INHOSPITABLE BEHAVIORS

INHOSPITABLE BEHAVIORS

Early sobriety is a delicate period not for the temperance itself but for all of the mental anguish that goes along with the circumstance that had driven us to drink. And even though the reasons we give for drinking are rarely justified, we have a history of involving others in our stories and our misfortunes often become theirs by default.

 Our loves, hates, families, jobs, children and fortunes are the hostages and sometimes the fallout of our inhospitable behaviors. And the toll taken upon our emotional well being may even have dire and mortal consequences if we misstep in our recovery.

It is not unusual for us to be suffering from post detoxification depression, a depression often severe enough to warrant treatment which may have been true clinical depression masked by the drug or alcohol abuse. Or the abuse, having depleted normal endogenous neurotransmitters may cause a post detox rebound depression that only time will heal. It is difficult at times to tell the difference between the two conditions.

But just being alcoholics and drug addicts predisposes to lability in the emotional department and our responses to stress are out of proportion to that of normal people. We can and do respond to routine life stresses at the extremes with greater tendencies toward suicidal behavior, overly histrionic acting out and deeper depressions than people without this handicap.

And like the clinically depressed person who, having started  medical treatment, emerges from the inertness of the psychomotor retardation of the depression and therefore is at greater risk for suicidal follow through, the alcoholic, finally released from the bondage of the dulling action of the alcohol may find he can actually act on his greatest despairs and take his own life.

So when the moderator asked if anyone had a burning desire to share and A’s hand crept up, all eyes turned upon his sad and drawn face. It looked pale, and pained and he was close to tears. And he said…

“I had to break up with my girlfriend of fifteen years; and I know that many of you think that doesn’t carry the emotional weight of a marriage. But I sit here and tell you that after two marriages and a fifteen year relationship there are certainly a lot of emotional ties there that won’t easily be dissolved.”

“And I was so depressed that I did not even want to drink at first. I did not even want a drug. I just wanted to die!... Die! And then my anger really took over and in a rage I destroyed every picture on the walls of the house; all this while talking to my sponsor on the phone.”

So what do you say in this situation? Don’t drink and go to meetings? That kind of pabulum seems inappropriately flippant. The type of readymade puffery that you would tell a resistant drunk who does not want to put the work in to stay sober and is just complaining about how hard it is to stay away from a drink.

No, you have to convince the person that this acute phase is a  difficult phase and the dread, fear and loneliness that he feels takes times to scab over. And yes there is scarring; scarring that is nature’s way of reminding us that the damage done at that site requires special tending. Scars do not heal as strongly as the tissue that they replace so that repeated insults at that site are subject to easier and earlier damage, so attention must be paid.

But healing does take place if you take the time to care for yourself.

When I first got sober, I knew that I could never drink again. But I did not know how I was going to get my life back together again. With no work and thus no income and having been  thrown out of my house, my marriage was, as far as I knew, unretrieveable. I was frightened, depressed, and bewildered. For me, it was as bleak as it could get.  And that prospect did not improve for more than a year and a half.

For months I keened for my former life and not seeing any other way out often sought comfort in the notion that if all else failed I could do myself in. And I guess that the fact that I did not drink was a measure of how  well I worked my program and kept the suicidal impulses at bay.

What did improve with time, however, was the way I decided to look upon my life.  And at first I had to decide that life was worth living in the first place. All else was a side issue and from that decision all other matters emanated.

For there was nothing I could do about my marriage. It might or might not improve and I could not do anything about it no matter how badly I chose to feel about it. Or I could choose to try to let the feeling simmer down; to get control over those feelings and see if they could be viewed in a more positive light.

By my will I could do nothing. I could only learn to live a better life not repeating the same mistakes again. I began to understand the panorama of my marriage and my part as the drunken director of that spectacle. And I began to understand the concept of powerlessness and acceptance.

 But I had to want to live first, just as the first stop for my friend  today has to be to want, to need, to live.

And in the paroxysm of his acute “break up”, like me, he does not know at this point whether this is a permanent situation. And to try to convince him of this may just be an unavailing endeavor.  At this emotional nadir he is too raw, too early, too sensitive, too uncertain about this situation.  Perspective is best left to more discerning minds. Minds less preoccupied by untamed energies of passion and hurt.

Perceptive sponsors and friends in the program can help such an agitated mind to stay clear of any irreversible decisions. Habitual practices to instill some calm into one’s daily life will introduce important rituals whether they initially have any personal meaning or not. Performing prayer and meditation may not, at first, seem to have purpose to the undirected life. But with practice comes serenity and peace.

We don’t have to be cornered into Butch Cassidy decisions, either to shoot yourself or to go out in a blaze of glory. There are other choices, less dramatically terminal with the added benefit that you can live to ponder your decisions another day.

And the more that one chooses to live, the more opportunities to learn how to live present themselves. So that one can learn to distill joy from grief, hope from despair and love from the misperception of an indifferent universe. 

© res 11/8/11

ARTISTRY

ARTISTRY

Artistry is a term we ascribe to those who practice the visual, plastic and performing arts. Rarely do we affix the term to those who practice their professions in such a way as to elevate its performance  in a way that we would call  artistic.

So it is a pretty straight forward affair to listen to a performance of Vladimir Horowitz performing Vivaldi, as I had the privilege of doing when I was in college, and be transported to realms of imaginings that I had never before experienced. And then last year, upon hearing Kaki King, guitarist extraordinaire, play her acoustic electric guitar as no one else does, sounding as if there were four hands playing on a single instrument and making that one sound like three different instruments.

We delight in the artist whose artistry creates in us and for others, other worldly experiences.  And in so doing we learn new things,  experience new ways of seeing the world and touch the divine through the vision of other peoples’ transcendent spirituality.

But I rarely get to experience the more mundane form of artistry that I forget to appreciate when I see it yet it is so necessary to my understanding of basic and important life and death decisions. Today I saw the artistry of a consummate professional, a physician at work today. It was without flash, without ostentation. Pretty matter-of -fact. But brilliant in its simplicity and clarity.

I sat in the office of the oncologist with my friend worrying if he would receive the same curt and staccatoed diagnosis and prognosis that he had received from his original examining physician.  But we were pleasantly surprised to be first introduced to a new nurse practitioner who was very thorough in her presentation of the disease process of lymphomas, the natural histories of the disease and how one goes about treating these lymphatic cancers. 

Next, and  without fanfare, the oncologist entered and quietly explained why he thought that the traditional treatment outlined by the previous physician might not be the treatment of choice in this case. There was the matter of age, my friend being younger than the age at which this condition typically presents and therefore he could withstand more aggressive therapy; and this kind of therapy thus applied had shown the promise about which we physicians only whisper but are chary about speaking  aloud for fear of invoking the ire and wrath of the gods when we talk about cures.

The physician was a gentleman of the old school of medicine. Methodical, soft spoken, and patient. Most of all he was unruffled as even I wasn’t when my friend misunderstood the meaning of the term remission, which he had mistaken to mean to be getting worse instead of the disease remaining quiescent.

But most of all, what the physician did was to present my friend’s state of affairs in a plain spoken clear and optimistic manner. He presented a treatment option that from my personal investigations were only experimental alternatives as I understood from my literature searches. And what his original physician had offered was a course of treatment that had outcomes that had survival rates of three to five years at best.

This treatment had gone from experimental to routine in the three years that my sources were written and the data showed that the survival rates had not been determined yet since there had been so few deaths. They were looking at this regimen as a possible cure, (spoken most softly but with much enthusiastic hope).

This was not an experience that I was ever expecting when I walked into that office this afternoon.

But most important, was that this information was delivered, not with clarions, nor with a puffed chest or encomiums written on plaques on the wall, but with a gentle explanation backed by knowledge of the experience of years of doing this work and the success that he has had. He quietly exuded confidence to the point of artistry that I previously mentioned. I was surely impressed. And glad that I had suggested that my friend go for this second opinion.

But almost more than that here was such a sanguine outcome was the sheer pleasure to observe a consummate artist at work, and to see it from a practitioner of my trade.

“Now that’s how it’s supposed to be done” I said to myself, with some satisfaction. It was almost as if this doctor was standing as a symbol for all of the accomplished physicians out there against the image of physicians as  penurious Scrooges  who appear to dominate the imaginations  of so many people.

“That’s how it should be done”.

And I left the office smiling.

© res 11/2/11

HOW WE LIVE

HOW WE LIVE

How we live is as important as how we die.  How we live in the face of death in particular is as important as how we die that death.

This quandary of being confronted with death was the topic of discussion at our men’s meeting this morning since one of our members  was facing this very problem when his sister called him up this week and delivered the  news of her impending demise.

He was shocked. He was speechless and unbelieving. He wanted to scream at the injustice of his younger sister having to die before him – receiving a sentence from her physician that she had but a year to live.  And since he was the closest sibling to her it fell to him to tell the remainder of the nine sibling family the news; not because he was the eldest but because of their special relationship and because it had taken all of her emotional reserves just to tell him and now  her emotional account was depleted.

What reserves remained she needed to carry her through this ordeal for herself and her family.

The topic of terminal illness and its corollaries of life and death have been salient ideas that have occupied me over the past week. In my day to day existence I do not typically dwell upon these matters.  It is only when confronted by the story of a peer who has to deal with the consequences or the sudden   intrusion into my life of a relative or friend who is ill or dying or suddenly dead that it comes, unbidden  to make its claim upon my consciousness.

 But it has forced its  attentions upon me this past week and I have resented it not because I am afraid of the feelings but because, like the rock that gets thrown into a still pool of water, it creates ripples in my serenity. As long as the irritant remains, its ripples disturb my placidity.  Not to mention that in many cases I am called upon to be an actor to help resolve many of the issues that involve the people affected by these  turns of events.

People, suddenly confronted by their own mortality, mulling through the process of grieving, feeling like  deer frozen in the headlights, and then being forced to get their act together in order to save their own lives. 

And if you are an alcoholic, you are tempted to just sit back and pity yourself and let your sobriety fall by the wayside and say that you don’t really need it anymore. If your higher power has dealt you a deathblow, why fight it? You can drink now. Who is going to care… after all, dead is dead. Whether you die sober or not will not have any effect upon the outcome.

But then I heard the plainsong of E. to whom I have been listening for the past eight months and today who, for the first time,  gasped in desperation that she finally had to admit that her life was unmanageable.  A woman who has that unhealthy “glow” that you see in people who have been drinking so long that their skin carries a pigmentation that almost looks like a tan.

When I mentioned it to her three or four months ago she said it was tanning oil to give an artificial tan.  Frankly I did not want to comment that a product that would give a person that kind of sheen should be quickly removed from the market.

But people hear what they want to hear and disregard the rest, and despite the urging that she should perhaps have her physician check her liver enzymes my concern was greeted with a polite not to worry type of put off. The kind you get when you know that your concern and suggestions are not taken seriously because the person does not take their own condition seriously. Yet…

Folks like her hover on the periphery of AA meetings coming and going not wanting to admit they are alcoholic but not willing to fully dive back into that abattoir that is grinding up their  body and soul every day and week that they continue to drink.

So today her life was finally unmanageable as manifested by the fact that her family has asked her to decamp from one of the many apartments that they own because they find her an unworthy tenant. One has to have a pretty fertile imagination, even for an alcoholic to conjure up how that scenario came about. But we alcoholics sure do know how to distance ourselves from our families, friends and associates.

We know.  We have been there.  We know how that desperation feels! And E. was defiant in saying that she had thirty days without drinking and she was not going to drink because of this.  She couldn’t drink;  she just had to stay sober to keep her life from getting more unmanageable. (She did frame it in the negative. She did not say that she needed to help keep her life more manageable!)

And after this litany of woes she said “But I still don’t think I’m an alcoholic”.

Plunk!...

Beat … Beat… Beat…

And then the moderator of the meeting took a long pause as if stunned by a blow to the gut. But he took a breath and then went on to the next topic of discussion.

What more was there to say?  For after nearly a year of coming and going in and out of the rooms with life clearly not getting any better, her drinking clearly getting worse and worse she finally came to admit that her life was unmanageable.  That is the second part of step one but  she fails to see that her life is unmanageable because “she is powerless over alcohol”. Why else would she be attending an AA meeting coming week in week out? (But that she is still not an alcoholic?!)

And I say this in full knowledge that I maintained the same thing for years myself not even getting the idea that my life was unmanageable. I was more willing to admit that I had a problem controlling my drinking than believe that it was causing my life to be unmanageable! Because if I admitted that, then that would mean I could never drink again because that would mean I was an alcoholic and alcoholics could not control their intake of alcohol because IT MADE THEIR LIVES UNMANAGEABLE! Whew!

What a concept! But it took me years. And here I am taking, what we call in AA, “somebody else’s inventory” meaning judging someone else’s faults rather than look at your own. Why? For two reasons, one, it is less painful to look at others’ faults and difficulties. And two, it is easier to see other people’s faults than your own.

Just as it is easier for your sponsor to help you with your problems than for you to see the solutions to your problems yourself so it is easier for you to see the fault lines in the geography of others’ personalities.

So for the new comer one has to sometimes “fake it ‘till you make it”. You go through the motions of the program until just by repetition you begin to make sense of it.  You pray even if the prayers don’t make sense nor have meaning to you. With time they may. Why would that be?

The act of prayer, kneeling or prostration is an attitude of humbling and humility. Especially for the person who is not used to doing it. Humiliating for someone not brought up in that tradition, for sure, but not without precedent if one scours his memory.

(I, for instance, baulked and said that Jews did not kneel in prayer. But on further thought, I would remember that on the high holidays the rabbi and the chazzan would indeed kneel at the climax of prayer on Yom Kippur. The time when prostration is indeed the time to show the greatest humility before the will of “the Lord”.

So if one needed precedent within one’s tradition, even the most Orthodox Jew would have no trouble in prayer. But of course an Orthodox Jew would not.  Only the secular Jew would have an “intellectual” aversion to getting on his knees and praying. And finding then that it isn’t in the “Jewish tradition” to do so. But that, of course, is a false finding.)

And when faked discomfiture turns into familiar comfort, then that is the beginning of humility. And you can start to begin to live a life differently than you were than when you were drinking and perhaps drugging.

The steps show us that there is a way to live a life filled with joy and love; filled with peace, less drama and lots of beauty if we allow it in. But we have to make the effort.  The effort is living a life of the twelve steps.  Admitting that we are sick and we need help. Admitting that we need to clean up our act. Facing up to those acts. Asking others to understand that we apologize for those acts and we take responsibility for them as we will try to make amends to the best of our ability. We then try to carry this message of self reliance, self respect, responsibility and personal faith to others and especially other alcoholics and that this can be done with the help of AA and the spiritual help of a higher power. And through this you can find a peace in this life that you had heretofore not been privy to while under the influence of the drink.

But all this could change in the face of life threatening disease if we should lose our faith in the goodness of that very life. But if we have worked our program well we will finally understand that even at life’s end, there is nothing in this life that a drink is going to make better; but it most assuredly will make things worse.

We think that we can die deaths of dignity but those dignified deaths are best served by having lived lives with serenity and dignity and goodness. Then the dignified death is practically a given.

© res 10/31/11

Post Script

Alcoholism is such a selfish disease that it would push the most thoughtful person to turn inward to self destructive  acts. When we receive bad news we act out by turning that news upon us and lashing out at the closest agent to express our hurt and anger. And that agent is usually ourselves. So when we are unhappy we drink to drown our unhappiness, drink for oblivion, to self destruct; to dull, dumb down and to numb.

Which is where I would ‘normally’ have gone had I not been practicing my program. At my professional meeting tonight I received the news that a colleague, about seven years my junior had died of renal cell cancer. One day he has a pain in his neck and then three months later he is dead.

And ‘normally’ I would turn his misfortune into a reason to pity myself for no other reason than to think the worst that life had to offer me and so I therefore will hasten the day when this would be true for me. Where is the sense of that? And what, by the way, is ‘normal’ in that thinking?

So it is a terrible thing that happened to Dr. T.. But it happened to him, not me. And tonight I will celebrate his life and his deeds for all the good that there was in it and not dwell on the reality that I cannot change. That is a fruitless endeavor and it ill serves the memory of T. by making his death all about me and not about his life and how he lived.

© res 11/1/11