But as Teddy improved and the emergency passed, my mom’s symptoms grew progressively worse. Several months after Teddy’s surgery, in May of 1974, she checked herself into Silver Hill in Connecticut for a three-week rehab. The statement from my dad’s office said she had gone for “emotional problems”—but since Silver Hill was best known for its treatment of alcoholism, it was clear why she was there. Several weeks after being discharged, she went back, for what my dad’s office called the “second phase” of her treatment for emotional strain.
—
TEDDY’S CANCER AND Mom’s treatment were covered not only in the regular press and the supermarket tabloids, but in a new medium somewhere in between them: People magazine. It had grown out of Time magazine’s “People” column as interest rose in “personality” journalism—initiated by the success in the late sixties of several city magazines and then the Washington Post “Style” section—and debuted the week of March 4, 1974. In its first several months of publication, my family was the cover story in two of the initial seventeen issues: one covered our family skiing trip to Vail and featured my dad and brother on the cover (noting that my mom, “who was not feeling well, stayed at home in Virginia”) and the other was a big piece on my mother.
By creating and presenting a whole new level of “respectable” personality journalism—previously seen as “soft” news for the “ladies’ section”—People magazine changed the role of public figures in America. It also presented a new forum for mental illness and addiction to be discussed more openly. This was good, in theory, because it did help expand the dialogue about illness and treatment—it was the very beginning of Americans realizing this was a common struggle. There was something powerful in seeing, say, Martha Mitchell—the divorcing wife of Richard Nixon’s Attorney General who was caught up in Watergate—talking about her problems with prescription drugs and alcohol. But there were also plenty of half-truths and myths perpetuated in some of those stories.
The story about my mother, for example, featured an interview with my maternal grandmother, Virginia Stead Bennett—though every other quote in the story was from an anonymous source. She denied my mother had any problem with alcohol dependence and insisted she had gone to Silver Hill because “she needed a rest.” The article later noted that my grandmother had once been at Silver Hill herself, but only because it was where she “retreated during her divorce” from my grandfather.
Nobody in the family, and none of her friends, wanted to say out loud that my mom suffered from alcoholism. In 1975 her father, Harry Bennett, finally admitted it in an interview, as my mom’s side of the family started getting more involved in offering a different spin than my father’s press office. While my grandfather was more open about my mother’s drinking, he did offer the same explanation for it that everyone else had: not the disease of alcoholism, but the unique pressures of being a Kennedy.
In reality, my mother’s father knew full well that she had inherited this illness, which affected every member of her family, regardless of whether they had married a Kennedy. My grandfather had issues with alcohol. My mother’s younger sister struggled with alcohol and would later become active in the recovery movement.
But my mother’s mother was the most ill. She was, by that time, living by herself in an oceanside apartment in Cocoa Beach, Florida, incredibly isolated because she had burned every single bridge with her family, her friends, and her community. On April 8, 1976, my grandmother was found dead in her shower. Apparently she had been that way for several days, before her body was discovered.
She was only sixty-five. When we got the news, it was the first time I ever saw my mother cry.
Chapter 4
My parents informally separated in 1977, when I was ten years old. We had been living in McLean, Virginia, and my mom, an accomplished pianist and musician, announced she wanted to spend more time in our Boston apartment so she could pursue an advanced degree and study more music. This was, like many statements my family issued about personal stuff that probably wasn’t anyone else’s business, technically true. In reality, she was leaving to try to save her own life, and finally get her alcoholism under control, by doing what an increasing number of Americans were doing—joining the free, all-peer-supported twelve-step programs of Alcoholics Anonymous. It was a brave thing to do.
Her care had, up until that point, been controlled by medical experts my father brought in—often the absolute leading people in their fields, but not people who could help my mom create any real care community she could rely on every day. She got intensive treatment at inpatient facilities, which always included a few sessions for us kids, sessions we viewed as so silly, famous therapists looking at us in horror that we weren’t heartbroken and crying (“families usually do that, you know,” they would tell us). We had lived in turmoil our whole lives, so the notion that this was especially traumatic was almost absurd to us.
So she would have these intensive inpatient experiences, and then she was back in the real world of one-on-one psychiatry a couple times a week.
After many cycles of this approach proved unsuccessful, my mother wanted to try something different: a twelve-step program with daily meetings. This was a big risk because, at that time, twelve-step programs were very separate from, and often critical of, most of the medical rehab facilities that had been her lifeline.
AA had sprung to life in the thirties and forties and was popularized in the early sixties when the main character of the Oscar-winning film Days of Wine and Roses (played by Jack Lemmon) was in the program. By the early seventies—when its founder, Bill W., died, not long after partially breaking his famous anonymity by testifying before Congress with no photos allowed—the organization reportedly had more than 300,000 active members worldwide (today that number is more than two million). But the mainstream mental health establishment viewed it as something of a cult and a threat. This was largely because AA was peer-run without professionals, and was based on daily free meetings, which competed with paid individual or group outpatient sessions offered by medical rehab centers. AA also had a spiritual basis for recovery, and mental healthcare at that time prided itself on being secular, because in the distant past of mental disease, patients had been accused of being “possessed.” And AA adhered to a model of alcoholism as a “disease,” which was, frankly, ahead of its time but also without much scientific evidence, just a lot of quietly satisfied customers.
Besides the conceptual debates, there was also the matter of privacy. Much of rehab—medical or in AA—was based on group sessions during which people were expected to be honest and supportive. Most people in these groups were trustworthy, but in both the closed medical rehab groups and more open AA groups, there was a fear that intensely personal things shared in meetings might not remain secret. This was especially worrisome for a very public family like ours, and when my mom first tried a twelve-step program, everyone’s fears were justified.
In early 1976, she had checked herself into a place in New York City called the Smithers Rehabilitation Center, which was private and medical but also employed the AA model, which a few other places around the country also did, following the example of Hazelden in Minnesota. She was very open during her twelve-step meetings at Smithers. And then she had to endure the violation of trust when two of her fellow patients, including one who had clearly been targeting her to talk to during treatment, sold stories about her to the National Enquirer.
Presumably, it would be a little safer for Mom to attend twelve-step meetings in our hometown, where people might be a little more respectful of her challenge and the process.
She took to AA very aggressively. Since I was living with my dad full-time in Washington, I remember being a little taken aback the first time I visited her and saw how she had redecorated her Beacon Street apartment with AA slogans: “One day at a time,” “Live and let live,” “Serenity is not peace from the storm, but peace amid the storm.” There
were framed posters, bumper stickers, pillows, oh my god, the pillows—it was like walking into a recovery gift shop. We’d kid each other about how sappy all this stuff was, but she was truly into it. I didn’t really understand then how important the fellowship and community of recovery could be in combating the isolation of these illnesses.
It was like she was in another world. But then, we were all in another world, because of the separation.
With my sister and brother heading to college, I felt increasingly lonely living in a big house outside of DC, being raised by my dad and a nanny, seeing my whole family together only at holidays. When the Senate was in session, I saw my dad mostly between evening meetings—although sometimes he would bring me into the sessions to lighten the mood and, occasionally, even ask for my opinion. He did, however, always drop everything when I was having a medical emergency with my asthma, which I too often did. The problem was, I was trying so hard to be normal, to be well, to be one of the guys, that I hated to tell anybody I was starting to wheeze, because I knew it meant we would have to go home early from wherever we were, and it was just a real pain; it would ruin everything. So I would wait and wait and wait, until I was really in trouble.
Asthma was harder to control then, and all the treatments weren’t as easy as they are today: I have this image of my dad, whose back never really healed properly from the plane crash he was in during the early sixties, lugging my twenty-five-pound Maxi-Mist nebulizer everywhere we went, always looking for a three-pronged plug for it. And the meds back then weren’t what they are today, so they were a bigger deal to take and the standard dose was probably a lot more than I needed. We didn’t know as much about prednisone as we do now, didn’t realize how much taking it could affect moods. Considering my genetic predispositions, these steroids, while the standard of care at the time, probably weren’t helping my youthful mental health.
—
IT WAS DURING THIS TIME, as my mom was starting to make some progress with her alcoholism, that I first tried drinking. It honestly never occurred to me that what I was doing had anything in common with my mother’s illness. I was more interested in drinking and trying pot to try to impress my older brother and sister and their friends, who were, like all kids in the seventies, “experimenting.” I wanted to be wild like some of my cousins, who to me didn’t seem to be depressively into drugs and alcohol; they just did it for fun.
In AA, it’s not uncommon to talk about the first time you ever drank. My story is a little atypical for most meetings: I got drunk during my father’s first diplomatic trip to China, in the winter of 1977. I was ten years old.
My mom came on the trip, along with my Aunts Eunice, Pat, and Jean, and my Uncle Steve Smith, with whom my dad was very close, as well as my cousins Caroline and Michael, who were college-age, and my brother and sister. I recall we visited Japan during the trip and spent one night in a place called the Three Sisters Inn—where my dad and Uncle Steve spent a long time jokingly speculating what an inn would be like if it were run by Jean, Pat, and Eunice.
I also remember—well, I sort of remember—drinking a lot of rice wine in the Forbidden City during one state dinner. Then–vice premier Teng Hsiao-p’ing hadn’t attended the dinner, saying he had a cold, and there was some question of whether he was slighting the US. But, apparently, he actually did have a cold, and ended up meeting with my family the next day. He even mentioned to the press that I had lost a tooth during the visit (completely unrelated to the rice wine) and said, “You have left a part of you behind. You must come back.”
It was a couple years before I really tried drinking or drugs, but I was still pretty early in my teens for that—and I am still amazed that, given how irritating any kind of smoke was for my asthma, I still insisted on smoking pot to keep up with the older kids. This was, after all, the late seventies, and young people were moving from pot and hallucinogens to more drugs people snorted. I was getting some psychotherapy during this time. But it didn’t seem to be geared toward treating any symptoms I was displaying, but rather toward trying to psychologically immunize me against my parents’ impending separation. In retrospect, I’d say I was probably already suffering from some anxiety and situational depression by my early teens. And I was certainly self-medicating. But the therapy wasn’t about any of that: the therapist just wanted to discuss how I felt about my parents.
I do worry that by explaining my depression and anxiety this way, it is easier to minimize. This is one of the basic challenges of all mental healthcare, that somehow a person is less sick, less disabled—temporarily or permanently—by illness, because some of the external stressors involved are somehow not extreme enough, not overtly “traumatic” enough. It is really difficult to make people who don’t have these illnesses, or don’t treat these illnesses, understand that it doesn’t matter if your particular combination of genetics and life experiences seems destructive enough to an outsider to lead to a crippling depression or anxiety attack. The question is only whether your symptoms—however you got them—have reached the point where they are preventing you from living a normal life.
Some people find themselves able to emotionally surf across the biggest waves of family trauma and dysfunction, the harshest circumstances of business or war. Other people can’t.
The notion that mental illness and addiction are directly “caused” by bad parenting was rejected years and years ago—but the news just doesn’t seem to have reached enough people yet. Up through the early 1960s, mental health professionals were still being taught that even treatment-resistant schizophrenia was caused by “bad mothering”—and could only be prevented by good mothering. We now know that people genetically predisposed to schizophrenia get it regardless of how they were raised. We also know that some people drink and take drugs and get addicted to them, and others drink the same things and take the same drugs and don’t.
This is not to suggest that childhood traumas do not have impact in many areas of health. The Adverse Childhood Experiences (ACE) study done by the CDC and Kaiser Permanente, which has followed a group since they enrolled as young people in the mid-1990s, found dramatic correlations between childhood maltreatment and compromised adult health. But that doesn’t change the fact that the strongest predictors of mental illness and addiction are clearly genetic in nature, and bad parenting can’t “turn” someone schizophrenic or bipolar.
Someday we will truly understand why. But the biggest challenge facing us today is to get people to realize that what they think they understand about this is incorrect, and there is finally some good science to prove that.
Are there some aspects of my childhood that look especially challenging and unique? Sure. And I’m sure that’s true of your childhood, too. But don’t you know people who had similarly challenging childhoods and do not suffer from debilitating mental illness and addiction? Of course you do.
Chapter 5
Although I didn’t see her as much during the next couple years, my mom did make great progress getting control of her illness in AA. In the summer of 1978, not long after former First Lady Betty Ford made the very first public revelation of her struggle with alcohol and painkillers, my mom gleefully announced to McCall’s magazine that she had finished her first year of sobriety. Unfortunately, by the time the issue came out, there was talk that she had “slipped” or had a “relapse.” (In recovery, a “slip” is a one-time or brief substance use that interrupts but doesn’t completely compromise treatment and sobriety; a “relapse” is more sustained use, after which you generally have to start again. When people casually use the word “relapse” I think they forget that for addicts their natural state is to be using substances.)
Some of her slips we didn’t know about at the time, but only discovered later when my mom’s personal assistant—and fellow AA member—decided to violate all confidence and decency to write a tell-all book to cash in on the experience. She actually had the audacity to suggest she was d
oing this for my mom’s own good, and to help AA. My dad’s driver during this time period also later wrote a tell-all memoir. It’s no wonder we were always taught to keep everything a secret, even things that didn’t need to be secret. (That’s how shame grows in children who are too young to even know what shame is.)
In the middle of all this, my father was urged to run against incumbent Jimmy Carter, whose presidency was floundering. This required a number of family meetings. He met privately with me and my brother and sister to get our blessing—not only for the public appearances we would be doing but for the heightened risk on my father’s life. We told him, however reluctantly, that we were on board. Although, really, what else were we going to say?
And then there was a meeting of the grown-ups, to discuss whether or not my mom was well enough to handle this. With my mother’s permission, my dad ordered an exhaustive retrieval of all my mother’s medical records going back to childhood, and a survey of the leading research in addiction care. And then he convened a team of physicians—his own healthcare adviser, my mom’s regular psychiatrist, and leading experts from Yale, the Mayo Clinic, and elsewhere, along with my aunts Jean, Ethel, and Eunice, to discuss with my parents what risks a campaign would pose to my mother’s health.
One of the surprises of the research, at least to my father, was that my mother apparently had documented problems with alcohol as far back as college in the 1950s—undermining the popular notion that her health problems were nothing more than a reaction to the Kennedy tragedies of the 1960s. Aunt Eunice—with whom my mom was closest in the family—was apparently the most concerned about whether a national campaign would be safe for her. They ultimately decided it would be.
A Common Struggle: A Personal Journey Through the Past and Future of Mental Illness and Addiction Page 5