Addiction & Stigma
Recently, I had the privilege of taking a friend to see an endocrinologist as she needed an adjustment in the medication she is taking for her autoimmune condition. I waited for her in the waiting room and as we rode down in the elevator after her appointment, I asked her if she liked the doctor. My friend hesitated and then quietly said, No. After some prodding, she finally admitted that when the doctor saw the evidence of her drug addiction, which is healing now but still a relatively fresh track record on her arm, the doctor’s demeanor instantly changed. The doctor’s words and tone felt condescending, judgmental, shaming.
When my friend shared this with me, I was horrified. I think she was still in shock, and I think that being so early in her recovery, she is like a timid little bird who is not quite sure of her footing, her view of the world, or most of all, her view of herself. I know enough about the disease of addiction to know that nobody gets to that level of self-destruction (and other-destruction) because they were blessed with good things and relationships and genes and all that stuff. Chances are, they are struggling with some level of trauma, and chances are pretty high they have inherited pain and suffering that their parents, grandparents, and other ancestors endured and never transformed - so they transferred it to the children they raised (or abandoned). In recovery, we build ourselves back up, and this is done with the help of people and a network who operate from a place of compassion. Ideally, this compassion eventually seeps into the blood and soul of the person in recovery, and one day they start to believe that they are worthy. But it is a long process, and my friend is in the early stages.
“Far more than a quest for pleasure, chronic substance use is the addict’s attempt to escape distress… Addictions always originate in pain, whether felt openly or hidden in the unconscious. They are emotional anesthetics.” - Gabor Maté
As we rode in the car I was driving, I helped her process what had just happened. I explained to her that the contempt she had just felt from the doctor was unprofessional, and my friend deserved better treatment. I said, “if you had told her that you had diabetes, or cancer, or heart disease, I am pretty sure she would have treated you with more dignity. The fact that she didn’t is a reflection on HER, not YOU. In medical school, doctors take the Hippocratic Oath, which states that they will first, do no harm. Unfortunately, doctors still are not taught about the disease model of addiction, nor are they taught, or given refresher courses, on how to treat someone who struggles with this awful disease.”
A friend of mine is a nurse in an ER that is on the frontlines of the disease epidemic in the U.S., and she is horrified by the way the doctors and nurses treat, and speak about, the patients who come in with every level of injury, disease, and overdose due to addiction. These medical professionals are exhausted, and understandably frustrated, especially when the “frequent flyers” show up - again. And again. I get it. It must be incredibly triggering of every medical professional’s fear that no matter what, they cannot fix this person. And they are on the front line of a medical establishment that is absolutely inadequate when it comes to addiction and other mental health dis-eases. So, their lack of compassion is in many ways understandable - it is a side effect of caregiver burnout.
And medical professionals are just one segment of the population that is ignorant and ill-equipped to effectively help people in active addiction, as well as in recovery. I have Fakebook friends (just a couple, phew) who share stories in the media that effectively shame people with addiction. Every time I see one of those posts (eg couple overdoses in car, kids in the back seat) I am deeply saddened. How can this be helpful? Again, I return to what I stated earlier - when a person becomes this sick, it is something that is beyond their control. And it is rare that someone is shamed into changing, and I am quite sure that shame does not lead to positive change in systems or in society, but rather, builds up and strengthens everything negative, from the individual to the global levels.
“We cannot grow when we are in shame, and we can’t use shame to change ourselves or others.” - Brené Brown
As we drove, I explained to my friend, that she is basically a Recovery Ambassador. I told her that next time she goes to a doctor, or interacts with anyone, really, she has the opportunity to educate them. Not in a shouty, emotional, indignant way, but from a place of compassion. I do believe that we are all doing our best, and it’s important to always see the other person’s point of view, and consider that their perspective is shaped by their experience up to that point. I told her, “You may be the only person in recovery that someone meets, and you have the chance to show them that you are human, and smart, and worthy, and dignified. And, you have the right to hold people accountable when they are not giving you the same respect and compassion that they might if you revealed you had a more “socially respectable” disease.” I have said this in different forums, that I believe that one of the reasons there is such a fear and misperception of people with addiction and other mental health dis-eases, is that the tradition of anonymity means that most people are not aware that millions of people can, and do, recover and lead incredibly productive, joyful lives. Imagine if the only way we heard about cancer is by obituaries and other stories of the horrors of cancer relapse. Instead, we have all kinds of events and media stories celebrating cancer survivors. I dream of the day when the millions of people in recovery, who are today contributing in meaningful and successful ways to the world, are also mentioning their recovery status along with “CEO/surgeon/coach/mother/lawyer/teacher/senator” etc.
I believe that change begins with you, and me, and trickles around and upward and downward. So, if you are reading this, and you are a medical professional, an educator, a parent, a sibling, a law enforcement officer, a first responder, a neighbor - whoever you are - you can be part of the change. Great change happens with tiny steps taken on a consistent basis. It happens when we become more self-aware. And when we do that - pay attention to our thoughts, feelings, and actions - we may realize how much of what we think, feel and do is based on fear.
When that doctor saw my friend’s track marks, she probably thought, “Oh shit” for all sorts of reasons that boiled down to fear. Which is no different from what drives medical policy, insurance policy, public policy, DARE programs, zero tolerance programs at school, and Fakebook shares. So, once we admit that, we can talk about it, and that is where change starts to happen.
“Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.” - Margaret Mead
Mother's Day, Stepmoms, Grace
When my mom was facing a premature death due to a cancer that was ravaging her body, she told me on one of our drives to her radiation appointments that she had urged my dad to mourn her for a year after she was gone, and then to find another wife. She told me that she was sorry she was so sick, and that they had had a beautiful life together and that he deserved and needed a companion. So, on the one hand, she regretted the pain and suffering that she felt in a way she may have caused (through years of smoking). On the other hand, she so very graciously and generously was giving him permission to honor what they had had, and to start a new chapter.
A couple of years after my mom had passed, my dad met Janet, after a friend urged him to create an eHarmony account. I remember when he created his profile - I think it took about three hours! - and he asked me to read his answers. It was thorough! My dad was a catch - apparently widowers in their early 60s are a hot ticket item in a demographic that tends to be largely female. He communicated and dismissed his share of women who were not intellectually and culturally satisfying to him (apparently “shopping” is a common hobby), and eventually Janet appeared. After a few online messages and phone calls, they met in person (she lived in VA, he in SC). A few months later they were engaged, and a few months after that they married. That was over ten years ago.
I remember during this time, well-meaning friends saying things like, “Susanne, aren’t you upset? Don’t you think this is rather soon for him to be dating/getting married?” Quite honestly, I did not know what they were talking about. Soon after they started dating, Janet flew up on her own to CT just to meet me, my husband and my kids. From the beginning, I sensed and now know that she is kind, authentic, and truly cares about my dad. And she is intimidatingly smart! They have the same obsession for opera, classical music, classical literature and art museums. They both dislike shopping, love to travel, cook, walk on the beach. Janet has taught at various universities including Georgetown and Howard U, and I think this may have been a factor in my dad’s decision to get his Master’s at the age of 69, and embark on a new career in teaching (he is now the head of his school’s language department!).
I realize that my mom paved the way for me to find acceptance, and this was perhaps one of the greatest gifts she could have given me. And my dad. He and my mom had a wonderful, adventurous three decades or so together, raising two children across four countries. And, that part of the journey ended for them, for our family. When my dad met Janet, he started a new journey, that did not take away from his time with my mom. Janet takes good care of my dad and I do not have to worry about him, knowing he is in loving, attentive hands. Sure, there was a transition when his new love distracted him from doting on his daughters and grandchildren, but that was a temporary adjustment and it gave way to a new normal. And they certainly dote on their five grandchildren!
As I was running yesterday and thinking about motherhood, and the often mixed feelings around Mother’s Day depending on where we are as mothers, daughters, wives, and how we are managing our expectations, I was thinking about how this day may feel for stepmoms. I imagine being a stepmom, even when you are entering a family with adult children, the way Janet did, is a scary adventure, with lots of potential for conflict and drama. I am grateful that my dad lucked out/chose well, and that my mom paved the way for acceptance and gratitude. And my hope is that on this Mother’s Day, as I think of my mom with love, sadness, and longing, and I also feel so much gratitude and love for my stepmom, Janet - that if you are a stepmom, or are struggling to accept a stepmom, that you feel love and compassion. In this morning’s yoga class, the teacher pointed out that we most fear external forces, but the truth is that the greatest sources of pain are within us. So, may we all just soften into this messy, brutiful existence, stay present, and accept that we are doing the best we can, right now.
Happy Mother’s Day :)
Rituals, Belonging, Connection
For the last couple of months, I have been privileged to work at a treatment center for adults (18+) whose lives had become unmanageable due to alcohol or other drugs, and are now seeking to learn healthier, smarter ways to cope with this crazy world in which we live. I was drawn to this place because of its holistic approach to treating addiction and other mental health dis-eases, complementing the individual and group therapy sessions with yoga, meditation, acupuncture, massage, healthy food, art therapy, gym time…
When a new client arrives, and when a client’s stay is coming to an end, a ritual is performed. An opening and a closing ceremony are held, where all of the clients and the therapists and program assistants welcome the newly arrived, or honor the departing client. Each ceremony is unique, and the closing ceremony is tailored to reflect the person’s personality, spirit, and the way he or she has grown, and has affected the others in the facility. It is a moving, beautiful way to honor him/her, while also allowing all of the participants to share how much the connection with this person has contributed to their own journey.
My family and I have been in the Northern Virginia area for eight months, and while we have by now figured out where the light switches are in the house, and discovered with amazement each new flower that has bloomed in our yard this spring, we still don’t quite feel rooted. I know that this takes time (I am working on Radical Acceptance with this fact), and won’t happen as quickly as the mint I transplanted to my garden have taken hold. My son is in 8th grade (I know, enough said). My daughter, in 11th grade, was just sharing with me over lunch how she has met a lot of nice kids at school, but how different this transition has been from her previous ones. Last year (10th grade) she went on her own to South Africa for her spring term, and after extreme homesickness for the first week, she quickly started to feel like she belonged. She was in a dorm with a group of other girls who were hours or continents away from home, and they quickly developed a bond, glued together by the intensity of their common situation. Our conversation about this tied into the themes that have been swirling round my head for months - belonging - connection - community - rituals. And how, when these human needs are not fulfilled, the result is often poor physical health, depression, anxiety, addiction.
I spoke with a counselor at one of my kids’ new schools last week and pointed out to him that while the school does a great job with producing high scores, in my opinion they were missing the boat in terms of social emotional learning. I explained how hard this transition has been on my son, and I cannot imagine how hard it must be for kids who are less self-confident, and I wondered how many kids were falling through the cracks? I assured the counselor that I understand the need to reach certain measurable goals (scores), but I am dismayed that there is not much effort that I can see, to build community. I (diplomatically, I think) suggested that they look at ways to build time into the calendar for activities where the students can do something fun, work toward a common non-academic goal, make connections. I also suggested that they start a program where existing families agree to adopt a new family for a year, so that the new kid has a guaranteed friendly face, and the parents aren’t floundering and wondering what they don’t know because they don’t know what they don’t know. When I was talking to a friend about it all, I pointed out that middle school is a rough time in general, and most educators shy away from that precarious stage, but like any challenge, it can be a great opportunity for positive change (and if we aren’t being intentional about positive change, negative change will easily step in).
When I think of the sense of belonging that my children - that we all - crave, I reflect upon the opening and closing rituals that bookend a client’s stay at the treatment center. Wouldn’t it be amazing to provide and prioritize an activity that provides our kids with peer acceptance and validation? We all, our children and our own inner child, long to be seen, heard, and accepted. Wouldn’t it be cool to build it into our school culture? I see the magic this type of framework works in adults through recovery groups and my place of work. Why wait till dis-ease and rock bottom force a person and family to take extreme measures? As an adult, I have experienced the type of authentic connection that is built through activities that in some ways are like, or incorporate rituals: Ragnar Relay races, participating in marathons and triathlons with a group of friends, attending She Recovers conferences and recovery/support groups and meetings, etc. These events and activities provide an opportunity for authentic communication, creative expression, physical exertion, intellectual growth. In short, they feed the soul.
As I point out in the podcast where I was just interviewed, I believe the best way to solve a problem is to prevent it in the first place, and I think that something as simple as creating rituals that cultivate belonging, will create positive ripples with long-lasting effects. Let’s start to think of ways that we and our schools can feed our children’s souls - because they are starving for a sense of belonging and meaning.
Wellness coach, athlete, mom, entrepreneur. I love helping people mindfully reboot their health & joy.