RECREATIONAL REHAB

Late last month, when pop star Britney Spears checked into a drug
treatment facility -- then checked out the next morning -- the
celebrity press cited her fickle approach to rehab as yet another
example of her need for an image makeover. (After weeks of partying in
various locales, she had gone on a bizarre grooming spree, shaving her
head and getting two new tattoos.) Ms. Spears has since returned to
rehab and remained there, but the interest in her flirtation with
sobriety raises the question: When did rehab become such an acceptable
part of the celebrity narrative -- an all-purpose escape from scandal
and, for an increasing number of public figures, a badge of honor?
Public figures seek rehab for a host of ills: drug, alcohol and
gambling addictions; racism; and even, in the case of evangelical
minister Ted Haggard, who had to resign his pulpit after admitting to
an affair with a male prostitute, for homosexuality. (Mr. Haggard's
aptitude for rehab is positively epic; his therapists declared him
"completely heterosexual" after only three weeks of treatment.) Mr.
Haggard is not the only public figure to use rehab as a timely escape
from scandal.

Rep. Mark Foley checked into rehab for alcohol addiction after a
congressional page revealed that Mr. Foley had been sending him
inappropriate text messages, and Rep. Patrick Kennedy sought treatment
for an addiction to painkillers after crashing his car into a security
barrier on Capitol Hill.

For celebrities, the journey to rehab frequently follows a formula:
Erratic or destructive behavior yields gossip-column space about
so-and-so's "cry for help," and within days a publicist is issuing a
press release stating that the celebrity in question has "voluntarily
checked herself into rehab." Completing rehab is now the secular
version of being "born again" -- stars emerge "healthy" and eager to
discuss their conversion experience with the press, although not all
of them appear wiser for it: Hours after leaving rehab, starlet
Lindsay Lohan could be found club-hopping around Hollywood. This
efficient, well-publicized rehabilitation experience is far removed
from the rehab of previous centuries.

The treatment facilities of today may have anodyne names such as the
Promises Treatment Center in Malibu, Calif., where Ms. Spears is now
comfortably ensconced.

But addicts in the 19th century endured treatment in places like the
Franklin Reformatory Home for Inebriates in Philadelphia. Admittance
to these homes marked one as a moral failure and a community danger,
not a person suffering from transient impulse control and a poor
public image.

By the late 19th and early 20th century, sanitariums and spas had
sprung up in cities across the U.S. to treat a host of real and
perceived ailments. The Battle Creek Sanitarium in Michigan, for
example, run by a quirky physician and Seventh-Day Adventist named
John Harvey Kellogg, boasted an impressive list of former patients,
including Amelia Earhart, Thomas Edison and Upton Sinclair. Here
public figures suffering from undisclosed physical complaints or
simply "nervous exhaustion" could spend a month in comfortable privacy
taking water cures, playing golf, and avoiding all animal products and
stimulants.

The modern rehab movement -- democratic, nonjudgmental, and
emphasizing addiction as a disease rather than as a character flaw --
might be said to have started in 1947, with the founding of the
Hazelden treatment center in Minnesota, which was established as "a
sanatorium for curable alcoholics of the professional class." From its
modest beginnings, Hazelden, which embraces the "12-step philosophy
for lifelong recovery," has grown into a small empire, with treatment
centers in several states, a publishing house and an impressive online
network that will send you daily email meditations and iCare cards.

Other residential rehab programs, such as Phoenix House, founded in
1967 in New York by six former heroin addicts, have also expanded
considerably.

The late 20th century spawned the celebrity rehab center, with former
First Lady Betty Ford opening the Betty Ford Center in 1982; musician
Eric Clapton opened his own Crossroads Centre in Antigua in 1993.
Today the Betty Ford Center's Web site looks dowdy next to the
polished images and poignant strains of violin music that stream from
the Web site of Promises, which markets itself more like a sumptuous
resort than a rehab facility. Promises describes its program as "an
unparalleled recovery experience" and boasts: "Our Malibu facility
offers uncommon luxury and is the rehab facility of choice for
business executives, professionals, celebrities, government officials
and anyone wanting the finest rehab program in the world." At a cost
of more than $30,000 for a typical stay, Promises is unlikely to treat
a working-class mother with a methamphetamine addiction. As the head
of the Betty Ford Clinic noted recently, the swanky accoutrements of
places like Promises, which offer massages and gourmet meals,
undermine one of the goals of rehab: to learn some humility. "The best
thing for you in rehab is to sit next to a guy from skid row and
realize you're just as much an alcoholic as he is," he told a
newsmagazine. But Promises may well be the future of rehab.

Just as sashimi and yoga have found their way from trendy enclaves
into suburban strip malls, so too might a taste for a well-pampered
rehab experience. Thanks to "American Idol" and YouTube, an increasing
number of ordinary people consider themselves celebrities -- even if
their fame is specious or embarrassingly brief.

It is not hard to imagine them aping the experience of the truly
famous by indulging in bad behavior and then going off for a stint in
rehab in a desperate search for authenticity and a "cure." The
distinction between self-help and self-promotion could well be lost.

This would be a shame.

Rehab may be a fashionable charade in certain quarters today, and an
expensive one, too, but the real thing has helped people get clean and
stay sober, and the counselors who treat addicts deserve respect for
what they do. It would be unfortunate if the whole idea of rehab --
the grueling process of overcoming your worst self -- lost its
legitimacy thanks to the shallow trends of our celebrity-obsessed
culture. And what of fair Britney? Although a tabloid legend by 25,
she once seemed to have some talent.

Let us hope that she will conquer her addictions and return to the
perky pop life she was meant to lead. If she does, perhaps in 20 years
she can open the Britney Spears Moment of Truth Rehab Center, where
patients receive treatment and -- who knows? -- a commemorative tattoo
upon completion of the program.