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Authors: Stephen Fried

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The Adams family was in shock. Barbara had left the teenage son from her first marriage—who had been raised by his maternal grandmother—and a huge emotional vacancy where her bright spirit had been. In her grief, Gia checked herself out of Eagleville to be with her family and attend the funeral. She stayed with her mother for ten days, and then disappeared. She turned up in Atlantic City with Rochelle, using heroin again and pawning anything she could get her hands on. And this time, Rochelle wasn’t so insistent that Gia go back to rehab. The line between being part of the problem and part of the solution, so clear to her only weeks before, was now very fuzzy.

With Rochelle no longer so insistent that Gia return to inpatient treatment, it was up to Kathleen and Nancy to pressure her. But with Barbara gone, there was nothing to temper the acrimony between the sisters. Everyone seemed to have been suddenly transported back to 1971, when Kathleen first left Joe and everyone started pointing fingers.

Kathleen saw Nancy as Gia’s corruptor. “Nancy has always
done everything to keep Gia and I at each other’s throats,” said Kathleen. “She tried to destroy me to Gia. For some reason Nancy was either extremely jealous of us or, I don’t know, it’s hard to figure out why a person does the things they do. I don’t know if she wanted to be me or wanted all the things I had—the nice, huge single home and lots of money—or what Maybe she wanted to be Gia. Whenever Gia had a friend, pretty soon Nancy tried to get in on it

“But, I think that she’s basically a very trashy person. Scum, in my opinion.”

Nancy saw herself as trying to stay out of her older sister’s way as much as possible, to make sure none of Kathleen’s mood swings connected. “I always wanted to have some kind of amicable relationship with Kathleen,” Nancy recalled, “in the hope that there could be some peace between her and Gia. The bitterness between Kathleen and I has been rampant at different times, but she’s paid. She’s the sorry figure in this. She has lost more than anyone.”

Nancy’s relationship with Kathleen had only worsened over the course of Gia’s drug dependence. In her belief that Kathleen was ignoring Gia’s drug problems—or selfishly refusing to do what needed to be done to improve the situation—Nancy would sometimes call their mother and try to convince
her
to pressure Kathleen into action.

But, despite their differences, Nancy and Kathleen finally agreed in early February that they should go to Atlantic City together and refuse to leave unless Gia came back with them to reenter Eagleville. Their first job in Atlantic City was
finding
Gia, since she had disappeared again and even Rochelle didn’t seem to know where she was. They camped out at Rochelle’s apartment for the weekend. To kill some time, and break some of the obvious tension in the fragile coalition of three women who could
barely
tolerate each other, Rochelle did artificial nails for Nancy. Finally, Gia showed up.

“I went into that room and Gia was so
broken,”
Nancy recalled, “like she didn’t have any spirit left for anything. She had been to New York, probably to pick up money and get drugs. I confronted her and she started again about her mother leaving her when she was eleven, and it was really
hard for me to be strong for her. I told her that she couldn’t think like that. Like,
big deal
if she blamed her mother for everything. It didn’t matter. Her mother wasn’t responsible.

“As soon as you say that you are
aware
that you blame your mother for everything, okay, it’s not her fault anymore. Now you
know
about it. What are
you
going to do about it? It’s your life, and you have to live it. Come on, you know,
life goes on.
Mommy left you. But you’re a big girl now. What do you want? You’re a heroin addict and living on the street and making Rochelle crazy and your mother is
sick
and you need to go into the hospital and this
can’t keep happening!
All that sadness, that intensity—it was like somebody putting their hand in my heart and taking a big yank at it.”

Several days later, Gia was back in detox.

Eagleville was everything that Gia’s methadone programs had not been. The program was relentlessly aggressive and generally unforgiving—especially since patients were so active in each other’s therapy and so many of the professional staff were themselves recovering.

But Eagleville was also caught at a theoretical impasse. There had always been two models for rehab: a psychological model and a disease model. “The field was in a raging battle then over whether addiction was the result of a personality problem or whether the personality dynamics were the result of the addiction,” recalled Charles Folks, a senior clinical staff member at Eagleville. The old-time, recovering alcoholics—who committed to twelve-step programs for life—believed in the disease model. Many of the academically trained people embraced the psychological approach that therapy or a therapeutic community could ostensibly
cure.
The debate had been largely theoretical until the federal funding cutbacks, which assured that
neither
theory could be adequately implemented. The crunch was especially difficult on Eagleville, which had prided itself on offering high-minded treatment to low-income patients—the most successful of whom could spend seven or eight months in an ambitious therapeutic community, looking at the issues themselves. Gia joined what would become the next-to-last
group to be offered such options. After that, the disease model would win by default.

“Goals were becoming very different when a person might spend a month in inpatient and
that’s all,”
recalled Folks. “All you can do is get through whatever denial of the problem might exist and say ‘Go into a twelve-step program.’”

At the level of the daily therapy sessions Gia attended, the theoretical debate translated into very concrete questions. Who ran the facility, the professionals or the inmates? Who decided what a patient’s “real problems” were, the therapists or a jury of one’s addicted peers? These questions didn’t apply just to the group therapy sessions, which tended to become very confrontational and emotional. There was also a system of “tabs,” in which patients accused other patients of sneaking drugs, breaking house rules or otherwise violating the codes of rehab honor by “tabbing” them to the professional staff. After a certain number of tabs—whether for suspicion of substance abuse or not throwing away a paper cup—patients could be discharged. Like points on a driver’s license, there were ways to reduce your tabs. It was a harsh system, but inordinately real: why pretend that in the outside world everyone who made decisions affecting your life knew what they were doing?

For the first forty-five days of treatment, Gia was in an all-women’s program. The women were housed in a separate building—the original sanitarium structure, which was physically charming compared to the institutional buildings that had been added later on—and all their therapy was single-sex. The rehab world was coming to understand that women were being done a disservice if immediately mixed with men for therapy. Women seemed less likely to confront underlying issues if men were around. Women also seemed less responsive to very confrontational therapy, which was often used to penetrate what professionals saw as a heightened system of denial among males.

“Women come in with a denial system, but it’s not as rigidly expressed,” said Gloria Zankowski, former director of Eagleville’s women’s program. “Women’s needs are more in assisting them to develop trust, make them feel they’re in a safe environment. Many are victims of sexual abuse and incest and are unable to handle something highly confrontational.”
Gia was told that her goals in the program were to overcome denial of her drug problems and recognize the underlying issues that led her to substance abuse. She was supposed to identify both her “enablers” and the circumstances that usually led her to use drugs.

After completing her inpatient phase, Gia applied for and was accepted into the Candidates Program, a more selective, rigorous, long-term program that had space for twenty women at any given time. The first phase of the program was designed to be a sort of psychological boot camp. Patients got up at six-thirty every morning, had breakfast in the central cafeteria and went through three-hour group therapy sessions. They were assigned co-ed or single-sex groups. The small, all-women’s group, to which Gia was assigned, was often referred to as “The Barracudas” by those in the mixed groups. After lunch, there was more individual therapy, three hours of work, some free time and then dinner. Gia was given a job in the cafeteria. “Gia worked the food line, putting out all the desserts,” recalled one former Eagleville patient. “You always knew when Gia was in the kitchen because the dishes were backed up to the ceiling. ‘Miss Carangi,’ they called her.” In the evening, there were often house meetings on the women’s unit, and patients were encouraged to attend AA meetings on the campus.

Patients were asked to choose a “role model” from among the professional staff. Gia chose one of her evening counselors, who was also recovering and, because she was attractive and had a warm personality, was a favorite of many Eagleville patients. “Gia was in love with her,” recalled another former patient in the women’s program, “but, then, a lot of us, women and men, were in love with her.”

Romantic or sexual relationships of any kind were strictly forbidden during the Candidates Program: they could result in an immediate discharge. Patients were supposed to be working on
themselves,
and even the most normal human drives were redefined as “avoidance behaviors.” Inside Eagleville, sexual attraction wasn’t sexual attraction: it was social anxiety and fear of rejection being misinterpreted as love or lust. Sexual preference was also heavily scrutinized. Much to her frustration, Gia found that her avowed homo
sexuality was considered a major problem by her group. She felt that being gay was the least of her problems, while her group continually harped on it as one of the roots of her difficulties.

Homosexuality was a difficult issue generally at Eagleville. The professional staff recognized that there was a difference between “healthy” homosexual lifestyles and unhealthy, ego-dystonic homosexuality. But no one was precisely sure how to tell the difference. Eagleville’s one openly gay staff member, a man, had become the facility’s de facto “gay expert.” He began a separate sexuality group to try to address the problems of homosexuals in a system that looked judgmentally at even the most socially acceptable sexual behavior. Patients had to learn to separate whether they were
capable
of having same-sex romantic attachments from the bigger question: Did they
personally
have no choice but to live as homosexuals, with a full understanding of the consequences of that commitment?

Many of her fellow patients believed Gia’s truthful answer to that question would be no. They harped on her gender-related issues as the prime example of her avoidance behavior. But Gia’s main therapists saw her problems quite differently. “There’s no question she had a lot of unresolved issues about her sexuality,” recalled one of her counselors, who is no longer associated with Eagleville. “She didn’t know where she fit, she was very confused about all of that. She felt real bad that she had no children. She really loved children and talked a lot about her older brother’s kids and said having kids was something she wanted but didn’t know if she could have.

“A lot of what I tried to talk to her about was not making that kind of decision when she was in recovery. When people are in recovery, you try to have them put things that are very difficult to deal with on the side, so they can stay sober long enough to have a healthier foundation and maybe then deal with other things in their lives.

“But, really, the bigger issues for her had to do with her deep depression. She was at Eagleville because she didn’t want to use drugs anymore. But once she was off drugs and in the therapy, her depression was immense. I thought her depression was mostly situational. She felt real overwhelmed
about her family situation, the modeling thing, that woman Wilhelmina dying—she had never really resolved that. But Gia’s major discussions with me were about the relationship with the mom. I think she loved her father very much and felt connected to him and had a lot of issues with him. But she wasn’t really dealing with him as much.

“I don’t think she or Mom could separate each other out. They were sort of enmeshed and Gia was very unhappy with that, but also couldn’t detach herself. I think the mom was really controlling of Gia. I don’t know if the mother was purposely doing that, but I know that was Gia’s perception. Gia felt real guilty about things, especially the things she did to please other people instead of herself. A lot of the modeling she did for other people. Getting sober, trying to get her life together, hiding this relationship with the girl in New Jersey, she did a lot of things to please her mom.

“And she would cry about her mom. Usually, when you’re in therapy with somebody and they start crying, the therapist can hold it together. Gia’s crying … was almost like it could click off other people’s crying. It was a deep, sobbing-type cry. She would cry in group and the other women would cry. It was just this immense pain that would just sort of come out, and it would leave a lot of her peers feeling real helpless, like there was nothing you could do to take away all of this. It was like she had tons of bricks on her.”

Besides the pains Gia had carried with her all her life, the situations she had just left in Atlantic City and Richboro seemed to loom larger with each passing day. No truce had been arranged in the war between Kathleen, Nancy and Rochelle when Gia went into rehab. In fact, it had escalated.

The fighting had begun again before Gia left Rochelle’s to go back to Eagleville. A dispute over how much money was left in Gia and Rochelle’s joint account led to accusations from Kathleen that Rochelle had robbed Gia. After Gia checked into Eagleville, she wasn’t supposed to have phone contact with anyone. But she soon sneaked calls out to Kathleen and Rochelle anyway, subtly pushing and pulling on each of them.

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