I’ve heard the sensation of craving described as a kind of thirst, but that’s not what it’s like for me. For me, craving is the intense desire for an experience: That moment when the first warm flush of alcohol hits my veins and everything feels like it will be all right. That lovely, tipsy glow. For alcoholics, it doesn’t really exist—once I take the first drink, I’m compelled to have another, and another—but we’re always chasing it, trying to get back to that place.
It was astonishing how quickly the compulsion returned. (In my head, the voice of someone at a meeting: “Alcoholism is cunning, baffling, powerful, and patient.”) In the morning after buying that first, almost celebratory bottle—Look at me, I beat this thing!—I woke up with my hands shaking and raced for the bathroom to retch into the toilet bowl. Right away, a kind of magical thinking set in—Whoops, looks like I overshot it. I’ll taper down over the course of the week; it would be dangerous to stop drinking again all at once. On the way to work, I grabbed another bottle—just to get rid of the tremors, I thought—and by three in the afternoon, I was peering over the edge of the same familiar pit.
In meetings, old-timers say, “You don’t have to drink, even if you want to.” But the fact is, most of us do. Our brains make relapse practically inevitable. Even after physical withdrawal and the fuzzy thinking of early sobriety subsided, my brain wouldn’t stop whispering: Wouldn’t this be better with a drink? Dependence doesn’t just make an alcoholic person’s brain less capable of experiencing pleasure, or even maintaining equilibrium, without a steady supply of spirits; it also creates long-lasting pathways between neurons that cause the brain to strongly associate certain mental states (depression, loneliness, excitement, guilt) or experiences with an overwhelming urge to drink. At the same time, long-term, heavy drinking damages the brain’s prefrontal cortex, the home of higher-level thinking like impulse control.
For me, what this meant was that every time I got on the bus, I wanted a drink. Every time I saw a friend I had disappointed, I wanted a drink. Every time I walked into the grocery store, I wanted a drink. Every time I looked in my closet, at the suitcase where I had stored all my empties, I wanted a drink. Now tell me how I was supposed to resist having a drink.
Every time I relapsed and went through withdrawal, those links got stronger and stronger, making it more likely that I would relapse again.
Given the odds, then, how does anyone manage to stay sober? There isn’t one way that works for everyone, but pretty much every evidence-based program for sobriety—whether it’s cognitive behavioral therapy, AA, motivational interviewing, or something else—involves reprogramming your brain so that certain moods and experiences no longer make you feel compelled to drink. People who manage to avoid relapse also tend to have a few things in common. They have a high sense of self-efficacy—that is, they feel as if their actions have an impact over what happens in their lives—and well-developed coping mechanisms, which provide resiliency when they’re under stress, when other people are pressuring them to drink or use drugs, or when things don’t go the way they’ve planned. This, by the way, is kind of the whole point of the Serenity Prayer: Accept what you can’t change, change what you can, and learn to tell the difference.
When I got out of Rez XII, accepting the things I couldn’t change seemed almost impossible—like it or not, booze was everywhere and the wreckage I created was still right where I left it. When I got back to my apartment, the dishes were still in the sink, and the unpaid bills had kept on piling up. Life was still waiting. My problems were still my problems. Everything seemed enormous and overwhelming. Pretty soon, it became too much.
* * *
—
We don’t talk about the high “failure” rate of residential treatments (failure, in this case, meaning that people don’t stay sober after they leave). But that rate is important, and it’s something people should be armed with before they decide to spend tens of thousands of dollars on what may be little more than a twenty-eight-day dry-out. So here are the numbers: Just four in six alcoholics who enter residential treatment stick it out until the end, and of those, about half will relapse within the first year of leaving treatment. Over four years, 90 percent of people who go to treatment will start drinking again, although many of them will eventually quit. Relapse, in other words, isn’t just “a part of recovery,” it’s almost inevitable. And yet treatment centers focus heavily, almost monomaniacally, on relapse prevention, while teaching patients almost nothing about what to do about relapse when it occurs. They teach you to HALT when you feel like drinking, a mnemonic that stands for “hungry, angry, lonely, or tired,” four conditions that can precede relapse. They teach you to practice DREAMS, which stands for diet, rest, exercise, acceptance, meditation, and schedule. They teach you the tools of rational-emotive therapy, or RET, which is itself a subset of CBT. (If you’re having trouble keeping track of all these acronyms, imagine how hard it is for a fuzz-brained alcoholic in early sobriety; I carried a card in my wallet for months to keep them all straight.) They teach you that a craving is a craving is a craving, which is why they often ban sugar and caffeine (a controversial theory, to say the least, and one that proscribes the two primary substances consumed at AA meetings). They teach you how to respond to stressful situations without drinking, using role-playing exercises and skills training. And they teach you about triggers—identifying them, avoiding them, and learning to deal with them or ride them out. Learning about triggers is extremely important because you can’t just lock yourself inside an AA meeting hall forever (eventually, even the Big Book thumpers will make you go home) and because numerous studies have shown that these contextual cues can be just as powerful as alcohol itself in making a person want to pick up a drink. My triggers, for the record, include: grocery stores, work, airports, the bus, the train, my apartment. Basically: life.
In early sobriety, your brain is still putting itself back together, during a process called post-acute withdrawal syndrome (better known by its cutesy acronym, PAWS), which can last for more than two years. In my few weeks of sobriety, when I could barely remember to brush my teeth twice a day, I pictured my brain as a soft, pliable sponge, full of holes large enough to stick a finger through.
I never found out how long it would take to get through this phase because, before I could get there, I went back through the revolving door.
Twenty-eight
Rock Bottom
What the fuck time is it?
I fumble for my phone, the sheets in a tangle around me, the mattress stripped bare. Four o’clock. Too early to get up, no stores open anyway. It’s been six weeks since I “graduated” from Rez XII. I reach under the bed for the cardboard bottle of white wine, praying to the ceiling that there are a few drops left, enough to calm the twitching, make my legs stop flopping back and forth like weather vanes in a storm. I’m feverish, I’m freezing, hair sweat-pasted to my forehead, and the dizziness when I lift my head hits me like an anvil. The bottle makes a thin swish, swish sound when I shake it, hoping for dregs. Once again, for the millionth time, I’ve failed to guard against the desperation of the morning by holding back a small supply the night before.
I stumble for the wall, something to hold on to, the light. The fixture blinks on, glaring; it’s too bright, so I navigate by the orange streetlights that seem at this hour to be aimed directly into my bedroom. In addition to the empty bottle under the bed, there’s a suitcase full of identical empties in the closet. I can’t tell you why it’s there, why I can’t carry my bottles down to the Dumpster in the morning, destroy the evidence like a normal person. I think back to my first year of college, when a blond bulimic down the hall saved her vomit in Ziploc bags in the bottom drawer of her dorm-room dresser. The bottles are a private history. They’re the evidence I refuse to destroy.
I stagger into the kitchen, grab a glass and a pair of scissors, and grip the walls all the way to the closet, where I unzip the suitcase in the
orange-gray dark. Methodically, like a lab tech conducting a delicate experiment, I cut a small slash in the corner of each box and squeeze the thick dregs at the bottom into the glass. Methodically, like a shop clerk taking inventory, I work my way through all the bottles, and by the time I’m done, there is half a cup of warm, sour white wine in the bottom of the glass. I give a little prayer of gratitude to whatever god provides resourcefulness in times of desperation. Then I gulp it down.
By the time I wake up again an hour later, the sun is streaming in through the long bank of blinds on the back wall of my bedroom and sleep is impossible. My heart is pounding so hard I’m sure that if anyone was here, they could hear it, too.
For a while, maybe a half hour, I just lie there, listening to my heart pound and flopping first onto one side, then the other, my body moving all by itself while I will it, endlessly: Just rest. Be gentle with yourself. You’ll be okay. Today will be better.
Well, it’s time to face this.
I pull myself off the bare blue mattress into a roughly vertical position. The shock of movement sends my stomach into rebellion, and I scramble the half dozen steps to the bathroom around the corner, assuming the familiar position in front of the toilet, my arms clutching its cool porcelain sides, my chest heaving in a ritual of retching.
Since there’s nothing in my stomach—since, truth be told, I haven’t eaten a full meal since a Reuben sandwich from the corner deli two days ago—what comes out is mostly stringy, bile-yellow spit, and a burst of involuntary tears from my bloodshot eyes. I haul myself up to the sink, drink the tiniest possible swallow of water, and go about the other rituals of my morning. I tug a pair of jeans onto my scrawny body, where they hang on to protruding hips under a booze-bloated stomach. I draw on eyeliner and sweep eyeshadow across my lids with a shaky hand, daubing myself with a tissue every few seconds to clear away the clammy sheen of sweat that keeps the makeup from adhering. I brush my teeth for a solid three seconds until the toothbrush initiates my gag reflex and I heave into the toilet one last time before pulling a headband over my greasy hair and head out the door.
Outside, even in the gray haze of a late October Seattle morning, the sun is bright, far too bright. I dig a pair of smudged, scratched-up plastic sunglasses from the depths of my backpack and plaster them on my face. The bus that stops in front of my apartment building takes far too long to arrive at this hour, but it does arrive, and I wedge myself into a row of early commuters heading to their jobs in retail or programming or finance, shrinking into my headphones and hoping to God I don’t smell like booze or puke. Everyone looks so shiny, freshly scrubbed, and rested. Where do people even go this early, and what right do they have to look so cheerful? All I want is to crawl out of my skin and leave it behind me, on this bus.
Instead, I get off at the supermarket, four stops—Angeline, Alaska, Genesee, Andover—past my house. Stomach lurching, I shove my way out the back door and into the planting strip, over to the sidewalk that leads past the liquor store. The winos who hang out around this strip mall have started to rouse themselves, their clothes almost indistinguishable from sleeping bags, their belongings in shopping carts stored around the corner for safekeeping. I nod at them respectfully as I walk by, looking them in the eye as they share a can of Steel Reserve from hand to hand, as if to say, I see you. We’re the same, you and me. At Rez XII, they drilled it into our heads: Look for the similarities, not the differences. This may not have been precisely what my counselors had in mind, but ever since I relapsed after my hopeful coin-out ceremony, I’ve seen nothing but similarities between myself and the homeless and marginally housed drunks who spend their days begging quarters for a can or six-pack; as far as I can figure, the only thing that separates us is that I have a family who will force me into treatment or make me move back home if I really manage to screw things up this time. Which won’t happen, of course, because I have a job.
The problem is, I can’t really get through my job without drinking, and drinking now starts the second I get up in the morning. Which is why, as soon as I’m done fumbling through pleasantries with the cashier—a plump, artificially redheaded lady I see more often than I see any of my friends—I erupt back out into the cold, pleasant air, wipe new sweat from my forehead, walk across the street, and crack the bottle.
The plastic teeth protecting the mouth of the Tetra Pak tear apart, and the crack-pop-crack of the lid as it releases from the bottle is the sound of comfort, sustenance, relief. I tip the box to my lips, the cool, lightly effervescent liquid pouring past my insensate tongue directly down my throat, into my raw, still-roiling stomach, which welcomes the cooling liquid, then immediately coils itself in a knot. I walk slowly, as delicately as possible, down the street toward the community garden where I’ve somehow managed to hold on to my weed-choked plot. I can make it, I can sit down, and I probably won’t throw up again this morning.
I don’t make it. I lose the wine in a ditch beside a lot overgrown with brambles, near a park where I picked blackberries just this past summer. It’s a triumph that no one is around to see me retching in the bushes, and if the Spanish-speaking family who owns the cheap blue-sided house that backs up against the garden has seen me coughing violently into my scarf or passing out on the picnic table or retching into the bark behind my garden, they’ve never let on. It’s frosty in my garden still, the weeds from last summer damp and sparkly in the rising light. I’m still sweating like a flu patient as I sit down at the familiar picnic table and chug half the bottle. This time, it stays down. The world rights itself. Despair retreats a few more feet into the distance, and I brush off my jacket, powder my nose and cheeks, and wander to the bus stop by the fish and chips stand, where I’ll sit and watch a few buses go by, drinking in a manner I falsely imagine to be stealthy, before boarding the Route 7 at 8:30, heading to the back, and closing my eyes all the way to work.
In these last weeks before I checked into my second rehab, I steadied myself for work most days by drinking enough alcohol to send most people back to bed until late afternoon—half a liter of wine on an empty stomach, or a few sharp swigs of bottom-shelf vodka, straight from the bottle. Without it—a combination of intense physical discomfort and crippling dread. With it—a sense of unsteady confidence, a rickety rope bridge extending from one physical location (the bed, the toilet) to the next (the bus, the office, the press conference). Either way—everything about my body felt unsteady and alien, not really mine, and booze-scented sweat leaked unmistakably from every pore, marking me as I shed layers on the overheated bus, the only person who was red-faced and sweating and yelling “Can you turn the heat down?” in October. My thoughts were panicked and unfocused, and I kept returning to bits of songs (Trudging slowly over wet sand / Back to the bench where your clothes were stolen) and a new mantra that kept showing up, unbidden: I feel like the light has gone out of my eyes.
When I was sixteen, I got to play piano in a small recital among a bunch of mostly younger kids. Our piano teacher, Ted, was a jazz musician who stuck to classical teaching, so the selections were in that vein: Tchaikovsky, Dvorak, Haydn. I played the Smiths’ “There Is a Light That Never Goes Out”—strings on the left hand, melody on the right. “To die by your side / Is such a heavenly way to die.” Robert and I would read the lyrics to each other on the phone after school, collapsing into hysterics at Morrissey’s melodramatic turns of phrase.
I feel like the light has gone out of my eyes.
* * *
—
For the next couple of weeks, I drank the way I wanted to—which is to say, constantly.
Through it all, though, I continued to work. One morning, I was running late for an interview with a city council member. I’ve known this guy for the last ten years, since the days when he led the local chapter of the Sierra Club in its fight against a boondoggle proposal to build a massive tunnel under Seattle’s downtown waterfront, the largest and riskiest project of its kind in t
he world. My old acquaintance lost that battle, but it helped win him a seat on the council, where he went on to become one of the most divisive figures in the city.
As usual, I’ve cut it close. To make the interview, I had to haul uphill two blocks wearing too many layers—it’s 40 degrees outside, pretty cold, but I’m a furnace—and my face is conspicuously red and dripping even after a quick trip to the ladies’ restroom downstairs, where I splash myself with water and take a long, greedy swig of Chardonnay. Upstairs, still sweating profusely, I stumble through a terrible interview, asking long, perambulatory questions that loop around themselves and land nowhere. “Are you okay? Do you need some water?” the council member asks me, looking concerned. Did he read Josh’s post about me on Twitter? Is he onto me? No, I just need to get through this fucking interview so I can get back to the office and keep drinking myself to death. “No, I’m fine. Sorry, just had to run up a bit of a hill to get here.” We shake hands in his office—Why does everyone keep their offices so hot?—when it’s over, his dry, confident palm clasping my damp, shaky one. I am relieved to have gotten through, and I reward myself with another trip to the restroom for a swig before tottering downhill to my office.
Back at the office, Josh eyes me warily. “Are you sure you’re okay?” he says suspiciously. Every conversation these days is in code. “I’m fine,” I tell him. “Just coming down with a cold.” “Come with me,” he says, glaring. There are cubicles all around. I roll my eyes defiantly, like the fourteen-year-old girl I sometimes still feel like on the inside, and follow him reluctantly to the stairwell. This is where he takes me to dress me down, out of sight of the people who could fire me. “You’ve been drinking,” he states flatly, for the millionth time. “Look at me and tell me you haven’t been drinking.”
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