This post won’t speak to everyone out there, but for those who have battled addictions of any kind, I hope it will be a ‘shout out’ of respect, guidance and fellowship. And the truth is, we’re all addicted to something: it’s just that some addictions are legal and socially sanctioned (material things, anyone?), whereas others are considered ‘bad’ and not tolerated.
Has it ever occurred to you that in some ways, all of society is just one big sandbox, and we’re all children playing around in it? Orson Welles once said that the whole development of civilization was just a way to impress girls, and I think that’s pretty close to the truth. All of us in this ‘sandbox’ want to be liked, we want to impress people, we want to feel included, we want to be like everyone else, and we want to be special. Like children, we all have a need to be good, and a need to be naughty.
We all have internalized ‘voices’ – from parents, teachers, religious institutions and other authorities – that tell us what to do. They tell us the ‘rules’, not just of our outward behavior, but even the rules of how to feel and think, in the privacy of our own minds – in fact, maybe mostly in our own minds. Imagine that – we live in a constant stream, a soup, a marinade, of judgments about our very thoughts and feelings. ‘They’ tell us where we go wrong, and we go wrong a lot:
Why were you happy when Jimmy got hurt? That’s not nice!
You lied about pushing your brother off the bed. What’s wrong with you?
You’re not very good at kickball – you better hide in the back the next time they choose up sides.
Now look what you did: you forgot to get Mom a Mother’s Day card and she’s all upset!
When we get older, the ‘voices’ get older, too, but they still have the same hectoring tone:
Why can’t you talk to people? Because you have nothing to say – that’s why!
Unbelievable: is that the best you can do?
Everyone else seems to be in a good relationship, but here you are, alone again!
I can’t believe you just did that: you must have been asleep the day brains were passed out.
And on and on it goes – sometimes it feels like a civil war inside your head. It’s frustrating and confusing to always be on two sides at the same time, or even worse, on no side at all. Other people seem able to do their homework, to plan for the future, to get hooked up with others, to belong, to not fail all the time, to relax, to have fun – but not you. And boy, do you hear about it: it’s yammer yammer yammer all the time.
Then one day, someone offers you a drink (or a joint, or a shot, or a pill). Well, it’s no big deal – besides, everyone else is doing it, and they seem okay. Well, just one won’t hurt. Besides, you don’t want to be a dork and an outsider, right? So you take one. Hmmm – tastes like crap, but it didn’t kill me. Another one? Sure – hit me again.
Wait – now this I didn’t expect: the voices stopped! Wait a damn minute – let me just take another one and test this out: Son of a gun – they did stop! Now this is more like it! I’m free! I’m living! I’m me! Where have they been keeping this stuff all this time? This is the best-kept secret of all time! And why did it take me so long to catch on?
Wow, I’m not afraid all the time!
I can talk to people!
Man, if this is what the Buddhists call being in the moment…whee, I’m a Buddhist!
And, for many women, there’s an added ‘bonus’:
I’m sexy! I can have my own sexuality and not be so uptight about it. Woo hoo – I never knew being bad could feel so good!
Okay, sure, so you wake up the next morning and feel like the scum on the s…house floor. Sure you’re hung over. Sure, you ‘tied one on’, but then that’s part of life, right? It’s part of being a real man! You were there, man – you were part of something. Finally, you were YOU!
Well, who wouldn’t want more of that? Who wouldn’t want to feel like yourself? Who wouldn’t want to feel the flow, to feel sexy, to feel like you belong, to feel, finally, like you’re all right, instead of all wrong? To shut those voices up? To not be angry all the time, hurt, out of it, shy, dumb, worried, ashamed? To be free!
So you want it again. And you get that good feeling. But it wears off. So you want it yet again. And it wears off again. And now you need it, and it’s starting to cause trouble – nothing big, nothing you can’t handle. You’re lying to people about little things: where you were, what you were doing, how much you had, who you were with. Why are they asking anyway, dammit? Why can’t they just lighten up and leave you alone? You’re even lying to yourself, not a lot, but a little: just one more, then I’ll study; just one more, then I’ll swear off till the weekend; just beer, no hard stuff; only after work; in the morning, but only on the weekends; in the morning, but just enough to get me going.
Now you’re starting to have some real trouble, but again, nothing you can’t handle: a DUI from some cop who’s just out to fulfill his frickin’ quota, and can’t leave decent citizens alone; some snitch at work who told the boss he saw you take a nip in the men’s room; getting an F because the teacher was too uptight to be flexible about the drop deadline; a friend who’s mad because you didn’t show up when you said you would, or at all for that matter. And you lie to yourself about it: anyone can get a DUI – it’s just bad luck; I do more at work drunk than the rest of them do sober; that F doesn’t matter, because it isn’t in my major, besides I can always make it up in summer school; friends come and go – besides, they never understand that I can’t be held to rigid schedules all the time.
And the truth? You actually should have gotten 50 DUIs; you missed work ten times the last six months because you were hung over or passed out; you haven’t gotten it together to study for any of your classes; you don’t have any friends anymore, because the bottle is your one and only ‘friend’.
Okay, okay – you finally get the message: you have to stop. Not today, but soon. Real soon. Promise.
And you try – you really do try. You lay off for two whole days. That shows you can stop whenever you want, right? So why stop now, when you can stop whenever you want? Or how about this: I’ll control it; yeah, I’ll only drink every other day, and only at night – and only beer, which I hate anyway, so it should be easy.
So you enter what I call the phase of Independent Research: you know you have a problem, but you think you can ‘handle’ it. You develop, and test out, more approaches, more theories, more hypotheses, more hunches, more sure things, than a roomful of experimental physicists would in a lifetime.
I’ll only drink high quality stuff: it’s better for you.
I’ll cut down, but I’ll do it slowly, so it isn’t a shock to my system.
I’ll only drink at bars – that way I’ll drink smart, because I’ll have to drive home.
I’ll alternate a day of Ativan and Vicodin with a day of booze – less dangerous that way, and I’ll get used to not drinking every day. It’s really not that different from a dry-out program. Now I just have to convince my doctor that my knee really is that bad, and that I can’t sleep. But it’s a good, sound plan.
The variations are endless, and I’ve heard some real lulus in my time, including this one:
I’m on straight Xanax now, and I figure if I can handle Xanax for six months, I can definitely handle booze again. So my course is charted.
And this was a very bright guy – a guy who, a few months into sobriety, would tell this story at an AA meeting and get a big laugh. And he laughed with them.
So what happens to these people? Why can’t they just stop, as the title of a popular recovery book asks? Well, let’s go back to the original situation I outlined at the very beginning of this piece: what about that verbal civil war going on inside? What about the anger, the shame, the shyness, the confusion, the lack of confidence, the social awkwardness, the sexual taboos? If ‘they’ just stop – well, what’s Plan B? Sure, you could ‘just stop’, maybe, with help, but if all you do is ‘just stop’, you’re sunk. Then what? What do you do about the voices, the storm of internal criticism, the lack of belief in yourself, and all the rest of it? Yes, your original ‘solution’ (drinking) turned out to be a bust, but like the old joke about the crooked gambling house – it’s the only game in town!
This is what we call a ‘dry drunk’ – someone who has “just stopped”, period, with no Plan B in place. It’s admirable, maybe, that they’ve been strong enough to stop, but now they not only have all the original problems – the internal voices, the civil war – but they’re years behind in the game of life, and in emotional development and emotional skills, which only evolve when you confront problems directly, so that real emotional growth can take place. And I’m saying this with great compassion: it’s HARD to ‘grow up’ when you’re 30, or 40, or 50! It’s embarrassing, it’s humiliating, and it’s cumbersome, to use a nice word for cluster-f___.
A ‘user’ relies on what I call the ‘one-person system’ to solve their problems: they rely on their ‘best friend’ alcohol (or weed, or meth, or oxy, or coke) to fix things (hence the word ‘fix’). They have given up on (or never had) the use of other people to help them move through difficulties, and they have never developed a familiarity with ‘sitting with’ problems until a solution occurs, or until the problem shifts into something more manageable.
What do I mean by ‘shift’? Well, let’s take a 33 year-old male patient, ‘Jim’, who had been drinking alcoholically for at least ten years. I finally got him to go to Alcoholics Anonymous meetings regularly, and he was starting to see that he needed support from other people if he was going to stay sober. I will present two hypothetical sessions with him: one before getting sober, and one after – that will demonstrate what I mean by a ‘shift’:
Jim: Well, Rickie’s up to the same old shit.
Me: What old shit would that be?
Jim: I think you know.
Me: Well, humor me, then. I don’t like to guess, and I don’t read minds.
Jim (Disgustedly, with a snort of derision): She has girlfriend-itis again. The same old story: Get yourself together! Where were you last night? You need to bring in some money, or you need to get out. Look at these bottles! I mean, what does she expect me to do? I’m dealing with a bad knee, I’m working on filing a grievance for getting fired by that bastard, and – oh yeah, a guy at the bar told me I should be drawing disability for having ADD: is that possible?
Me: Rickie sounds pretty frustrated.
Jim: Frustrated? Hell, we’re all frustrated on this bus! She just specializes in blaming me for her problems. She’s got a Ph.D. in it, dude!
Me: What do you expect her to feel? After all, with you either being drunk, or gone, or both, most of the time, she’s not getting much out of the deal, is she?
Jim: I’m there, ain’t I? I try – I even brought her some flowers the other day, and do you know what she did?
Me: No – what?
Jim: She looked at ’em and started crying! Crying – I am not shitting you! Then she said, “Let’s put ’em in a vase of whiskey, and see how long they last.” Can you believe that shit? So, why should I try?
Me: It seems pretty clear that as long as you’re still drinking, nothing’s going to change.
Jim: You sound like her.
Me: Maybe there’s a reason.
Jim: Jesus, Doc – you and Rickie got the same Ph.D.
Jim: Rickie’s mad again.
Me: What’s she mad about?
Jim: Well, I got sober, but I guess that ain’t enough. Now she wants me to listen to her, too.
Me: Listen to her, how?
Jim: You know, like about her day, her job . . .
Me: Her feelings?
Jim (laughs): Yeah, her feelings.
Me: Is that so crazy? We all have ’em – even you.
Jim (pauses, looking down): Yeah, sometimes it’s weird-like . . .
Me: You mean like they’re coming out, coming back?
Jim: Is that weird? (foot jiggling now, still looking down).
Me: No – it’s normal. You’ve stuffed ’em, drowned ’em, starved ’em and strangled ’em for a long time – but you’re lucky, you’ve got some tough guys inside there, that refused to die.
Jim: You mean it’s good?
Me: Well, let’s put it this way: all human beings have feelings about things. It’s part of their internal GPS – feelings help you evaluate what’s going on.
Jim: You mean like, ‘Know when to hold ’em, know when to fold ’em’?
Me: Exactly – you wouldn’t drive a car without any gauges, would you?
Jim (laughs): I used to have a Ranchero with a hole in the floor – and nothin’ on that sucker’s dashboard worked, dude!
Me: But you don’t drive it anymore, do you?
Jim (thoughtful): Naw – that’s kid stuff.
Me: Maybe stuffing your feelings is kid stuff, too.
Jim (chewing on his lips and looking away – big sigh): Like, ‘Time to grow up’?
Me: Dude, you are growing up: you got yourself sober, didn’t you? That’s man’s work.
Jim (cocking his head): Feelings too?
Me: Feelings too. Feelings especially – they tell you who you are.
Jim: But man – sometimes they’re hard!
Me: That’s why I said it’s man’s work – a real man isn’t afraid to wade in and take care of business. Or to ask for help, either. Or to talk to his girlfriend.
Jim: You mean, like, trade back and forth – about, you know . . .
Me: Exactly: she doesn’t have a monopoly on feelings. Now, you have something to throw in there, too. Back and forth. You help each other out.
Jim (laughs): You mean, like, now I can torture her with my feelings, too?
Me: Haha – now you’re catchin’ on, Bro.
See the difference?
Before, he was shut down, blaming, locked into his own experience, unwilling and unable to take in anything new. Later in his sobriety, when he recognized these same qualities in AA newcomers, he would call it Paranoid.
And After, though he was still defensive, unsure of himself and wary, he had the capacity to take in a new point of view and ‘sit’ with uncertainty, until he had done something with it – that’s the shift, and that shift is the core of therapy, the core of sobriety, and, in my humble opinion, the core of a good life. For only when you listen, take responsibility, and have a willingness to change, do you truly have any power.
Running away isn’t power, and that’s why addictions are weak. Facing the truth is the only real power. And when you make facing the truth a way of life, sobriety starts to be fun: then you’re catchin’ on, Bro!
Note: All clinical vignettes herein are significantly altered to protect patient confidentiality and privacy.