Salon

By spring, Dominic had dropped out of college. His parents turned to the family doctor for advice. She told him to double down on AA-to attend ninety meetings in ninety days, which is a common AA prescription.

It worked. Although many of the faces at the meetings kept changing and Dominic constantly felt the urge to drink, he found a few “oldtimers” who believed wholly in the program and who encouraged him to dismiss the great majority of people who fell through the cracks. They just weren’t ready to stop, he was reassured. Dominic soon learned to distract himself from thinking about alcohol and to call his sponsor when the urge arose.

Four months into the program, Dominic became frustrated during a call with his bank. He bought a fifth of vodka and drank so much that he fell down the stairs, suffering three cracked vertebrae. A series of increasingly expensive stints in rehab followed throughout his twenties, with poor results. During this time, he was hospitalized twice and lost every job he held. A brief marriage ended in a bad divorce, and Dominic was deeply depressed by the time someone in his life recommended that he try something other than a 12-step program. Maybe talk therapy was worth a try.

When Dominic entered my office, he had accepted as empirical truth that he was a deeply flawed individual: amoral, narcissistic, and unable to turn himself over to a Higher Power. How else to explain the swath of destruction he had cut through his own life and the lives of those who loved him? His time in AA had also taught him that his deeper psychological life was immaterial to mastering his addiction. He had a disease; the solution was in the Twelve Steps. When he was ready to quit, he would.

It took eight months of psychotherapy before Dominic stopped drinking for good. Although he remained in therapy for several years after that, the key that unlocked his addiction was nothing more complex or ethereal than an understanding of what his addiction really was and how it really worked.

Dominic had felt enormously pressured all of his life, consumed by a suffocating need to excel in every activity. He was driven by a hunger to be “good enough”-accomplished enough, successful enough-to please his demanding father and blameful mother. Whenever he felt he was not performing up to his potential, his old sense of being trapped by implacable demands arose, and with it came a deep sense of shame and an equal fury at the awful helplessness he felt about this burden. Those were the moments he had to have a drink.

Eventually, he came to realize that this odd coping mechanism made a certain kind of sense. By making a decision to drink, he was empowering himself-he no longer felt helpless. Once he understood the connection between his lifelong feelings and his urges to drink, he was able to view them with some perspective for the first time. He found that he was able to predict when his drive to drink would return since it always tended to surface right after that old, unbearable pressure to perform. He developed enough awareness into what was beneath these urges that he could take a step back and deal with those issues more directly and appropriately. Over time, he was also able to work out the underlying narrative forces that had led him to feel so helpless throughout his life. He had, in other words, supplanted the notion of a Higher Power with something far more personally empowering: sophisticated self-awareness.

Dominic’s history follows the same contours as thousands of others. But one part of his story warrants special attention: the series of failed attempts at rehabilitation. Dominic’s family lost close to $200,000- their total retirement savings-on this string of ineffectual programs.

It’s a long article — but well worth reading — especially if you have been through the wringer of, “Going for rehab.”

It used to be that articles like this would come out once a year — and the authors would be immediately drawn and quartered. Now I’m seeing more than one per week and, though there is still significant heat coming from proponents of, “The program,” there are also huge numbers of people listening.

But the above is interesting for two reasons:

(1). I’ve had so many people come through my office who have literally spent all of their retirement funds putting their children through one rehab after another — with zero success. The above story is far from an outlier — it’s pretty much the average.

(2). It’s an excellent picture of how people really stop any sort of addiction: Self-awareness, skills and empowerment.

Apparently, free is far from cheap…