San Diego Mayor Bob Filner

San Diego Mayor Bob Filner. (Bill Wechter / Getty Images / July 25, 2013)

What can San Diego Mayor Bob Filner expect during his two-week intensive rehabilitation program? Will it set him on the path to a more healthy expression of the needs that have led him to wrestle women into headlocks, talk dirty to them and plant unwanted wet kisses on their faces?

It’s possible that he’s packing his jammies and toothbrush, as two-week programs are usually residential, said David B. Wexler, a San Diego clinical psychologist and author of “When Good Men Behave Badly.” 

According to Wexler, clients in this sort of treatment spend the first few days of rehab undergoing a “deep psychological evaluation” during which they will try to pinpoint some of the factors in their childhoods that may have led to their problem behavior.

After that, Wexler said, Filner will probably be in some sort of intensive group therapy with other men. It’s a place, he said, where “the individual is put in the position of describing in detail the behaviors he has committed that are destructive to others and himself and is confronted by peers when he makes rationalizations or minimizations or denials.”

Everyone will be there because some aspect of life went haywire. “In his case,” Wexler said, “the crisis is personal and professional.”

Filner’s fellow patients will have similar compulsions. They probably won't be elected officials in a pickle, but they could be philanderers or pornography addicts.

“We’re not talking about sexual offenders,” Wexler said. “We are talking about people whose sexual behavior has led to problems, people who can learn from each other and support others.”

Filner, Wexler said, was likely to realize that his offensive behavior is about power, not sex. "It's a craving for a certain kind of attention and a belief that you can use your position to satisfy certain needs.”

James Reavis, a San Diego forensic psychologist who has treated criminal sexual offenders, agreed.

"I have not evaluated him and haven’t treated him," Reavis said, "but it seems like a major potential underlying disorder is one of narcissism. He’s getting off on the devaluation of women and furthering a sense of omnipotence."

And though we will never know, one can almost take pleasure in imagining the mayor’s bad-boy peers administering emotional headlocks every time he tries to explain away his behavior by claiming, as his attorney has, that the city never forced him to take sexual harassment training.

Many San Diegans have said they don’t believe that two weeks is enough time for the twice-divorced, 70-year-old bachelor to get well.

“Why should he have to go someplace for two weeks to get his mind straightened out? With his track record for almost 30 years, that’s not gonna happen, let’s get real,” said 60-year-old Izean Rim, who urged the San Diego City Council on Tuesday not to pay Filner’s legal bills in connection with a sexual harassment lawsuit filed by his former press secretary.

"Intensive rehab sounds like PR rehab," said Carol Knott, a retiree who lives with her husband in Mission Beach.

"I think like Weiner in New York, he has an illness," added her husband, Roger Knott. "and you can't unteach that illness."

But Wexler, who works with men like Filner, is optimistic. “Is two weeks enough to ‘cure’ a longstanding problem? The answer is unequivocally no. It’s just a start.”

Anyway, he added, “’Cure’ is probably the wrong word. Certainly in 12-step groups, you are never ‘cured.’ You are always in recovery. That’s the best way to think about it for any kind of recurring problem behavior. We are always preaching to people: you are more vulnerable to acting this way than the average person, and therefore you have to, for the rest of your life, take precautions. You can never get fat, dumb and happy.”

Reavis was less sanguine. "You can rearrange these things inside a person," he said, "but to do that takes a tremendous amount of time. You are not even going to be able to trace the origins of the narcissism in two weeks. To root them out and put him on the right track, it would probably take between two and four years."

If Filner’s therapy is typical, Wexler said, he will leave rehab with a “relapse prevention plan.”

“That’s usually a very specific set of tools for how to catch myself when I notice myself starting to think like this…this is what I can do when I start to slip down that slope.”

He will learn cognitive tools like “self-talking,” or practical tools like meditation, or interpersonal tools like calling a sponsor. His biggest challenge will be learning how to tolerate distress, Wexler said.

“This is probably the most challenging task for people who are prone to impulsive and need-gratifying behavior,” he said.

With a majority of residents calling for his resignation, a recall effort underway and the San Diego business community rising up against him, Filner will need all the tools he can get.

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