Category Archives: Essays

Guest Blog: Musings – What If Addiction Was Actually Treated Like a Health Problem?

Snap Out of It

Dear Blog Friends,

Craig W. has kindly given me permission to re-post the following musings he shared with LSRSafe, one of LifeRing’s  e-mail support groups which he wonderfully moderates, that so clearly describe what it might – what it should – look like if the medical community were to treat addiction as they would any other health problem.

Thank you, Craig!

🙂 Bobbi

Imagine, if you will, a time in the not-too-distant future …

You’ve decided to face the fact that you’ve developed a drinking/using problem. Your urges have become cravings and your ability to resist those cravings has steadily lessened. Your use is beginning to affect nearly every aspect of your life. You know it’s a problem that has to be dealt with. So you go to your doctor and discuss it with her.

 

The doctor has you fill out a questionnaire asking about quantities, frequencies, sleep, diet, etc. She gives you a prescription for blood tests and maybe a liver-function test. She hands you some informational pamphlets and schedules you for a follow-up as soon as the test results are available. At no point does she treat you as anything but a person with a distressing but manageable medical problem. It’s very much the same as a consultation with a primary care physician about, say, depression. Perhaps she suggests a supplement — vitamins, say — but otherwise you’re on your own until the follow-up.

 
You leave that appointment relieved to have spilled your secret but perhaps disappointed that no treatment was offered. Still, you know you’ve started down a path that might offer hope.
 
The follow-up appointment comes a week or two later. Your tests show nothing drastically wrong physically — maybe some early warning signs from the liver test and a couple of blood readings slightly outside the normal range. But nothing major. She asks if you’re still drinking/using and when you say, sheepishly, “Yes”, she gives you a referral to an addiction specialist. As you leave, she tries to reassure you that your decision to come in was the right one and that the condition is highly treatable. “You’re going to be fine,” she says. You have trouble believing that, but you do feel a bit of hope.
 
Two weeks later, you visit the specialist. Again there’s a questionnaire to complete, this one more detailed, covering any family history, asking about certain medical conditions that may seem unrelated and going into considerable detail about your emotional situation and your current life difficulties. You go through the usual pre-appointment routine and then the specialist comes in. You have a fleeting regret that you ever started this process.
 
But the doctor has a very good bedside manner and quickly puts you at ease. You notice immediately that there is no judgment and no condescension in his voice. He runs through some of the information from the questionnaire, mentions that he has looked at your earlier test results and says, “This is what I suggest we do …”
 

He mentions a drug useful for controlling cravings, and another one to reduce anxiety; he hands you a book to read, and he suggests participation in a support group and offers some pamphlets about various such groups, including both face-to-face and online meetings. “Many people,” he says, “benefit greatly from support groups. It’s up to you which group best meets your needs. You don’t have to use any group at all, although if you have difficulty quitting on your own, I’ll be reminding you that they can be a big help.”

He goes on to say, “I want you to meet with one of our counselors once a week for at least a month and then less often if you’re doing well. And you’ll see me regularly as well. You do need to understand that your condition is very likely permanent and that you will need to abstain completely from any recreational use of drugs or alcohol. If you were diagnosed with diabetes, you would have to give up, for the most part, making high-carbohydrate diet choices; with Celiac Disease, you’d have to give up any food or products that contain gluten; if you had a serious allergy to something, you’d have to avoid it permanently.

You do have what is in effect an allergy and you have to abstain from recreational use of mind-altering substances permanently. This may be socially inconvenient, but you’ll find that, as time passes, you’ll adapt without undue difficulty. Quitting your use will be hard at first, but will get easier soon. I’ll help you and, if you need more help, you’ll get it from a support group. We have other prescribed drugs that may help, as well.”

 

The doctor writes a prescription and hands it to you, adding”Millions of people share your condition; it’s nothing to be ashamed of. These drugs will help, but they can’t solve the problem by themselves. We can give a diabetic a drug to help them, but if they don’t change their habits it won’t work. Change is hard, but not at all impossible. Get the prescription filled today and take the first pill tomorrow. And then don’t drink or use! Take the anti-anxiety medication mid-day. The book will give you some ideas for how to change what has become a habit. Here is the phone number of a help-line — don’t hesitate to use it. I’ll see you in a week.”

Why isn’t something like this the practice in dealing with addiction? Isn’t the above procedure what happens with other chronic diseases that spring up during our lives? Take Type 2 Diabetes, for example, which can be caused or made much worse by, among other things, behavioral choices made by the sufferer. You go to the doctor and you’re offered a treatment protocol which will require serious behavior modifications on your part, and then you manage it together.

With addiction, the common protocol now is to be shoved into treatment programs, in-patient or intensive out-patient, that cost a fortune and/or cause enormous upheaval to work and family life in return for very poor results. Or they are pushed towards support groups which refuse to allow efficacy studies that might demonstrate their success rate or that simply don’t work for them.

Treating addiction in a medically sound way — why is that even a question???!!!

~~

Late Night, with Jimmy Falling

 

Drunk in a Forest

 

Every once in a while I’ll see or hear something about someone’s drinking that makes the hairs on the back of my neck stand up, a phenomenon interesting to me because while it could easily be mere physiological speculation on my part (i.e. neck hair stimulation it isn’t scientifically quantifiable, and therefore doesn’t mean jack squat), there’s also a deep level of knowing which hovers beyond my control somewhere around the pit of my stomach (i.e. my gut) that I can’t ignore.

Whatever you might think about that, please try to believe me when I tell you that I don’t suffer from some twisted sense of schadenfreude where I hope people are alcoholics or addicts because I’m a little Sober Sally who thinks she knows everything, including what is best and right for everyone else, and enjoys lording her superior self over all she surveys  – I don’t. I wouldn’t wish addiction on my worst enemy – and I really, really disdain some people, OK? – much less on someone I either don’t know or do know and actually like.

Every once in a while, though, as an observer with personal recall of certain experiences, I can sometimes discern the handwriting on someone else’s wall, and shiver at what I find there.

Such has been the case with Jimmy Fallon, the newest, most popular host of NBC’s “The Tonight Show”, a fellow I’ve adored since his days on “Saturday Night Live” (you can see some of his “Best of” sketches here if you can hack the stinkin’ T Mobile ads. My apologies). Not only is he warm, accessible, incredibly versatile, and genuinely hysterical, not to mention cute as a button, to me he’s the best reflection of everything I loved about growing up in the 80’s, from the comic sensibilities and musical influences to the explosion of popular culture we were exposed to through such mass mediums as Mtv, from then on through to the internet in the 90’s and beyond.

But as links in this recent EW article attest, he seems to have become somewhat…accident prone in recent months. Accidents that have had explanations attached to them that seem a little, well, I don’t know… kinda sorta like explanations abuse victims give when someone inquires about the visible bruises, cuts, bandages, scratches and/or other injuries on their bodies. “Oh, can you believe it? I tripped over our cat and fell down the stairs” scenarios are certainly plausible enough to buy once or twice, but after a while, when there are no stairs anywhere in this person’s general vicinity and they don’t have a cat,  these tales more practically serve as A). reminders of further need for the victim to cover their injuries up much more carefully in the future and 2). cues to the inquirers to shut up and mind their own damned business. 

This is especially true when it applies to people who don’t fit our ideas or expectations of what someone with a “real” problem looks or acts like. Someone too smart, talented, and  successful, who looks too well and is too much of a family/people person with way too many friends in high places and far too powerful to have these sorts of…issues.

No, those people with the black eyes are easy to spot a mile away, and isn’t it too bad for them? Such a shame they can’t pull themselves together… These people are too likable and way too great for their peers and superiors not to back them 100%, even if the things they say seem a tad misconstrued. And hey, Jimmy hasn’t hidden anything about his little gravitational scrapes. If anything, he’s been most upfront about them and shared them for all the world to see. 

So, he tripped over a rug and nearly severed a finger. So, what? You’ve never tripped over anything and ended up in the hospital before?

So, he tripped again at a Harvard Lampoon event and injured his other hand. What do you expect – it’s the fucking Harvard Lampoon!

So – to recap, in a slightly redundant way – he nearly cuts off a finger on one hand, injures the other hand, and then he chips a tooth while trying to open a bottle of pain medication, but you think the guy’s got a drinking problem?! Get outta here…

Even though a large percentage of the internet fancies itself way too perceptive for its own good (and no one else’s), apparently I wasn’t the only one having a Maalox moment over all of this, so NBC executive Bill Greenblatt felt he had to go out of his way to assure everyone that Jimmy doesn’t have a problem, OK? He just likes to party a little, that’s all. He’s fine. (Except saying someone’s “fine” is usually the best indicator of their un-fineness.)

Most interesting to me, and the point of this random rumination, is the fact that the same scenario plays out day after day, year after year because believing somebody who appears to be worthy of all the reasons we like/love/respect/admire them is an alcoholic is just way, way too awful a thing to contemplate. If it was true, not only would it mean they and their lives are screwed up in a way we’ll never understand forever, it would force us to have to think differently of them in a way that simply wouldn’t be right. It would be almost like trying to convince yourself they’re a murderer or something equally horrifying –  I mean, you have to be a really, really bad, fucked up, amoral idiot of a person not to be able to handle your shit, or to continue drinking if you can’t handle it. We know this. So how in the hell could you allow yourself believe that about someone like Jimmy? (Or your Mom, Dad, spouse, sibling, kid, friend, beloved co-worker/employee/employer/superstar. Yourself?) No one with a heart or a brain would do that to somebody, would besmirch them in such an egregious way. 

Would they?

So, is Jimmy one of us? I have no idea – before now I didn’t even know he drank much. But even if he isn’t, and truly, I hope not, I’m still left with a simple question: If someone doesn’t have a problem, then beyond all the obvious reasons (he’s NBC’s better-than-Jay Leno, 21st-Century-Johnny Carson, late night gravy train they’ll want to be riding ’til doomsday – oh, and Johnny drank and smoked, y’all!), um…why go to the trouble of publicly announcing it?

Oh, and what’s up with this “Dry January” crap?

~~

 

So Long, Farewell, Auf Wiedersehen Goodbye, 2015!

Do Not Move On To 2016

 

Well friends, here we are, not much further than a few turns of the dial until another year arrives and we’ve made it through the holidays! 

A lot of people look at the New Year as an opportunity for enormous growth, for change, for becoming whoever it is they thought they wanted to become the year before but didn’t. I once heard it described as one big “Do over”, which is a rather fanciful way of looking at it, don’t you think? Especially if the previous year didn’t quite work out like you planned…

Then, of course, there are the bah-humbuggers who scoff at the idea of making these silly little resolutions, usually by posting “In 2016, I’m still going to be the same asshole I was in 2015” memes on Facebook or otherwise poo-pooing all that nonsense. They know there’s absolutely no point in it because they also know that by about Week 3 things will inevitably go south, at which time the gym that will continue getting their membership fees for the rest of the year will rejoice while they will continue muddling along…until next year, perhaps.

They know – they’ve tried.

For myself this year, rather than come up with some grand plan such as swearing or declaring I’m going to finally lose that pesky extra 20 pounds (’cause I am, damnit!), I’m going to try something new, like the idea in the meme I’ve included here. It feels refreshing to me that I don’t need to expect some ginormous transformation from myself into something else, which, indeed, feels like carrying around a boulder so massive the only reasonable choice – what’re you, crazy?! – is to drop it.

I remember when I was a kid and I had distinct periods of wishing I could run away to some place else and **poof!** become somebody else entirely – a whole new me, the way I always wanted me to be. Alluring, adorable, irresistible, and oh so talented and cool, a star hovering above all in the junior high firmament. I carried that feeling right along with me into adulthood, and tried using alcohol to make it go away. It took me a long, long time to accept that it wasn’t working for me, neigh –  wasn’t, couldn’t, didn’t, never will work for me.

Changing that became a journey of its own, and one that did not involve becoming a new version of the old scene. (Because what such a transformation would amount to is the affirmation that there was always something fundamentally wrong with me to begin with. Thus, I would still be the same asshole I always was, too –  just not a drunk asshole, and I think that’s an important distinction.) Like almost all other change, it was a daily, incrementally concerted effort which involved letting go of old beliefs about myself and what alcohol woulda/shoulda/coulda been for me, and then allowing that whitespace to be filled up by the reality of my Sober Self.

Among other things, what it mainly involved was being open to the idea that I was capable of real, lasting sobriety – something I’d previously thought impossible – and I’ve come to be reminded of that feeling over the past year, of being…open. Being open to learn new things, have new experiences, get to know or reconnect with people in more than a passing way, being grateful for what I have and what is. Getting out of my “comfort zone” and taking risks, even if compared to, say, base jumping off of El Capitan, they’re likely to be very, very small.

For someone whose natural inclination is to hang out snuggled in my cozy little clamshell, that’s no small feat! More importantly, though, I know from my experiences with getting sober that being open, or at the very least developing a willingness to be open, means two things: A). I will be scared to death at times, because exposing my soft little clammy underbelly will mean that I’ll be vulnerable, and what am I, crazy?! And 2). even if it’s hard, whatever comes from it will ultimately be good.

So, all things being equal, and New Year’s Eve in reality just being one (more) big drinking opportunity we can all avoid like the plague in our own, fun ways – my darling hubby and I are going to a tasty burger joint and a movie this evening, after which we’ll arrive home and wait until 12:01 to go outside and bang on pots and pans in our deathly quiet neighborhood – what whitespace might you open up to tomorrow?

~~

Mental Health Week 2015: Whaddaya Mean My Brain’s Been Lying to Me?

Hey, everybody. In the midst of all the usual holiday hustle and bustle the interwebs have kindly informed me that it’s “Mental Health Week”, which I suppose basically just means that those of us with mental health, um, issues get a week of our very own (yay!). You know, where things like depression, bi-polar disorder, body dysmorphia disorders, and other stuff that fucks with your head are highlighted in online articles across various sites (and maybe a tumblr post or two? Who knows – all that’s way beyond my ken), so as to enlighten the public and encourage anyone who’s having troubles, or knows someone who’s having trouble, to seek some help.

It seems like that should be pretty easy to do and make fairly obvious sense to everyone, right? And yet never is anyone so surprised as when someone they love got to the point where suicide appeared to be the only logical solution to what was happening to them. Most people get to that point without arousing any suspicion that this is where things were headed, because killing themselves aside, the very last thing they want to do is try to explain to anyone what’s going on inside them – especially those closest to them. One day, they seem OK. The next day, they’re dead.

And then the loved ones left behind spend years of their lives trying desperately to understand what drove the one they’ve lost over that terrible edge, and what they could’ve, should’ve, done differently to change things. (Which is mostly nothing, by the way. Even if you know your beloved’s not well, ask yourself this – of everything you can do, can you also lasso butterflies?)

That’s usually because it’s most often not an easy situation to understand, including for the person suffering so much they decide they – and everyone they love – would be so much better off without them trapped in this hellish life. And even if they could tell anyone what’s going on – but they can’t, you see, they just…can’t – it’s not easy to describe in any way that fully expresses the level of psychic, emotional, and sometimes physical, pain they’re in.

A few people of letters have been able to articulate their experiences over the years – William Styron, well-known author of “Sophie’s Choice” and other literary tales, was one of the very first to talk about depression publicly in the autobiography of his discontent, “Darkness Visible”, published in 1990 – and a few others kept it to themselves and died, like David Foster Wallace did, hanging himself in 2008.

The rest of us have to find our own ways out or though, and one of the most famously popular ways out since it was built in the 1930’s has been jumping to one’s death from the Golden Gate Bridge in San Francisco. It certainly seemed a viable, attractive option to me in the darkest depths of depression over the years for reasons that, again, are almost too arcane for even I to try to explain, except that if you’re brave enough to get yourself there, and there’s nothing or no one to stop you by the time you find a good jumping off spot, it’s both extremely swift and extremely final.

A fellow, well-liked LifeRinger from the Bay Area chose this option – RIP, dear Barbara – likely for pretty much the same reasons intermingled with what I’m sure felt like her own unconquerable quagmire. And that’s just it – at the heart of matters, people choose such options because their illness has them convinced that it’s the only thing they can possibly do; otherwise, there is no help for them and thus no point in seeking it.

Wait, what do I mean by “their illness has them convinced”, as though it’s some sort of separate entity or being inside of them that’s commandeered their lives and free will? Well, I mean…exactly that. See, our brains are the most potent and powerful operating systems known to mankind – Android technology’s got nothing on us – and it runs on scripts, internal working orders if you will, which instruct us on how to perform. Most of them are learned, and certainly many of them are chosen. It’s not an abnormal process – this is pretty much how everyone’s brain works.

But then there are the scripts that invade us for reasons unknown for the purposes of insinuating themselves inside our minds, at first disguised and undetected, until they’ve taken over without our being the wiser, so that just like everything else that runs through our brains, it becomes our reality – and we believe everything it tells us, absolutely. And then, once it’s got us hooked, it begins directing our behavior, too.

So even if you still haven’t got the foggiest idea of what in the hell I’m talking about, one example of what this looks like is addiction. The other, of course, is mental illness, and to my own benefit this week, I ran across this most incredibly important and effective Buzzfeed article and video about a guy named Kevin Hines, who made the same choice as my friend Barbara and lived to tell the tale – including what living with mental illness feels like.

So if you have a few more minutes and if not the inclination then the curiosity, do yourself and everyone you love a huge favor, and give it watch. You won’t be sorry – I promise – and then you can carry on. 🙂

~~

Guest Blog: Carving My Gravestone by Mahala Kephart

Hi all! Last time you heard from me, I was off to Colorado to try heading down an icy mountain on a coupla personalized foot sleighs. The good news: I made it down with all appendages still attached and functioning properly. Yay! The bad news: Upon our return home, life got a little hectic. Boo!

Thank goodness my fellow LifeRinger, the brilliant Mahala, wrote and offered me the following wonderful piece to post, a response to Oliver Sacks’s moving and profound Op-Ed in the New York Times (link attached at the end) on facing his recently diagnosed terminal cancer.

– Bobbi C.

When-it-comes-your-time

 

Carving My Gravestone

February, 2015

Samburu National Reserve, Kenya

 

Somehow, in spite of having completed two intensive outpatient programs and hours upon hours of conversations with therapists, I have managed to avoid the morbid-sounding exercise of writing my own obituary. But carving my gravestone? I’ve been chiseling away at that one for years.

When I was in the sixth and seventh grades, every week I would walk through an old cemetery, reading the gravestones and making up little stories. It’s not as ghoulish as it sounds: my Girl Scout troop met on Thursdays in a church near my school. The church was old, and so was the cemetery that surrounded it. The church, a white building that was not nearly as wide as it was tall, stood at the top of a slight hill.  The church steeple, pointing ever-skyward, was the commanding feature of the building itself. It remains so to this day.

To enter the building, you have no choice but to walk through the oldest part of the cemetery, on what must be the path of an old carriage lane … a long lane that would have allowed a horse-drawn carriage to approach the front doors of the church, its passengers to disembark (unless of course the horse-drawn carriage was a hearse, in which case the disembarking would be a different sort of process altogether), and the carriage to continue moving forward past the front doors, making a little turn back downhill, and then to proceed, perhaps clattering a little bit, down the other side through the cemetery to a little field that has been, for many, many years now, a paved parking lot. But in my daydreams, both the parking lot and the carriage lane were unpaved, grassy, and perhaps a bit rutted. Sometimes they were muddy. I share them with you today as they were in my daydreams.

Unpaved, as they were in my imagination, and sometimes muddy, the shoulders of the carriage lanes were distinctly defined by the headstones that flanked them. Each stone monument stood as if at attention, at a sharp ninety degree angle to the earth, its lettering, whether raised in relief or carved into the surface of the stone, clear and legible.  That sharpness, those angles, and the bright white of the markers, I thought, would have stood in sharp contrast to the less disciplined grasses, and perhaps the occasional dandelion, that grew between the stones.

Whatever might have been carved on those stones: a name, a date of birth, a date of death, perhaps the name of a spouse or child, perhaps a cause of death (the tiny stone of an infant who died from an unknown illness and the full-sized stone of a soldier who had died on the battlefield already distinguishable by their size) — on many stones, those individual letters and numbers, even whole words and years, had been worn away by the wind and the rain. By the time I was walking through the cemetery, nearly a half-century ago, the stones themselves were becoming weathered. Some were simply chipped or pitted. Others seemed to be disintegrating before my eyes, reminding me of sugar sculptures that had been first nibbled by the wind and then rained upon by the sky, the nibble marks left by the wind becoming rounded and blurred. How a stone had weathered, how chipped it was or broken, how much it tilted at crazy angles by unrelenting tree roots and shifting soils, how many of the few letters and numbers that summed up a life had been partially — or completely — obliterated … It all seemed random, capricious, and sad.

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