This is the message of Bermudian addiction therapist Mrs. Marie Alves Picard who, on her return home from Canada, has reBehavioural Recovery Service.

Mrs. Picard, who married fellow specialist Mr. Michael Picard in December, explains, "Knowledge about addiction and its treatment is changing constantly. It's no use sticking with programmes that were used in the '70s -- or even the '80s -- because experts have learned more about the treatment of substance abuse in the last six years than in the preceding twenty.'' The couple are also concerned that relatively little seems to have been achieved in Bermuda in the treatment of eating disorders. According to Mrs.

Picard, the very nature of diseases such as bulimia nervosa or anorexia nervosa, suggests that their prevalence on the Island is under-reported.

"This is serious, because these diseases are killers. And great strides have been made recently in their treatment. People can be returned to a normal way of life.'' Noting that in the US and Canada, therapists are now required to upgrade their training every year in order to retain certification, Mrs. Picard is hoping to introduce to Bermuda, through her agency, jointly owned with her husband, Alves, Picard & Associates, the newer methods of recovery programmes which they have been successfully pursuing in Canada.

"This is known as a developmental model of recovery, based on an acceptance that for the addict, long-term needs can't be met in the usual 30-day rehabilitation programme currently in use in North America,'' says Mr. Picard, who specialises in relapse recovery treatment. "Our main function is assessment, outpatient treatment, and continuing after-care of the patient, which may take a year or even more, depending on the individual.'' Where possible, he explains, patients are encouraged to stabilise as outpatients, but sometimes it is advisable to spend some time in a protective environment while they are learning new lifestyles: "We have acquired referral status with over 100 facilities all over the US and Canada which are specifically designed to deal with personal needs and problems. Our initial assessment and then the after-care period is all part of that programme and, of course, we maintain close links with the treatment facility. At present, Bermuda does not offer this intense treatment process.'' Prior to the development of this method of recovery, he explains, the primary aim was directed towards the detoxification of a patient. "In fact, experts have come to realise that the `stabilisation' of a patient is essential and can take up to two to three months. Stabilisation really means getting people comfortable with their day to day existence. After all,'' he adds, "it's not drugs and alcohol that are the problem -- for anyone who is suffering from addiction, it's learning to live again without using them as props which is so difficult. The patient has to go through a process of re-learning life skills.'' Mrs. Picard says that the main difference between their method, which is enjoying a high success rate in North America, and the traditional 30-day approach, lies in the emphasis on the long-term recovery aspect.

"If a person is sent off to a rehab centre for 30 days, they tend to think, `That's it!' By taking a patient through what we call the stabilisation process, we are giving the patient a better chance to really understand the gravity of what is happening to him -- physically and mentally -- and to make the commitment to long-term recovery. Patients have to understand for themselves that you can't play games with this disease of addiction -- we're talking about peoples' lives here -- it's imperative to get people to face up to the truth and reality of their situation. Ideally, it would be better if they came out of the "denial'' period before they actually ended up in a rehab centre. Denial is the biggest hurdle to recovery and once someone has admitted, even it it's only to one other person, that they have a problem, they've taken the first step to recovery. That's known as the transition period.'' Part of the process is known as "comfort in recovery'', where a patient comes to terms with the fact that there will be "bad days'' and perhaps period of high physical and emotional stress. The patient is taught to realise that it is quite natural to feel like that -- it's all part of the recovery process.

And, says Mrs. Picard, "we help a patient to `talk out' the bad things in his or her past, in the knowledge that there's now a better `present' to come back to.'' An important part of the recovery programme is encouraging patients to join one of the 12-step self-help groups, such as Alcoholics Anonymous, or Narcotics Anonymous. "Once they have been stabilised, the support of one of these groups is very important in helping people to become self-reliant, rather than having to depend on therapists or facilities,'' says Mrs. Picard.

She and her husband also point out the importance of working with the families of patients: "We call this Families in Recovery, because they usually need treatment as much as the patient, after all they've been through! And, of course,'' she adds, "it's vital that families understand exactly each stage of a patient's recovery.'' In Mr. Picard's view, accurate and thorough assessment of an individual's problems is increasingly seen as the key to successful treatment. "Maybe five or six years ago, treatment programmes and facilities were set up with the effect that people had to fit into the existing programme. But the developmental model of recovery -- which is seeing an 80 percent success rate -- recognises that not every client has the same needs. It's important for a therapist to understand a patient's underlying problem, to assess the nature of that problem and, if necessary, send that patient to a treatment facility best suited to a particular need, and where he will probably find himself amongst people who have similar problems.'' The Picards have both worked extensively in the field of eating disorders.

"People who over-eat, and then purge, or starve themselves go through a lot of the same things as alcoholics and drug addicts. Some foods, such as caffeine or sugar are mood-changing substances and people can get addicted,'' says Mrs. Picard. They point out that people eat, just as some people drink alcohol, to `feel better.' "The development model of recovery is especially successful in treating eating disorders,'' she continues, "because the stabilisation process is the most vital part of recovery.'' Noting that "diets are a bad word in our business'', this recovery plan pinpoints the emotional problems which underlie almost all eating disorders. Sometimes, according to the Picards, these may have started in childhood.

"If a child is upset, a parent will often give them candies to cheer them up.

This can give the idea that candies are a good way of dealing with pain. Or the opposite may occur. An adult may subconsciously recall her childhood when she was constantly being told to `eat up', so the child becomes conditioned to thinking that eating is always a good thing to do. An anorexic, on the other hand, has to be taught that food is not only essential to survival but that it can also be a nurturing experience. So a daily recognition of both emotional and food balancing helps a patient to stabilise.'' Mrs. Picard emphasises that her approach to treatment is not in competition with any existing agencies. "We have done education and training programmes with employers. We would see ourselves as a resource for the Employers' Assistance Programme (EAP), Family and Social Services, doctors, church ministers, lawyers, police or probation services.'' Marie Picard met her future husband when he was operating a half-way house and she worked for him as programme director. After leaving Mount St. Agnes Academy, Mrs. Picard took her degree in Psychology at York University in Toronto, followed by a course at George Brown College in human services counselling, with specialisation in addiction.

"In my first year out of school, in 1987, I worked at the St. Michael's Detox Centre, in Toronto, which is on `Skid Row'. We developed a system there called the Anchor Person Project which encouraged addicts to detox and then to get long-term help and so prevent the `revolving door' problem. It's been a big success and has been spreading to other detox centres in North America.'' Her most rewarding job, she says, was when she worked at a native Canadian treatment centre: "People came from reservations and all over Canada, even from the US. I was there for three years and it was wonderful to learn their traditions and about their way of life.'' After that, she worked at Doctors Hospital in Toronto, as alcohol and drug dependency clinician.

Mrs. Picard says that when she returned home to visit her family in 1992, she was dismayed to see that people were still making "big plans'' about tackling Bermuda's drug problem, but that, from what she could see, not a lot had actually been achieved. "I was really disturbed that the numbers here are still so high.'' Mr. Picard, who attended Queen's University and the University of Western Ontario in Kingston and London, Ontario, is highly experienced in treating criminally-involved addicts. He is certified as a stabilisation and relapse and recovery specialist. He has designed therapeutic programmes for Ontario prisons and half-way houses, as well as programmes specially co-ordinated for young offenders' facilities.

At present, he is a non-working partner in Alves & Picard, studying for a further degree in health care management.