A seven-day-old infant had arrived back from the hospital the day before, and the house was quiet.
Like most homes, cleanliness is attained through a combination of hard work and appreciation for the collective living space. Unsurprisingly in a house with a newborn, the wall in the living room already is filled with pictures. A tree born out of imagination, construction paper and tape spreads across the far wall, leaves at the top with messages of hope and positive affirmation. The dining room table is large; the kind whose leaves are utilized to their fullest extent to fit all the chairs that fall around it.
This house seems like any other in the Grove Street area.
It is not until you look closer that you begin noticing the slight inconsistencies. While images of family cover a corner of the wall, there is not an errant toy or crumpled juice box that may belong to one of the pictured children to be found. Words atop the construction-paper tree read “love” and “laugh often,” while “insecurity,” “codependency” and “dwelling in the past” appear to have fallen away, scattered across the ground below.
And as you walk through the halls, the 25 names that label the doors are all decidedly female. This house is not like any other around Grove Street.
This is Beryl’s House, a residential treatment facility run by Community Healthlink that serves women in recovery from substance abuse and addiction — 25 at a time. (The location of the house is kept from the public as a safety measure for its clients, to keep damaging influences and abusive acquaintances at bay.)
In 2014, the Massachusetts Bureau of Substance Abuse Services served 85,823 individuals, nearly one-third of them women. In operation for just over a year and a half, Beryl’s House prioritizes admission of drug court clients, pregnant and postpartum women with children up to a year in age, 18- to 22-year-olds, and women released from Section 35 — a court-mandated involuntary detoxification after their addictions were deemed to present a danger to themselves or others — commitments. Yet while priorities are priorities, Beryl’s House operates beyond these neat categories.
“I have a Section 35 waitlist, and a regular referral waitlist,” explains Jessica Martin, Beryl’s House clinical director, adding that she has received calls from individuals struggling in their own homes. However the majority of the clients, as they are called, arrive from the Women’s Addiction Treatment Center in New Bedford. The process is one of referral, followed by a phone call between Martin and the prospective client to explain their potential daily schedule.
“There’s so much shame when [clients in recovery] come in, especially for women.” — Patricia Clark, director of recovery services in Community Healthlink’s Recovery Environment Supports division
Arriving with a bag of clothes and any medications they may have been prescribed, clients at Beryl’s House wake up at 7 a.m., during which time they share a reflection group over coffee. Between 7:30 and 9, they get their bedrooms and themselves ready for the day. This is followed by an hour of chores (to be repeated again at 4 p.m.) with an allocation of jobs rotating every two weeks. A half hour of meditation comes next, followed by an hour of groups, two hours intended for scheduling appointments and serenity time conducive to self-care. Groups meet again at 3 p.m., followed by dinner shared together at 5, before an outside meeting, and finally another 10 minutes of meditation before lights out at 11 p.m.
While seemingly constricting, structure is often beneficial to individuals newly in recovery.
“A lot of us don’t know what’s good for us in the beginning,” says Patrick Cronin, program director for the Massachusetts Organization for Addiction Recovery, himself in recovery for 10 years. Addiction, Cronin elaborates, removes structure and routine from an addict’s life; neither likely to come about following nascent detoxification or on the streets where many may return.
“Oftentimes the court-mandated treatment is for 30 days, and subsequently individuals return to a place without any treatment or with substance, and you are kind of back to where you started,” said Dr. Theresa Kim, a physician of internal medicine at Boston Medical Center’s Clinical Addiction Research and Education Center. Also an assistant professor of medicine at Boston University, Kim asserts “the real work happens after detox.”
The real work
The first step in that work comes over two to three weeks, when the newly admitted women learn their routine and adjust to 24 other women.
During this time, called Orientation Phase, women are introduced and introduce themselves to the community. Provider networks are set up by Beryl’s House, utilizing resources in Worcester, including those offered by Community Healthlink, while the women participate and reach out to sponsors and support networks within the addiction community independently — though not necessarily alone.
“There’s so much shame when [clients in recovery] come in, especially for women,” observes Patricia Clark, the director of recovery services in Community Healthlink’s Recovery Environment Supports division, and a 19-year veteran of Community Healthlink. It is upon completion of the Orientation Phase that this shame is most deliberately stripped. The new client shares her story to the congregation, touching regularly on unmanageability and powerlessness. Placed again in a position of vulnerability, upon completion new clients are met with support and affirmation from their peers.
“A lot of suffering [with drug addiction] can come from feeling very alone and feeling hopeless.” — Dr. Theresa Kim, Boston Medical Center’s Clinical Addiction Research and Education Center
This model, continued within the Beryl’s House curriculum through daily groups, can serve both to open individuals and join them together. “It’s very important when addicts are feeling ‘less than,’ when someone is talking to them at a peer-to-peer support group,” Cronin said, “they’re not trying to be a sponsor, they are just basically being another person in recovery trying to be there for them.”
Inescapable throughout the process at Beryl’s House is one key tenet: family.
Women further along in treatment are expected to be role models, while Saturday nights provide a weekly treatment of “Sober Fun.” “ ‘Mandatory sober fun’ — we say it just like that, so you have to fun,” Colleen Sullivan, the program coordinator at Beryl’s House, says with a laugh, expressing a sincerity with a touch of humor that permeates the staff. What is important, Sullivan notes, is that the mixture of expectations and activities creates the authentic fellowship and mutual support requisite to maintaining sobriety.
It was the absence of community, in fact, that often helped stoke these women’s addictions. “A lot of suffering [with drug addiction] can come from feeling very alone and feeling hopeless,” Dr. Kim said. In a house in which women are regularly two to a room and meals are shared as a family, this sense of loneliness is by design curtailed at Beryl’s House.
This can be seen positively. The wall of family photos began with just one, though now is expansive; the overlap of photos evidence that the connections between the women persist far beyond the walls of the house.
A surprise baby shower — remnants of which remained hanging in the basement, though the diaper cake was no more — was formulated and crafted by the women as they sent off their peer and prospectively welcomed an infant into the house. Then there are the smaller things: the different handwriting on affirmations throughout the hallways, shared meeting space on every floor, a garden tucked in the backyard where a badminton net slumped from use, the quiet conversations between women on couches of the type that only friends share.
When a client leaves against the recommendation of staff, though, the house can become tense. The reaction? “Sometimes it’s anger,” Martin says, adding “[The women] are mad because they know that it is life or death, and they’re mad because now they have to worry and it’s scary out there.” Under these circumstances, coping is kept by opening the floor, allowing the women to express themselves, followed by a reaffirmation of support from their peers.
As the clients become embraced by their new family, they must also sometimes sever ties with people in what they hope to be their former lives.
The need to avoid untenable living situations, particularly those that include other substance abusers, is a key attribute of those often suited for in-patient treatment, notes Dr. Kim. “Residential treatment is a big commitment,” she said. “I sort of admire people who are open to that, because it is really upending your life.” Often despite the adjustment, the freedom from familiarity ensures that clients of Beryl’s House are provided a fresh start and limited capacity to leave —both conducive to continued care.
Freedom isn’t free
While Beryl’s House may provide a fresh start, it must also prepare its clients for the fundamental changes of full reintegration into society. This begins at the four-month mark, known as the Transition Period.
Drinking became problematic for Jackie when she was about 22, an age when she miscarried her second son at 6 months, and when she would soon thereafter be throwing her cousin a baby shower.
Names have long been on waitlists for sober housing, leaving clients’ comfort in mind as they attain expected employment or schooling. From this an individualized schedule is created on top of an already individualized treatment plan. Freedom is expanded incrementally, first through extended passes, followed by overnight passes, and finally extended overnight passes. There’s a continuation of the structure earlier to be sure, but with enough leniency for comfortable reintegration, with the assurance that clients retain the care and support of Beryl’s House.
The meaning of such freedom became more prescient when I was brought downstairs.
Her name is Jackie. She is 29. We sat in the basement. She chose a blue chair. Behind her were cartoon aquatic animals on the walls, painted relics of a previous housing facility here. Drinking became problematic for Jackie when she was about 22, an age when she miscarried her second son at 6 months, and when she would soon thereafter be throwing her cousin a baby shower. For five years she managed it before ultimately losing control. Work became less of a necessity, as did paying her bills on time. Most acutely her son, now 10, had his mother present maybe 20 percent of the time — on a good day.
Last October, well into her two years of deep insobriety, her uncle placed her under a Section 35 commitment. Jackie was initially comfortable with this. “I just thought it was going to be easy,” she recounts about the processing, “that he was going to pick me up, drop me off at a detox facility and we would be good.”
Instead she found herself drunk in front of a judge, going between two courthouses to secure her uncle taking custody of her son, before being handcuffed in front of the judge and detained. “I was devastated,” she says.
She was released from her Section 35 and entered a post-detox facility. She stayed in the area, living in the treatment center from Dec. 2 until she was kicked out Feb. 11. Afterward, lacking the skills to say “no,” she relapsed.
On Valentine’s Day, living in Boston, Jackie’s then-boyfriend assaulted her. She stayed in the house for a week, her face bruised, the blood vessels in her eyes broken, her head concussed.
Still, during that time she knew she wanted to live. “And if I didn’t want to die,” Jackie says, “then I had to make a choice, and that was my decision.” Choosing to live, she went to her sister’s house, and requested her uncle commit her once more. She knew the protocol, and following detoxification at the Women’s Addiction Treatment Center, transitioned to Beryl’s House. At the time of our discussion in August, that was five months earlier.
Jackie came into the house with a wall up, thinking more relationships equaled more points of conflict. Wanting to grow, when her wall became a problem for points of introspection and learning, she took it down. “I have boundaries and a respect line,” she acknowledges, but hopes that if someone were in need, they would feel hers might be a good ear to bend. “If you see someone falling on their face, you’re going to try to pick them up,” she said. While not always easy, there is always someone there for you, she adds graciously.
Still, she acknowledges work to be done, and at times a house of 25 women can be trying. “I have a mouth,” she says bluntly, “and I don’t know sometimes how to control it.” She does, however, accept suggestions by the staff on that and other growth areas and attempts to put them into practice. Without such, Jackie finds there is little room to improve. She calls her sponsors regularly, and attends counseling both generally and for domestic violence.
Her son is a regular theme during our conversation, not least because his name is tattooed on her, enshrined in a heart and angel wings (another is present for the son she miscarried).
In nearly every answer, she gives consideration to her son’s well-being. Why, for instance, was her uncle initially chosen to gain custody of her son? “They could take him to school and they wouldn’t have to remove him in the middle of the school year,” she replies. For another, Why enter a post-detox facility near her hometown? “I was actually able to see [my son] every weekend.” Finally, Why, then, was she so willing to leave? “It was a sacrifice,” she admits. “I had to decide, is it worth me seeing him every week and potentially putting myself in another position of relapsing? Or me being out here and trying out something different and new, and actually when I see him, and when I’m actually able to be a part of his life, I make it worth it.”
“I’m going to make mistakes. But as long as I’m aware of those things, and am willing to [do] things a little different each day, I’m going to be OK.” — Jackie, 29
She glows when she talks about him, but does so candidly. “I feel blessed, because my son is in a great position, because he has his father and an amazing stepmother; she’s the mother I can’t be right now.”
She continues, praising his position to go to a good school, play football, have his siblings, and finally, “to sleep at night with a sense of security.” She talks to him every night, a condition partially out of want on her part, and born of worry on his — stemming from her relapse. This year with a pass from Beryl’s House, she took him to his first day of school, and attended his football game; a memory recalled with a sprinkling of tears.
“I’m going to make mistakes,” Jackie said. “But as long as I’m aware of those things, and am willing to [do] things a little different each day, I’m going to be OK.” By the time her son graduates from high school, she hopes to have a career, noting that her background does not generally promote recovery as a viable option.
“God willing,” she continues, “I will be able to make an impact, and just be present for life.”
Climbing upstairs, Jackie returning to her schedule, I am caught by the staff. “She has grown so much since she first walked in the door; she’s so great,” Sullivan says quietly, in a celebratory tone — not for herself, but for the transformation she has seen occur in Jackie over the five months.
“We can’t want it for them more than they want it for themselves.” — Jessica Martin, Beryl’s House
The staff are dedicated and unhardened from working under tenuous circumstances at times. They inject humor when appropriate, and will role-play with the women, easing them through the prospect of a job interview, or beyond the hesitancy to broach a subject with a therapist. Their collective presence is continuous, operating on a 24-hour schedule, and ever observing. If there is problem, the staff may not know what in particular is occurring, but they know who and when to ask.
Being so intimately involved in their clients’ work, perspective is a quality that requires maintenance from the staff. “We can’t want it for them more than they want it for themselves,” says Martin, who concedes that this is not always the case. Such moments require a step back, regular training on boundaries, admitting that they themselves are powerless over individuals’ actions while pursuing sobriety, and mutual support.
Like the clients, the staff requires regular communication and supervision. They utilize their time, Martin said. This varies, from using vacation time, to getting particularly tasty food for a staff meeting, to heading out on a quick Starbucks run. When a client slips, or chooses a worrisome transition path, the staff attempts to keep it in perspective. “I think that everyone always has some way that they can focus on the positive,” Martin said, urging potentially discouraged staff to “think about all of the work that [the client] did around group, and acknowledge all of the stuff that she did work for.”
How many of the clients who have passed through Beryl’s House have been successfully changed? “All of them,” Martin said.
“I would think that, even if they only were here for a couple of days,” adds Sullivan, to which Clark rounds out “because at least they know a program like this exists.”
In June, Beryl’s House held its first Alumni Cookout, and another is scheduled for the end of this month. For the staff it was inspiring. “It just showed me that I can do it, and that I’m worth it,” reflects Jackie, adding that it was an extra push in the right direction.
During the event, a keychain was handed out: on one side a butterfly, its meaning not needing much explanation; on the other, against a field of vibrant patterns, was the phrase: “She turned her can’ts into cans and her dreams into plans.”
For those who’ve been to Beryl’s House, there seem few phrases more apt.