Most people entering rehab plan to make it their only time. It’s quite understandable, especially if one can recall the physical and emotional place they were in when they got there. But there are some people who actually can’t wait to repeat the process, and it’s not always due to a desire for relapse. To some extent, it’s akin to those that are heavily institutionalized. Jail or prison, for instance, is sometimes the only place where certain people feel comfortable. There is a certain level of comfort, if it can be called that, and it’s a place where all of your general needs are met… and the social pecking order is apparently, acceptable. It may be the only place where one feels important. Sometimes it’s all they know, and the fear of the outside world is quite real.

The term “institutionalization” is employed to illustrate the way which inmates are shaped and altered by the institutional milieu in which they live. Sometimes called “prisonization” when it takes place in correctional settings, it is the shorthand representation for the negative psychological effects of incarceration. The process has been analyzed at length by sociologists, psychologists, psychiatrists, and others, and involves a distinctive set of psychological adaptations that regularly come about — in varying levels — in reaction to the demands of prison life. In general terms, the course of prisonization requires the assimilation of the norms of prison life into one’s habits of judgment, thinking, feeling, and acting. The same thing can hold true in the drug rehabilitation setting.

Many people who receive repeat treatment often develop a new way of speaking and thinking. It goes beyond simple vocabulary additions, although this is often the first sight of this phenomenon. Many cross the often grey line between client and staff, and tend to give a lot of direction and advice to new members of the rehab community. This is not to negate the positive aspects of community and passing along strength. But often there is a somewhat twisted sense of importance that goes with it. Many times the downside to this is when one neglects their own recovery in order to act as ‘counselor’. This can be a dangerous area to engage in… for both sides.

It is imperative to underscore that these are the customary and common adjustments made by people in reaction to the unnatural and unusual circumstances of life in rehab. The dysfunctionality of these adaptations is not “pathological” in nature (even though, in practical terms, they may be detrimental in effect). They are normal rejoinders to a set of pathological situations that become problematical when they are taken to excessive lengths, or become persistent and intensely internalized (so that, even though the state of one’s life has changed, many of the once-functional but now counterproductive patterns continue).

Like all methods of ongoing adjustment, of course, this one generally occurs in steps and, all other things being equal, the longer someone is in treatment, the more considerable the nature of the rehabilitation transformation. When most people first enter treatment, of course, they find that being required to become accustomed to an often uncomfortable and strict routine, deprived of a certain amount of privacy and freedom (to surrender to their old habits), and subjected to a common status, like that of all others in treatment at that time, and sometimes slightly sparser material conditions is stressful, unpleasant, and difficult for certain people. Higher-end treatment centers tend to have a much lesser degree of this problem, as well as less repeat treatment stays.

However, in the course of becoming familiar to treatment, a transformation begins. Persons gradually become more accustomed to the restrictions that rehab imposes. The various psychological mechanisms that must be employed to adjust, become increasingly “natural,” second nature, and, to a degree, internalized. To be sure, the process of institutionalization can be subtle and difficult to discern as it occurs. Thus, those in treatment do not necessarily “choose” do succumb to it or not, and few people who have become ‘treatment friendly’ are aware that it has happened to them. Fewer still consciously decide that they are going to willingly allow the transformation to occur.

As one can see, it’s a very subtle animal, and in the end, it can be extremely dangerous to be too used to treatment. Get in treatment…get everything you can out of it…revolutionize your life, and then, leave. Yes.