he assists the staff of Gatehouse in handling matters such as clinical crises or resistance to recovery. Additionally, he provides directions and rationale for necessary medical interventions, including both lab testing and medications, so that the Gatehouse staff can stay informed at all times as to the medical needs of the residents as well as the clinical needs.

Dr. Don also provides the clinical evaluation and needed psychological testing on every Gatehouse admission. He is thus connected with every resident, even when not providing the ongoing direct clinical services, so that he is in a place to be able to direct the treatment of every resident. He also initiates and maintains professional relationships with other ancillary clinicians who may be needed in the care of each resident, such as a dietitian, physician, psychiatrist, or specialty assessment clinician.

We see the goals of Gatehouse as assisting the resident in learning a strong work ethic, age-appropriate social skills, effective life skills, and an effective, integrated, internalized experience of a 12-Step lifestyle. The goals of GTHS with each resident are complementary:

• Unfreezing feelings. Either from trauma that has been experiences, and/or from the process of addiction itself, most residents say words about feelings, with very little if any actual expression of emotion! This is because if they once begin to feel feelings, they are afraid of what all they will have to feel; better to feel nothing than to feel so much pain. And yet, in the words of John Bradshaw, "you can't heal what you can't feel." So one of our first tasks is to create a therapy environment that is safe enough for the person to begin to experience a full range of feelings.
• Family of origin work. The families is which we grow up help form the templates upon which the rest of our lives are built. To the extent that those templates are faulty or incomplete, the ways in which we build our relationship skills, coping skills, and problem-solving skills will be skewed. Our task in therapy is to examine the critical aspects of a resident's developmental years, evaluate the impact of wounding patterns and events, and expose the resulting dysfunctional patterns of living that have contributed to the substance addiction.
• Self-esteem work. An addict has been defined as an ego-maniac with an inferiority complex! By definition, an addict has a low sense of self-worth, but typically covers this up with an artificial arrogance. The humility that is required to make recovery work is an accurate self-assessment; in therapy we want to expose the reality-distorting arrogance that is a part of the resident's defense system, while building a true foundation for self-esteem and a healthy sense of caring for oneself.
• Day-to-day issues of life in community. Most addicts have been very "busy" with lots of "party buddies," but few have experienced true intimacy. As residents living together begin to "get real," dropping their defenses and thawing out their feelings, conflicts, transference, and other relational dynamics will emerge! This is a necessary, but painful, part of the healing process; until a person learns how to handle relational conflict and relationship intimacy, he or she is highly vulnerable to relapse into addictive processes.