Posts Tagged ‘Alcoholics Anonymous’

The Recovering: Intoxication and Its Aftermath, by Leslie Jamison

This book will stay on my bookshelf to read again; that’s the highest praise I can give any book. Any person interested in substance use disorders and recovery from substance use disorders will find the book interesting and informative.

This is a memoir of the author’s drinking days and her forays into recovery, but it’s more than that too. Intertwined with her story, she divagates down some interesting roads.

She talks about artists, and the relationship between intoxication and the artistic temperament. Since she is an author, most of the examples she gives are of other authors, like David Foster Wallace, who wrote Infinite Jest, or Charles Jackson, who wrote The Lost Weekend. She does talk about the singer Billie Holiday, and about the misery her heroin use brought into her life, and about many other artists.

By page 352 (out of a hefty 448 total pages), the author reveals that her PhD dissertation was about authors who got sober, and how their sobriety affected subsequent work. No wonder she had interesting details about these writers and their struggles. In some cases, she could point out their best works were in sobriety.

I appreciate this idea. I’m bored to death of the cliché of intoxication as artistic muse. Sure, some works of art, be they literature, paintings, music, or other forms, were inspired by intoxicants. Yet how many renowned artists’ lives have been cut short by substance use disorders? The main examples that spring to my mind are musicians, like Janis Joplin, Kurt Cobain, Michael Jackson, Prince…how much enjoyment has the world be cheated out of from the early demise of these artists?

Dead artists don’t create. I hate to hear people imply that great talents must have substance use problems, as proof of how much they suffer for their art. That’s a tired, inaccurate lie.

In her narrative segments, she gives a window into the mind of an alcoholic, or anyone with an obsession that causes harm. She describes the usual justifications and rationalizations she used while drinking, and the same thoughts that came to her while sober.

In other segments, she talks about how race, class, and sex impact how society regards people afflicted with substance use disorders. She points out the inequities of the legal system, and how the percentages of blacks in prison is higher than of whites. She uses the cocaine laws of the 1980’s to make her point. Then, crack cocaine, which was more often used by blacks, carried the same penalty as ten times that amount of powder cocaine, more often used by whites. This meant blacks received much stiffer sentences of incarceration than whites for the same amount of drug. That’s one example of many of how minorities face more consequences for drug and alcohol use disorders.

She gives some history of the Lexington, Kentucky, Narcotic Farm, where people with opioid use disorders went voluntarily or were sentenced for recovery.

She gives a little history of how Alcoholics Anonymous was formed, and how the 12 steps and recovery community work together. She describes what scientists found years later – that peer support and contingency management treatments work, and AA has offered a version of them since the 1930s.

She also writes about the negative aspects of AA. She writes about how simplistic it is, how it’s too reductionist for complex people, and how some people may feel too smart for AA. It’s obvious that she is highly intelligent, and she admits, throughout the book, to her struggles with AA’s basic concepts.

She didn’t have an easy recovery. During her first try at sobriety, she tells how her primary relationship suffered, how depressed she felt much of the time, and how she didn’t feel as creative. She planned her relapse ahead of time at her seventh month of sobriety, with predictable results. She initially enjoyed her return to drinking but it didn’t take long to become more miserable than ever.

Her second try at sobriety went better. She was more enthusiastic about AA, and she eventually sponsored other people. She stopped focusing on herself and saw the importance of being part of a bigger community. She saw the value of people’s stories, even when they were so similar. Indeed, she saw value in the similarity of the stories, because people in AA could relate to one another even though their life experiences were different.

The emotions behind the events of drug and alcohol use connected people seeking recovery. People from different lives and lifestyles bond over shared emotional experiences common to during substance use disorder and their recovery. That’s why it’s not unusual to see a tattooed biker dude hugging a nun at a 12-step meeting

Though much of the book is about her struggles with alcohol, she describes traveling to and working in some exotic places, all of which became dreary under the influence of alcohol. She describes similar drabness in her relationships while drinking, coloring her world gray.

I have few criticisms about the book. I got bored with her constant relationship problems before, during, and after sobriety, but then I tend to have little patience with that sort of thing. If the relationship isn’t working, then end the relationship instead of bemoaning the dysfunction. I understand that sometimes relationships, even the best ones, need work. But she described mostly the work and rarely the rewards of these relationships.

I thought she should have ended her relationship with her long-term boyfriend Dave when she suspected he was cheating on her. While I read about her painful moments when she was at home and he was out doing who knows what, I kept muttering, “Dump him! Dump him!” But who among us hasn’t held on to a relationship longer than we should? So, I do understand. I won’t spoil the book by telling you whether they stay together or not.

Best of all, I like how the author ultimately embraced Alcoholics Anonymous in all its imperfections, while acknowledging other recovery paths are valid. At the end of her book in the section “Author’s Note,” I was happy to read her clear statements that one treatment doesn’t work for everyone, and that medications should be made available to help people. She specifically mentions buprenorphine, which of course warmed my heart.

She also talks about the War on Drugs, and about countries who have found a better way to deal with substance use disorders, without the moral disapproval that is so common in the U.S.

In short, it’s an interesting book with information tucked into an entertaining narrative about one woman’s alcohol use disorder and recovery. It’s the best book I’ve read on this subject since Caroline Knapp’s “Drinking: A Love Story.”

I highly recommend this book.

 

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Is Your Recovery Portable?

Today I listened to a friend talk about the difficulties of keeping her recovery program going after she moved to a new area.

 From what my patients tell me, this is a common problem. Last week I had yet another patient say that her relapse started when she moved to this area from another state. She had more than eight years of good recovery, but when she moved to North Carolina, she stopped doing all the things that previously made up her recovery program: 12-step meetings, calling a sponsor, and helping other addicts. Gradually, staying clean off alcohol and other drugs lost its priority, and addiction was a distant memory. She listened to the old lie of addiction: she could use drugs now, and it would be different. Her disease told her she’d been clean so long, she knew how to keep from going back to active addiction.

 This was, of course, not true. I saw this patient shortly after she lost her job because of intravenous opioid addiction.

 Why does moving to a new area seem to begin a downward slide toward relapse for some people?

 My friend in recovery who just moved was able to describe it to me. She says it’s a starting over process, and she feels like she’s on the outside. She feels like she did when she was a newcomer to meetings. She misses the feeling of being at home in meetings, surrounded by people she knows who love her. She says getting involved in meetings in a new area is the hardest thing she’s ever done, more difficult than coming to meetings for the first time.

 She says, “I’ve done this before, and I think to myself this should be easy. It took me by surprise. The loneliness is super-dangerous. I have these dangerous feelings, like I don’t belong. It’s just like my first few months of recovery, except now I keep thinking that it should be easier, and I shouldn’t be having these feelings. In early recovery, I had that gift of desperation. I was acutely aware that the drugs brought me to that point and I had to come to meetings to stay clean. I had willingness to do whatever it took. Now I don’t feel that desperate, and have a hard time making myself go to meetings. It’s hard as hell.”

 “Plus, I don’t know who in these new meetings is working a program of recovery, and whose life is just full of drama. I don’t know who the winners are. And the formats are different, though I like them. They have topic meetings and everyone who shares stays on the topic!”

 My friend seems to be doing better than she’s feeling. The last I saw her, she was surrounding by laughter and hugs. She says she’s getting through this difficult time by sharing about her feelings, and listening to the experience of other recovering people who have moved to a new area and new meetings. She stays in touch with her old friends from previous meetings, and travels the four hours to visit these friends once or twice per month during her transition.

 I think my friend will be fine, so long as she continues to do what she needs to. Going to new meetings is difficult and staying at home would be easier, but not in the long run. Given the havoc addiction has caused in her life, she’s not willing to risk a relapse with all the heartache it brings.

Is Alcoholics Anonymous A Cult??

Some patients say they object to the “cult” atmosphere of AA or NA. From my own observation, 12-step groups bear little resemblance to cults. Cults have a charismatic leader, who wants all of its members’ money, and he or she attempts to control the lives of cult members.

But in NA, there is no leader. Every recovering person is considered an equal in the group, regardless of the amount of clean time. There is no “Head Addict” or “Head Alcoholic.” Responsibilities for chairing meetings, making coffee, and setting up the meeting rooms are shared by the whole group. The people who lead meetings are considered “trusted servants.”

Twelve step groups don’t ask for all your money, like cults do. In fact, it’s optional to place a dollar in the basket that goes around at most meetings, which is collected to pay for coffee, supplies, and rent. Some groups pointedly ask newcomers and visitors NOT to put any money in the basket.

Every addict is treated with respect, and newcomers are told that they are the most important people at the meetings. It’s through helping new addicts that the members of NA stay clean themselves, and contact with new members prevents older members from getting complacent about their disease. Recovering addicts in NA don’t give advice, but rather share their own experience, strength, and hope with the expectation that this will help other recovering addicts, struggling with similar issues.

Alcoholics Anonymous and Narcotics Anonymous do not recruit members, as cults do. No one forces membership upon anyone. In fact, one of their traditions prohibits this. “Our public relations policy is based on attraction rather than promotion…”

To me, it appears that 12-step groups are the exact opposite of cults.

But don’t go to a meeting expecting saints, either. Alcoholics Anonymous and Narcotics Anonymous meetings are not” bastions of mental health,” as a close friend put it. These meetings are filled with people who have been ill with a potentially fatal disease. Some members may also have severe mental illness. Some may still be physically shaking from withdrawal. Some may be warm and welcoming, and others may be just plain mean. These people are like people anywhere. They are imperfect, but trying to get better. But if you want to know how to make it through the day without drinking or drugging, while retaining peace and serenity, these people can help you.