Why I Can’t Join You for Thanksgiving

As I approach three years without a glass of wine – or beer or of any alcohol of any kind – I have wondered if my time of abstinence is a rubber band around my waist. The farther I walk away from that last glass of wine, the tighter it gets. The next step into the next day of abstinence may be the step that tightens the band beyond my strength and snaps me back to the wine I both love and loathe.

What not drinking feels like

Lately, I have been dreaming of wine. In one recent dream, I pulled a single swallow of wine into my mouth then spit it out. I awakened with the conviction this was a turning point in my recovery, negating the rubber band analogy. I could, after all, of my own volition, stop myself. Ah, but the night before last, in my dream, I drank the wine, sneaking it into a glass of club soda, talking amiably with a person in recovery who was not drinking.

People suffering from addictions are not morally weak; they suffer a disease that has compromised something that the rest of us take for granted: the ability to exert will and follow through with it.
– Nora D. Volkow, M.D, quoted in What We Take for Granted

To loosen the tightening rubber band, to eliminate these distressing dreams, wouldn’t it make sense that I do a little real drinking instead of dream drinking? Just every once in awhile? The same small amount I do in my dreams? I wasn’t a huge drinker, only a bottle a night towards the end. Surely, both my days and nights would be eased if I just drank every once in awhile. That makes sense, doesn’t it?

Within days of my sister inviting me to Thanksgiving at her house, I began to plan how, while I was helping set the table, I could pass by the wooden cabinet where the wine is kept, use whatever corkscrew was out because I am athletically quick with even the simplest version, palm the bottle (probably cabernet rather than merlot, but okay), take about twenty steps (yep, I mentally counted) to the hall bathroom, lock the door, and pour the wine right into my mouth from the bottle.

On second thought, why don’t I palm both the wine bottle and the corkscrew and then open the bottle in the bathroom? Oh, dear, that’s kind of like stealing, though, and wouldn’t it inconvenience my sister? Still, I would decrease my chances of detection. But, the pause in the bathroom to open the bottle feels like agony! I would want the bottle open before I got there so I could close the bathroom door with one hand and raise the bottle to my mouth with the other.

See how rationally I plan the irrational? I am such a bright, aware, educated, determined, willing person! Yet my thoughts plot substance use through theft.

Two months ago, I would be beating myself to a bloody pulp with a mental two by four for having these thoughts. My last theft was gum from the dime store in first grade. I never drank from the bottle when I was an active drinker. My family does not police my drinking. I did my best to do a little drinking – and couldn’t stop! After everything that’s gone down, after all the care so many people have given me to help me not drink, how could I possibly be thinking of drinking?! What is wrong with me?!

[T]he addicted person’s world is like a threatening virtual environment, a landscape calculated to pose maximal threats to their sobriety – in the form of drugs and drug cues – around every corner and lurking in every shadow. Yet the person playing the game must navigate this environment with a broken controller, such that no matter how hard they try to steer clear of hazards, their game-world avatar heads straight for the drug that will lead them to relapse.
– Nora D. Volkow, M.D, quoted in What We Take for Granted

Two months ago, I still thought addiction was my fault and, therefore, under my control. Any problems I had were because of me – I wasn’t doing recovery right. I wasn’t right.

In October, 2015, a groundswell of authoritative voices began to articulate what’s really up with addiction and how to treat it rather than repeating the folklore that predominates addictions treatment.

Today, I recognize my drinking thoughts as symptoms of the brain disease of addiction. I wish I didn’t have such a condition. But having a brain disease beats believing I’m a good person gone bad a millionfold.

We need to talk about these disorders [substance use disorder and mental illness] in a language that reflects their true nature; they are medical conditions, the origins of which lie in the person’s brain, and the effects of which extend into every part of that person’s life, and as with other illnesses, virtually always into the lives of the people who are touched by the patient.
– Robert Kent, J.D., and Charles Morgan, M.D., New York State Office of Alcoholism and Substance Abuse Services, quoted in The Fix

The science of addiction frees me from responsibility for my addiction and offers me responsibility for my recovery. How much time, heart and effort I have given to attempting to understand what went wrong with me!

Critics of our stance tell us we are absolving people of responsibility for their actions, when in fact we are doing quite the opposite. By delineating the true nature of the illness [substance use disorder], we can allow patients to get proper treatment for their illness…. [W]hen we treat SUD rationally in this way, rather than as a series of “volitional behaviors” that those afflicted should be able to stop if they were properly motivated, people affected by SUD can then take responsibility for their illness and get effective treatment.
– Robert Kent, J.D., and Charles Morgan, M.D., New York State Office of Alcoholism and Substance Abuse Services, quoted in The Fix

Thankfully, with what’s left of my volition and with enormous help and support from literally thousands of people, I have focused enough of my attention on recovery – rather than on addiction – to learn and practice what helps me stay sober and to become acutely aware of what threatens my abstinence.

Currently, being around wine – even thinking about being around wine – makes me want it beyond bearing. It’s not wine’s fault and it’s not the fault of people who drink wine. And it’s not my fault. My brain has become trained to want.

Last Thanksgiving, I was able to handle being around alcohol. This Thanksgiving? Days away, I’m already salivating – and not just for the exquisite feast my sister and brother-in-law will prepare for the family. I am so sorry I can’t go. And I’m so sorry what I have hurt and disappointed the people in my life. But the rubber band of the brain disease of addiction pulls me too tightly right now.

Ultimate Addictions Numbers Post

By Anne Giles and Laurel Sindewald

How many people have drug and alcohol problems in the U.S.? What percentage? What are the numbers for men and women?

Beneath these calls for hard data is often a more personal query. How many are like I am? How many are like my loved one? How prevalent is this in my workplace, in my community?

Google the questions and clear, reliable answers are hard to come by. With the majority of the research and extrapolations contributed by Laurel Sindewald, we’ve done our best to present the most current, meaningful numbers.

If we were seated in 2010 at a conference table of 11 people representative of the population of the region of southwest Virginia in which New2Recovery was founded, one of us would have had a drug or alcohol problem in the last year.*
numbers

How many Americans have substance abuse problems?

Approximately 21.6 million Americans aged 12 or older are classified with substance dependence or abuse. That’s 8.2% of the population aged 12 or older.

How many men?

10.8% of American men aged 12 or older have substance dependence or abuse.  Using 2013 census data, we can estimate that this means 14 million American men aged 12 or older have substance dependence or abuse.

How many women?

5.8% of American women aged 12 or older have substance dependence or abuse. Using 2013 census data, we can estimate that almost 8 million American women aged 12 or older have substance dependence or abuse.

How many children?

5.2% of adolescent Americans aged 12 to 17 are classified with substance dependence or abuse. That means over a million adolescents have substance dependence or abuse in America.

17.3% of young adult Americans aged 18 to 25 are classified with substance dependence or abuse. This is 5 and 3/4 million young adult Americans classified with substance dependence or abuse.

What races have the highest prevalence of substance abuse problems?

In 2013, of those 12 or older, American Indians or Alaska Natives had the highest proportion of illicit drug use at 14.9%. Native Hawaiians and Pacific Islanders had the second highest proportion of illicit drug use at 11.3%. 8.6% of Hispanic Americans used illicit drugs, 8.4% of White Americans, 7.4% African Americans, 4.6% of Asians, and 10.9% of those reporting two or more races.

How many people with substance abuse problems have co-occurring mental disorders?

Approximately 6 out of every 10 substance abusers have one or more other mental disorders.

About 37 percent of individuals diagnosed with alcohol dependence or abuse and 53 percent of individuals diagnosed with drug dependence or abuse have at least one co-occurring mental disorder.

A 1997 study of 719 addicts found that 47% of their sample had one or more comorbid mental disorders. The most prevalent mental disorders were antisocial personality disorder (25.1%) and depression (15.8%).

How many people with substance abuse problems are homeless or in poverty?

It is estimated that 34.7% of homeless people in the U.S. suffer from substance use disorders.

Of the people in America who are chronically homeless, an estimated 30% have mental health conditions, and 50% have co-occurring substance use problems.

How much is crime associated with addiction?

A survey conducted in 2004 found that 32% of state and 26% of federal prisoners committed their offense while under the influence of drugs.

A meta-study of 7563 prisoners in 2006 found that alcohol abuse and dependence ranged from 18-30% among male prisoners and 10-24% in female prisoners. 10-48% of male prisoners and 30-60% of female prisoners were estimated to have drug abuse problems or dependence.

Almost 50% of federal inmates were incarcerated for drug offenses in 2014.

How many people in the U.S. abuse or are dependent upon tobacco?

18% of all Americans, or 56.5 million, smoke tobacco as of 2012.  Specifically, 21% of men, or 32.5 million, and 16% of women, or 25.5 million, smoke tobacco in the U.S.

How many people in the U.S. abuse or are dependent upon alcohol?

In the United States, an estimated 17.3 million are classified with alcohol dependence or abuse. That’s about 5.4% of all Americans in 2013 and 1 of every 12 adults.

How many people in the U.S. abuse or are dependent on illicit drugs?

6.9 million Americans, or 2.2%, have illicit drug dependence or abuse.

How does education affect substance dependence or abuse?

There was a correlation between level of education and rates of illicit drug dependence or abuse in this population: college graduates had the lowest rates (0.9%), followed by those with some college education (2.1%) and those who did not graduate from high school (2.5%).

What is the association between addiction and employment?

Unemployed adults aged 18 or older had a much higher rate of current illicit drug use (15.2%) than those who were employed full time (9.5%) or part time (9.3%).

How many people in the U.S. abuse or are dependent upon pain relievers?

1.9 million Americans (0.6%) have pain reliever dependence or abuse.

How does geographic area affect substance abuse or dependence?

Rates of illicit drug or alcohol dependence and abuse of people 12 or older were about the same across the country, with 8.9% in the West, 8.3% in the Northeast, 8.2% in the Midwest, and 7.8% in the South.

Rates of illicit drug or alcohol dependence and abuse of people 12 or older were higher in metropolitan areas, at 8.6%, than in nonmetropolitan areas, 6.6%.

How many people with substance abuse or dependence have a history of past trauma?

Up to 3/4 of people who survive violence or other trauma have drinking problems.

*New River Valley Community Services provides this document with the most recent statistics on addiction in their service area.

What We Can Do

In July, 2015, I went to a women’s retreat in Tampa and I was asked by a fellow attendee with decades more experience than I have to develop a personal philosophy of recovery. At 2 years and 9 months without alcohol –  and continuing to be plagued by wishing to drink (with less frequency but too often to feel as if I can get on with my life) – my current philosophy of recovery is defined as “what can be done to keep me from drinking.”What we can do for ourselves and together

Since I work with others challenged by addiction, I’ve included “using” to mean using external sources rather than internal sources to handle our inner experiences: illegal substances or legal substances not as prescribed or intended; overeating or undereating food; people, relationships, sex, gambling, shopping, porn and/or other activities or processes.

I have used “we” rather than “I” because, while I am responsible for providing my own 24-7 addictions recovery care, alone, without the help of others? I drink.

Working Hypotheses

  • Pre-drinking or pre-using is a two-fold, heightened internal state: one of strong feelings perceived as unbearable – anxiety, fear, sorrow, pain, grief, loneliness, anger, rage, frustration, joy, agitation, boredom – and a sense of an inability to do anything about them – feeling helpless, hopeless, powerless, overwhelmed, useless, purposeless.
  • Some kind of dynamic exists between the self, addiction, consciousness/awareness/attention, and that heightened feeling state that can result in unconscious drinking or using. This is where will power, determination, commitment, working towards goals, or working to avoid consequences can fail. This is why that heightened internal state must be protected against at all times, at all costs.
  • The primary method we can use to help ease ourselves during heightened states of emotion is 1) become aware that we’re in the midst of that state, 2) calm ourselves just enough to be able to think and become aware of the judgmental statements we’re inwardly making to ourselves that are part of creating the state, 3) refute or transform those thoughts, then 4) further calm and reassure ourselves.
  • Accumulated, unresolved sessions with heightened feelings and negative thinking (“racing thoughts,” “spinning thoughts”) lead to relapse. To counter this power, we strive to find and equip ourselves with individual ways that help us prevent, resolve, work through, counter, or release strong feelings.
  • If we are experiencing strong feelings, most of the time it is not due to outside circumstances but due to inwardly brutalizing ourselves with judgmental self-talk, self-defeating beliefs, and/or pereceiving negative judgments from others, all of which are invoking shame. Brené Brown defines shame as “the intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging – something we’ve experienced, done, or failed to do makes us unworthy of connection.” In contrast, guilt is “holding something we’ve done or failed to do up against our values and feeling psychological discomfort.” Brown offers this example from her TED talk: “Guilt: I’m sorry. I made a mistake. Shame: I’m sorry. I am a mistake.” (See Lifehacker on the difference between shame and guilt and why it matters.)

Tasks

  • Wrest and liberate our true selves from the past. Address our family of origin issues.
  • Monitor, tolerate, and manage our feelings and thoughts in the present.
  • Occupy, engage and anchor our true selves in the present.
  • Connect with others with common purposes to feel a sense of belonging.
  • Nourish and grow relationships with ourselves and others.
  • Practice radical self-care.*
  • Move from “What is wrong with us?” to “How do we build better lives?”
  • Take time to come to terms with the past, acknowledge personal strengths and limitations, develop our own systems of beliefs and values, and become self-accepting and self-appreciative.

Premises

  • Accept the all-day, every-day nature of this endeavor.
  • Accept the need for on-going physical and emotional self-care to maintain the endurance necessary for the continual effort required to abstain.
  • Accept that healing ourselves will require initiating and maintaining healing relationships with ourselves and with supportive others. While no relationship is perfectly safe, we seek relationships with others with whom we feel worthy and receive enough support and enough safety most of the time.
  • Accept that we are not all-knowing, accept that what we’re thinking may not take all knowledge and all views and all possibilities into account, and consult with others about what we’re thinking before we take action. If we don’t want to tell someone what we’re thinking of doing, that’s a sign that we need to talk with someone about it.
  • Accept that we need help with what we can’t do for ourselves.

Moment-to-Moment Consciousness

  • Pause.
  • Become aware of feeling flooded with emotion – sometimes all we can do is name one of the “big four” feelings: mad, sad, glad, afraid – then reassure and calm ourselves just enough to unsoak the brain so we can think again. (Celebrate this mastery and self-control!)
  • Catch every single self-critical thought. Transform self-critical self-talk into realistic, supportive self-talk. Examples: Negative self-talk: “I am a loser.” Transformed: “I am trying.”
  • Catch every single awfulizing, castrophizing, worst-case-scenario-envisioning, self-alarming, self-terrorizing thought and challenge it. Example: “I am going to die from this!” Challenged: “Right now, I am okay.”
  • From the dire state of believing we are helpless to keep ourselves from feeling overwhelmed, move ourselves to a safer, more objective, discerning place. Example: First thought: “I can’t bear this!” Second thought: “Wow, look how strongly I’m feeling about this. It’s okay. I’ve made it through this before. I’ll make it this time, too.”

On-Going Consciousness

  • Talk about what we’re feeling, thinking and doing with multiple, supportive, trusted others to 1) discharge distress, 2) learn about ourselves as we self-disclose, 3) connect with others through mutual self-disclosure, 4) experience universality by learning of commonality, 5) experience the shame-healing power of non-judgmental acceptance by others.
  • Be a supportive, trustworthy, non-advisory, non-judgmental listener and reciprocate the healing benefits of sharing.
  • Recognize, anticipate, and plan for situations that might trigger drinking or using.
  • Avoid or limit time with people who call us to our pasts, call us to question our value, or trigger shame.
  • Avoid situations and places that might provide environmental cues, triggering a complex decision-making phenomenon over which we have little to no control. (Desensitization might be possible over time but may be impossible in the moment in early recovery.)
  • Use imagination for creative thinking rather than anxious thinking, for fantasizing about recovery experiences rather than drinking or using experiences.
  • Reach out to others to continue to build connections, networks, communities, and relationships.
  • Continue to seek, create, and be open to invitations to new memberships in new or existing communities which are supportive and cohesive.

Consciousness of High Sensitivity

  • Accept the possibility that we might have the characteristic beauties and burdens of being a highly sensitive person.
  • Accept we may have strong, instant, persistent reactivity – rather than discerning responsiveness – to the words and actions of others and to stimuli in our environments.
  • Accept we may have greater difficulty than others regulating our feelings and thoughts.
  • Accept we experience things so strongly – body sensations, body functions, feelings, thoughts, situations, events, smoke alarm beep! perfume! – that we may think we don’t have the capacity to contain the experience within ourselves. What others may experience as physical and emotional discomfort we experience as physical and emotional pain. We have to find individual ways to handle this acuteness. Otherwise, it may become unbearable (see first bullet point) and lead to drinking or using.
  • Be aware enough to put up boundaries between ourselves and difficult others to keep from “catching” their feelings in what could be, for us, risk of emotional “contagion.”
  • Accept we may have the tendency to project or displace our feelings onto others to lighten the load. Example: Internal experience: “I’m feeling like such a loser. Is he/she thinking I’m a loser?” Outward expression to another: “Why are you such a loser?”
  • With those in our inner circles, pre-plan and co-negotiate terms of engagement during heightened feelings states. If we slip and blame or accuse others of our own feelings and thoughts, apologize immediately to preserve personal integrity and to attempt to preserve the relationship.

Limitations

  • In addition to substance use disorders, most people with addictions challenges struggle with the legacy of difficult early lives, trauma, and, frequently, acute levels of anxiety and/or depression. Many have co-occurring substance use disorders and mental illnesses. Luckily, what we can do for ourselves helps with all these conditions. But we have underlying reasons for why we drank or used. Addressing these reasons requires professional help.
  • We need to acknowledge and accept what we cannot do for ourselves by ourselves. Individually, we cannot be our own counselors, psychiatrists, physicians, pharmacists, nutritionists, sponsors, support groups, therapy groups, or communities.

. . . . .

*Radical self-care includes extreme care and training for emotional and physical health, including nutrition, exercise, and sleep. We need to eat recovery-supporting foods in recovery-supporting amounts on a recovery-supporting schedule. We need to exercise and keep moving, i.e. avoid the couch unless meditating. We can ease our ways by accepting that sleep problems are normal for people in recovery and practice radical sleep hygiene to counteract the known challenges.

The opinions expressed here are mine and do not necessarily reflect the positions of my associates, clients, employers, friends or relatives.

The content of this post is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.

When the Silence Ends

If you and two more people were on a raft, the other two both of seeming equal “quality” – however you might define that – and only one could stay on the raft in order for you to survive, and one of the two was a known addict or alcoholic in recovery, whom would you push over the side?

I am contemplating attending Unite to Face Addiction, the march on Washington, D.C. on October 4, 2015, to  support “solutions to addiction and the harms of alcohol and other drug use that are based on science and compassion, not stigma and shame.” (Unite’s lead organizer, Greg D. Williams, shares his vision on The Huffington Post.)

Unite to Face Addiction’s organizing slogan is “The Day the Silence Ends.”

In October, 2014, my advice to people in recovery from addiction was to keep silent. I gave the same advice last month. After excruciating deliberation and consultation with family and I friends, I ended my silence and shared publicly 6 months earlier that I was recovering from addiction to alcohol. Now, 16 months after first sharing, I still don’t see another choice for myself.

But I’m having trouble typing, “I have no regrets.” I regret profoundly that I suffer from addiction to alcohol. This is not one of those “what doesn’t kill you makes you stronger” gigs. The killing part is too close. And that others also suffer from this brutal, relentless condition? Beyond heartbreaking.

As Unite’s mission points out, shame and stigma are killers, too.

I wouldn’t wish addiction on anyone. But I also wouldn’t wish the social consequences of being known as an “alcoholic” or “addict” on anyone, either.

Brené Brown defines personal, internal shame as “the intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging – something we’ve experienced, done, or failed to do makes us unworthy of connection.”

When society believes what we’ve done makes us unworthy of connection? Oh, my, it hurts. And it’s frightening as well. In the raft scenario, I assume, given the choice between me and another woman with similar attributes, given that you know I’m in recovery from addiction to alcohol, you’d give me the shove.

Even so, look at all the brave people ending the silence.

Photo: Risa Pesapane

Would You Feel Ashamed If It Happened to You?

Would you feel ashamed of yourself if you discovered when you tried to quit drinking or drugging, you couldn’t stop? Would you feel ashamed of finding yourself with these thoughts: “I’m an alcoholic” or “I’m an addict”?

Would you believe that some flaw in you had led to your addiction, that it was something you had done or failed to do? That who you are and something about how you drank or used – even that you drank or used in the first place – was the result of personal flaws and failures? That somehow you’re to blame for your addiction and, if you seek help, for the course of your recovery?

Brené Brown defines shame as “the intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging – something we’ve experienced, done, or failed to do makes us unworthy of connection.”

Anne Giles

If you did feel ashamed of yourself – “unworthy of connection” – you would be thinking along the lines of the majority. Study after study on the public perception of people with substance use disorders shows that, no matter how well-intentioned people might wish to be, most of them believe that not only is first use voluntary, but continued use as well. The person would stop if he or she really wanted to. That the person doesn’t stop and claims “can’t” is a result of personal weakness, not illness. Or, worse, self-indulgent self-pleasuring. In public.

If they’ve sought help and still struggle, they’re not suffering from the continued effects of a disorder, but choosing to let “their addiction talk” to them. They’re still “selfish,” not willing or ready to let go of self-pleasuring.

They should be ashamed of themselves.

Stereotypes are generalizations by definition, and we would argue that in the case of alcoholism, even if they apply to some (under certain circumstances, for example, intoxication), they hurt many more, particularly those struggling to recover from their illness. Affected individuals have a right to be judged by their personal behaviour, not by the stereotypes attached to a diagnostic label.
Schomerus et al., 2011

I’ve included a photo of myself in this post. Whatever descriptor you want to use – I developed substance use disorder, am addicted to alcohol, am an alcoholic, am an addict – according to this 2011 study on the stigma of alcohol dependence and many others like it, if you knew I was an alcoholic, you would be hesitant to rent a room to me, work side-by-side with me, and be my friend.

Not that you shouldn’t hesitate. Over about 7 years, I drank alcohol at an increasingly heavy level, way beyond the limits for women or men. Near the end, I started to say things, loudly, angrily, that I regretted deeply later. And I was beginning to fall. A day or two more and you, the public, would have been helping foot the medical bills for my cracked skull. Or the medical and legal, possibly tragic consequences, of me driving under the influence.

If I start drinking again? Don’t rent a room to me. Don’t work with me. My thinking and behavior would be unpredictable, possibly threatening and dangerous. And if you are my friend? Please. Please get me help.

As of this writing, I’ve been 949 days without a glass of wine. Or a bottle. Or any other alcoholic beverage. I am intelligent, educated and self-aware and I absolutely cannot tell you when the shift happened from choosing to have a glass of wine to must. I was in my early-50s at the time. Certainly I had enough age on me and enough life experience to pinpoint when things were going badly and to do something about it? No. I did not.

I do not consider myself a weak-willed, public self-pleasurer. No verb works to describe what happened but I will try: I got mugged, ambushed, hijacked, enslaved, imprisoned, used against my will, overpowered and puppeteered by a force against which every iota of self I possess was worthless.

What I have done publicly is disclose that I am recovering from addiction to alcohol. I made a brutally conscious choice to do this and ran it by my family and advisors before I did so. Given the stereotypes and stigma associated with addiction, and the real threat and harm that those actively drinking and using can do, at this time, in 2015, I do not recommend to others also in recovery from addiction to disclose it. (If you want to reach out to me, I will protect your privacy to the best of my human capacity.)

If you feel ashamed of yourself for recognizing you have a drink or drug problem, give yourself a hug. Shame is at the heart of addiction and feeling ashamed worsens, not lessens, the possibility of recovery. What happened to you happened to me – with regard to substance use, we got robbed of choice. We can now choose self-care, self-calming, self-kindness, self-compassion. These are at the heart of recovery.

Johann Hari reports, “So the opposite of addiction is not sobriety. It is human connection.”

So we can also choose connection with others who see us as we are – individuals with a problem whose management requires daily, sometimes moment-to-moment effort almost beyond bearing. I welcome judgment of my efforts to recover. I reject judgment as a person for having this problem.

And, for own sakes, we have to accept that what has happened to us most people believe we have done to ourselves.

The content of this post is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.