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23 years at the head of a drug rehab centre

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In the calm and controlled woman in charge of the island’s rehabilitation programme THEO PANAYIDES finds someone driven by compassion fighting fiercely for the less fortunate and against the delusion there is no drugs problem in Cyprus

Yesterday was a tough day, sighs Tina Pavlou, sitting in her tiny office in the Ayia Skepi facility for juvenile substance abusers. “I had to deal with suicidal ideation of a client – thinking of, you know, harming themselves,” she adds, noting my puzzled expression. “I had to deal with an arrest, one of our clients” (this was a ‘client’ from the adult facility). “There was a warrant out, he was wanted – so he was arrested and brought to court. Hopefully he’ll be returning [to the programme] in a few days, but that was also a tough situation to deal with… And then we admitted a homeless boy, who is 12, on crystal meth.” Tina shakes her head; they have two 13-year-olds in the juvenile programme, she tells me – but they’ve never had a 12-year-old here before.

‘Here’ is at the end of a dirt track, out of sight of the main road; you wouldn’t find it unless you were looking for it. The juvenile facility is on the outskirts of Latsia, unlike the main Ayia Skepi ‘therapeutic community’ which is up in the hills around Machairas monastery (and was actually founded by Athanasios, now bishop of Limassol, when he was abbot of the monastery). The teenage addicts are fewer in number – there are currently six boys and one girl in the 15-bed facility – partly because they’re only “a very small part of the drug-abuse population. We get the kids that have already been in the criminal system, dropped out of school, have been using daily for at least a year…” The adult community hosts around 40 men and four women, and is more established; the juvenile centre has been running for about three years, but Ayia Skepi (one of only two inpatient programmes in Cyprus) opened in May 1999 – and in all that time, over 20 years now, Tina’s been the person in charge, the clinical director.

It’s remarkable, really. She was 25 at the time, with a Master’s in family therapy specialising in addictions; she’d studied on a scholarship in the US, obtained her licence as a therapist in the Washington DC area and was hired (by the Department of Human Services of the DC government) a month before she’d even graduated. She was flying high, doing a job she loved, with no plans to move back to Cyprus – but Athanasios had been her “spiritual father” so she agreed to a job interview, “thinking that [Ayia Skepi] was up and running”. Instead, much to her surprise, the board said they wanted her to design and implement the entire programme. ‘I can’t,’ she explained; ‘Give it a try,’ they persisted, unfazed. It seems extraordinary that such an ambitious project was launched with such a young, inexperienced person at its head; then again, many at the time didn’t think it was worth launching at all. “They thought it was a waste of money,” she recalls of the naysayers. “They thought Cyprus didn’t have long-term drug users.”

That’s something of a frequent delusion, our drug problems tending to be hidden behind the usual prosperous small-island façade. Most suburban normies probably don’t even know we have crystal-meth users here (let alone 12-year-olds), yet in fact meth has become quite an epidemic in the past few years, taking over (along with cocaine) from the more expensive heroin. “It’s a living breathing nightmare,” says Tina grimly. “I’d rather work with heroin addicts… Crystal meth will make people a lot more violent. It causes psychosis, it messes up their brains, it changes personalities.” She’s deeply involved in these distressing issues, both through Ayia Skepi and her 15 years (2000-15) on the Anti-Drug Council of Cyprus (she’s also in her second term as a member of the Parole Board) – though also as an ordinary mum, her own 12-year-old (the youngest of four, and the only boy) surely coming to mind when she contemplates the new arrival at the juvenile centre.

Yet she seems so calm, so controlled. That’s the main takeaway from our conversation – how poised and pleasant she appears, an elegant woman with long brown hair and a light-purple wristwatch (she’s a big Swatch fan) adding a playful splash, answering questions with the ease of a social scientist giving a presentation. This is partly (maybe even mostly) training, and partly character. “I believe that people need to be in control of themselves, as much as they can,” she says at one point. What about when she hears all these stories, though, and meets all these lost souls? Does she not get depressed? Of course, she replies, “but like most of us in the field of psychotherapy, we contain ourselves. A lot.”

So it’s been years of self-control, then?

“Yes. Because I work in a facility where there’s a lot of uncontrolled feelings 24/7.”

profile the ayia skepi juvenile facility
Ayia Skepi juvenile facility

The Ayia Skepi programme is all about structure, and following rules. (It’s not like they invented anything new, she admits; she basically copy-pasted how a therapeutic community works in America.) The teenage facility is different, “because teenagers are very different. They’re very impulsive, they can be violent. You just have to run after them like – y’know, children. In the adult facility, though, you’re not allowed to raise your voice outside group therapy, you’re not allowed to use swear words, you have a ‘big brother’. Wherever you are during the day you have someone older, more senior helping you out, helping you contain yourself. In group therapy – where you have one or two psychologists working with you – you’re allowed to lash out. So we allow that outburst daily, but contained within a therapeutic environment”. Taking drugs, using violence or having sex are “cardinal rules”, meaning instant expulsion if broken. Almost half of ‘clients’ drop out – but there’s also a high return rate, and people tend to do better the second time. “It’s expected. Addiction is a relapsing condition.”

Rules are important; they’re the path to self-control. But that’s not the whole story. Firstly, living with rules is a natural part of living with others (or in society); Tina recalls her 14-year-old being asked at school recently what rules they have at home, and replying that they don’t have any – not because they actually don’t, but because the rules have become so ingrained. (“My belief is that if you set boundaries from zero to 12, you don’t have to do anything from 12 to 18,” she laughs, only half-joking.) Secondly, the point isn’t to oppress people, or limit their choices. Tina is devout, from a religious family – she was born in Famagusta, just before the invasion – yet she always chafed at the narrow-minded church rules; Bishop Athanasios’ spiritual contribution to her life was precisely in teaching her a new kind of Orthodoxy, “a free, open relationship with God”.

Religious zeal often goes hand-in-hand with helping those on the margins, like substance abusers (the other inpatient programme in Cyprus is also faith-based). Tina goes to church on Sundays, and prays every night – but she’s also “a very strong believer in personal freedom”, in no way an authoritarian who thinks everyone should do what they’re told. “People need to feel free. Even in my work with addictions, we need to respect people’s freedom – even if they’re choosing the wrong thing for themselves.” It sounds like a contradiction in her character – but in fact she couldn’t have done this job for 20 years (working all hours, being woken up at night to deal with crises) if she were driven by a passion for rules. Like most inveterate helpers, she’s driven by compassion.

‘Yes, I overthink but not because I want to feel sad. I just feel too much, I value things’ goes a quote on Tina’s Twitter account (@tpavlou73). She doesn’t recall the quote – she doesn’t use Twitter very often – but readily agrees that she ‘feels too much’, especially when it comes to people. “I think that I’m naturally empathic… And I have a very strong belief that my purpose in this world is to alleviate other people’s pain.”

One might say she’s a lot like the types who tend to end up in Ayia Skepi – their common characteristic, she explains, being that they’re all extremely sensitive. The tragedy of drug addicts is perhaps that they crave love even more than most people – and instead get even less, to put it mildly. “The majority of our clients are people who’ve experienced serious levels of abuse… Drugs were the relief of a very tough life.” Tina feels their pain, disappointment, rejection – but this is where self-control comes in, otherwise she’d go mad from a surfeit of empathy, so she’s trained herself (for instance) to always talk about other things, never work, when she’s out with friends, or to deal with problems on the phone then immediately turn her mind to something else after she hangs up. What she tries to achieve for her clients, through the discipline of rules and structured emotional outlets, is exactly what she seeks to achieve in herself, placing protective limits around her sensitivity.

What are her own emotional outlets? “I try – not always successfully – to spend two hours a week somewhere in Nature.” Even more importantly, “I’m in therapy, always… Every clinician, who’s an active clinician, should be in therapy. It’s a rule. It’s a rule that’s not very respected in this country, unfortunately – but I was trained in the US, so it’s a rule”. She has none of the usual bad habits. “I abstained from alcohol for 17 years,” she says, rather startlingly (granted, she was never much of a drinker); her college professor set it as an abstinence exercise, asking students not to drink all semester so they’d know how an addict feels in rehab – and Tina decided to keep going, because “I wanted my words to be true” when she reassured clients that abstinence was possible.

Has she ever actually tried drugs herself?

“Yes.”

And? Can she see the attraction?

“No…” she replies, and laughs out loud. “I’m a control freak! I’m never going down that road. I need to control everything.”

Is that bad? Well, yes and no. If it takes a control freak to develop her sense of vocation, then by all means let’s have more control freaks. In a country where hospital doctors work civil-servant hours, Tina will often tell new staff at Ayia Skepi to “throw away your watch… If you look at your watch, it’s going to be tough!”. She didn’t go home for three months when they first opened, then would often stay till 11pm. (The staff are all similarly motivated; some are former addicts who’ve graduated from the programme.) Her kids would often tag along too, spending the day at Ayia Skepi even as tiny babies; “I have to be honest that I never found raising kids difficult,” she admits with a wry smile, “because I had a very difficult job”.

There’s a certain friction – a certain hidden conflict – despite it all, despite her hard work and formidable empathy. Tina’s kids go to private school. She herself is a high achiever, a manager, a policy-maker. She’s poised, pleasant, sociable. Can she really claim to feel the pain of an addict, a criminal – about half her clients are prisoners, enrolled in the programme in lieu of incarceration – who’s endured a life of abuse and deprivation?

“In my 24 years [at Ayia Skepi] I’ve had moments that were very painful,” she admits earnestly. “One of those moments was years ago, when my oldest girls were 13 and 14. It was a day we admitted a 15-year-old who was pregnant, and in bad shape – a kid that was in care since the age of four, in and out of foster homes, had a really tough life, and ended up 15 and pregnant.

“So I read the history and I did the intake, and I thought ‘Oh my God, this is awful’. Then I had to leave and go to their school to attend a meeting, where my girls were sitting in the front row with their friends – and the presentation was called ‘What to take on the ski trip’! And I sat behind them – they were so excited, the teacher was showing pictures of the Alps – and I thought: ‘No, I can’t bear the discrepancy in this world’.”

Tina pauses, then goes for the punchline: “Which makes me work even harder to alleviate the pain of the less privileged kids. Because mine are so privileged”. She walks me to the exit and I look around at the mostly young people we pass, acutely conscious of the hidden turmoil around us; all the secret memories of unhappy lives, now slowly healing.

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