…between this step and the next

…between this step and the next

“I know that I can stop drinking in here; and I know that I can stop the heroin too. But I also know that it was the best thing to do to let my kids be taken by my mom because if they stayed with me that would be no life at all, dangerous for them and for me.  That’s what my mom did to me when I was growing up.”

“She’s recovering now for 17 years and so she can take care of the kids. I know they’ll be safe with her.”

“I have nothing waiting for me when I get out except  maybe some jail time so why should I stay clean and sober? I mean, I’m goin’ to have to get sober anyway, so why should I give it up before I go to jail?”

“Besides, if I have nothing to live for, what would even make me want to stop? I mean, you said it yourself…do you want to live or do you want to die? Well I’m not sure I want to live…”

All this came from Josie, a diminutive woman who looked no older than twenty-two but who claimed to be days from her thirtieth birthday. Her jeans had torn knees, tattoos screamed down her arms shooting out of the short sleeves and thrust up between her breasts making an angry bolt of lightning onto the right side of her neck.  

But her eyes were dull, with drooping lids, and they stared past the people sitting in the circle, not focusing on anyone in particular. She was too ashamed to speak directly to anyone.

It was not an unfamiliar argument. I don’t want to live or I think I don’t want to live so why should I even bother with trying to make an effort to get sober.  And in this case as with so many, this person admitted that she was depressed as well as bipolar as well as an addict and an alcoholic.

So we discussed what the problem is with the thinking of the plain alcoholic let alone the person with mixed psychiatric disorders complicated by drug and alcohol abuse. And we admitted how hard it was to tease out the differences between the many conditions and how they all seem to get in the way of one another.  In us pure alcoholics, we have such disordered thinking that we could just simply think of it as  doing the same things over and over again and expecting a different outcome.  Almost an instant amnesia.

And then there is the magical thinking component that believing and wishing things to come true will actually realize the result. Or then the conditional thinking of making our behavior conditioned on the outcome of events or behaviors of other peoples’ behaviors or actions. Sort of, “If Dad buys me a car, I’ll change the way I talk to Mom”. All of this is way a “normal” alcoholic thinks and acts without the added overlay of depressive or bipolar thinking to add to the already nebulous haze that is the rather dim thought pattern that we call the alcoholic mind.  

So when someone who is being treated for multiple mood disorders with alcoholism, those suicidal thoughts cannot be allayed until the mood is stabilized and the alcohol and drugs are fully flushed from the system.

So what I tried to let this young mom know was that her desperate thinking was not at all the sole and inevitable product of the deeply disturbed circumstances of life and her thoughts. But she needed to know that after her medications had finally stabilized her “mood” she had to fight the lingering effects of the alcohol and drugs that would remain in her brain for the next 4- 6 months. They would continue to obscure and cloud her thoughts and press her to think suicidally  or at least think harmful thoughts about herself.

It may even be an inherent defect of our medical  rehab programs that we release people, still in the throes of the thought disorder component of the  disease of substance abuse, into the general community, under supervised, undertreated and without appropriate support systems, and frankly completely unaware that they have not been fully treated and what they should be expecting to feel while they are trying to recuperate.

So I warned her that the point of going to AA meetings was to find the daily support in friends and meetings that would help her to do the rote things she needed to do in order to survive one day at a time.

Until she could do things for herself, and until she could think clearly. Otherwise, her best thinking, which in her case was to harm herself, would return her to those habits and behaviors which would return her to the streets, to the drugs, alcohol, to overdosing and perhaps to death, never to know if that truly was the decision that she wanted to make, for herself, for her children for her life.

Wallace spoke next to say that he had nineteen months sober and he was here to get his depression taken care of. He wanted to remind everyone that although he went to AA meetings regularly and participated, at some point he no longer felt comfortable there. He was sure that he no longer wanted to drink and drug and that AA would help with that. But the “war stories” that he would hear meeting after meeting just got him more and more depressed. So much so that he dreaded going to the meetings. And so he started to avoid the rooms.

But he recognized that he was going into a deep depression and sought medical help.  Which I quickly picked up on and thanked Wallace for reminding the group that AA is a self help organization.

AA is an organization of lay people for lay people who know a lot about alcoholism and about how alcoholics can help other alcoholics. But they also recognize their limitations. They are not doctors, not psychiatrists or analysts and everyone who is a member must understand that if they have physical and mental ailments, they must seek treatment from professionals. 

The most that an AA member can do for another in these circumstances of mood or physical  disorders is to suggest going to a doctor. Any other advice is un called for. One should never look for solutions to these problems from another AA member, even if they should be a member of one of the health professions. Maybe a referral from them is in order but nothing else. But certainly nothing else is warranted.

We are just friends helping friends. So Wallace’s point was well taken. And Josie, I think, began to understand that this period of  detox was just the beginning of the journey.

What she needed to understand was that if you step from a dark passage into a dark room in an effort to escape the darkness, you need the candle that you know is there to light the way. But you have to slowly feel around for the matches  to light that candle.  And then by the flicker of that candle, you have to find the doorway at the other end to find the way out of that room. That dark passage is your rescue from your immediate addiction and that dark room represents that incubation time that it takes for the effect of those drugs to wash out of your brain while on the road to recovery.

Until you can step through that doorway, into the light of a mind unmediated by alcohol or drugs, clear thinking, and therefore clear feeling will not soon be experienced.

© res 6/30/2011

YOUR CHOICE: CARPATHIA OR TITANIC?

YOUR CHOICE: CARPATHIA OR TITANIC?

“Please excuse me if I talk too much. I’ve held lot of this in for so long because I thought that this would not be the right place to share this stuff. But the only thing that that I accomplished by that was that it brought me closer to a drink. And when that happened, I knew that I had to start saying something. Because, (and  I’m I ashamed to say this but I have to get it off my chest), I’m afraid.

“I used to drink gallons of liquor and beer, and shot heroin until I was almost dead. And when my liver began to fail, I finally came around; not right away but gradually over years of drinking, drugging, and getting clean, I’ve finally accumulated twenty or so years of sobriety.  And that wasn’t easy since at first I was just white knuckling it. I didn’t believe in any higher power, I didn’t  think there was a higher power to begin with, even if it was only the rooms or the group. But over the years, I gradually began to see that if I wanted to survive, I needed to believe in something greater than myself, have a reason to live.

“Gradually, my belief in God evolved. That belief is very personal and it may not be the same as yours but it works for me. Mostly.

“But I have to say that that belief has been quite shaken. Because I’m angry and hurt since I believe that I’ve gotten a raw deal.  I mean I saw the light; I changed my ways; I got sober; I got a spiritual life.

“And then I got liver cancer…

“And then I got really scared. And that is why I need to talk and share this with you all today. 

“I have to start chemo soon and although the docs have told me what it is going to be like, it scares me.  I mean, the doctors say there is a 50-50 chance of the treatment working and if I had those odds every time I went to a casino, I’d be a rich guy by now.”

At age forty-five, Tom had finally learned to use the AA meetings as a forum for sharing the most  important information, like that news that would be most likely to drive him to use or to drink. Or if nothing else, plunge him into a deep depression.  Tom’s was profoundly disturbing information. And if it had no other effect than the deep anxiety that it obviously was causing, it was critical for Tom to get it on the table for him to share. Because he was afraid.

Afraid of dying? Perhaps so. He did not say. Of the treatment from the chemotherapy? Surely, somewhat. But in a moment of dispassionate reflection I was wondering why, with all of the near death experiences that he had with his addictions and his alcoholism, did he seem so panicky about a treatment which had such a relatively rosy prognosis?

Tom admitted to close encounters with death  from alcohol poisoning, liver toxicity and heroin over dose. Three separate occasions, in fact.  And the only explanation for this mounting anxiety was that with each successful resuscitation, the fear of another brought the truth of the permanence  of death that much closer to conscious awareness. So that when he finally realized that death was in fact real, everlasting, eternal and irreversible he took pause until fear finally filled that void where common sense had failed to previously register.

He realized that he could actually die, and with death, never return, not having said goodbyes, hellos, or even made an imprint on this world. He would cease to exist and apparently have had a meaningless existence.  And that scared the hell out of him; scared him sober in fact.

So now, in the face of death from a horrible  disease, he was fearful, the way most of us fear the unknown; not unwilling to move forward, but just needing that extra support to help us take those first steps toward the future, whatever it may hold.

I, frankly, was  stunned, and caught up for a moment, lost my place in moving the discussion along when Marie sort of slurred her story-share back into my consciousness.

“I came here to get my meds straightened out. They never get the meds right. After I leave a place like this, the meds always wind up wrong and when that happens I always try to self medicate. I know that is wrong but they never get it right, and then I have to start to using alcohol or drugs.

“They never get the dosage right and I wind right back in a place like this again because I self medicated with alcohol and that really throws things off. I return and they adjust the meds once more and then send me out again and the same thing happens.”

When asked how she planned to use AA to help her make this a different experience, she muttered that she was very shy and had trouble sharing, and so never felt comfortable at AA meetings.  And when told that she could find smaller, more intimate groups, she granted that when she got out she would go to a women’s meeting that she was comfortable with.  

When pressed, she admitted that this was the extent of her plan. Except that she took up the theme of another woman’s share whose goal was to help other people because her sobriety was best when she was engaged in AA service. Marie as an afterthought decided that she should help her father to stop drinking and asked the group how she could do that. He was on the brink of delirium tremens and showed signs of alcohol withdrawal if he went too long without a drink.

When the proffered answer was that she should not do much more than urge him to find a doctor so that her father could get admitted to a detox unit, she got angry . She thought we were not being helpful, that we were undermining her attempts to stay sober.

In point of fact, Marie had no program, had put no other thought into staying sober, had not yet gotten past the notion that her sobriety was anyone else’s fault but her own.  It was always a problem with her medications.  But her first and only solution was to self medicate not to pursue a well outlined program of recovery.

When the share got to Mike, a twenty four year old heroin addict, he readily admitted his abuse, took ownership of his addiction and added that this time he completely detoxed, getting entirely clean, no suboxone or methadone programs, realizing that these were as toxically addicting as the street drugs he used.  And as a result, he fell victim to one of the scourges of  IV drug use, Hepatitis C.  He realized at the age of twenty four, that if he did not want to look back with regret at the age of fifty, (assuming he ever reached it), at those guys who got sober in their twenties, then he would have to give sobriety one hundred per cent of his effort now.

It was also critical if he wanted to get treatment for his Hepatitis C and in order to avoid some of the eventual long term consequences of the infection such as liver  cancer, as Tom so touchingly shared just moments before.

So Mike had his plan.

Mike was followed by Ed (another twenty something) whose share unfortunately had a very Hobbsian portent (an end foretelling a life that would be nasty, brutish and short).  While he admitted that he was definitely an addict, he also admitted that he was powerless over his drugs. But he hadn’t admitted that his life was yet so unmanageable that he would not leave the rehab facility and immediately call his drug dealer and be “out” within two hours of having been discharged. 

I asked why he did not have a plan. And his answer was an unsatisfactory “the urge to use is too great”. 

To which I suggested that his urge to live was not great enough or that his urge to die was too great. And until he got those two priorities reversed he would either wind up missing the recovery boat and die or wind up back again in a detox and rehab facility. It would only be then, when he was finally fed up with being “sick and tired of being sick and tired” that he might finally find his way back to sobriety.

I don’t think I was being too hard on Ed, since he did not rebut these observations, and there was a general agreement that from what had been discussed, only those desirous of life choose to become sober. Only those who want to drop the pretense that only they “know the right way to do things”, that self centered, terminally unique attitude that the world should revolve around them (and that it is the world that is at fault for all their problems); those who want to give that up, will ultimately succeed in the sober game of life.

For the rest who want to argue what the color of the life vest should be before they put it on, well, good luck to them.

© res 6/26/2011

AMBIGUITY OF FAITH

AMBIGUITY OF FAITH

“It’s tough at times to have your faith shaken by events both in your control and out of it. But it is not always easy to know which events are those that you are in control of until you can look back upon them and see where it was that you went wrong.  And that ‘s what happened most recently when I just found out some very disturbing news,” said a distraught Van at this morning’s meeting.

“Many of you know that about a year and a half ago I was diagnosed with a tumor that had a rapid and fatal prognosis but my faith and determination never wavered, and I stuck close to the program, prayed and sought the counsel of many physicians.  And by the grace of God, it was determined that the original diagnosis was either wrong or somehow rapidly spontaneously remitted. But I survived not only with my sobriety intact, but with my faith and serenity at an all time high.

“And many of you know this story because it was one that I readily shared many times in the rooms and  with some people who were challenged by difficult afflictions too to boost their hope and serenity  and belief.

“One such person was a lovely young tenant that I have who, during the course of last year was found to have a particularly aggressive form of breast cancer for which the cure was a bilateral total mastectomy.  All went well, reconstructive surgery proceeded at a wonderful pace, and this beautiful woman, who had a lovely daughter,  recovered well during the year. 

“As she and her husband were preparing to move out of the house that I rented to them they found out at the last check up that her cancer had returned with such an aggressive tumor that she was given only four months to live. 

“And they begged me to put them in touch with the “miracle” doctors who treated me.  “Miracle” doctors? You know I don’t think I ever thought that I described them in those terms.  Nor do I think that I described my situation as a miracle cure. Did I?

“Could I, in my enthusiasm for the faith that served me through my tribulations,  have overstated the case regarding my recovery? Surely it was faith that allowed me to make sober and intelligent decisions about my life at that time without picking up a drink and clouding my judgment. Yet, had I overstated the skill of my treating physicians instead of plainly stating that what they actually had done was report that my original physicians had misdiagnosed the disease in the first place? Did it sound like I thought that my doctors were miracle physicians?

“Because in that case this dear woman was pleading with me to send her to people in the false hope that they would do for her what they did for me and perform another “miracle” just as I had told her!  What had I done?

“I have had tremendous good fortune since that “illness” last year and “near death” experience. My business and health have rebounded.  My optimism is at an all time high and I can only attribute this to my program, my faith and my higher power.

“But this woman does not belong to the program and the best I can do for her is to ask her to pray. And I do not even know if she prays, or has a higher power or has even a bit of faith.

“I have already shared my “experience, strength and hope” with her, but to what end? Has it given her the notion that miracles truly happen just for the asking? Does she truly understand that the miracle is that inner peace which comes with knowing that you have done your best in this world both for yourself and for those around you?

“That is the miracle that awaited me as I worked my program. I only hope that I can show her that’s how it worked for me …

“That only you can make your own miracles.”

© res 6/23/2011

A TRICK OF THE MIND

A TRICK OF THE MIND

{We were sitting around a large round table all pleased that the deal had been brought to a “satisfactory conclusion".  Boris was in a congratulatory mood and called to his servant to bring out the good crystal  to seal the deal with a toast.

His hostess went around dropping a blue crystalline icy cube no larger than 5 mm ice cube into each crystal glass which melted upon hitting the bottom. Boris thrust his glass in the air and exclaimed  ‘nostrovia’!

We echoed the toast and downed the drink in a gulp and a searing taste of vodka hit the tongue and suddenly I panicked. What was I doing!}

I sat bolt upright in my bed. Confusion swirled in my mind, sweat trickled from my neck and brow, my heart pounded in my chest and I had to wait until my breathing started to subside before the sweat would start to evaporate. 

Drinking  a toast? And who was Boris? What was I doing toasting? What was I doing drinking?

And then it occurred to me. A drunk dream. Only a drunk dream. Only a terrifyingly real drunk dream that I have from time to time that sets my teeth on edge and disturbs my tranquility for the rest of the day, maybe the rest of the week, depending on the content of the dream and perhaps the events that set it off. 

And mine wasn’t the only drunk dream that recently disturbed the equanimity of some of the members of today’s “Twenty Four Hours a Day”  reading group this morning.  Several members had been similarly agitated and indeed needed to share about it this morning. 

The reading thanked God for the rooms of AA that helped bring all of the “odd ducks” who found themselves out in the world of swans, into the rooms to be with others of their kind so that they would not feel so out of place in the world. And here we could discuss those trials, vicissitudes and ordinary daily ups and downs which only we could mutually understand as those “normals” out of the rooms would not, could not comprehend.  And so it is with the experience of drunk dreams. 

Normal folk do no awake in a cold sweat because they have dreamed about drinking alcohol when they believe that they should not have. That is not a normal experience.

But for the newly sober as well as for the experienced drunk, these are not uncommon encounters; they come unbidden, unwanted but not unexpected as a part of the recovery process.  Some drunks with years of sobriety say that they never go away. They may spew forth from the past after remaining dormant from years of inactivity, only to strike one unawares, in times of mental turmoil to remind you that yes, you still must remember that you are susceptible to the attraction of the poison of alcohol.

But what do they mean? Are they warnings of impending drunkenness? Are they admonitions against any weakness of will toward one’s program of sobriety? There are many thoughts on the origins of these dreams that go from the sublime to the amusing, all of which serve a purpose for someone in the program if it works for them.

Al started his share that his drunk dream came unbidden last week in the form of suddenly drinking after almost a year of solid sobriety, in an out of the blue encounter with friends. Very matter of fact drinking about which he was horrified when he awoke. 

I  have shared my most recent experience above. And although we did not go into a complete analysis of each of these dreams, there were at least three currents of opinions that ran through the conversation.

Sam shared that historically, Carl Jung, as an advisor to Bill W. who was very concerned about the meaning of the content of the dreams, felt that the dreams were manifestations of God, (or of a higher power) in contact with the dreamer, keeping the person on the recovery course.  Sam further elaborated that Freud, was of the opposite school, that dreams were purely a fiction, a construct of the subconscious and had nothing to do with God, higher powers or anything but the person himself and must therefore be interpreted within that context.

Mike, quoted his sponsor who said that drunk dreams, being a manifestation of a drunk mind were just an attempt of that mind to start to get sober.   Which I followed by my own theory which is that drunk dreams are the mind’s way of telling us that we are still sober. In support of this I posit the following:

While in recovery we are fearful of many things among which are the loss of the self esteem, health, trust and personal pride that we have been working so hard to recover. Having lost these, over years of poor acting, deceptive behavior, prevarication and outright lying  we are now attempting to recoup our position in our family, jobs and society and reacquire some moral high ground.

Having achieved even a modicum of these qualities and things, we now have too much to lose should we pick up a drink again. Too much trust we have worked so hard to regain, health we have reestablished, jobs reacquired, social standing reestablished ,we hold onto with a dubious grasp are now actually at risk of imminent loss should our drinking become known. Worst, regained love will be crushed, perhaps never to be retrieved again.

So drunk dreams are a constant reminder that we are on the right track, that we are doing the right thing; and of all we have to lose should we not stay on the right track.  Why else would we react with so much anxiety were we not afraid of losing so much hard won territory?

As I said above, normal people do not have dreams like this. Even binge drinkers or those who drink too much but do not consider themselves alcoholics. Not even alcoholics themselves have these dreams. It is only the alcoholic in recovery  whose subconscious carries the guilt of slipping and going out that permits all of that anxiety over the drunk dream in the first place.  Otherwise the dream does not even occur.

Which sort of dismisses George’s theory that the dreams are warnings to those of us who are ‘on the brink’ of another drink. Maybe. But my money is on the person with the greater sobriety. The person on the brink is not dreaming of going out, he’s plotting it, and no amount of dreaming is going to stop him. He is already there.

No, I believe that the drunk dream is the safety valve, the somnambulist’s safeguard that nudges us every now and then to remind us in times of anxiety or joy to be on the lookout.  We’re in a good place. 

Don’t screw it up!

© res 6/12/2011

SHE HAD A GOLDEN GLOW

SHE HAD A GOLDEN GLOW







She had a golden glow which drew your notice first when she spoke. And then you noted the slow careful speech of someone who was not quite sure how the sound would actually come out had she let her free will have its way.


The glow was not a healthy one, as one would expect of anyone in such an institution. She had been admitted only a day before and her speech still bore the affect of the residual alcohol as the glow revealed the ravages of the poison on her body; that sickly golden “tan” of the chronic alcoholic, acquired after years of many-downed drinks insulting and assaulting her liver.


And now, having given up this round of the fight and admitted herself to this detox unit, she sat there glumly telling those of us sitting in this circle, how she arrived at this point in her life, this evening, at this meeting, mumbling her pitiful story.

“I was not always a drinker; in fact I hadn’t started to drink heavily until ten years ago, and I cannot remember why I started. But when I did, I did so with intensity and singleness of purpose. I drank until my parents wouldn’t speak to me or even let me back into the house. I got so bad that about a year ago I wound up at a psychiatric hospital in New York and then was sent to an AA rehab in Northwest CT. After that I spent six months in a sober house in Ableville.

"But I had to go to a family function and on the way back to NYC I knew I would drink. I don’t remember how I wound up back at that psychiatric hospital and then another sober house but that one was really classy; a nineteenth century restoration with a library and a swimming pool and it is there that I truly got sober.

"I went to AA meetings and took on commitments and stayed sober for eighteen months and all was going so well. Everything was great. And then I went to another family meeting but I never got there because I “knew” I was going to drink on the train ride down there. And here I am.”

I looked at her dumbfounded. It wasn’t as if I hadn’t heard this story before. It was irritatingly familiar but as the group leader it caught me somewhat speechless.


I had begun the meeting with my typical (mild) harangue that people get sober because they want to. They choose life over death. They choose the work of sobriety over the laziness of going back to drink and excuses for not choosing an alternative means of avoiding those people places and things that drive one to drink in the first place.


And here we were again, the same story.


“I guess I’m just not doing something right”, she whined.


And as I listened to the slow slurring of her speech I realized that it would be pointless to engage her in any meaningful discussion of the true nature of why she “went out”, her motives, her “choice” to dismiss using the tools that she presumably had developed over eighteen months during her previous sobriety… just to drink again. And we in the rooms know that she “chose” to drink because she “knew” she was going to pick up before she actually did and did nothing to avoid it.


This is the kind of behavior that sends me ballistic. It is chocked full of all of the excuses for behaviors so characteristic of drunks, self pity, self centeredness, self delusion, denial, and on and on. It is the type of behavior that I have excoriated, lambasted and castigated in the past; if not particular people then to the room in general at that sort of behavior in general. And I have been likewise berated by the audience for being unsympathetic, cold, haughty and superior for holding opinions of these as “failures”.


What these personal criticisms left out was that these “failures” frightened me. What the others in the rooms do not see is that I hold these same weaknesses which for some selfish reason, or anger, fear, retribution, or a behavior to strike back at another by drinking “at” them, seem like an appropriate behavior when it is really not. Realizing all the time that the only person that I could possibly hurt would be myself, and that is who I exactly am aiming my gun at.


But instead of acknowledging this shared behavior in a sympathetic way, I get angry, eager to ignore all the evidence that people like this woman and I have a thought disorder which does not permit straight thinking all the time. Actually, straight thinking at any time for me and those of our ilk, is a rather tenuous affair. And to blame her for the disease that she has, (that I have), would be like blaming the victim of a tsunami for the wreckage of his home.


But how do I square that with the notion of responsibility in recovery?


When we finally admit we are alcoholics, we finally accept the fact of alcoholism and that we must stand ready to do anything to become and remain sober. Having done that, we then pledge ourselves to a plan of rehabilitating the way we think, the way we behave, conduct our affairs, run our day to day lives, who we associate with, where we go and how we go about doing these things. And if we are successful, we have come up with a plan for living.


So my sympathy for the alcoholic presents itself in works, commitments to bring the message of sobriety and all of the techniques to remain sober through the offices of the society of Alcoholics Anonymous. The sympathy and empathy are integral to helping those who want to get sober. And once sober, I have a responsibility to help others to get and remain sober as well as to maintain my own sobriety.


My sympathy and empathy for those who slip in their program should be to try to return them to the program, not to feel sorrow or pity for them, and not necessarily to help them to dig a deeper hole for themselves with handouts of money and shovels full of kindness that will be blithely ignored because the drunk is in no shape to reciprocate. It is almost a squandered effort and most assuredly will be ignored again and again for those who do not want to return to the fold to try harder once more.


So I had very little to suggest to this woman tonight. Her story sounded like she was yet on the merry-go-round and would not be coming off any time soon. For her there were too many rides left in the amusement park.


Still, there were three other gentlemen awaiting the results of their liver tests, each expecting to hear bad news, each resigned to drastically foreshortened life spans. Yet each seemed willing, when asked, to “do anything” to stay sober, for they had hit their bottoms. But they had determined that they wanted to live out the remainder of their lives awake and aware of the world around them. And their skins all had that rather gray hue to it, the kind that hangs on unhealthy looking people before attaining death or achieving recovery.


Yet our woman had that golden glow, which hovered somewhere between liver overload or failure. And that face that shined like a golden apple in the sun looked like it had not yet seen death up close.






© res 6/8/2011