We had questions: Are we watching glorified train-wreck TV, or real rehab where good work can be done? And why is the show so, dare we say, addictive to watch? We had to talk to a shrink to sort it all out.
"I feel that 'Celebrity Rehab' does for rehab and substance abuse what the 'Jersey Shore' does for New Jersey," says Eric Sherman, LCSW, a psychotherapist who's treated patients with substance abuse problems in Montclair, N.J., and New York City. "It gets publicity out there, but is that really the most helpful thing for people to be seeing?"
"What Dr. Drew is doing is in essence paying people money to come on the show," he continued. "It's encouraging bad behavior -- the more they act out, the more screen time they get. And by very the nature of television, things get boiled down to highlight the most dysfunctional and the most emotional. It gives a somewhat false impression of what one might actually encounter in substance abuse treatment."
Because the treatment is being taped for national broadcast, treatment with Dr. Drew only breaks one aspect of the fame-addiction cycle that many of the patients are caught in. The role of TV rehab as a stepping-stone to a broader career comeback can't help but skew the reality of what happens in treatment.
"It means that they're playing for the camera, which comprises the tenets that are necessary for substance treatment: confidentiality, safety, and a genuine sense of motivation," Sherman says. "Their motivation is that their agents negotiated this for them. And if I can get a lot of attention on this show, I can get on other reality shows."
Sherman pointed to casting Heidi Fleiss and Tom Sizemore, who had a violent romantic history together, as particularly troublesome. "Why would you bring on a couple and create tension, and impose that on everyone else who needs to feel safe? The answer is it's great for ratings. He's trying to teach patients to minimize drama in their lives, as he's inadvertently stoking it."
So, why do people find watching the show so compelling? Last season's finale notched 2.1 million viewers. Is train-wreck voyeurism the real reason people watch? Are there any benefits to viewers? Could someone watching with an untreated addiction get inspired to seek treatment from watching the show?
"It could," says Sherman. "On the one hand, it could be helpful to see this and say, 'I'm not alone,' and there are opportunities to be treated for this. If somebody gets to see, 'Wow, you get in touch with your pain and you can get better,' that could be helpful."
But Sherman worries that those benefits could be drowned out by the sensationalized picture 'Celebrity Rehab' presents, potentially furthering denial among viewers who might have their own substance abuse problems. "We watch shows like this because we want to feel better about ourselves," he says. "My concern is that it paints a picture that might only make some peoples' sense of denial more intractable. The sense of 'Look at how screwed up those celebrities are. That's not me, my problems aren't that big.'"
Even with those criticisms, Sherman stresses that that Dr. Drew shouldn't be blamed for failing Mike Starr and Jeff Conaway: "Both of those people had very serious problems, and no matter how good the doctor or treatment is, we're not God, we're not miracle workers, we can't make people do anything ... It would be unfortunate to look at this and somehow conclude that Dr. Drew is somehow negligent or a bad person. It's a tough population, and the recidivism rate is tremendous."
Indeed, outcomes on 'Celebrity Rehab' vary tremendously, much as they do in other types of drug treatment: some patients kick drug habits entirely, others continue using with a focus on harm reduction, while some relapse or even overdose.
"If you really want to work on a problem that's deeply entrenched, difficult, getting into tons of problems and which causes lots of shame, you'd want to do it in a private place," Sherman adds. "If you want to air dirty laundry and get attention, 'Celebrity Rehab' is the place for you. There are a ton of celebrities who go to rehab that are greatly helped by it, and then there are celebrities who go to rehab, and it's good rehab, and they just keep going back. That's just the nature of the beast, and part of the nature of being a celebrity in this day and age."