A Conversation with Terry Gorski: Celebrity Addiction Treatment

Following the death of singer Whitney Houston in 2012, Terry Gorski and I had a series of phone conversations and written exchanges discussing the unique challenges of treating drug-dependent celebrities. This candid and insightful dialogue reveals some of the therapeutic approaches, special considerations, and interventions required for treating high-profile clients.

Terence T. Gorski (1949–2020), MA, CAC, was the founder and president of The CENAPS Corporation, an international training and consulting organization specializing in addiction and related mental health problems with a specialty in relapse prevention and cognitive restructuring. He was an internationally recognized expert on substance abuse, mental health, violence, and crime. Gorski is remembered for his contributions and expertise to relapse prevention, managing chemically dependent offenders, and developing community-based teams for managing the problems of alcohol, drugs, violence, and crime. He published numerous books and articles, including Staying Sober: A Guide For Relapse Prevention (Gorski & Miller, 1986), The Staying Sober Workbook (Gorski, 1992), and the Relapse Prevention Therapy Workbook (Gorski & Grinstead, 2010).

Whitney Houston’s Death: Conflicting Accounts

Alexio: The LA County Coroner’s Office reported Whitney Houston’s official cause of death was an accidental drowning, but the report also notes contributing factors such as heart disease and cocaine use. In the aftermath of her death, conflicting accounts emerged regarding the performer’s final days.

The Los Angeles Times reported that the afternoon before her death, “The singer smelled of alcohol and cigarettes” and was “wandering aimlessly” around the hotel lobby (LA Times, 2012). Media outlets such as TMZ also reported episodes of erratic and bizarre behavior.

This information was noticeably absent from public statements rendered by Houston’s spokespeople, all of whom seemed intent on protecting the memory and reputation of the departed singer. A conga line of worshipers, miscreants, and self-identified “best friends” bemoaned the loss of the great talent they believed was poised for a triumphant comeback.

R&B singer Kelly Price told MTV News that her old pal seemed fine, saying, “You can’t just automatically assume that something else happened . . . she (Houston) was happy that night.” In a startling display of ignorance, Price then appeared on an interview with Drew Pinsky, claiming that Houston wasn’t an addict because the singer “drank only a couple of glasses of champagne” the night before she died. A stunned look of disbelief registered on Pinsky’s face.

Gorski: I’m amazed at how many people, including treatment professionals, are not aware that you don’t have to be addicted to die from drug use. The part of your brain that keeps you breathing while you’re asleep shuts down under the effect of narcotics and alcohol, and in relatively small quantities. So, all you need to do is mix prescription narcotic pain medications with a few drinks of alcohol and fall asleep. Few people want to die of their addiction or related causes—many just don’t recognize the risk.

Blanket of Denial

Alexio: The reports of a disheveled and impaired Whitney Houston that seeped out after her death were the final warning signs that someone needed to intervene. The life preserver she so desperately needed was never tossed; the last gasp of a broken songbird was heard by no one. Kelly Price was wrong. Whitney Houston was not doing fine.

Gorski: Denial is a powerful process. It allows us to avoid what’s too painful and instead rely on wishful thinking to handle serious problems. People in denial deal with the world as they’d like it to be, not the way it really is.

Denial can be fatal when dealing with addictive illness. Imagine standing on the railroad tracks while an express train is coming your way. Being in denial is like turning your back on the train, looking the other way, and feeling relieved that you don’t see a train anymore. Both Houston and the people around her probably held an active mindset of denial. It’s a tragedy because her death was so preventable.

Alexio: The early responses formed a blanket of denial shrouding the truth since no one wanted to state the obvious: they were all witnesses to the demise of a talented drug addict and, even more disturbing, they did little or nothing to help. This is a surprisingly common occurrence for addicted celebrities like Houston—the people closest to them are afraid to confront the addicted person and risk losing access. These same individuals expressed shock that this woman, drowning in a vortex of addiction, would submerge and not return.

The “Social Aura” of Celebrity

Alexio: “Celebrity treatment” or “star treatment” usually refers to providing special care or consideration based on peoples’ celebrity statuses. In her final days, Whitney Houston was shown great deference by those around her, but her addictive illness still went unchecked.

Gorski: Celebrities are judged by their work and image, not by who they are. Sometimes I think celebrities—performers, artists, athletes, and others—are simply a commodity bought in the marketplace of entertainment, even after their deaths. In the film The Longest Yard, an aging football player said it better than I ever could: “Hell, we aren’t the players in the game, we’re just the equipment!” (Ruddy, Horowitz, & Aldrich, 1974).

Alexio: Ideally, treatment of celebrities for drug dependence recognizes the “celebrity factor” while identifying how it contributes to their pattern of relapse.

Gorski: Exactly. Celebrity status itself is difficult to deal with in treatment for two reasons. First, clients have absorbed the positives and negatives of fame into their habits, usually without self-awareness or critical thought. They believe that being famous only has an upside and are surprised when the downside kicks them in the head.

Second, everyone’s affected by the social aura of celebrity. Most therapists—that is, more than 51 percent—lack the maturity and skill to keep from being captivated by the power of celebrity. They need to recognize it’s a legitimate factor that must be accommodated in the treatment and recovery plan.

Further, good supervision and a team approach make it less likely that therapists will become overwhelmed by issues related to celebrity. Very few therapists are trained in the psychosocial characteristics of celebrity, how to develop rapport with celebrity figures, and the legitimate differences of celebrities that need to be dealt with in treatment.

Luxury Rehab Facilities

Gorski: I’m surprised that you didn’t address the issue of celebrity treatment based on amenities of the facility rather than the clinical interventions required to actually treat people. For celebrity clients, this would involve developing an effective recovery plan that’s tailored to match their specific needs.

Many people complete treatment without highly personal recovery plans that identify their goals in sobriety, the life issues they’re motivated to change, and a strategy for addressing them.

Alexio: I hesitate to condemn high-priced luxury rehab facilities because some do provide very personalized, innovative treatment that considers the differences and similarities of various addictions.

One of my interests is the phenomena of “institutional denial.” Many rehab centers find it difficult to recognize that it’s their responsibility to continually evaluate their program. Too often they will consciously (and subconsciously, I suppose) blame patients when they fail to achieve sobriety, saying they “gave them all the tools they needed.” Really? Maybe you gave him a screwdriver when he needed a hammer!

Treatment Failure

Alexio: In my opinion, many unsuccessful outcomes reflect treatment failures, rather than patient failures. I often dismiss the notion that you can’t help individuals who don’t want to be helped. I know this is an unpopular viewpoint with rehab administrators, counselors, and the general population of recovery folks, but that doesn’t concern me. I’m results-oriented; I’m not devoted to any particular school of thought. I’m interested in what’s going to work best for each client. This allows me to view addictive illness from a variety of perspectives and to consider different approaches (if they have a theoretical basis).

Gorski: I really like the concept of viewing patient failure as an indicator of treatment failure. I’ve been pushing for recognition of this for years with little success.
Most relapse occurs because treatment has failed to meet the needs of the client. The wrong approach in recovery doesn’t work, even if you “work it.” Treatment that doesn’t meet the needs of addicts seeking recovery just reinforces guilt, shame, and the sequence of hopelessness, depression, and despair. That’s when we hear clients say things like, “What’s wrong with me?” or “What am I doing wrong?” or “Nothing works, so why bother?”

When a celebrity (or anyone for that matter) dies of an addictive illness, it’s incumbent upon treatment professionals to ask themselves what could’ve been done differently.

Alexio: I expected I’d catch some grief by scrutinizing the role of treatment providers. Some of my peers responded with the predictable “There’s really nothing you can do if someone doesn’t want help.” Certainly, some individuals who come into treatment facilities and Twelve Step rooms have little interest in recovery. However, Whitney Houston didn’t fit that profile. She had a chronic relapse history that involved a very addictive drug—cocaine—with other drugs orbiting around that addiction.

Gorski: I also like your idea that “One size doesn’t fit all.” For treatment to succeed, it must carefully meet the needs of the client.

Alexio: Yes. Skilled psychotherapists must first gain the trust of their clients, and then craft person-specific approaches that fit like a pair of fine Italian loafers.

I believe an effective treatment strategy for Whitney Houston should’ve considered all aspects of her personality: her celebrity status, her self-concept, and other important recovery factors such as her religious beliefs.

The Pattern of Relapse

Alexio: When a celebrity (or anyone for that matter) dies of an addictive illness, it’s incumbent upon treatment professionals to ask themselves what could’ve been done differently. In Whitney Houston’s case, and others with a history of relapse, it’s critical to turn their treatment failures into a blueprint that can then be used to understand their unique relapse pattern. I call this the “addictive fingerprint”—no two are the same.

However, identifying a celebrity’s relapse pattern is not enough. Therapists must also constructively engage the individuals who surround the celebrity. Similar to family members doing a classic intervention scenario, the individuals who represent the celebrity’s inner circle often want to help, but don’t know how. Granted, most have a financial interest, though it’s also likely that some would welcome an opportunity to be actively involved in their benefactor’s recovery efforts. The goal is to turn an enabling entourage into a recovery support team.

While watching the coverage of Houston’s death, I realized that no one in her circle seemed to know (or wanted to say) when Houston began using drugs again. What’s clear is that she was in a full-blown addictive state before her death. Your approach, Terry, would maintain that the relapse process was unfolding long before any drug use took place, perhaps months before that fateful week.

Gorski: Absolutely. Relapse begins long before people start using alcohol and other drugs; it starts when people begin using old ways of thinking, managing their feelings, and behaving. When self-defeating and drug-seeking behaviors return, recovering addicts put themselves around people, places, and things that distance them from recovery support. Instead, they associate with people who’ll support their alcohol and drug use, which activates craving, the powerful urge to start using their drug of choice.

These celebrities, of course, need to identify how they want these early warnings addressed at a point when they’re stable in their recovery. They also need to actively work at developing the specific steps needed to manage relapse warning signs and high-risk situations and to develop a plan to stop the relapse process quickly, should it occur. Relapse prevention and early intervention strategies are plans made in moments of sanity for use in moments of insanity. The most effective plans involve significant others who otherwise might become enablers.

A warning-sign management strategy and an emergency relapse early intervention plan could’ve literally saved Whitney Houston’s life.

Did Whitney Houston Deserve to Die?

Alexio: By all accounts, Whitney Houston desperately wanted to be free of the addiction that had embarrassed her and capsized her career. Quite simply, she was not treating her illness in a way that was effective and suffered a fatal relapse.

Gorski: After her passing, an odd sentiment arose: that Houston somehow got what she deserved for not taking recovery more seriously. I reject this notion outright. If Houston was reluctant to follow the dictates of a recovery program, I’d attribute that more to a function of her disease than a question of motivation or willingness to change. In any event, the likelihood of some degree of resistance must be factored into all intervention strategies.

Lessons Learned

Gorski: Let me bullet-point the major considerations when working with a high-profile client like Whitney Houston.

Alcoholism and drug addiction is a fatal disease.
You don’t have to be an addict to die from an overdose.
Celebrities have special needs that can be addressed in recovery.
The wrong approach doesn’t work, no matter how hard you “work it.”
Enablers contribute to the death of celebrities and often fear losing access to them.
What’s labeled “client failure” is sometimes “treatment failure.”

These factors can literally mean the difference between life and death.

References

Gorski, T. T. (1992). The staying sober workbook: A serious solution for the problem of relapse. Independence, MO: Herald House.
Gorski, T. T., & Grinstead, S. (2010). Relapse prevention therapy workbook: Identifying early warning signs related to personality and lifestyle problems. Independence, MO: Herald House.
Gorski, T. T., & Miller, M. (1986). Staying sober: A guide for relapse prevention. Independence, MO: Herald House.
Horowitz, A. P., Ruddy, A. S., & Aldrich, R. (1974). The longest yard [Motion picture]. United States: Paramount Pictures.
“Whitney Houston dead: She was spotted displaying erratic behavior.” (2012). Los Angeles Times. Retrieved from https://latimesblogs.latimes.com/music_blog/2012/02/whitney-houston-dead-erratic-behavior.html

Spero Alexio

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Spero Alexio, PsyM, MSW, CRPS, is a writer and clinically trained psychotherapist with a virtual counseling practice located in Las Vegas, Nevada. He is considered both an expert in the dynamics of relapse and a pioneer in non-traditional drug treatment. Alexio trained with Terence Gorski at CENAPS and became a certified relapse prevention therapist. In 2003, he developed Qtherapy, a form of exposure therapy that neutralizes the cues associated with addictive behavior. Alexio also provides aftercare for individuals who have detoxed with ibogaine and other plant medicines.