A Place Like This
By Michelle Chen
Tony Sisti, a substance abuse counselor on the third floor, distinguishable by his long
gray ponytail, thinks the biggest problem with most drug treatment plans is that in devising a
method, “everybody has a specific way—like if you were looking for a way to cook that
hamburger. There’s no specific way. Maybe I want my hamburger to just cook slowly in the sun.
Maybe I wanna microwave mine, maybe I wanna fry it, maybe I wanna deep fry it.” His job as a
treater is to find out how each client would like his hamburger, be it a twelve-step program,
inpatient, outpatient, or group therapy.
He accomplishes this through “motivational interviewing techniques.” In his exuberant
voice, he presents the pros and cons of treatment and the pros and cons of remaining an addict.
He then tries to “let them come to a decision on their own” through “an honest admission.”
Without encroaching upon the client’s personal conscience, he must convince a client that “the
thing that’s been making them cope for their entire lives” is actually bad for them, and “it’s hard
for me to sell that to you.”
I wasn’t totally sold. “What separates your interviewing technique from what we’re
doing sitting here and talking right now?”
He responded with an analogy. When I began asking him questions, he said, my motive
was to learn about him, and my job was to convince him of the validity of that motive. When he
sits down with a depressed addict, his motive is to “eventually, at least make you wanna consider
the fact that you’re messin’ up.” He began to talk to me as if I were in his position: “you’re trying
to get me to understand that you know in your heart that I need SA treatment. I’m telling you that
I don’t want no treatment. Your responsibility now to me would be to try to make me see clearer,
no matter how slightly it would be at this point.”
The beauty of the technique is that since it is up to the client to accept or reject the
treatment, the client feels in control of the situation. So the motivational interviewer’s objective
is “to make me think I thought what you wanted me to think. It’s kinda like a gentle art of
“Yeah, more or less. I was just wondering … how do you go about doing this?”
That was my mistake. It was an intuitive process, not a method. I began to suspect Tony
was interviewing me as much as I was interviewing him.
“There’s no set standard, there’s no set rule … And that’s what you’re looking for, here,
and that’s where you’re failing me already. Because there’s no cooking of the hamburger right
now. I’m thawing it out right now.”
Then he put me in the position of a client: “your life is in shambles, you’re wearing two
different shoes … Your family has locked you out of the house … But you’re using drugs, it
makes you forget your problems, you’re getting high, and you love it. Now there’s three different
things. There’s three good things and three bad things that I’ve just put on the scale for you.
Right? You’ve got a disease that wants you to stay in the back. You have common sense and
morals and standards that want you to go the other way.”
As a counselor, Tony’s role is to tip you in the direction of common sense. “I need you
to trust me … I want you to know that I’m not doing this for a paycheck, you know, that’s not my
sole reason. My sole reason is because I know how you feel. I know what it’s like to be in that
chair with that pen because I was a student once, too.”
But does he know how his clients feel?
As a recovering addict himself, Tony explained that he knows exactly how they feel—
how it feels “to be homeless, to be helpless, and have my family hate me. To have nothing … I
know what it’s like to sit in a prison cell because my disease brought me there … I also know
what it feels like to recover from this disease, and it’s the most marvelous, wonderful thing.” And
being high “doesn’t even compare.”
Tony’s only rule is “never give up.” If you deem an addict hopeless, he warned, “you
might as well hand them a gun.” To clients who relapse, he says, “it’s not your fault. We failed
you, as a system.” His goal is “to pick you up … even if I’m lowering you into the ground, I’m
gonna pull hope out of that, because I’m gonna bring somebody there that is where you just were
before you just killed yourself with these drugs.”
Still, though he may pull hope from a grave, he is not blindly optimistic. He reflected,
“Owning this addiction is the only way you can recover.” He owns his addiction by controlling
it, and by using personal insight to help others. He said he was currently formulating a
revolutionary treatment plan—a leap from the “sphincterized,” medical approach that he said is
often used in treatments. His plan draws from the addict’s experience, the same way Tony uses
his own recovery to enhance his work.
“I did what I did for a reason,” he said, “and I do what I do now because of what
When I asked him when he started using, he seemed unnerved.
“I’m an addict,” he replied soberly. “You just put it in my system, and the disease just
took over.” He paused and then added, “that’s not a substance-abuse-purposeful question.”
But it was purposeful for my interest, I explained, which was to find out more about him.
“I was two years old, I had my first glass of wine.” He started experimenting with more
serious drugs during the Hippie Era—“turn on, turn off, turn up, tune in, all that dopey stuff.” He
started to quit by forcing himself to stay clean for an hour. Eventually, he worked his way up to a
day, a week, a month, a year. “Now, I’ve got about 36,000 hours clean.” He still attends twelve-
step program sessions occasionally.
“It’s not just putting the drug down, Michelle, it’s soo much more. The drug is just a
symptom of the disease of addiction.” An addict has to change his mind in order to change his
behavior. Tony still doesn’t think of his recovery as permanent, and every day he deals with his
addiction along with each client’s.
He also knows that not everyone deals with addiction the same way, so he tries to be
responsive to each client’s preferences. “My only way to recover is abstinence, total abstinence.
But personally, that’s not everybody’s hamburger.”
“So what’s the weirdest hamburger that you’ve ever encountered?” I asked, amused by
“The one that I bury. The one that I bury. And I believed that I failed … but
unfortunately, Michelle, some people are just … are gonna get it.”
Toward the end of our conversation, he learned that I like to write. “How’d you like to
write my life story?” he asked. “You wanna make a lot of money? Oooh.” I told him he probably
wouldn’t want to hire someone right out of college.
He grew a little more serious. “Never slight yourself. You’re worth more than to even
consider you don’t have the ability to do this … There’s hope even for you, Michelle.”
As I got ready to leave, he asked me to tell him “one thing that you didn’t know before
you walked into this office. What would that be?”
I paused for a second. “That someone like you exists.” He thought that was “deep.”
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