Two and a half years pass, and you have just gotten out of jail again. I know it won’t be your last time, but I wish it were.
To the Most Interesting Girl I’ve Ever Known:
Do you remember the first day that we met? I do. I was sitting on a couch with a few other girls and we were watching a movie. That was pretty much all we could do to pass the time in detox. It was my first rehab and your fifth. That night you came out of the bathroom in ridiculous unicorn pajamas and your hair was wrapped in a towel. I didn’t even realize you were there until you started violently throwing up into a trash can. Everyone was watching you and shaking their heads. I found it sad that these women were judging you for getting sick. After all, we were all there to get better…weren’t we?
I wasn’t. You weren’t either. I was in rehab because I had nowhere else to go and you were there because your parents forced you to get clean.
The next day, you wandered into my room, jumped up onto my bed, and we talked about everything. We talked about how miserable it was to be stuck in this building when all we really wanted to do was to go out and get high. We didn’t want to be there, but it was really the best option for both of us at that time.
I learned so much about you during our time in that place. I found out that you were three years younger than me and that when your dad died, he left your mom an obscene amount of money. You have never lived in a house with less than five bedrooms and have never gone hungry. All your clothes came from the mall and you judged people based on what their teeth looked like. Your mom was used to you going to rehab every other month and she would make sure that you had plenty of cigarettes and nice things to wear.
I had nice things to wear, too. My dad made sure that I had new clothes and nice shampoo for my first trip to rehab. I was homeless but far from hitting rock bottom…that came later. We bonded over our love of superficial things and our misery there. You confided in me that you were a new mother and embarrassed about it. You did not want to be a mom and you shot up every day during your pregnancy. You gave birth to a little boy three months early because you went into withdrawal and weren’t able to get your dope that morning. It pissed you off because you didn’t like children and still didn’t want any.
I understood and didn’t judge you because I didn’t want children, either. I knew that if I were ever pregnant, there would be even less time and money for me to get high. After social services told you that your drug use prevented you from keeping the sick baby in your care, your mom adopted your son and took on all of the responsibility that you didn’t want to have.
I understood you and you understood me.
We were moved together to the residential area of the rehab program where they took away our comfort medications and forced us to interact with the other women there. That didn’t last long. We didn’t want anything to do with these women who had hit their rock bottom. We didn’t want to hear their sad stories or participate in anything therapeutic. If we talked about other people there, it was to judge or make fun of their appearance.
Looking back on my behavior during this time, I am remorseful and embarrassed by our cruelty. We were both sick and should have taken advantage of the help that was being offered, but we weren’t ready. We fed off each other, encouraging destructive behavior. A few days after being moved, we were kicked out of that rehab together for buying drugs from a man in a different unit.
Do you remember sitting on that curb in the sunshine with our freedom and trash bags full of clothing? A guy that you knew picked us up and bought us each a gram of heroin and a brand-new bag of needles. He then took us to a hotel in a sketchy part of town and we stayed there for the next three days. We looked at each other as we pulled out of the rehab parking lot and smiled so big. We had won our freedom and were now able to get as high as we wanted without consequence.
We didn’t think about the fact that we’d both just screwed up a really good chance to fix our lives and to rebuild the trust we had broken with our respective families. We weren’t thinking about anything past the three days that the hotel was paid for. We bonded and became closer during that long weekend. You overdosed in the bathtub and I brought you back. The first thing you said to me was, “where’s my shit?” I laughed, you laughed, and we continued to get high. After being kicked out of the hotel we went our separate ways but continued to stay in touch. You went home to your big house and I continued to crash where I could because it was getting cold out. We even planned our next rehab stay together!
We really had our priorities straight, didn’t we?
The next “vacation” we took together was a bit more successful. We didn’t get kicked out, but we came close. We didn’t take it seriously and continued to judge people, something that I’m still ashamed of. You told me you’d been arrested twice since we’d seen each other last, both times for felony possession. You saw your son and he’s walking now, but you still hate being a mom. I nod and agree, it sounds like a hassle to me at that time in my life. We graduate from this 30-day program and go our separate ways again. You go back home again to your fancy house and I go to a sober living facility, something I wasn’t ready for. You came to visit me often and took me out for coffee on my birthday.
I got kicked out of that place too and had to stay on a lot of different couches, each more desperate and filthier than the previous. My parents were done housing me because they saw me getting sicker with each visit. They saw me lose weight and gain track marks and strung out boyfriends while you were sleeping in your childhood home with a fridge full of food. I never compared myself to you and I never complained about my situation, especially to you. In rehab, we judged people like me; I had become one of the unfortunate. I was someone whose addiction had completely taken over her life. I was paying for my heroin with money that I stole or earned in ways that I don’t like to talk about. You paid for your drugs with money that your mom handed you and if that wasn’t enough you stole it from your stepdad.
Maybe I was a little jealous.
The following summer I hit my rock bottom. I won’t tell you how it happened, but it was brutal. The drugs we so enjoyed doing in your car ended up taking my soul and my self-respect. I decided that I needed to change and right after making that decision I met the man who changed my life. I’d started taking methadone a few months prior to meeting him and finally my life was starting to make sense. I had a home, a job, and someone who loved me unconditionally.
I still called you every few weeks to check in. You told me you were still getting high and that you overdosed a few times and that you had just gotten out of jail again. We laughed about it and then we didn’t talk for almost six months because we were both so busy with life. The next time I called you, you kept talking about how “nasty” the girls in jail are and how they’re missing their teeth and you’re sick of having to pee in front of your probation officer.
I didn’t tell you that the damage I caused to my own teeth led to them all being pulled and replaced with porcelain ones.
You asked the last time I used and when I said eight months, you yelled at me. “How?! You were the WORST! You LOVE getting high!”
I told you about the methadone and how it was really helping me fix my life. You said you will never be on that stuff because you don’t want to have to take something every day. I wish you would at least try. If not methadone… just try something.
I tell you I’m pregnant and getting married and you are in disbelief again. You say my child will have issues and I won’t be able to bond with him. In the same conversation, you get upset because I don’t invite you to my baby shower. My husband doesn’t want us to see each other and I agree with him. You are now dangerous for me and the little life that he and I built together. Perhaps you always were. I imagine you falling asleep or getting high in the bathroom as I open presents.
I am a different person now and happy about it, a different kind of selfish.
Two and a half years pass, and you have just gotten out of jail again. I know it won’t be your last time, but I wish it were. You don’t look three years younger than me anymore. We don’t talk on the phone because we don’t have anything to talk about. I know how you feel about the medication I take and that’s okay. I have a family now and a home, and I wish that one day you’ll get to have the same things. I want you to know that the unconditional love that your child has for you is better than the best heroin you’ve ever done. I want you to know that eventually, once you stop using, you can enjoy things again. Sushi is amazing. Sleeping in late is amazing. Not being sick and desperate every morning is amazing, too.
We might never see each other again but I just wanted you to know that I still think about you and that if you give it a chance, you can find happiness too. You deserve to have a good life, we all do. Just try, okay?
Intervention is never easy. But this step-by-step guide can help you navigate the difficult task of talking to a loved one about their alcoholism or addiction.
When you know or suspect that a friend or family member has a drug problem, even well-intentioned conversations can turn prickly. Here are eight steps that may help smooth things out and pave the way to productive, respectful, and supportive discussions. Even if you already have a history of bickering and arguing, all is not lost. You can ask for a new start and then follow these steps.
1. Keep Calm
If you’re worked up and agitated, it’ll be almost impossible to have respectful and cooperative dialogue. So, put aside your hurt, scared, or angry feelings. Take a deep breath. The feelings won’t go away, but maybe you can think of them as parked – pushed aside for the time being. Deep conversations that lead to connection and empathy require a measure of self-discipline. It’s difficult to process information and communicate effectively in emotionally charged discussions.
2. Set Realistic Expectations
When you see or suspect a drug problem, you may want to rush to the rescue and fix everything right away. Maybe you think it’s best to demand a commitment to abstinence, or insist upon counseling, or even send the person to rehab. The thing is, no one wants to be “fixed.” The harder you push, the stronger the resistance you’ll encounter. The best way to help someone is to engage their brains – to get them to think things through for themselves and to make their own decisions. So, start with a reasonable and realistic expectation: to open the dialogue and increase mutual understanding. This won’t fix a substance use disorder, but it can improve the situation.
3. Ask Permission
It’s common courtesy to find out if someone is receptive to conversation at a particular moment. Start out by saying: “I’d like to talk with you about something that concerns me. Can I do that now? Is this a good time?” Asking permission gives your friend or family member a sense of control over the discussion and a moment to prepare for it. If not now, then you can ask: “When would be a good time?”
4. Explain Your Plan
Communication has to be a two-way street. You want to express your own point of view, but you need to also hear the point of view of your loved one. Make it clear that you want a mutual and cooperative exchange of information, and have as much desire to hear your friend or family member’s point of view as to express your own. This is important because communication about drug problems is often one-way, as in: “I know what’s going on and you need to quit drinking (or quit using drugs).”
You could put it this way: “I’d like to tell you what I’ve been thinking and feeling. I’d like to hear how you see things as well.” When friends and family members are treated with this type of respect, you might be surprised at how much they are willing to disclose.
5. Start From a Place of Concern
When you get the go-ahead to talk, start with an expression of concern based on your observations, being as specific as possible about what you have noticed, and your thoughts and feelings about it. You can also talk about how you are affected by the drug or alcohol use. Be sure to pause as you speak to give your partner time to think.
Here is an example of a well-stated expression of concern that combines observations, thoughts, and feelings:
“I’m concerned because I’ve noticed you’ve been drinking more often and in larger quantities in the last few months. It seems that you drink every night as soon as you get home from work, and much more than you used to drink. By dinnertime you’re often groggy and a little incoherent. Sometimes, you even fall asleep before dinner, then wake up and start drinking again.
“I’m worried because, in my opinion, the amount you drink is unhealthy. I’m also concerned for myself. The drinking seems to interfere with us talking about our lives and enjoying each other’s company. I can’t say it’s all because of the alcohol. There might be other things happening. But it seems to be part of the pattern.”
Notice that these are “I” statements, as in: I’m concerned; I’ve noticed; and I’m worried. They merely express what the speaker saw, thought, felt, or noticed when certain events occurred. There are no labels or put-downs. They contrast with “You” statements, which are often pronouncements about a “truth,” or a dire prediction about the future:
You’re an alcoholic.
You drink too much.
You’re addicted to opioids.
You have a drug problem.
You need to quit now.
If you don’t quit now, you’ll end up a drunk in the street.
These “You” statements are opinions that may or may not be true. They are judgmental. Without explanation, they seem arbitrary. Without discussion and an understanding of the other person’s point of view, they come across as arrogant.
Be careful to steer clear of two pitfalls that could arouse defensiveness:
Avoid self-certainty. It kills discussion. You may think you are right. You may be convinced you are right. You may even be right!! But keep an open mind and show some humility. Leave open the possibility that there are other ways to look at what is happening. (There’s always another side to a story.) Until you listen to what your communication partner says, you really don’t have the full picture: You may misunderstand something or not fully understand the situation.
Resist the urge to jump in with advice. It’s too early. You don’t even know what your friend or family member is thinking. Save recommendations and advice for later.
6. Request Feedback
You can be sure your friend or family member will have a reaction, perhaps a very emotional one. So, in good faith ask: “What do you think about what I just said?” Also: “Please tell me how you see things.” At this point, you never know what to expect and you’ll have to use your best judgment about how to proceed. If your partner is highly receptive, listen carefully to what is said and then proceed to the next step.
If your partner gets angry and highly defensive, back off, stay calm, and let some time pass. Take the high road and avoid an argument. Later, when things calm down, you can say: “You know, I told you how I see things. I’d like to know how you see things.”
7. Listen to Understand, Not to Argue
Too often while someone else is talking, people get busy developing their counter-arguments. This transforms a discussion into a debate. While your friend or family member talks, try to listen closely and understand their perception of the issue. You will certainly increase your understanding of your partner, and quite possibly be surprised by what you learn. Maybe the problem is not as big as you thought. Maybe there have been changes you didn’t notice. Maybe you will get some clarity as to why your friend or family member was using drugs. Maybe you’ll discover that your friend or family member is also concerned about the drug use. To the extent you show respect and demonstrate open-mindedness, you serve as a role model to your communication partners.
8. Seek Mutual Understanding
Now you can say, “Let’s see if we understand each other.” A good way to do this is by using what is called reflective listening: you make an effort to paraphrase what the other person said, then ask: “Did I understand you correctly?” Then, you allow for clarification. When people reflectively listen to each other, there are two advantages:
We often get insight when we hear our own thoughts reflected back to us.
We think twice when we have to paraphrase what someone else said.
Reflective listening will force you and your communication partner to think hard about what each of you say. Of course, you hope your loved one will be influenced by your presentation. You can be sure, too, that they want to be understood and hope that you will be open-minded.
At this point, you have to use your best judgment about what comes next. You could try to calmly discuss differences, now or in the future. You might want to ask if there is anything you could do that your loved one might find helpful. Also, you could politely ask if you can offer advice. Regardless, these eight steps are foundational to a productive dialogue and can stand alone as a measure of success. Savor it and avoid the rush for a quick fix.
Robert Schwebel, Ph.D. is a clinical psychologist who wrote and developed The Seven Challenges program, now widely used across the United States. He is also the author of his soon-to-be released book, Leap of Power: Take Control of Alcohol, Drugs and Your Life.
Chemists create new drugs faster than officials can schedule them, resulting in a drug supply tainted with chemicals that can’t be tested because they don’t really exist.
My wife came with me to the intake session at the city’s drug and alcohol center even though I had a protection from abuse order pending on the court’s docket. She knew I’d been in recovery and had started drinking again, but she’d only recently learned of the extent of my addiction when I broke down the bathroom door to stop her from calling the police. Why she stuck with me or what she was thinking I couldn’t say; I was too ashamed of what I had done to ask her if she was all right.
Instead, I buried myself in the mundane paperwork of medical billing and told the counselor my story while my wife sat mostly silent. For almost two years, I trafficked in grey market drugs for my personal use. An assortment of chemical mixtures was delivered to my door, sometimes within reach of my kids.
4-FMPH, a Synthetic Analog of Ritalin with a Fluoro Substitution
The first drug I purchased was 4-FMPH, a synthetic analog of Ritalin with a fluoro substitution. Fifty dollars, plus the cost of shipping, bought me a few grams of the stuff from an unassuming website called “Plant Food USA.” People who know about these types of things remember that site for the scams that it pulled, like selling α-PVP as 2-FMA. These are the risks in a chemical world.
It wasn’t a clandestine operation, save for what I hid from my wife. I found the site through Reddit and paid with Google Wallet for two-day delivery via the U.S. mail. An unlabeled bag of white powder arrived at my door in a large white priority envelope. I swallowed a portion of it without question and spent the next couple hours worrying about how to throw out the packaging without anyone finding it.
Before long, the drugs, and the schemes, became more intricate. I tried ethylphenidate, isopropylphenidate, 3-FMA, and Hex-en. Bitcoin became my new banking system, which meant keeping my wife away from our finances and making her think we had less than we did. I’d stay late at work emailing vendors while ignoring her texts for help with the kids.
It was exhausting, hiding my habit from her. The day the cops showed up to serve me those papers would have been a relief, had she not been outside with her family trembling in fear. And yet here she was, a week later, sitting in a Medicaid-funded outpatient program listening to a counselor ask me how I was doing while telling old war stories from his days off the wagon.
His brother doesn’t speak to him, I remember he said. “But that’s his problem and not mine anymore.”
The Molly Enigma
Designer drugs, research chemicals, synthetic analogs, and novel-psychoactive substances, as they’re sometimes called, have long been on the periphery of the illicit drug trade. Often, local news channels reduce them to fodder about bath salts and flakka and face-eating zombies. But today, experts are beginning to draw a straight line between the overseas chemists who create these drugs and the overdoses that plague so many people who unwittingly use them.
“We missed the boat when Molly first appeared, went in the wrong direction, and avoided a lesson which could have predicted the fentanyl crisis,” he continued.
One of the more well-known designer drugs to hit the scene, Molly is thought of by many to be pure MDMA. According to the DEA and the National Institute on Drug Abuse, however, it’s more likely to be a cauldron’s brew of synthetic cathinones like MDPV, 4-MEC, 4-MMC, Pentedrone and more. My vendors sold all these at discounted rates.
Somewhere Between Face-Eating Zombie Hysteria and the Fentanyl Crisis
When looked at alone, most of these drugs lie somewhere between face-eating zombie hysteria and the fentanyl crisis, vanishing from small pockets of the country as fast as they appear. In 2015, around 30 people died in the Pittsburgh area after overdosing on U-47700, an opioid painkiller that pharmacists developed back in the 1970s. Two years earlier, an Oklahoma man pleaded no contest to second-degree murder after accidentally selling a highly-toxic mixture of Bromo-DragonFLY at a party. He purchased it on the web, thinking it was a less caustic drug known as 2C-E.
But as Dr. Hall explained, taken as a whole, this new trend in substances has its roots at the turn of the decade, when discarded medical research turned up on the web.
“We saw the beginning of clandestine manufacturing of these chemicals primarily occurring in China, but also some in Eastern Europe, [and] in the former Soviet Union,” Hall said. “Then the spread first of the synthetic cannabinoids, the K2 or spice into Australia, New Zealand, and then into the European continent. Then to North America, which has also been a sort of pattern of the emergence of these substances rather than first appearing in the United States.”
Novel Psychoactive Substances and Drug Tests
I discovered alpha-Pyrrolidinohexiophenone, or A-PHP, when 2-FMA dried up in a big Chinese ban. Shortly after that, I disappeared from my family for a week. The “Missing” posters that my wife put up finally prompted me to make contact, but only because I was angry that she would do something like that to embarrass me. I didn’t ask about our kids, only why she used such a terrible photograph of me.
At the time, she made me beg to come home for what I did to the kids, so I told her the things that she needed to hear. Then I spent another night away from the house because everything would be the same regardless. Who knows what she was thinking when she took me back in; I didn’t care to ask her if she was all right.
Novel psychoactive substances, or NSPs, live in a grey market world, walking a line of legality that’s tough to pin down. MDPV begat α-PVP, which begat A-PHP with the tweak of a molecule. Chemists create new drugs faster than officials can schedule them. The process results in a few hollow legal victories along the way, and a drug supply tainted with chemicals that can’t be tested because they don’t really exist.
“You can have all these people intoxicated on, say a new form of fluoro-amphetamines, but most hospitals have what are called targeted panels,” said Roy Gerona, a toxicologist at the University of California, San Francisco, who, along with a team of researchers works with the DEA to identify new NSPs as they come on the scene.
“So even if the patient comes in and is intoxicated by this new derivative when the hospital tests the patient, it will test negative,” he continued. “They will not confirm the drugs.”
Gerona, whose work was explored in an article about designer drugs a few years ago, told me how NSPs create a new set of problems for both the legal and scientific communities. The DEA can’t schedule a drug without first showing that it’s both toxic and addictive, something that’s difficult to prove rapidly, he told me. Meanwhile, strict guidelines from the FDA have researchers hamstrung when it comes to identifying new substances quickly.
“In that six months in 2015, for example, there have already been three generations of synthetic cannabinoids, meaning that by the time that you have developed and validated those methods, the draws that you’ve included in the panel, it’s not popular anymore,” Gerona explained.
Cathinones: Bath Salts and Antidepressants
Some of these drugs have actual medicinal properties and can be used as prescriptions, Gerona told me, negating the idea of a blanket ban on them all. The Federal Analogue Act tried to rein in the problem by making any substance that was “substantially similar” to Schedule I or II drugs also illegal. Still, it’s rarely been used or held up in court.
“Bupropion or Wellbutrin is an antidepressant,” he explained. “Wellbutrin is a cathinone. Cathinones are the active chemicals in bath salts. So, if you schedule all cathinones, then research on a lot of these medicinal chemicals would also be impeded.”
But that doesn’t mean there’s nothing to be done.
Building off of his work surveilling such cases, Gerona and his team developed what he calls a “Prophetic Library” of new drugs, hoping to outwit the overseas chemists and lessen the downtime it takes to respond to further incidents.
“We thought if people creating these are chemists, we are chemists,” said Gerona. “If they can look at the literature [and] know what tweaks that they can make from publications or expired patents from drug companies, we should be able to predict what they would be potentially doing.”
For Gerona and his team, there’s no glory in the task, because publishing their findings would create reference material for more clandestine operations. They’re hidden away until, hopefully, they can help.
Predicting the future can be a difficult task, because the stories we write, well, they never end. On the day after New Year’s, my wife went to bed, and I went online to buy more A-PHP. For me, I was looking for more of the same, until I noticed she moved all our money to a separate account.
Not All Right
I woke her up, intent on throwing her out of the house, and stormed through the place with fire and rage. When she locked herself in the bathroom to call the police, I broke the door down and ripped the phone from her hand. What right did she have to come between me and my drugs?
When the cops did arrive, I said what they needed to hear and taunted my wife as soon as they left. But I felt ashamed of what I had done. I apologized to her and asked if she was all right.
The next day she filed that protection from abuse order on me. She wasn’t all right.
People often think of PTSD as being something that affects the nervous system, the brain, the body. I think it also affects the soul.
After years of covering war, terrorist attacks, and natural disasters in the Middle East and Southeast Asia for Reuters, journalist Dean Yates was diagnosed with PTSD and “Moral Injury.” He sought healing not only with professionals and clergy, but by writing and sharing his story with the world. What happened next created a new role for him at Reuters and an opportunity to turn something tragic into something inspiring.
After meeting at a conference in London, Dean Yates spoke with me from his home in Australia.
What did it mean to be a bureau chief for Reuters in Bagdad at the time you were there?
Yates: I was the bureau chief in Bagdad at the height of the Iraq war just before the surge of US troops into Iraq. This was George W. Bush’s last roll of the dice. It had plunged basically into civil war. That first six months of 2007 were the most violent period during the Iraq war. There were car bombs going off every day. That job entailed being responsible for coverage of that story but also being responsible for close to 100 men and women in the world’s most dangerous reporting zone. That made it an extremely stressful job. If I had half an idea of what it was going to be like, I’m not sure I would’ve gone there in retrospect because what ended up happening was way beyond anything I was prepared for.
On the roof of the Reuters office in Baghdad
Over the years you reported on many tragic events including a nightclub massacre that killed 202 people in Bali in 2002 and a tsunami that killed 165,000 in Indonesia’s Aceh province in 2004 before you arrived in Bagdad. You’ve written in your stories about losing several colleagues in Iraq. Can you talk about what that was like?
What it comes down to really is, you know, I felt morally responsible for the safety of my staff. I think that’s something a lot of people experience. Even though people say you did everything you could, you shouldn’t blame yourself, that wasn’t how I felt. It surfaced later into this moral injury. I just couldn’t live with myself because of what I saw as my own culpability and my failure. It was a spiritual care worker at the psych ward who helped guide me through a healing ceremony where I was able to pay my respects to Namir (22) and Saeed (40), the two men who were killed in an attack by a U.S. Apache helicopter on July 12, 2007 in Baghdad. This spiritual care worker was able to be at my side. No clinician could have done that. I really found I was able to make peace with myself after that ceremony.
What is Moral Injury?
Actually, you can trace it back to the writings of Homer, the ancient Greek poet, and his epic poems “The Iliad” and “The Odyssey.” What it really means is if someone feels there is something that they did or didn’t do or that they witnessed that so deeply contravenes their moral compass or ethical values, they end up with a moral injury. People often think of PTSD as being something that affects the nervous system, the brain, the body. I think it also affects the soul. Think of a soldier who believed he was doing something good for the community but the Taliban, it turned out, didn’t like what he was doing and so the end result is that children die. You can’t give someone medication for that or give them a bit of evidence-based therapy.
That makes sense. I’ve heard a lot of people in recovery talk about how when they were using and drinking, they did things in service of their disease which were not in alignment with their own moral compass.
You talk in one of your stories about taking paracetamol and codeine tablets to get to sleep and about drinking heavily as well as staying in bed, do you feel you were self-medicating your undiagnosed condition at that time?
Oh yeah, totally. I honestly don’t think I’ve ever suffered from addiction. I went through bouts where I’d rely on alcohol or prescription medication but I was never in that years long cycle that some of my colleagues have been in. I had a little bit of an experience with it, but I got off the booze quite easily on my first psych ward admission.
Journalists have been known as boozers for as long as the profession has existed. I remember one weekend I was on duty and I was in the office asleep on the couch so hungover and the boss walked into the office with his wife and I remember him saying to his wife “let’s be quiet, I think Dean’s had a big night, we don’t want to wake him.” If that happened now, I’d be fired. But back then it was all part of the journalist culture. We went out and got roaring drunk. It was how we dealt with a lot of the traumatic stories. When we were in Baghdad we used to spend huge amounts of money on alcohol. Because we had to. Otherwise we would have gone crazy.
You’re lucky you were brave enough to seek out help and you did find the help you needed so you no longer had to self-medicate. We talk now in the addiction field about trauma being one of the main causes of addiction.
Oh anyone. All it takes is a severe enough traumatic event for someone to be at risk of developing PTSD. But the problem is that people associate PTSD with soldiers and increasingly with first responders. I’ve seen it across so many different sectors of the work force: nurses, doctors, and then in the civilian sphere—domestic violence, road accident victims. In Australia 70% of people will experience a traumatic event, according to Phoenix Australia (a center for post-traumatic mental health in Australia). In the U.S. the biggest group of people with PTSD are actually victims of rape. It doesn’t matter what brought you to the diagnosis. It doesn’t matter what your profession was. You all have flashbacks, nightmares, anxiety, depression. We have these things in common that I thought wouldn’t have been possible and it makes me angry that so many of these people suffering with PTSD are silenced. It’s the same with addiction.
Addiction is very much a disease of isolation. The whole idea of stigma contributes to the avoidance. It looks to me like avoidance has a role in the development of mental illness and PTSD in the first place.
Yes, I had isolated myself incredibly. The only people who knew I had PTSD were my family and a few close friends. It was the same when I was in the psych ward. When I walked in that door it was terrifying. You know once you go through that door you can’t take that back. How’s that going to look on your resume? Because people think you’re crazy.
What do you think happened for you in the process of writing your story “The Road to Ward 17” even before you published it?
The writing process is cathartic, it’s therapeutic, you learn a lot about yourself; it’s part of the recovery process. There’s so much research out there about the power of writing and sharing your story with others.
When you wrote your story, how were your expectations different from what happened when you actually published it?
I had initially thought that this could maybe be used as a blog for other colleagues, but then I thought this should actually be published. One of the things I thought about in the psych ward was that these folks who were in there, they were going through really rough times, and no one could tell their story. But I thought if I tell my story it’s a little like telling their story.
The story ended up in the hands of our investigations editor in New York who is responsible for what’s called our special reports. We rarely publish first person account stories. But he really liked it. And when the story came out I wasn’t prepared for the response. I was more prepared to get negative responses. For people to be angry about me talking about the Apache attacks and Wikileaks. But I got messages from people all over the world and all walks of life who had experienced trauma just saying thanks for writing your story, thanks for putting this out there, thanks for telling it like it is. I’d only come out of the psych ward a couple months earlier.
The video of the attack that killed your two colleagues, and the way only parts of it were released, created a certain perspective that skewed much of the response to it, even your own if I read you right. What have you learned about perspective in all this?
Two weeks after Namir and Saeed had been killed, I was sitting in this office with these two generals and they started playing the tape and we had no idea that was coming. I saw the first— not even three minutes— of the tape and the tape was stopped at the moment the Apache fired on the men which included my staff. I walked out of that briefing with this one image in my head of our photographer peering around that corner. That image actually was burned into my brain for years and I just could not get that image out of my head to the point where I actually started seeing him as being responsible for what happened, whereas the order to fire had already been given before he even peered around the corner. And then when the (full) tape was released in 2010 I could not actually physically watch it. I knew what happened. I had read the transcripts by then but I hadn’t actually watched it. It was only when I wrote that story that I was able to watch that tape for the first time because I knew I had to get the timing of the events correct. So it did give me a different perspective. That tape to me shows the world what the Iraq war was really like.
Tributes to Namir and Saeed
Changing the Face of Mental Health at Work
How are you transforming what was a tragic event into something inspiring in your new role at Reuters?
I wanted to try to create an environment where our staff felt comfortable putting their hands up and saying I’ve got mental illness or whatever and have management respond with compassion so that they could access the resources we have available. Because when you have an environment where people don’t feel comfortable talking about it, there’s not much you can do.
We’ve been doing a series of internal blogs at Reuters. I wrote about my PTSD issues, and what it did is it kicked off other journalists writing about their own issues. The next person was a journalist in the Middle East who wrote about his struggle with bi-polar, another woman wrote about her depression, another guy wrote about his burnout. Some of these journalists have been overwhelmed with responses which also makes them feel like they’ve got meaning out of what they’ve done. They’ve got purpose out of what they’ve done.
We’ve had about 30 now but not a single blog about addiction. So this colleague of mine in London is going to write about her addiction but she wants to remain anonymous. I think that just shows how much stigma there still is.
Those blogs were very powerful in normalizing that conversation to the point where I think they’ve been as effective as anything we’ve done in getting that message out there that it’s okay to come forward, and that you’ll get the support you need. And it’s helpful for managers because if they’re reading about colleagues getting help, they’re thinking I want to be a good manager and make sure my people get the help they need,too. One of my areas of focus this year has been in training managers on how to look after the mental health of their team.
This is an important endeavor considering that, according to the Mental Health at Work 2019 Report BiTC, 62% of managers faced situations where they put the interests of their organizations above the interest of their colleagues.
You’re not a psychologist or a psychiatrist but what you’re offering is peer support; you can explain to a manager how to talk to their staff who are struggling because you’ve been there.
Right, I know the profession and I’ve got the lived experience of mental illness. I try to operate in the early intervention space. I am not an expert but I can be an advocate. I’ve got the street cred. No one can look at me and say you don’t know what you’re talking about. Because I do.
If the 12-step movement has taught us nothing else it’s taught us that peer support works.
It crosses my mind that there’s something in this for the corporate world. How does mental health and addiction effect a company’s level of productivity?
I was able to function very highly for a long time but one of the symptoms of PTSD is avoidance. And so one of the great ways of avoiding your issues is through work and that was how I did it and I know a lot of people who have done the same thing. People want to contribute and they want to be part of something bigger than themselves. All the research shows that work is good for people’s mental health in general. But the point is: Don’t look after people’s mental health because it’s good for the business, look after people’s mental health because it’s the right thing to do. People with a mental health issue just want to be acknowledged. They want to be treated as if they had come into the office with their leg in a plaster (cast). You come into the office with your leg in plaster–it’s okay, we’ll sort this out; you’re supposed to be at that conference next week, we’ll send someone else; and okay, you’ve got to go to that doctor appointment, no problem. If you treat people like that, the numbers take care of themselves.
Fair enough, though it is interesting to note that at the Mad World Summit in London, where we met, Sir Vince Cable was quoted as saying, “Mental illness costs the UK economy more than Brexit.” Which is a lot of money. And, according to the CDC, by combining medical and behavioral health care services, the United States could save $37.6 billion to $67.8 billion a year.
One last question. What would you say to someone out there who’s suffering in silence from depression or PTSD or trauma or substance use disorder or any kind of mental illness?
You are not alone.
Dean Yates in Times Square, October 2019 (Helen Barrow/Evershine Productions)
Both Big Book zealots and AA’s harshest critics will have a problem with this book—you’re either blasphemous for criticizing a saint or not going far enough to expose a fraud.
It’s been 40 years since Earnest Kurtz’s Not God: A History of Alcoholics Anonymous, which was the last substantial scholarly research into AA’s early years. This week, William Schaberg’s three pound, 800-page Writing the Big Book: The Creation of A.A. was released, and it’s already cracked the top 20 in both Amazon’s Twelve-Step Programs and Alcoholism Recovery categories. People are ready for something new.
“The first chapter is called, ‘Challenging the Creation Myths,’” Schaberg explains. “The chapters that follow in Writing the Big Book do just that, again and again.”
The “We” Myth
The Fix: “I’ve heard the stories about the Big Book being a collective effort of AA pioneers recording their shared experiences. Bill W has said he was less the author and more the umpire, with members arguing, deliberating, and carving out Alcoholics Anonymous together, chapter by chapter, line by line. Is this story of an authorial ‘We’ a mischaracterization of how the Big Book was written?
WS: “Bill is writing back and forth to Dr. Bob and sending him draft chapters. By the time of the third letter, Wilson writes, ‘I’m having a hard time getting input here in New York, Bob. I’m glad you like the chapters but I need some critical feedback, here.’ Bill gets zero from Ohio.
I think one of the reasons that Bill was having a hard time getting feedback was, despite his protestations, Wilson didn’t do very well with input. Bill said proudly that despite adding ‘as we understood Him,’ and taking ‘on our knees’ out of Step Seven, the Steps remained exactly as he wrote them. Bill was fighting a rearguard action all the time because people did want him to change it. A Dr. Howard famously reviewed The Big Book with many criticisms, saying, ‘You’ve got to take all the You out and replace it with We. You can’t tell an alcoholic what to do; tell them what you did; explain how it worked for you.’ Wilson did not want to make these changes.
Late in my research I stumbled across a letter Hank Parkhurst wrote 17 days before the book came out saying, ‘Bill you’ve got to make these changes. If you don’t, I’ll form a committee and we’ll make them for you.’ It was a huge powerplay by Hank to get what he thought had to be done in the book. Bill finally conceded but he didn’t want to do it. This is one example of how resistant Wilson was with anyone messing with anything he’d written.”
The Fix: “So, Alcoholics Anonymous isn’t the work of a collective?”
WS: “The hundred men, who argued about the book in AA meetings, blood on the floor. It didn’t happen. It did in fact happen out at Hank Parkhurst’s Honor Dealers office between Hank, Fitz Mayo and Bill arguing about what should and shouldn’t be in the book. It didn’t happen in meetings; it did happen in a New Jersey office.
It’s amazing how recalcitrant and negative Akron and Cleveland was about this whole book. Dr. Bob got an old newspaper man sober—Jim Scott—and we are told a story that these Akron guys weren’t writers; they wanted to write their story, but they needed Jim to help polish it up. The truth was, aside from a couple of members, they didn’t want to do them. Jim was sent by Dr. Bob to go have coffee with them one at a time, he gets them to tell him their story, Jim goes home and writes their stories. Is that the same as this sainted story about how Jim just helped these guys? No. Bill was putting heat on Bob for stories. Bob was desperate and he found a way to get it done; Jim wrote the stories.”
The Twelve Steps Origin Myth
The Fix: “AA’s Pass It On describes The Big Book chapters as being written in the order they appear. How did the book come together chronologically?”
WS: “‘Bill’s Story’ and ‘There is a Solution’ were written in late May of 1938. Hank Parkhurst and Wilson were shopping the sample chapters around in the hopes of raising money; June, July, August—nothing. Parkhurst comes up with a new idea. There’s a writer for This Week Magazine, Silas Bent, that they’re trying to sober up – he’s slipping and sliding – Hank convinces Silas to submit a story about Alcoholics Anonymous. Hank’s idea was that, at the end of the story, they’d ask readers to send $1 and for that dollar they’d get five chapters, Hank thought five chapters would make the buck worthwhile. So, he goes back to Wilson and says, ‘Two chapters isn’t going to cut it—we need more.’
Wilson started writing on September 15th, 1938 and wrote ‘More About Alcoholism’ and ‘We Agnostics,’ Chapters Three and Four.”
The Fix: “Chapters Five and Six in the Book are “How It Works” and “Into Action,” all about the Steps. That’s not what Bill Wilson started writing next?”
WS: “Right, he didn’t have Twelve Steps yet. ‘Working With Others’ was written next, ‘To Wives,’ ‘The Family Afterwards’ and then ‘A Vision For You.’ Somewhere in there, Hank Parkhurst wrote ‘To Employers.’ So, these Chapters were basically done by December 1938.”
Schaberg describes this stage in a section in his book called, A Vision for How to Get and Stay Sober:
Wilson knew that sooner or later, he would have to face the challenge of creating a chapter that outlined, in the clearest possible terms the actions needed to get and then stay sober. It was, he later commented, a problem that “had secretly worried the life out of him for months before he finally got around to writing it.” But so long as there was at least one single chapter that still needed to be written, Bill would elect to write that instead of facing the intimidating task of putting down on paper the exact details of the program of recovery.
WS: “’Writing the Twelve Steps’—Chapter 23—it was the hardest for me to write. It took months and months. I was trying to make sense of the contradictory stories I was hearing. We’ve all heard the story that Bill laid in bed with a yellow pad and a pencil, he realizes that he has to write something concrete, you know, that ‘drunks couldn’t wiggle out of.’ he gets inspired, he wrote them out, there were twelve, he thinks that’s the coolest thing in the world; he goes downstairs; two guys are there having coffee with Lois. They gave him all kinds of grief, ‘God use to be at the bottom; now he’s at the top. You have drunks getting down on their knees,’ in the original version of Step Seven. That’s how Bill tells it. And when I started looking at it, it just didn’t make any sense. Other times, Bill said that The Twelve Steps were based on the word-of-mouth six steps.”
The Fix: “Pass It On gets referenced in AA meetings, it talks about a variety of six step programs being practiced. From your findings, when did the story of six steps first start getting told?”
WS: “1950; that’s the first evidence I could find of him telling that story. The [six steps] story morphs from 1950 to 1951. First there was the ‘Ebby brought Bill the six steps’ story. Then, a story he often repeated later was that the six steps came out of the group’s collective experience. This was the pragmatic answer, in six steps to how you stop drinking. But here’s the problem: there’s no six steps before 1939. There are 28 stories of alcoholics in the back of the First Edition Big Book written by people from Ohio and New York. Now you would think that if there was a six-step program, people would be talking about it, somebody would be talking, most of them would be talking about working this step or that one. but read the original stories.”
The Fix: “Zero for 28, right?”
WS: “Exactly, O for 28. The common theme is they were powerless, they turned their lives over to God and they stop drinking; no six-step program written about before 1939.”
The Fix: “You write about Frank Amos, sent by the Rockefellers following the infamous December 1937 New York meeting to report on what Dr. Bob and the others did to get and stay sober.”
WS: “He travelled to Ohio to check up on what Dr. Bob and the other members were doing. He writes a report highlighting seven things they were doing to stay sober; those seven things don’t correspond to the six steps that Bill Wilson was later talking about. So, I’m up against a wall, none of this is making any sense to me.
One of the great reveals was when I was given a copy of Bill’s first draft of his story. Written late May of 1938, the first version, if you will—there were a couple of versions before that were really, really terrible but this was the one—that, over time, morphed into what appeared in the book. And as we’re taken through Bill’s experience in Towns Hospital, you can number about ten of those Twelve Steps.”
The Fix: “So, the Steps are Bill’s experience, not a universal experience?”
WS: “Things did come together in a way that made sense to me and is a credible story about the genesis of the Twelve Steps, right there in that May 1938 version of his story. You put numbers on them and there’s (at least) ten of them, right there. So, what we’re doing here, we’re not using six steps that Ebby brought to Bill or any collective experience of early members, this is ‘What I did; how did I get sober?’ Bingo, there it is.
In the archives there is a copy of a letter, before 1950; a lawyer, Paul Kirby Hennessy wrote to Bill to confirm a discussion they had on a train ride to Washington. Paul had asked him, ‘Hey, how’d you come up with the Twelve Steps. There is a lot more detail about this encounter in my book, but Bill wrote back to Paul confirming his story that the Steps came from his personal experience. That October 19, 1948 letter is in the archives, ‘Bill’s Story of the Evolution of the Twelve Steps.’
Bill Wilson could have written ‘Do what I did and you could get sober, but isn’t it a better story to say here is what we did—one hundred of us did—we did this, we got sober, and you can, too?’ ‘We did this,’ is a powerful message.”
Co-Founder Mythology
WS: “The whole co-founder thing is another example of how Wilson wasn’t inclined towards historical accuracy. He was and still is a guy who is worshipped as a guy who walks on water. Bill knew he had an ego problem. One of the things he did to cope with that was to take the spotlight off himself as much as possible. The co-founder idea is one way that Bill could do this.
I’m almost offended when the co-founder thing comes up. Bill Wilson is the founder of AA.
Mel B, a really good AA historian, came into AA in the early 1950s. I heard a really great interview with David L whereby Mel B said that back then, ‘Bill W is referred to as the founder; Dr. Bob is the co-founder,’ giving primacy to Bill Wilson.’ Bill would call himself a co-founder and Dr. Bob is a co-founder, and somewhere along the line, William James or Sam Shoemaker, Sister Ignatius or Henrietta Seiberling is a co-founder, Frank Amos claimed he was a cofounder. Bob Smith isn’t mentioned as co-founder until 1946.
Ebby Thatcher, who brought the message of recovery to Bill—the seminal moment in AA history—if Ebby isn’t a co-founder then who is?
I’m almost famous for saying this by this point: ‘No Hank; no book.’ That’s absolutely the truth. The book Alcoholics Anonymous just wouldn’t have happened without Hank Parkhurst. So, if Hank isn’t a co-founder then who is? Bob Smith was the last man standing who stayed sober, that’s why we call him co-founder today.”
Conclusion
The Fix: “AA’s first official accounting of historical events was A.A. Comes of Age which the 1956 General Service delegates unanimously voted to approve, relying on Bill’s recollection of early AA—nearly twenty years after writing The Big Book. Dr. Bob and the Good Oldtimers didn’t appear until 1980 and Mel B’s Pass It On: The story of Bill Wilson and how the A.A. message reached the world wasn’t green-lit until 1984; relying on many of these AA folktales recounted by sources, many of which are secondhand.”
WS: “The people in Ohio told stories after the fact that never happened, how deeply they delved into the chapters that were sent to them. What happened was this project that they were in open rebellion against became very successful. Five, ten, twenty years later they aren’t telling stories about how they opposed the writing of the book, they’re telling the story as if they were on board from the very start. It’s just people tell stories of the past in a way that reflects the current reality—say a 1950 reality, a 1960 reality or further out—contrary to what actually happened. It’s a perfectly understandable human tendency.”
The Fix: “There’s a difference between investigative inquiry and looking for fault like there’s a reward for it. It’s hard not to have an agenda when researching history. I’m not surprised that Writing the Big Book, maintains a fact-driven discipline. What did surprise me, as an academic text, it read like a detective novel. I’m surprised that it is such a page-turner.”
WS: “The historian’s everlasting quest is to answer, ‘What really happened?’ I don’t know what really happened, but I have a better idea of what happened, having done all that research. When you start finding out the stories Bill told just aren’t true in some sense, you ask, ‘Was the guy a liar? What am I doing being involved with this project, with this guy who’s a liar?’ And I actually had a couple of people who came at me from that direction.
But it wasn’t too long before I came to see Bill Wilson as a man of vision. Wilson wasn’t a historian; he wasn’t trying to be. Bill Wilson wasn’t a liar. He was a salesman, with a solution to alcoholism, a problem that had ravaged the nation for centuries. He thought he could save hundreds-of-thousands of lives and that is what he was trying to do. Wilson was the ultimate pragmatist; he wasn’t a dogma guy; he wasn’t a this-is-the-way-it-is guy. If it worked, he was all for it. He was telling stories that left out messy details, closer to parables than a historical account. Frequently he slips into mythmaking. The stories were supposed to be powerful, incisive, impressionable stories for people who were trying to get sober or who weren’t quite convinced yet to get sober. A myth captures the essence—not the details—of truth.”
The Fix: “It’s fair to expect that this book will put a target on your back by both the Big Book zealots and AA’s harshest critics—you will be perceived as either blasphemous for criticizing a saint or not going far enough to expose a fraud. To skeptics, what would you say?”
WS: “There are 1570 citations at the back of the book along with 416 footnotes throughout the text – if you don’t believe what I’ve said in the book, or the facts I’m quoting in the book, go down to archives and find another document; I’m on board with that.
We need to get back to primary document research; we have to get off of this quoting Bill Wilson thing because that’s not always what happened. It makes a good story. If you’re trying to tell an inspirational story, tell that story, but if you’re trying to tell a historically accurate story, go back to the archives and read the pieces of paper that are there.”
Fix readers wanting to learn more about Writing the Big Book: The Creation of A.A., visit http://www.writingthebigbook.com/ and read a sample chapter for free.
After staring at a wall for almost half of my life, being able to look out the windows of the halfway house at the world but not being able to go out and experience it was maddening.
When you’re being escorted out of a federal court room in shackles and handcuffs, after being sentenced to almost two decades behind bars, you can almost feel the life ooze out of your pores. The pronounced slam of a gavel drives home the fact you’re not in Kansas anymore, while one hope creeps its way into your brain: the day those cuffs come off and you’re free. This image is your savior, your best and only friend to keep you company throughout the brutally unforgiving years of violence, isolation, and solitude. Visions of beautifully simple things like going to the park or eating strawberry pancakes shoot through your psyche in bright shining lights onto the faded white graffiti laced brick walls of your 9-by-6-foot cell of despair.
All this promise makes it all the more devastating when that magical day arrives for the nightmare to end, and you realize just how far you are from getting out of the rabbit hole.
“Have you ever played a PlayStation? Hell, have you even used a cell phone?” These are the words the middle-aged Latino case manager told me through the battered food slot inside the cell door of the Special Housing Unit.
“Someone like you, I wouldn’t give more than 4 months. The world has passed you by…but good luck.”
These words of encouragement came from someone who spent almost as much time in the Bureau of Prisons as I have. A man who has witnessed firsthand how hard it is to adjust to a world that will chew you up and spit you right back. He wasn’t talking about my transition back into the free world. He was talking about the federally funded center that was in charge of restoring my sanity.
Institutionalization, PTSD, and Post Incarceration Syndrome
PTSD and its sister syndrome, PICS (Post Incarceration Syndrome), are disorders in which a person has difficulty recovering after experiencing or witnessing a terrifying event. The condition may last months or years, with triggers that can bring back memories of the trauma accompanied by intense emotional and physical reactions.
During my 15 years of incarceration, I experienced and witnessed atrocities that would make most war veterans cringe. Divided racial lines and the total disregard for human life were the first things that greeted me behind the grimy walls down in the swamps of Louisiana, USP Pollock. The “slaughterhouse of the south” averaged 40 stabbings a month, while incurring 16 murders in an 18-month span. Desensitization set in rapidly when watching a stabbing was as common as watching a baseball game. This was just the first of four penitentiaries in which I was beaten, stabbed, isolated, and herded throughout half of my life.
While President Bush was fighting his wars overseas, and smartphones, text messaging, and iPods were shaping humanity, I was envisioning a breathtakingly beautiful sun setting over the ocean. The sound of waves crashing danced through my ears, as I felt the cool wet sand beneath my feet. When President Obama was still fighting the war, and Google, Facebook, and YouTube took over society, I was sitting in solitary confinement, my stomach touching my ankles, as I dreamed of the family dinners at my parents’ house. The four cheeses of mom’s famous lasagna made my mouth water, as I imagined the smiling faces of better years sitting around the table listening to Dad’s old war stories. As President Trump was halfway through his reign of terror, the cuffs finally came off and I was released. But little did I know, the nightmare was far from being over.
Institutionalization is a gradual normal reaction to the unnatural and abnormal conditions of prisoner life. The more extreme, harsh, dangerous, or otherwise psychologically taxing the nature of the confinement, the deeper the damage that will be done. During this process, a prisoner incorporates the norms of prison into their habits of thinking, feeling, and acting. It renders some people so dependent on external constraints that they gradually lose the capacity to rely on internal organization and self-imposed personal limits to guide their actions and restrain their conduct.
When I was released from the SHU in Big Sandy Kentucky on July 29, 2017, the world seemed to be in hyperdrive. My parents and sister, along with the girlfriend I’ve never held, laughed as I bounced around the car like a dog in heat. The speed of everything left me spinning as I tried to comprehend the tiny screen in my hands that was speaking directions towards the home I’ve never seen. Inside that car I felt alive for the first time in over a decade and a half. Then we stopped a block short from my residence, and all the rules that I’d just broken by being with my family drove away with five minutes to spare, as a whole new nightmare began.
Bait and Switch
According to the Federal Bureau of Prisons: “Residential reentry centers provide a safe, structured, supervised environment, as well as employment counseling, job placement, financial management assistance and other programs and services. RRC’s help inmates gradually rebuild their ties to the community and facilitate supervising ex-offenders activities during this readjustment phase.”
When I walked into the reentry center in downtown Pittsburgh, I wasn’t greeted with a homecoming of old friends and relatives like in the movies. Instead, I sat in a drearily filthy break room as paramedics wheeled off a semi-conscious reentrant to a waiting ambulance. These overdoses, ranging from heroin to K-2, would become a normal part of my daily routine. Once I made my way to the seventh of eight floors, each floor packed to capacity with clueless ex-cons all trying to breathe free fresh air, the prison mentality quickly set back in.
My case manager greeted me in her tiny cluttered office and gave me a list of all the rules and regulations that make readjustment damn near impossible. No smartphones, riding in cars, or being ANYWHERE without approval a week ahead of time. If I wanted to stop at 7-Eleven for a cup of coffee in the morning on my way to work, I would be in violation of my release. I also received the bonus of not being allowed to publish any of my writing or leave the city limits. She concluded her orientation with the added kick to the nuts of twenty five percent of my pay getting kicked back to the house for the opportunity to feel the sunshine on my face for the first time in a decade and a half.
I also was given the one-time warning about being late. If I was more than 5 minutes late back from a pass, whether it be a late bus or a broken leg, it was back to the box to finish out the remainder of my sentence. Just riding on public transportation is enough to give me a panic attack after years of isolation. The need to sit with my back against the wall is uncontrollable while my hypervigilance runs wild surveying everyone and everything. When you add a traffic jam to that equation, it’s almost debilitating. Going from a world with nothing but time, to one that will literally put you in a cage if it’s mismanaged, was and still is one of the hardest things to deal with after my release.
During the 15 years of my incarceration, I lived with a lot of different people. A redneck from Wyoming to a skinhead from Seattle, I’ve been forced to share a bathroom with the best of them. No matter where they were from, there was one thing in common: I didn’t like any of them. Even Mother Teresa is going to get on your nerves if you’re stuck in a broom closest with her 24 hours a day for months on end.
Standing on the Edge of Freedom
In the late 70’s, psychologist Bruce K. Alexander conducted his Rat Park study. In this study he took lab rats and housed them in two different environments. In the first, “skinner boxes” (solitary confinement), they were completely deprived of everything, even movement was difficult. The second environment housed the rats in a space 200 times bigger, with wheels, and boxes and other rats to interact with. Inside both settings were two different water bottles. One filled with narcotics to numb the pain that will run through any being under such harsh conditions, and the other without. Each time when the rats are housed in skinner boxes, they go right for the drugs. But, when they’re in rat park with all their friends, free to make decisions and live a good life, they always chose the clean water.
After staring at a wall for almost half of my life, being able to look out the windows of the halfway house at the world below but not being able to go out and experience what I’ve been dreaming about for so long was maddening. Having that freedom dangling in my face, after coming so far, was heartbreaking. After years of dreaming about what you want to do, where you want to go, who you want to see, and then discovering you won’t be doing any of those things for a long time, it absolutely puts you right back into that ‘I don’t give a fuck’ mentality.
Institutionalization can be taken to extreme lengths or become chronic and deeply internalized so that even though the conditions of one’s life have changed, many of the once functional but now counterproductive patterns remain.
I spent 14 months inside the halfway house after my release. It almost seemed to last as long as the 15 years that I did behind the walls of our fine penal system. During that time, I wasn’t allowed to go to the park, or take my girlfriend out on a date. I couldn’t sit down for those family meals or see that sunset on the beach, but I made it through it.
I absolutely know that I suffer from PTSD and PICS as a result of my incarceration, and I’m far from the only one who suffers from these syndromes. Anyone would feel the same way as I do if they grew up deep inside the belly of the beast. Who knows if the hypervigilance, paranoia, and anxiety will ever allow me to be at ease when I’m out in society. It took me getting out of the system completely before I could even begin to heal.
Overlooking the physical impact that substance use disorder has had on our bodies will exacerbate disordered eating and poor mental health. As many as 72% of women with alcohol use disorder also have an eating disorder.
Diet culture is insidious. We spend our lives obsessed with our bodies — always wishing for a smaller shape, scrutinizing the size of the portions on our plates, and unscrupulously comparing ourselves to thinner people. It’s damaging because it leads us to equate our worth with our appearance. For people in recovery, that is especially harmful. We experience physiological changes quickly — including weight gain — once we find recovery, and we can often leap to the assumption that we have a food addiction and reach for harmful, quick-fix solutions.
But what if that weight gain is actually the inevitable evolution of our bodies in early recovery?
When we stop taking drugs and drinking and instead prioritize basic human needs that we previously neglected, like eating, we often gain weight. Unfortunately, before allowing our bodies and appetite to achieve homeostasis, we seek to avoid feelings of discomfort which makes us vulnerable to the pervasive messaging from diet culture.
What Is Diet Culture?
Diet culture affects people of all body sizes, but it is particularly harmful for people who have larger bodies. It also perpetuates eating disorders because being seen as fat is believed to be one of the worst things that can happen to a person. And in many ways, it is: we’re treated differently, we’re stigmatized, and we’re valued less.
The National Eating Disorders Association states: “Diet culture creates the belief that it’s okay to risk the life of a fat person in order to make them a thin person.”
In order to overcome diet culture, however, we must first create awareness of what it looks like. NEDA identified the key tenets of diet culture as:
Encouraging rules about what, when, and how much to eat. This can manifest as restrictive diets — perhaps marketed as juice cleanses or liquid diets — and the trend to label food “good” and “bad.” We can also see it demonstrated in fasting diets and not eating within certain time frames.
Suggesting that people are more or less good/moral/worthy based on their body size. As a culture, we reward people for thinness. Compliments are almost always based on how someone looks, and we’re particularly congratulatory if the person we’re complimenting looks like they’ve lost weight. Conversely, we stigmatize, oppress, stereotype, shame, and harass fat people because they don’t meet our perception of how we think they should look. Fatness is the butt of many jokes, it is the source of much ridicule, and it is the reason we make assumptions about people in larger bodies. We assume that fat people are lazy, that they sit in front of the TV favoring binge-eating over exercising, and that they are probably depressed.
Creating thin privilege. Weight becomes a barrier to jobs, benefits, support, comfort, and accommodation. Expecting that public transportation, amusement park rides, medical facility waiting rooms, and exam rooms will accommodate you is thin privilege.
Using exercise as punishment. Instead of exercise being joyful, movement is seen as a means of punishing ourselves for eating too much, or a way to “earn” a “cheat meal.”
Viewing fat people as higher risk medically. Clinicians often recommend restrictive surgeries or prescribe medications to fat people, even though there are serious (sometimes fatal) and lifelong risks associated with these treatments. These invasive and drastic measures are often favored by doctors over evidence-based interventions, completely overlooking the patient’s quality of life and the associated risks.
The Risks of Diet Culture for People in Recovery
We often overlook our physical needs in early recovery, instead focusing on getting and staying sober. But programs focused solely on spiritual well-being aren’t enough. Overlooking the physical impact that substance use disorder has had on our bodies will only exacerbate disordered eating and poor mental health. Prioritizing proper nutrition, however, has been shown to significantly improve rates of recovery.
Substance use disorder can cause considerable damage to our bodies that can take years to even out. It can disrupt metabolic and hormonal processes leading to poor calorie consumption and nutrient deficiencies. These deficiencies can be serious as they impact our mental health, vital organs, and immunity — that’s why we often feel depressed, agitated, and out of sorts in early recovery. What we eat during this crucial time has the potential to impact our mental well-being and how our bodies heal. Part of that healing often includes weight gain, whether we like it or not.
Once we remove drugs and alcohol, we experience biochemical changes that can lead to an increased appetite and a desire to boost our low mood. Our brains are now wired to seek that pleasure externally, so we look to highly palatable foods: candy, fried foods, fast food, cake, cookies, and sugary caffeinated drinks.
People in recovery often lack sufficient nutritional education about the right foods to eat. We also move less in early recovery, sitting in meetings, spending a lot of time in coffee shops, or sleeping. The combination of increased consumption of highly palatable foods, disrupted bodily processes, poor food choices, and a lack of exercise inevitably lead to weight gain.
However, despite the fact that many of us were underweight when we came into recovery, we still treat any weight gain as a negative. That’s because of diet culture. We are quick to label our sudden increase in appetite and desire for highly palatable food as a problem. Some jump to the conclusion that they are addicted to sugar or food.
Many women in recovery have a disordered relationship with food. As many as 72 percent of women with alcohol use disorder also have an eating disorder. This makes it even more crucial that we allow the process of recovery to take place and eat a balanced diet free from restrictions.
Carbohydrates are needed to produce the neurochemical serotonin to balance our mood, help us sleep, curb food cravings, and sustain energy. Protein is crucial to healing and mental health: a lack of dopamine can trigger a return to substance use to improve mood. Fat is essential for mental health and also plays a role in stabilizing mood and reducing symptoms of anxiety and depression.
It can be hard to accept weight gain. It leads us to look at our bodies and our relationship with food more critically. But this hyper-focus on our appearance leads to further harming our already damaged self-esteem.
“Women in recovery have already been through a tremendous amount of shame,” says intuitive eating coach and RN Tiffany Thoen.
“Feeling that we are not good enough or that there is something wrong with us is familiar and contributes to the desire to change ourselves to be ‘better,’” she says. “Diet culture preys on these feelings of low self-worth for profit. For women in recovery, this adds to self-loathing by becoming one more way we aren’t good enough.”
Rather than acknowledge that our bodies need food in order to heal and what we are experiencing is a normal part of recovery, we try to reverse that weight gain by going on restrictive diets, which only undermines the healing process. It can also have disastrous consequences: it can inhibit the healing process and our ability to function, trigger co-occurring conditions like eating disorders, and risk a return to using substances.
How Do We Combat Diet Culture?
In order to focus on our healing, we must allow for the process of recovery and not get sucked into diet culture. Thoen recommends that we empower ourselves to reject diet culture by taking these steps:
Cultivate awareness around negative self-talk
Notice where you might see messages promoting diet culture: on TV, in magazines, or on social media
Consider who is benefiting from your believing these messages
Set boundaries with friends and family around diet talk and commenting on bodies
If you use social media, follow people of all shapes and sizes doing a variety of things, such as the hashtag #womeneatingfood
Cultivate respect, acceptance, and gratitude for your body as it is today, because our bodies are doing their best to support us
Do the inner work around value, worth, and self-forgiveness
Get support from the many available resources, books, podcasts, online groups, coaches, etc. so you don’t have to do it alone
Don’t lose hope. As Thoen says, “Diet culture is insidious and can keep up in a cycle of self-loathing. Healing your relationship with food and body is possible.”
Overdose survivors need more than a second (or third) chance: they need a parachute. When you’re in free fall, a little more time isn’t much help.
Perhaps everything that is terrible is, in the deepest sense, something that wants our love.
Rilke
The overdose epidemic in the U.S. has been called “the greatest public health crisis of our time.” It’s also our greatest opportunity.
The opioid crisis is an identity crisis: it’s a challenge to how we see ourselves. Do we truly believe that we are all in this together? One answer leads us deeper into despair. The other, into a hopeful future.
It’s been said that “doing more things faster is no substitute for doing the right things.” What are the “right things,” the measures that can resolve the crisis, not just postpone it? The right actions come from the right thoughts. Those thoughts come from feelings, and feelings are never right or wrong. But there are some feelings we are born with. They are our birthright. And one of them is love.
The Kindness of Strangers
Hatred never ceases by hatred, but by love alone is healed.
The Buddha
Behind the opioid epidemic is a prevailing lack of compassion, of caring about everyone equally. At the heart (or lack of it) of this societal disease is rampant inequality. The social determinants of health: stress, unemployment, lack of support, poor health care, etc. are major drivers of addiction. Many authors promote this view, including Gabor Mate, Bruce Alexander, Sam Quinones, Robert Putnam, and Harry Nelson.
Our increasing fragmentation affects everyone, poor or rich.
Drug overdose is the leading cause of death for Americans under the age of fifty…
Our material lives may be outwardly prosperous, but our psychological and spiritual lives are in freefall. What is driving us to self-destruction? There are many factors, all with one unifying theme: we are no longer living in community with one another and, consequently, we are lonely.
Francie Hart Broghammer
We all hunger for the same thing. The question is this: do we love our neighbor as ourselves? That’s not just a commandment; it’s a requirement. How do we rebuild community? First, by taking full responsibility for the fallout of not being one.
For Whom the Boom Tolls
Compassion is not a relationship between the healer and the wounded. It’s a relationship between equals. Compassion becomes real when we recognize our shared humanity.
Pema Chodron
I live in Asheville, a city that has recently, like the opioid crisis, exploded. Tourism is at an all-time high, and Asheville has appeared in dozens of destination top ten lists. It has also been ranked second in the country in gentrification.
Asheville sits in the heart of Appalachia, where the opioid crisis is at its worst. In 2017, North Carolina had the second highest increase in opioid deaths in the country. The Blue Ridge Parkway runs through town and I spend a lot of time there, mostly foraging. That’s where last summer, for the first time, I found not mushrooms, but needles.
Despite the crisis, the city just spent six months trying to shut down the local syringe exchange. The same thing is happening in other cities. In Asheville, the exchange had been operating without incident for over two years — until the houseless (a.k.a., homeless) in adjacent areas were kicked out to make way for new development.
Addiction depends on denial. What if development is the real addiction? Will we face up to the dark side of gentrification or just try to make it “go away?”
If a canary dies in a coal mine, you don’t blame the canary. Yet blaming the victim is exactly what we’ve been doing.
Blue Ridge Parkway, 8/20/18
License to Ill
A man came to the Rabbi and said, “Rebbe, my son has turned against me. What should I do?” The rabbi said, “love him even more.”
Hasidic story
Most people by now have heard that naloxone (Narcan) can prevent a deadly overdose. So many Americans are dying — often from a mix of drugs, but mainly due to opioids — that naloxone should be as ubiquitous as aspirin. Everyone using a drug that may contain opioids should carry it like an EPI pen. And with the increasing prevalence of fentanyl, a single dose may not be enough. Everyone should know how to tell how much naloxone to give someone in the midst of an overdose. This should be basic, universal knowledge.
But keeping someone alive is just the beginning. In fact, while naloxone may be physically safe, it does have one significant side effect: precipitated withdrawal. And not helping someone through it is like catching them from falling only to drop them from higher up.
A Devil’s Bargain
Be kind, for everyone you meet is fighting a hard battle.
Ian Maclaren
As one response coordinator describes it, precipitated withdrawal is like “the worst flu you’ve had… times 100.” For some, the feeling is so bad that they find themselves dying, so to speak, to use again.
To the uninformed, it is inconceivable that someone who nearly died from a drug would run out that very same day and buy more of it. Narcan works by binding to opioid receptors, blocking the effect of narcotics like heroin. In drug users with a physical dependency, it also has the effect of causing severe withdrawal symptoms. This all but guarantees that the first thing a user will think of after their overdose is reversed is getting another fix…
Christopher Moraff
Naloxone is not just a “bandaid on a bullet hole.” It can feel like ripping open a wound. For “withdrawal is the very situation that [users] are seeking to avoid in the first place.”
“A dose of naloxone,” according to the Chief Medical Officer for a Connecticut health agency, “is a chance. But if it’s not coupled with immediate offers of treatment, it may be a slim chance that leaves the revived individual running back to the same dealer who sold them their last lethal dose.”
Overdose survivors need more than a second (or third) chance: they need a parachute. When you’re in free fall, a little more time isn’t much help.
Back on the Chain Gang
Without forgiveness, our lives are chained, forced to carry the sufferings of the past and repeat them with no release.
Jack Kornfield
“They’re usually very angry when we bring them around,” says one responder. “One kid yelled at me, ‘You think this will make me stop doing drugs?’” Indeed, one substance abuse specialist in Ohio says that 67% of people revived with naloxone in her area use again within 24 hours. NPR reports that “about 30 percent of those revived with Narcan at Boston Medical Center have been revived there more than once… and about 10 percent of patients more than three times. Those statistics are in line with what’s seen in ERs elsewhere, public health officials say.”
According to a former agent for the DEA, one woman in Ohio, within 24 hours of being revived for the the sixth time, was using again. In the first half of 2017, one man in North Carolina was revived fourteen times.
To be clear, I am not saying naloxone provides a safety net that encourages people to take bigger chances. Studies have shown that naloxone does not increase drug use any more than free condoms increase sex. Nor am I saying we should place limits on the number of times we revive people.
What I am saying is that naloxone is no miracle drug. When you “come to,” the problem remains. Overdose survivors are 24 times more likely than the general population to die in the following year. One study found that for those revived with naloxone, nearly one in ten are dead within a year, the majority within the first month. Follow up is critical. But even that is not enough.
Not by Locks Alone
Few things can help an individual more than to place responsibility on him, and to let him know that you trust him.
Booker T. Washington
In June of 2019, New Jersey became the first state to allow paramedics to administer buprenorphine along with naloxone to ease the pain of withdrawal. Buprenorphine is the drug that, like methadone, is used in opioid replacement therapy. But this measure will, according to one expert, “make a meaningful difference only if rescued individuals are linked immediately to ongoing treatment and agree to participate in that treatment.”
“Immediate” is key. And at least one hospital in New Jersey has been making that link, through state-paid recovery coaches, since 2017. A coach might work with someone “for weeks or months.” And the cost to taxpayers of helping people in this way is surely far less than the cost of leaving them on their own.
Unfortunately, however, getting people into treatment is not enough. Not all treatment is good treatment. In fact, much of it is worse than doing nothing at all.
Under the Rug
Beware of all enterprises that require new clothes, and not rather a new wearer of clothes.
Thoreau
People usually go to rehab for 28 days, maybe a month and a half. In most cases, the treatment fails, if you regard failure as return to use. A study reported in the Irish Medical Journal found that 91% of people who go through rehab are using again within a year; 80% in the first month.
“Most honest program directors,” says veteran addiction expert Julia Ross, “will admit to 90% relapse rates, and I assume that if they admit to 90%, it’s probably worse.” Drug courts are no better. A national study of seventy-six drug courts found a reduction in the rate of rearrest of only 10 percent.
Moreover, when people come out of abstinence-based rehab, their tolerance has gone way down, so they are more likely to overdose. This is a common reason why fentanyl is killing people: it’s much stronger than they are expecting, especially in an opioid-naïve state. Making fentanyl test strips available can help prevent overdose, but that still doesn’t deal with the basic issue of why they’re using in the first place. What pain are they killing?
Zero Tolerance
Winning isn’t everything; it’s the only thing.
Henry “Red” Sanders
I watched my grandmother die a very slow death. At 90 years old, after three cancers, open heart surgery, and several strokes, she still fought tooth and nail. Christopher Ryan, author of Civilized to Death, compares our approach to death to the final minutes of an NBA basketball game. We drag it out. We go for quantity instead of quality. Is that also our approach to addiction? As long as they don’t die, we’re OK. This is similar to abstinence-based approaches to addiction treatment: As long as you don’t use, you’re OK. This amounts to saying, “it’s more important to look good than to feel good.”
To be clear: I’m not saying we should just let our neighbors die. I’m saying we need to do more than just keep people alive; not less. We need to treat the cause, not just the symptom.
Spare the Prod
If you want to be heard, whisper.
Author Unknown
The overdose crisis is part of a larger epidemic of despair. The facade of America as the “land of opportunity” is failing. Asheville today is “booming.” For whom? Are we saving lives or just saving face?
Fortunately, Asheville has begun to address its weak spots, and we now have three needle exchanges. We all need to look in the mirror and face where we — as a community, as a country — are really at. Because not doing so is killing us. Whether we die quickly from overdose or slowly from alcoholism, cancer, or depression, we are ALL canaries in a coal mine. And you can’t just rake the canary over the coals.
It’s one thing to save lives. But throwing someone into withdrawal without providing detox support or throwing them out of treatment because they’ve relapsed is like hitting a child to make them stop hitting other children. Such heavy-handed measures only perpetuate a cycle of abuse. Even a magic bullet leaves a wound.
Sticks and Phones
Can you love people and lead them without imposing your will?
…leading and not trying to control: this is the supreme virtue.
The Tao Te Ching
There’s a reason our greatest leaders practice nonviolence. If all we do is arm people with naloxone, if we fight firearms with firearms, the conflict will only escalate. Stronger opioids are already requiring stronger antidotes.
With this approach, we may win a few battles, but we will lose the war. You can’t win when you see this as a war to begin with. Because you can’t force someone out of addiction any more than you can force them to stay alive. Force is what causes addiction.
In 2015, Victoria Siegel, 18, died of a methadone overdose precipitated by cyberbullying. We worry about bullying in schools. What about parental bullying — or governmental? Some of us are aware of the alarming incidence of domestic violence. How many of us recognize how our culture is inherently abusive, our very way of life?
Sometimes we forget that we are treating people, not diseases. We are bio-psycho-social beings. We have feelings. If addiction comes from pain, and pain comes from hurt, then we need to reduce hurt, not just harm.
A Dying Shame
You cannot be lonely if you like the person you’re alone with.
Wayne Dyer
We will not end drug abuse until we end human abuse. We will not end human abuse until we end abusive thinking, because violence starts with what you think. A saying often attributed to Martin Luther King Jr. is that “you can have no influence over those for whom you have underlying contempt.” As long as I think, “you’re not good enough; this is all your fault,” or I say that to myself, addiction has a foothold.
The blame game has no winners. “We’ve lost what it means to just be ourselves and for that to be ok and for that to be enough. So we find ways to self-medicate,” says Rev. Shannon Spencer. People will use painkillers as long as the pain is killing them, for there are few emotions more agonizing than shame.
We Are Faminy
I don’t remember now how many days we stayed—long enough to hear David sing often and tease us about white people’s music, which, according to him, is only about “love.” He observed that the Hopi have many songs about water, which they consider the rarest and most precious of resources, and then asked, with feigned innocence, if white people sang so often about love because it was equally rare in our world.
Peter Coyote
To many, opioids feel like the opposite of shame. One user describes the feeling as “like being hugged by Jesus.” Indeed, “the very essence of the opiate high,” according to Gabor Mate, is that it feels “like a warm soft hug.” This is the feeling of unconditional acceptance and support, or love.
We live in a culture where love is the one thing we sorely lack. Millions of people are starving for just a few drops of it. If only for a few moments, we desperately need to feel like we’re OK, that someone wants us to be here, as we truly are. Like they say, it is rain that grows flowers, not thunder.
Inside, we know we’re not just here to feed The System. We know it should be feeding us. We should not be starving. We should not have to be forced, or force ourselves, to do anything. People need to be supported to decide for themselves what healing looks like for them and to approach it in their own time.
The Emperor in the Room
Opioids are like guns handed out in a suicide ward; they have certainly made the total epidemic much worse, but they are not the cause of the underlying depression.
Anne Case and Angus Deaton
To solve the drug problem, we need to focus on more than drugs. Otherwise, we are shooting the messenger. Drugs are like the emperor’s clothes; it’s time to look at who’s wearing them.
Like Dr. Jekyll and Mr. Hyde, opioids and their antagonists are two sides of the same coin. Focusing on either is like looking for your keys under the streetlamp when you know you dropped them further up the street. There is an “upstream” issue here. That issue is our domination-based, “have to” culture. If we stick to our guns, if we continue to be violent, inside and out, we will continue to die.
Whether we kill another person, the planet, or ourselves, we are a culture committing suicide. We are overdosing on “progress.” We are addicted to things far more insidious than opioids; you’re looking at one.
Progress isn’t progress when it’s in the wrong direction. The direction we’re going is apart. The direction we need to go is back together.
Only the Lonely
Humanity’s current crisis may not, at its root, be an economic crisis or an environmental crisis. It may well be a crisis of consciousness, a crisis in how see ourselves and the world around.
Peter Russell
If you’re in the right place at the right time, armed with enough naloxone, you can save a life. But what about an hour later, or the next day? You might get someone into treatment, but what about after that? A person that susceptible to overdose can scarcely be left alone. And that aloneness is the real problem. In fact, it’s how addiction starts.
The connection between social isolation and addiction shows up on many levels, from treatment to prevention. The most obvious is that you can get naloxone into the hands of every drug user, but it will do them no good if they overdose alone.
Human beings may be the most social animals on earth. Social isolation can drive us to despair, addiction, and even suicide. Loneliness is self-reinforcing and can lead to shame, for it can mean “I don’t deserve to be loved.” This can be the underlying emotional pain that comes back during withdrawal, whether from an opioid or from someone withholding their affection. And that lack of affection could be the primary cause of addiction.
Fatal Attraction
If one has a friend, what need has one of medicines?
Bhartrihari
There can be no healing without community. “This unique American moment asks not for a call to arms, but for a call to neighborliness.” (Francie Hart Broghammer)
No amount of “care” can substitute for the watchful eye of loving family, friends, or neighbors. No amount of “treatment” can make up for how we treat each other. It truly takes a village.
Ultimately, it’s not drugs that are killing us; they are just finishing us off. Whether or not we beat the horse, we’re already practically dead. Something has weakened us enough to succumb to drugs. It’s the same thing that allows dealers to intentionally make some of their merchandise deadly, or if it’s naloxone, to jack up their prices.
What our culture is most addicted to is exploitation. It’s what the system is set up for. It compels us not to care. As Ken Eisold says, “The loss of community is not a problem that can be dealt with through psychotherapy,” for what needs rehabilitation is our society. There’s something wrong “with the village.”
The greatest tool I know for rebuilding community is Nonviolent Communication (NVC). The best approach I’ve encountered for addressing the disconnection inherent in addiction is SeekHealing.
We are the Medicine
At the root of the opioid epidemic are deeper questions that we have to ask about society. What kind of society do we want to live in? Do we want to live in a society where we believe every life truly matters? Do we want to live in a society where we all chip in, recognizing that we are vulnerable in some way, whether it’s to addiction or loneliness or other conditions, and that we are stronger when we come together, when we recognize our interdependence, and when we help each other?
As tragic as the opioid epidemic is, if it can move us in a direction of shared understanding about our interdependence, if it can help us address these deeper social roots of disease, then I believe that we will have used it ultimately to improve ourselves to become stronger as a country.
Vivek Murthy
To make it out of this crisis, we need to look at the big picture. As writer David Dobbs puts it, “trying to understand mental illness without accounting for the power of social connection is like studying planetary motion without accounting for gravity.” If we only look at addiction on an individual level, we are missing the forest for the trees. If you don’t heal the forest, it gets harder and harder to heal each tree.
It’s especially hard to heal when you’re continually cut down. In this culture of mutual exploitation, we treat each other like truffula trees. We factory-farm humans and clear-cut them for fuel. We do it to each other and we do it to ourselves. All to feed the machine, the matrix. To race into space, we’re melting our wings.
Saving lives, then, is only the beginning. It’s the tip of the iceberg. Because it is we, not “they,” who have an addiction. This isn’t about how we use drugs; it’s about how we use each other. Because ultimately, there are no others. We are not just a bunch of individuals. We are one, interdependent whole. Our greatest public health crisis is that we’ve forgotten who we are.
The Opposite of Addiction
Sometimes out of really horrible things come really beautiful things.
Anthony Kiedis
This crisis is an opportunity, a wake-up call. If we take responsibility for it, there’s no limit to what we can do. It’s said that anything is possible if it doesn’t matter who gets credit for it. The same is true of blame.
We are all in this together. That’s the bottom line. There is but one answer to this crisis, and we each carry it at the bottom of our heart.
In rehab, LaBeouf used a flashlight under the covers to write what he was learning about mental illness and alcoholism. These notes evolved into the screenplay for “Honey Boy.”
Actor Shia LaBeouf, now 33, wrote Honey Boy during his 10-week lockdown in court-ordered treatment, which he nicknamed “head camp.” That was the sentence for his highly-publicized 2017 felony arrest for public drunkenness, obstruction, and disorderly conduct—a charge that could’ve landed him seven years in prison. Since then, much has changed for LaBeouf.
“I want to thank the police officer who arrested me in Georgia for changing my life”
This week, only two years post-rehab, the Hollywood Film Awards honored LaBeouf with its Breakthrough Screenwriter prize. Now sober, his acceptance speech was all gratitude, with the first shoutout going to Savannah cop Arthur Bryant:
“I want to thank the police officer who arrested me in Georgia for changing my life. I want to thank my therapist and my sponsor for saving my life. I want to thank my team for being part of my life and my parents for giving me life.”
LaBeouf’s mother Shayna Saide, who accompanied her son to the ceremony, teared up during the award speech. Honey Boy is based on a thinly-veiled story about a child actor named Otis Lort—played by Noah Jupe—and his bitter ex-rodeo clown father James Lort, played by LaBeouf. Before LaBeouf’s stay in rehab, he had been estranged from his father Jeffrey for seven years. LaBeouf gives a powerful performance as the elder Lort, a deeply disturbed, bitter alcoholic whose drinking destroyed his marriage, his career, and scarred the psyche of his young son. Yet, these complex characters display an obvious love for each other.
The screenplay is a slice of LaBeouf’s life. The movie begins with Otis as a preteen, so it doesn’t include earlier scenes such as his parents divorcing when he was only three, nor the violence he witnessed at age nine—overhearing a man raping his mother in another room. In LaBeouf’s last rehab stay (his third), he learned about his PTSD.
The daring, vulnerable script originated with email correspondence between two close friends. The actor, holed up in a treatment facility, used a flashlight under the covers to write what he was learning about mental illness and the family disease of alcoholism. He shared his innermost thoughts with Alma Har’el, an award-winning Israeli filmmaker he’d first met in 2011 after seeing Har’el’s Bombay Beach, which won Best Documentary at Tribeca Film Festival (TFF) that year.
Alcoholic Fathers, Jewish Mothers, and Deep Emotional Scars
They met for dinner and soon found much in common: Both had alcoholic fathers, Jewish mothers, and deep emotional scars. LaBeouf produced Har’el’s second doc, LoveTrue (2016), which also premiered at TFF.
While LaBeouf was writing about his experiences in treatment, he described painful memories that were surfacing. Har’el recognized the seeds of a cinematic story and encouraged him to keep writing.
The process of revising the script was a group effort with director Har’el at the helm. The moviemaking team included 12-year-old Jupe, Lucas Hedges as Otis in his 20s, and Byron Bowers as Percy, a kindred spirit for Otis during his rehab stay. LaBeouf and Har’el were open to everyone’s input.
We reached out to Alma Har’el to find out more.
How did making your first feature film compare to documentaries?
AH: This film felt like a documentary even though a large part of Honey Boy was scripted. It was a combination of Shia’s real-life story, his dreams, and adding fiction. Regarding the documentary part, it was very important for me to find out as much as I could about where real events in Shia’s life took place. I spoke with both of his parents to understand as much as I could. His mother Shayna Saide provided so many photos. We used as many as we could in the credit sequence. It was to help bring the story to life as much as was possible.
How true to Shia LaBeouf’s life was it?
We were making a film about [the fictional] Otis—not about Shia. Much of the movie was inspired by real-life events and whenever [possible], I wanted to rely on those truths. It was a big help that Shayna, Shia’s mother, was on set with us every day, all day.
Was his father offended by the portrayal of him?
I don’t want to speak for him, so I don’t want to say what he felt, but I could say that he sent me a very warm message after he read the script. Then he sent me messages on Facebook almost every day. I think that [brought] good luck on the shoot. When he saw the final film, he was extremely happy for Shia.
Was it like an AA living amends for him?
It was. I think it was exactly that in so many ways.
How do you feel about the use of the word “god” in 12-step programs?
Yeah, it’s very challenging, but it is, as they say, your higher power, so it’s up to you to define what it is. I think that’s the power of these programs. It is the power of the people that support each other and come back to share things together and find …their own higher power. Much [of it] is a personal journey. [Everyone] has their own terms. But, yeah, I have my challenges with that. That’s been one of my biggest challenges—to find what those destinations are outside of religion. I think gods can be real even if it’s not the god everybody else is praying to. It is certainly about figuring that out for yourself—a personal journey.
Can you add anything to that?
Well, it’s like, what is that thing that makes you present? What makes you have faith in something bigger than yourself? Also, the part of Percy was written much more religious at first. It spoke about god-related steps in rehab….When Byron Bowers [was cast] in the role, he rewrote that part for himself so it was based on his own experiences.
What was it like when you said something but didn’t realize it was a trigger. Did Shia have to take care of himself by taking a walk or was it smoother than that?
It was a lot more intense than that! We had to deal with very, very intense situations, often on set, but we did it with privacy when we could. We always made sure that Noah, and all of us were feeling safe. I’m very happy that we were all able to … be present.
Do you mean present for the difficult topics in the script?
Yes. We all went through these deep feelings and learned so much.
About each other?
Yes, and about PTSD. I also feel like our movie could help children of alcoholics [who may be] struggling. We didn’t want to [shy away] or disregard anything.
Was it cathartic for Shia?
An exorcism! And not just for him. We let demons come up.
Noah Jupe said he went into this movie as a child but left as a teenager. Did you see that metamorphosis taking place?
I’m not a mother so I was really glad his mother was on set with us every day, and Shia’s mother too. They became close allies of mine in directing. We were all very intimate on set, having … intimate discussions about everything. I loved watching Noah’s perceptions and his ability to express himself emotionally and see things in a deeper way. It was happening, but I hadn’t really seen how much he’s grown until we took a break after Sundance. It was obvious then that he’s now a teenager just by the way he walked. He has physically and emotionally grown up so much. It’s so funny when we were sitting together doing the Q&A, some of us teared up when he was talking…from how much he’d grown up and what an amazing young man we were seeing.
Hard to overlook taking a can of black beans from a church pantry on the same day I spend $74 on hair care, when I bother writing out my nightly inventory.
Riding on the back of my dad’s Honda in western New York when I was a teen, we stopped by a cornfield and stole a few ears for supper. The kernels were tough (actually inedible). Turns out it was feed corn. That memory stuck, along with its moral: stealing ain’t worth it. It never turns out like you’d hoped, and you never get off scot-free…
In my first year of recovery I pilfered fistfuls of Sugar in the Raw packets from Starbucks (I don’t take sugar in my coffee). This bad behavior went into my nightly inventory for months, but I still stole those sweet square pillows any chance I got. I wrote about it, talked it over with my sponsor, but it didn’t stop.
Eventually, as a newly single head-of-household, I connected thieving to my fear of not being able to provide for myself and my two sons. And this awareness helped me to see I had a choice: fear or faith. I could stay in scared survivor mode, working those sticky fingers at Starbucks, or instead, start shelling out for sugar at the supermarket for William’s breakfast strawberries, while still believing I’d manage to pay the July/August combined electric bill on an apartment climate that artificially supports both cool and warm zones (for humans and equatorial pet lizards respectively.) And while I still sometimes make the un-sober choice at the cream and sugar station, I’ve gotten my haul down to two packets; the amount, I reason, every customer is entitled to, whether or not they use sweetener.
While some of the promises outlined in the chapter “Into Action”in the Big Book of Alcoholics Anonymous are, indeed, starting to materialize (I AM “intuitively” able to “handle situations” that previously “baffled” the hell out of me), others remain misty. I won’t say I’m panicky, but “fear of economic insecurity” does remain a vaporous dread…
Absolute Honesty – Aiming for The “Great Ideal”
Originally, the third tradition went like this: “The only requirement for membership is an honest desire to stop drinking.” That’s how it was written, until Bill Wilson was persuaded to axe the “honest” by other sober drunks, concerned that word might scare some rummies away. I agree, it’s a tricky adjective. In a letter from 1966, the co-founder of Alcoholics Anonymous writes:
“Only God can know what absolute honesty is. Therefore, each of us has to conceive what this great ideal may be—to the best of our ability.”
Hmm… leave it up to each delusional drunk to define the term, know right from wrong, truth from fiction? Problematic. But Bill knew that alcoholics–maybe more than normies–need regular reality checks. That’s why accountability to other sober alcoholics is embedded in the steps, and it’s why fellowship with others, also aiming for this “great ideal,” is important, if not critical, to long-term sobriety. And the fourth and fifth steps, taken in tandem, are two flea bombs to the infested sofa of the dishonest alcoholic mind. At least they worked this way for me, driving to the surface a teeming nest of selfish, self-serving behavior, driven by false beliefs of incompetence and unlovability.
Writing for The Grapevine, Bill W. admits:
“Fallible as we all are, and will be in this life, it would be presumption to suppose that we could ever really achieve absolute honesty. The best we can do is strive for a better quality of honesty.”
Yes, it’s “Progress, not Perfection,” an overworked AA cliché that still works for me.
Tenth Step…
As I just celebrated my sixth sober anniversary, I’m self-assessing, looking for evidence of change. For 2,229 days now, I’ve been striving for this “better quality of honesty.” But am I any less of an opportunist, a conniving cheapskate looking to get over? After all, I am still wheeling over to the express check-out line with well over ten items. I do still abuse mascara testers at Sephora with no intention to buy, slather hand cream samplers up past my elbows, and spritz enough cologne to reek as bad as that OKC coffee date who pinched my calf and finished my almond pastry. Last time I was at the dermatologist’s, I scooped all the free ointments for scaly skin conditions I don’t have, and just last week in the health food store, I sampled the salsa and chips, both coming and going. I justified that snacking by lying to myself that someday, I would actually buy that breaking-bank bag of corn chips. I even tethered my teenager to the tasting station to graze while I shoveled spicy cashews in the bulk section. A few missed my baggie and met my palm instead. For as long as I’ve been around the rooms, I haven’t gained as much ground as I’d hoped on “rigorous” honesty. I’m less afraid, yes, but I’m still a tightwad. What’s been sorta acceptable ‘til now is finally starting to really bother me, six years later; little acts of looting are getting under my sober skin.
So tonight I put this question to the cleansed face in the mirror: What does recovery from shifty and self-serving look like, entering year seven?
“Well for one thing,” my reflection replies through toothpaste paw prints, “you can pay better attention to what you’re actually doing, and the results you’re getting from these actions. Are you still boxing fellow commuters into tight parking spots and returning to your bumper the next morning to find profane love notes under your wiper? How about cutting the line at the Lincoln Tunnel? You are definitely still guilty there…”
My mirror image is not getting off her soap box. “What about those five dead minutes between applying your serum and moisturizer? Wouldn’t it be a good look to jot a 10th step review then? Remember those?” I do. Hard to overlook taking a can of black beans from a church pantry on the same day I spend $74 on hair care, when I bother writing out my nightly inventory.
“Then there’s meditation,” my two-dimensional me adds. And she’s right. Sanity is somewhat restored when I light incense, hit the gong, and sit for ten minutes. Sometimes I fall asleep. Doesn’t matter, still helps.
“Oh and call your sponsor.” Because my spiritual growth is inversely proportional to my enthusiasm towards any particular action, the single best move I can make is to remain accountable to another sober alcoholic: to recommit to running anything eyebrow-raising by my sponsor.
Today it’s less about how many sobriety coins I’ve collected, and more about whether or not I’m dropping the suggested donation in the collection plate. (I can damn well afford the two bucks). I tell myself that “tasting” 12 grapes in the produce section before deciding on red over green is old behavior that won’t ever again find sea legs on this sober ship. Same goes for wheedling out of traffic violations or fighting late fees. But I’m lying. Only today, the Con Ed customer support chick waived all late fees for one lame reason: I’d somehow “overlooked” the whopping summer billing summaries to my inbox.
And five years ago, my son reached 44 inches, the legal height to pay full fare on New York City public transit. Yet I still make the seventh-grader duck the turnstile while I glide my MetroCard just once. I won’t say “no, never,” but I don’t see this behavior resolving until William sprouts facial hair. Why? Because I’m cheap and manipulative—always angling to get something for nothing. AA is a program of change, but some defects die hard.
Recognizing Progress
It has gotten better in other important ways though. Post-divorce romantic relations are above board and approaching sane. And thanks in part to my sponsor, who flagged flaws in my interactions with others that serve no one, my wuzband and I now communicate, commiserate, and reciprocate in rearing adolescent males under separate cover; our co-parenting game is tight.
These are the payoffs for continuously striving for this “better quality of honesty” —better relations with others when I keep my inner-cheater, the little girl who collected loose change from her mother’s purse to buy cola slushies from the corner store, and who grew to collect new boyfriends before losing old ones, in check; a conscience that’s becoming clearer than the bathroom mirror. That feels good.
But here’s why rigorous honesty is life-or-death to my long-term sobriety—and it’s not the petty larceny— because sure, I can probably carry on for a while stashing stray Oreos in my overalls after the 5:30 meeting instead of leaving them for the 7:30 drunks. It’s because these minor infractions lead to major ramifications. It’s the excessive texting on company time that leads to the O’Douls, that leads to the oyster stout, or the laughing gas for the routine filling that leads to the first bloody Mary—light on Absolut—that leads, absolutely, to the first drunk. Because this is what it’s really about, right? Tricking myself straight into the insanity of the first drink.
My BS detector needs its batteries changed more than just when Daylight Savings Time rolls around…
The most honest and most important action I can take on a daily basis is to follow through on my primary purpose: to stay honest, to stay sober, and to help another alcoholic.
