The Last Addictions Memoir (Hopefully): An Evidence-Based Recovery Story Pt. 18

The Last Addictions Memoir (Hopefully): An Evidence-Based Recovery Story Pt. 18

By Anne Giles 08/08/17

Wine, wine, everywhere, and not allowed to drink a drop. Where's a rural townsperson with alcoholism to go?

Image: 
Waiter in tuxedo holding a bottle of red wine with custom designed label

What's a person with alcoholism to do in a rural town where there's almost no place to go where alcohol isn't served?

Our town's community events have nifty, alcohol-laced names: Fork and Cork, Brew Do, Cocktails and Collaborations. Sports? Our town's economy depends on college football and its alcohol-infused tailgates. Our movie theaters serve wine and beer. Church socials can include tastings of local wines and craft beers, or cash bars at fundraisers. Our grocery stores have floor-to-ceiling wine aisles and "wine guys."

If I want to dress up in heels and a black cocktail dress - um, let's make that a "little black dress" - and go out on the town for an alcohol-free dinner, I have a choice between Wendy's and Panera. We do have daily support group meetings where alcohol isn't served, but, by definition, the subject of the conversation is alcohol.

What's the matter with me? Why can't I go to places where alcohol is served and just not drink it? Why can't I remain unaffected when the conversation turns to drinking? What's the big deal?!

People with substance use disorders are warned to avoid "people, places and things" associated with use. Science confirms the danger. "Environmental cues" can invoke the brain's structures and functions to automatically, involuntarily, instinctively perceive something and desire it. Mind over matter? I don't have direct power over my brain's nucleus accumbens, amygdala, stria terminalis, or brain stem any more than I have direct control of my abdomen's pancreas or my lungs' airways. I can do things to lessen the likelihood of problems, but I can't directly make my organs obey me.

When I see wine, against my will, my attention is nationalized by it and my desire for it invades. I want it and must have it. It's that simple. No one's fault. Just a brain thing.

So why don't I just hang out with abstinent people? With over 86% of Americans drinking alcohol, abstinent people are hard to find. Then why don't I join our local recovery community? We don't have one. Stigma is powerful in small towns. What small-town boss risks losing customers from hiring a known "addict" or "alcoholic"? What parents lets their children play with the children of a known "addict" or "alcoholic"? Consequently, what person with substance use disorder risks being seen at a "recovery event"?

Outside of a small number of support group meetings in my town, occasional, invitation-only gatherings of people in recovery from substance use disorders tend to be of people with similar ages and from similar backgrounds. I've been delighted to be invited to several gatherings. For me, however, alcoholism is all-day, everyday, right here, right now. Gaps in between gatherings can be anguish-filled.

The odds are that 299 more people in my particular town also developed addiction, but they haven't introduced themselves to me, which certainly is their right and prerogative.

I don't fault people for drinking alcohol or talking about not drinking it. For my particular case of alcoholism, however, I seem to need my mind and my personhood to be as far away from the beverage as possible.

I stay home a lot.

And that's dangerous. Social connection fosters abstinence. And just going to the mall to be with people won't do it. Humans need to know and be known and, optimally, to love and be loved. The connection has to be meaningful at some level. It has to be deep enough to matter.

I see two counselors, one who specializes in substance use disorders and one who specializes in cognitive behavior therapy (CBT) and dialectical behavior therapy (DBT). The latter has taught me the concept of "opposite sides that can both be true."

Here's a sampling of opposing truths from Interpersonal Effectiveness Handout 16A by DBT inventor Marsha Linehan:

9. You can accept yourself the way you are AND still want to change. (You can accept others as they are AND still want them to change.)

11. You may have a valid reason for believing what you believe, AND you may still be wrong or incorrect.

13. The day can be sunny, AND it can rain.

This is my "both sides are true" inner experience of alcoholism and environmental cues:

I see alcohol and I long to drink it AND I see alcohol and want to scream and run from it.

I see alcohol and want to drink it AND I do not want to reignite alcoholism.

I want to go wherever I want, whenever I want, and do whatever I want with whomever I want as long as I don't hurt anybody AND if I go where alcohol is served, I risk drinking it again and hurting myself and others.

And…wait for it…

My abstinence may be damned if I stay away from people drinking AND my abstinence may be damned if I go where people are drinking.

Damned if I do and damned I don't? Why, that's the definition of a double bind, a psychologically punishing Catch 22, no-win situation. It's the premise of solitary confinement.

Why don't I move to a place with a recovery community? Actually, why doesn't any middle-aged woman just pick up, move and start a new life? Because women my age are doing what I'm doing: caring for an aging parent.

I think if I could just meet face-to-face with even one other rural-living, middle-aged, college-educated, partnerless, childless, grandchildless, caregiving woman with alcoholism, I would feel better.

I think that's the crux of the problem. It's not lack of evidence-based treatment, resistance to psychological work, or neglected abstinence-protecting self-care that make me a social pariah, Hester Prynne wearing the "A" of alcoholism. It's demographics. Or lack of them. In my small town, I don't belong with anyone's group or tribe. I'm simply an outlier, isolated through traits primarily beyond my control. I'm in an Oliver Twist horror movie, hands scrabbling at the window. I can see the people, I can long for them, but I can't be with them because of the beverages they hold in their hands.

On this side of the window, I see abstinent people younger than I am, busy with partners, children, school and work. We certainly care for each other. But what are we are going to talk about? I didn't drink or use today. You didn't either? Cool. Now what?

Drinking in people my age is on the rise, especially in women. As Maia Szalavitz tweeted, "[W]hat drugs do for you is why you relapse." A drink would do me good AND it would do me some serious bad AND what would do me the most good - meaningful connection with enough people enough time of the time to fend off despair - I just can't seem to find a way to create for myself.

So, kitty cats, what movie would you like to watch at home tonight?

The Last Addictions Memoir below:

Part 1 here  Part 2 here  Part 3 here Part 4 here  Part 5 here Part 6 here Part 7 here Part 8 here Part 9 here 

Part 10 here Part 11 here Part 12 here Part 13 here Part 14 here Part 15 here Part 16 here Part 17 here

Anne Giles, M.A., M.S., is a counselor, writer and business owner. She writes about addictions treatment, recovery and policy at annegiles.com. As of this writing, she has been abstinent from alcohol since December 28, 2012, and is in remission from alcohol use disorder.

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Anne Giles, M.A., M.S., is a counselor, writer and business owner. As of this writing, she has been abstinent from alcohol since December 28, 2012, and is in remission from alcohol use disorder. You can find Anne on Linkedin and Twitter.

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