Which Came First: The Addiction or the Wilderness Camp?

Imagine you are sixteen years old.

It is the middle of the night.

You wake up, and there are two strangers standing in your bedroom.

They tell you to get dressed.

You aren't allowed to call anyone.

You aren't told exactly

ly where you're going.

Your parents know.

In fact, your parents arranged it.

The strangers are there to take you away.

Not because you've been kidnapped.

Because you're going to treatment.

That distinction may make perfect sense to the adults in the room.

To the terrified teenager being removed from bed?

Perhaps not so much.

And that is where I think we need to ask a difficult question:

What happens when the thing we do to help a struggling child becomes another thing they have to recover from?

The Remedy and the Disease

Francis Bacon is credited with an observation that has survived four centuries:

Sometimes the remedy is worse than the disease.

I keep thinking about that when I hear stories from people who were sent to wilderness programs and other highly confrontational adolescent treatment programs.

Years ago, Cracked published an article about what became known as the “troubled teen industry.” It described teenagers being awakened at night by hired escorts, transported against their wishes, separated from their families and placed in programs built around extreme structure, confrontation and obedience.

The article was intentionally provocative.

But underneath the provocation was a question that deserves to be taken seriously:

Can treatment itself cause harm?

Of course it can.

Every other branch of medicine accepts this possibility.

Surgery can cause complications.

Medication can cause side effects.

Chemotherapy can damage healthy cells while attacking cancer.

Yet when it comes to behavioral healthcare, we have sometimes behaved as though anything done in the name of “treatment” must therefore be therapeutic.

That is a dangerous assumption.

Parents Were Trying to Save Their Children

Before going any further, we need to say something clearly.

Most parents who sent their children to these programs were not monsters.

They were terrified.

Imagine watching your child disappear in front of you.

Drugs.

Depression.

Self-harm.

Violence.

School failure.

Running away.

Suicidal behavior.

Police.

Emergency rooms.

Maybe you've tried therapists.

Psychiatrists.

Schools.

Outpatient programs.

Medication.

Consequences.

Love.

Begging.

Threatening.

Negotiating.

And none of it seems to be working.

Then someone tells you:

We know how to help your child.

There is a program.

There are experts.

They need structure.

They need consequences.

They need to be removed from their environment.

You may be told that your child will manipulate you into changing your mind.

You may even be told that resistance proves the intervention is necessary.

And when you are frightened enough, certainty can sound a lot like expertise.

Parents weren't trying to traumatize their children.

They were trying to keep them alive.

That distinction matters.

But good intentions do not immunize an intervention from bad outcomes.

When Treatment Becomes Trauma

Over the years, I have worked with people who describe their wilderness or adolescent-treatment experiences very differently.

Some say the experience helped them.

Others describe it as terrifying.

For some, being separated from home, physically transported, deprived of autonomy or subjected to highly confrontational methods became part of their trauma history rather than part of their healing.

That doesn't mean every wilderness program was the same.

It doesn't mean every clinician was abusive.

It doesn't mean every teenager who hated being there was harmed by being there.

Human beings are considerably more complicated than that.

But it does mean we should be willing to ask:

What was the effect on this particular person?

Not:

Did they comply?

Not:

Did they finish the program?

Not:

Did they follow the rules?

But:

Were they healthier afterward?

Did they trust people more?

Or less?

Did they feel safer?

Or more threatened?

Did treatment increase their ability to form healthy relationships?

Or teach them that people with power could control them while calling it love?

Those are very different measures of success.

And Then Comes the Chicken-and-Egg Problem

This is where things get complicated.

A teenager enters treatment with anxiety, depression, substance use, impulsivity, trauma, family conflict, or some combination of all five.

Years later, they may have severe addiction and significant mental-health problems.

So which came first?

Was the treatment responding to a rapidly developing illness?

Absolutely possible.

Did the illness worsen despite everyone's best efforts?

Also possible.

But could frightening or coercive treatment experiences have added trauma to an already vulnerable nervous system?

That possibility deserves equal consideration.

Because trauma and addiction can become very effective dance partners.

Trauma says:

I don't feel safe.

Drugs say:

I can fix that for a few hours.

Trauma says:

Don't trust anyone.

Addiction says:

You don't need anyone. You have me.

Trauma says:

Something is wrong with you.

Addiction says:

I can make that feeling disappear.

Until it doesn't.

Then the solution becomes part of the problem.

And the person needs more of it simply to escape the consequences created by the thing that originally helped them escape.

That is how the trap gets deeper.

Compliance Is Not the Same Thing as Healing

Behavioral healthcare has historically had an uncomfortable fascination with compliance.

Follow the rules.

Complete the assignments.

Attend the groups.

Don't challenge authority.

Don't leave.

Don't use.

Do what you're told.

Compliance is certainly easier to measure than healing.

You can put it on a clipboard.

Patient attended 5 of 5 groups.

Great.

But a person can sit perfectly still in a therapy group while becoming more frightened, ashamed, and disconnected inside.

Conversely, someone can be argumentative, distrustful and difficult while taking the first fragile steps toward learning that another human being might actually be safe.

One looks better on the chart.

The other may matter more.

The Most Dangerous Lesson

There is one lesson I worry some young people learned from coercive treatment:

When I am struggling, the people I love may disappear or send me away.

Think about that for a moment.

Because one of the central problems in addiction is disconnection.

People become isolated.

Secrets grow.

Relationships fracture.

Shame increases.

And shame has never been famous for improving human decision-making.

So if someone already feels frightened, defective or unworthy of love, and our intervention reinforces that belief, we may inadvertently strengthen the very conditions in which addiction thrives.

Hannah Gadsby once said:

“A lot of people who have experienced trauma at the hands of people they've trusted take responsibility, and that is what's toxic.”

That observation stays with me.

Because people who have experienced trauma frequently don't say:

Something terrible happened to me.

They say:

There is something terrible about me.

That is a profoundly different wound.

The Question We Should Have Been Asking

For years, addiction treatment often centered on one objective:

How do we make this person stop using drugs?

I increasingly believe that question is too small.

The better question is:

How do we help this person build a life in which drugs gradually become less necessary?

That requires more than abstinence.

It requires safety.

Trust.

Relationships.

Housing.

Purpose.

Mental-health treatment.

Medical care.

Education.

Employment.

Community.

Movement.

Meaning.

And perhaps most importantly, connection.

Because a human being is not simply a collection of symptoms waiting to be extinguished.

They are a person trying to figure out how to live.

We Need Humility in Treatment

Sometimes adolescents absolutely need intensive intervention.

Sometimes parents must make decisions their children strongly oppose.

Some situations involve imminent danger, and safety has to come first.

But urgency does not eliminate our obligation to ask whether the intervention itself is humane.

Treatment should never get a moral exemption simply because we call it treatment.

We should measure what we do.

Study outcomes.

Listen to former patients.

Listen to parents.

Listen especially carefully when someone's experience doesn't fit the story we hoped to tell ourselves.

And when an intervention causes harm, we should have enough humility to say:

We need to do better.

That isn't an attack on treatment.

That is how treatment improves.

First, Do No More Harm

Perhaps the question isn't really:

Which came first, the addiction or the wilderness camp?

For many people, we may never know.

Human development isn't a laboratory experiment. We can't rewind someone's adolescence, remove one variable, and run the trial again.

But we can ask something more useful:

When someone comes to us already hurting, did our intervention reduce the hurt—or add to it?

That question should haunt every one of us who works in behavioral healthcare.

Because treatment cannot promise recovery.

Parents cannot guarantee recovery.

Clinicians cannot guarantee recovery.

Sometimes we do everything we know how to do, and people still struggle.

But there is one standard we should never stop pursuing:

The person who comes to us for help should not leave needing to recover from the help itself.