Problems Other than Alcohol.

There is a lot of information out there about AA and other issues. Generally, when we talk about problems other than alcohol, we mean drugs. I’m fortunate. I never got involved in drugs to any degree that influence my life. I smoked pot a few dozen times, and took Xanax recreationally a little bit less than that. I never had any issues with addiction or negative effects with either. But I really ought to preface everything I’m saying here with a bright red disclaimer:

Even though I am a doctor, I am not a physician. Nor am I a psychologist, nor counselor of any kind. My doctorate is in systems engineering. Nothing I say in this post should be construed as medical advice to other people. I am talking only about my own experience, which is unique to me. Your experience, or that of those you cherish, may be wildly different from mine.

So, AA is clear that we cannot help people who have drug problems, but not alcohol problems. For a long time people who felt they could drink normally, but had problems with cocaine or heroin or whatever would come to AA meetings, and it caused problems having people in the meetings who were not abstaining from alcohol. Thus the third tradition: “The only requirement for membership is a desire to stop drinking.” You don’t have to succeed, but you have to want to quit alcohol to be a member of AA. Thus, NA was organized to aid people with drug problems rather than alcohol problems.

Also, there are many AA meetings that are described as “dual-diagnosis”. This means that in addition to alcoholism, the members suffer from a co-morbid mental health condition. Often major depression, bipolar disorder, or schizophrenia. Many people find that the program of Alcoholics Anonymous helps them to confront those issues in a responsible way. The program of responsibility, sobriety, and action will often galvanize people to be more medico-compliant, for example, so that they can manage their symptoms of those diseases more effectively.

Despite the fact that I have suffered from bouts of major depression, including engaging in pharmacotherapy to address it from time to time, I have never enjoyed dual-diagnosis meetings. I have not found a meeting where I feel the same comradeship with the people I find in the straight old, boring AA meetings. I find the recovery I need in those rooms. And that’s saying quite a lot, in fact.

Because my depression, when I drink, is formidable. In fact, and this is the first time this has gone in print, I used to cut, rather extensively. I found cutting to be a psychic release of pain orders of magnitude more powerful than any drug I ever took. I’m not certain why this is such a painful thing to write about. I guess I’m once more revealing myself to be rather less than a paragon of mental health. It’s terrifying. Cutting is stereotypically the arena of black-clad teenage girls. But I didn’t begin until I was in my twenties.

But for me, the cutting vanished, on its own, when I got sober. I’m not saying that that is likely to be anyone else’s experience. I know that cutting is addictive, and I know that it is often intractable. But for me, when I removed the alcohol from my body, the cutting was removed along with it. I haven’t had to fight not to do it anymore. And I’ve dealt with the underlying issues about it, which were, of course, elaborately intertwined with the reasons I drank.

Drinking was about obliterating the feelings. Cutting was about releasing them. I often used to fantasize that when I cut, the blood would pour out black. That inside me was some viscous evil that I could release one ounce at a time, that somehow I was purifying myself by purging this toxin. And I’ll confess: I miss that sensation. I miss feeling like I was being made clean, drained of blood and filled back up with perfect, distilled water.

But being sober, I find I have a more rational and calm perspective on the world, on my body, on health both mental and physical. By finding in myself and point of balance, that sublime, stable balance of a ball in a trough, I feel no compulsion to purify. I eat well, I exercise, I take time for my mental health. I see a psychiatrist and a family practice physician each a few times a year to maintain that condition, much like I go to AA meetings a few times a week to maintain my sobriety.

I used to think I would keep these things hidden. So that people might look at me and think that I am sane and stable and strong. Now, I have come to believe that sharing them is better. Because I think everyone suffers. And we construct facades to ensure that our peers don’t think we’re weak, or strange, or anti-social. I won’t cower anymore. I’ve learned not to fight. And since I don’t have to fight, I don’t have to be afraid.