Friday, February 26, 2010

What's Wrong With Rehab?

I was thinking this morning about the first Step and why my initial attempts at getting sober failed. I suppose this was because I was reading a blog yesterday in which the writer, an AA old-timer, was criticizing people who'd used rehab as a way to get sober. She claimed that people who go to rehab spend $40,000 to get temporarily sober because they inevitably go back out. They don't adhere, she said, to the steps and traditions of AA. She concluded that people who go to rehab miss the boat: you can be successful in AA for free!

(Another problem she had with rehab is that they tend to treat all addictions as the same: whether you're an alcoholic, or a drug addict, or a sex addict, or whatever, her assertion is that Alcoholism is different. I disagree with this, but that's a post for another day.)

So since she ruffled my alcoholic feathers (because let's face it: it's very easy to piss off somebody who has addiction problems), I started wondering why AA didn't work for me initially. I tried AA, and some alternatives, three times before I finally tried rehab. The first time was way back when I lived in Ohio, when I managed to stay sober for 7 months before I went back out. What was the problem? Well, I couldn't relate. AA meetings were chock-full of old guys chain-smoking and drinking coffee as if all coffee plantations on the planet had been hit with a sudden pox. I didn't fit in. Nobody ever said hello to me, and I was too shy to go up and introduce myself to anybody. After six meetings or so, I finally chucked it and tried to do it on my own, and, well, after seven months, I forgot what it was that had made me want to stop drinking in the first place. It couldn't have been THAT bad.

Time number two was about five years later, and this time I found a non-smoking women's meeting, and I even mustered the guts to reach out and ask somebody to sponsor me. She started me on the Steps. One night we met over dinner, and she started telling me all about her own past drunk life, including that she'd been forced to admit she had a problem when she was arrested driving drunk down the 101 the wrong way. And her friends were sick of her stealing from them all the time. I looked at her, then looked at me, and I thought, "Dude, I've never even gotten a DUI. I've never stolen. I have a job; I have two freaking master's degrees. The most I ever do is get drunk and pass out sometimes." So the first Step was a problem for me. I just couldn't bring myself to admit alcohol had me in its grips and that I couldn't control my binges. I persuaded myself that I could switch to beer only, and that wouldn't get me in trouble. Besides, I was just getting ready to go on vacation to Puerto Vallarta, and who wants to go on vacation and not be able to drink and enjoy themselves? Mexico: land of margaritas and Corona (with a wedge of lime, please), for godsakes! And if it turned out I had a problem keeping it under control in Mexico, then I'd try quitting again when I got back.

I was determined; I had to white-knuckle it in Mexico at times, but I did okay, so back out I went.

A few years later found me in the Emergency Room with an IV in my arm, having passed out and fallen off my barstool in a bar and puking my guts up all over the place. That was scary enough to keep me sober for three months. But I'd developed a real attitude about AA by then. The AA people I'd met were religious assholes. AA was a cult of simple-minded people with self-esteem problems. How could anyone admit to things like character defects or powerlessness? The feminist in me bristled. We can overcome weaknesses and lack of control by trying harder. I don't need God to "fix" me. That's irrational. And don't even call alcoholism a disease. Cancer is a disease. THAT, you can't control. I choose whether or not to drink; I clearly just haven't really tried. So, I tried some AA alternatives: Moderation Management, Rational Recovery, SMART Recovery.

All of these things worked only temporarily. I'd control my drinking for awhile, but inevitably I'd tumble back down the well again.

A couple years later, I was in a period of successful controlled drinking when I met someone I fell hard for. The third time I tried AA was right after I broke up with her. She flat out told me I was an alcoholic. (It's not the reason we broke up.) But I think a part of me wanted to prove her wrong; maybe some part of me believed that if I got sober, she'd be impressed and want to stop seeing other people and get back together with me. It's a dumb reason to get sober, to do it for someone else. The moment I accepted she truly was in another committed relationship (and heaven help me I couldn't stand the woman she was with!), this little dance with AA didn't last. I think I went to all of three meetings that time.

Fast forward five years later, after graduating from occasional nightly binges to three-day weekend benders. I was making all kinds of mistakes and on the verge of trying a geographical cure. Rehab seemed to be the only option. (And it didn't cost $40K. It cost $9K). And it worked. Or I should say, so far it's working.

What worked is that I was in a controlled environment for 28 days, surrounded by other people fighting the same fight. I got to see firsthand the horrible effects of addiction (you see this somewhat in AA, but you really haven't until you've witnessed, or roomed with, somebody who is detoxing.) There was my own detox. It hadn't even occurred to me that my morning sweats weren't hormonal. Neither was the racing heartbeat. And since they monitored my blood pressure for the first week, I saw for myself how it went down and returned to normal as my body adjusted to functioning without booze. My detox was an easy one. There was one guy who shook so badly he had to use both hands to bring his fork to his mouth at dinner. He used to drink a quart of vodka a day, when heroin wasn't available. There was my Christian roommate, as sweet a person as could be, who had been in AA for years but just couldn't kick her addiction. She had liver damage and had already had surgery for esophageal varices. She left rehab and within 7 days had gone on a bender that landed her back in the hospital. There was one guy--a brilliant man, an MD, a cardiac surgeon, for godsakes, who had lost everything to crack cocaine.

And seeing all this, and suddenly feeling lucky, then going through a checklist with my counselor that asked me to examine how alcohol operated in my life, I had to admit that I had about as much control over booze as I have over Sarah Palin saying something comprehensible. It was a moment of clarity and surrender. My ego finally had to admit it wasn't all-powerful. No amount of self-control would keep me sober. Damn, it was a relief to finally see that. I finally understood the First Step. And what I'd always thought would make me feel embarrassed, stupid, or humiliated actually made me feel grateful.

Grateful that my bottom didn't have to go any lower than it did.

So, you know, we can make fun of rehab. We can parody the braindead people who stand up and say, "Hi, I'm Joe, and I'm an alcoholic." We can poke fun of the self-help movement and how everybody is working the Twelve Steps nowadays. We can laugh at Al Franken doing his Stuart Smiley impression. We can watch 28 Days and laugh at the chanting and all the New Age stuff. But I'm all for rehab. I think it's like anything. You get out of it what you put into it. Rehab worked for me because I was finally ready to listen.

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