Book Excerpts

BEAUTIFUL BOY. . . a father’s journey through his son’s addiction
by David Sheff
Excerpts from . . .

David Sheff is a writer whose books include Game Over, China Dawn, and All We Are Saying. His many articles and interviews have appeared in the New York Times, Rolling Stone, Playboy, Wired, Fortune and elsewhere.  His piece for the New York Times Magazine, “”My Addicted Son,” won many awards and led to the writing of this book.

•”God is a concept by which we measure our pain.”  John Lennon

•“Drugs shield children from dealing with reality and mastering developmental tasks crucial to their future.  The skills they lacked that left them vulnerable to drug abuse in the first place are the very ones that are stunted by drugs.  They will have difficulty establishing a clear sense of identity, mastering intellectual skills, and learning self-control. They will chronologically mature while remaining emotional adolescents.”  Robert Schwebel, Ph.D. in Saying No Is Not Enough p.98

Parents of Addicts:

It would be all right.  It also occurred to me that this was a promise I could not keep.  I could not always take care of her.  I could not never leave her.  She was no longer a child. She was an adult.  Things happened in life that mothers could not prevent or fix.

Joan Didion, The Year of Magical Thinking

•”When you cross the street, Take my hand.”  John Lennon, Beautiful Boy (Darling Boy)

•My children will live with or without me.  It is a staggering realization for a parent, but one that ultimately frees us to let our children grow up.  P. 310

•our acrimony since the divorce has been pushed aside by our shared worry about (Nic).  It is with relief that I come to see (her) not for what separated us but for what unites.  We both love (Nic) in a way that only parents love their children and no one else can be part of.  (Karen) and I share a particular quality of worry – acute and visceral. We are never free of worry about our (son).  We wonder what went wrong.  We wonder if he is alive.  We wonder if it is our fault.

•Whatever the parental failings may be, it is almost inevitable that the addicts will recognize these vulnerable spots and take advantage of the parents.

“Addicts may have many complaints, including major and minor grievances from years past.  Some of their accusations may, in fact, have truth in them.  Families may well have caused pain for the addicts.  They may well have failed the addicts in some significant way.  (After all, what human relationship is perfect?)  But addicts bring up these problems not to clear the air or with the hope of healing old wounds.  They bring them up solely to induce guilt, a took with which they manipulate others in pursuit of their continued addiction.” p. 146

Beverly Conyers, Addict in the Family

•therapists say that parents of children on drugs often get a form of posttraumatic stress syndrome made worse by the recurring nature of addiction.  We pretend that everything is all right.  But we live with a time bomb.  It is debilitating to be dependent on another’s moods and decisions and actions – codependent on her well-being for ours.  p.228

•”Some of the times when Nic wasn’t all right it got so bad that I wanted to wipe out and delete and expunge every trace of him from my brain so that I would not have to worry about him anymore and I would not have to be disappointed by him and hurt by him and I would not have to blame myself and blame him and I would not longer have the relentless and haunting slide show of images of my lovely son, drugged, in the most sordid, horrible scenes imaginable.” p.241

•we are connected to our children, no matter what. . . the perpetual angst and humming anxiety and intermittent depression that comes with (Nic’s) addiction.  I don’t reember me before this.  I am accustomed to the way that joy can be fleeting and I can sometimes fall into a dark pit.  p.249

• . . . some of us come to a place where the good news is that our children are in jail. P.176

•Al-Anon’s 3 Cs:  “You didn’t cause it, you can’t control it, you can’t cure it.”

•. . . it’s futile.  You cannot control an addict.  Family members’ moods become dependent on how the addict is doing.  People become obsessed.  There is no joy left in their life.  p. 153

•(Nic) is absent, only his shell remains . . . I have lost him. . . I have been grieving for him since the drugs took over – grieving for the part of him that is missing. P.269

•” . . . people told me to give up on him, but I didn’t.  How does a mother give up on her son?  If I had, he wouldn’t be here now.  That’s a guarantee.  He would have died.  I called just to tell you this story.  Do not give up hope and do not give up on him.” P.276

• . . . it feels too risky to wait for him to “bottom out”. p.276

•”. . . I am not naïve enough to believe that any expert has the answer to our family’s problem.  Nor am I arrogant enough to think that I know the answer.  I will not blindly follow anyone’s advice, but I gather information and will weigh it and decide what, if anything, to do.  I know that no one know the answer to what is right for (Nic) or any other addict.  No one knows what will work.  No one know how many times. p.277

•Every call fed my growing obsession with the promise of reassurance that (Nic) was all aright or confirmation that her was not.  My addiction to his addiction has not served (Nic) or me or anyone around me.  (Nic’s) addiction became far more compelling than the rest of my life. p.305

•Parents of addicts learn to temper our hope even as we never completely lose hope.  However, we are terrified of optimism, fearful that it will be punished.  It is safer to shut down.  p. 305

•This realization impelled me to do whatever I could to get past my obsessive worry about (Nic).  I could not change (Nic), only me.  And so instead of focusing on (Nic’s) recovery, since then I have focused on mine.  (Al-Anon)  I learned that at some point, focusing on (Nic’s) perpetual crises became safer territory than focusing on myself.; p. 309

Addiction:

•There’s evidence that people who become addicted, once they begin using, have a type of compulsion that cannot be easily stopped or controlled.  They cannot just stop on their own or they would.  No one wants to be an addict.  The drug takes a person over.  The drug, not a person’s rational mind, is in control.  p. 150

•with practice, addicts become flawlessly gifted liars, and this coincides with parents’ increasing susceptibility to their lies.

•What happened to our daughter?  Where did we(I) go wrong?  According to Al-Anon, it is not my fault.  But I feel solely responsible.  P.177.

•A using addict cannot trust his own brain – it lies, says, ‘You can have one drink, a joint, a single line, just one.’ p.261

•Only Satan himself could have deigned a disease that has self-deception as a symptom, so that its victims deny they are afflicted, and will not seek treatment, and will vilify those on the outside who see what’s happening. p.263

•” . . . thankful that of all the fatal disease my (son) might have gotten, he got one for which there is this little sliver of hope that if he surrenders, he’ll survive.”  Thomas Lynch  p.272

• . . . in mortal combat with addiction, a parent wishes for a catastrophe to befall his (child).  I wish for a catastrophe, but one that is contained.  It must be harsh enough to bring him to his knees, to humble him, but mild enough so that he can, with heroic effort and the good that I know is inside him, recover, because anything short of that will not be enough for him to save himself.  P.274

•”I had to hit bottom when there was no one and nothing and I had lost everything and everyone.  That’s what it takes.  You have to be alone, broke, desolate, and desperate.” P.279

• . . . recovery, like addiction itself, is a long and complex process. Families should never give up hope for recovery – for recovery can and does happen every day.  Nor should they stop living their own lives while they wait for that miracle of recovery to occur.”

Treatment/Treatment Programs:

•” . . . making a selection of programs in the mental health/substance abuse service system is like reading tea leaves.  “  Dr. Rawson, p.289

•The psychology of intervention is that an addict feels overwhelmed and vulnerable in the presence of his family and friends.  P. 279

•only about 17% of people who go through drug rehab programs are sober after a year.  Many rehabs employ one-size-fits-all-addicts programs.  They tend to be rooted in the principles of AA, which seem to be essential to staying sober for most, if not all, alcoholics and addicts, no matter the drug.  But other than that, they offer a slipshod patchwork of behavioral, psychological, and cognitive therapies.  Without standards based on proven protocols, patients are often subjected to the philosophies of a program’s director, some of whom have no qualifications other than their former addiction.

•Meth:  As with many drugs, the dopamine deficiency causes depression and anxiety, but it’s often far more severe with meth.  This compels the user to take more of the drug, causing more nerve damage, which increases the compulsion to use – a cycle that leads to both addiction and relapse.  Many researchers hold that this drug’s unique neurotoxicity means that meth addicts, unlike users of most other drugs, may never completely recover.  p. 133

•Rather than a moral failure or a lack of willpower, dropping out and relapsing may be a result of a damaged brain.  Severe cognitive impairments may make patients incapable of participating in therapies that require concentration, logic, and memory.  Also, patients with extremely high “chronic agony”, as London describes it, are at a major disadvantage when taking part in cognitive and behavioral treatments.  Research shows that it takes a long time for the brain to return to normal – if it ever does.  p. 135

• . . . relapses can be part of recovery. As Dr. Rawson said, it sometimes takes many of them before an addict stays sober.  If they don’t die or do too much damage, there’s a chance, always a chance. P.272   . . . recovery is an ongoing process.  He may have relapsed, but rehabs interrupted the cycles of using.

•regarding relapse:  failure, even serial failure, may lead to success.  Treatment catches up with you.  Treatment should be conceived as an ongoing process rather than as a cure. P.167

•. . . though a (meth) addict may become well enough in four weeks to understand the need for ongoing care, he or she may not become well enough to follow through on it.  . . . programs most likely to be effective would last for many months.  It probably takes at least a couple of months for a patient to recover enough to engage in treatments in meaningful ways.  “in the meth users, at least in the first few weeks, the cognitive strategies that the brain is using are abnormal,” Dr. London says.  This means that, in addition to the biologically rooted high anxiety and depression, people getting off meth have severely impaired cognitive functioning. P. 136

•Problems with steps 2 & 3:  concept of a “Higher Power”:

•Step 2:  “Come to believe that a Power greater than ourselves could restore us to sanity.”

•Step 3:  “Made a decision to turn our will and our lives over to the care of God as we understand Him.”

There’s a lot of room in ‘as we understood Him’.  The idea that morality is right for its own sakes.  The Dalai Lama refers to “ key ethical principles we all share as human beings, such as compassion, tolerance, a sense of caring, consideration of others, and the responsible use of knowledge and power – principles that transcend the barriers between religious believers and non-believers . . . “  These principles are a “higher power”, accessible to each of us.  Once concept of God is:  the “still small voice” inside us – our consciences.  You have to trust that there is something bigger than us out there – something that can show us the path that will save our lives. P.154

The first step is honesty: my life is out of control.  So what are your choices?  Continue, or submit to a higher power.  You have to risk it – to be courageous enough to take a leap of faith and trust that there is something bigger than us that can help. P.155

•As they often repeat in AA, you’re as sick as your secrets. Though it is not a solution, openness is a relief.  Our shared stories help us remember what we’re dealing with.  Addicts need ongoing reminders and support, and so do their families.  It helps to read others’ stories.  Taking it one day at a time.  p.315

•chose as long an inpatient program as possible, to be followed by a gradual transition to a comprehensive outpatient program that would continue for a year or more.  This would begin with 4 or 5 daily or evening sessions a week, then less frequent sessions, tapering off to once a week. Since the less someone uses, the easier it is to stop, the longer he is in treatment, the better.  p.312

•it makes little sense to start behavioral and cognitive therapies during the initial withdrawal period. Addicts in outpatient programs seem to benefit when they get help making a schedule they can follow until their next session. Drug testing, with severe penalties for relapse, is, the experts claim, essential.  Behavioral and cognitive therapies should be added slowly.  When they are, they should be monitored so that they reflect an addict’s ability to participate in them.  “Talk just can’t penetrate the wiring problems.” Dr. Ling adds, “Understanding things will not change an addict’s life.  Doing things differently will.”

•The first goal is to keep addicts in treatment long enough for them to participate in cognitive and behavioral therapies that train or retrain them.  In theory, new behaviors eventually become habitual.  At Matrix-based programs, addicts are trained to interrupt their normal reactions to anger, disappointment, and other emotions.  They are taught about components of addiction such as priming and cueing, which often lead to relapse. P.206 Since addicts may slip at certain stages of their recovery, the program trains them to reframe the incident.  Rather than responding to priming, an addict can stop the process at a “choice point”. The moment can be viewed as an opportunity to try an alternate activity.

•Cueing leads to drug use when an addict encounters a trigger that starts a cycle of intense craving that often results in using.  Studies have shown that cues (the people, places, and things, smells, sounds, etc. associated with the drug) dramatically change an addict’s vital signs.

•The ideas is that any behavior, including behaviors that seem automatic or compulsive, can become conscious and can then be interrupted.  Time in treatment – time measured in many months if not years- is usually required for dramatic change.  In the process, the drug user’s brain is probably regenerating, and dopamine levels may be normalizing.  A cycle of abstinence replaces a cycle of addiction. p. 207-08.

• . . . the bitterest irony of sobriety – the reward for your hard work in recovery, is that you come headlong into the pain that you were trying to get away from with drugs. p.229

•(Nic) says that the work he’s doing in treatment isn’t about finding excuses for his debauchery or his craziness and it isn’t about blaming anyone.  It is about healing.  His therapists have told him that he has to work through whatever it is that causes him to harm himself, to put himself in danger, to turn from those friends who love him, to lash out at his parents and others who love him, to lash out at himself, mostly at himself, to try to destroy himself.  He is an addict, but why?  Besides the luck of the gene-pool draw, what is it?  They want him to face it all so he can heal and mover forward. p.301

•”Recovery is . . . about dealing with that hole in the soul.” William C. Moyers, son of journalist Bill Moyers and a recovering addict.  P.310

•”Addicts persist in their self-destructive, addictive behavior until something within themselves – something quite apart from anyone else’s efforts – changes so radically that the desire for the high is dulled and ultimately deadened by the desire for a better life.”  Beverly Conyers  p. 310

Treatment Centers referenced:

•Thunder Road in Oakland.

•Matrix drug rehab centers, founded by Dr. Rawson and his UCLA colleagues.

•Ohlhoff, Hazelden – 6 month programs

•Herbert House: long-term stays in sober-living communities

Books Referenced:

Addict in the Family, by Beverly Conyers – a remarkably useful book.

Additional, large bibliography, worth perusing

NIGHT NAVIGATION, by Ginnah Howard

Mark (the addict son in the novel):

•Drug dramas.  And manic-depression.  Hard to know which roller coaster you’re riding.

• . . . the money’s gone and everybody’s starting to get sick;  despair and isolation; somebody hocks something, another flurry; treading dark water until the beginning of the next month when everybody’s got money. . . All of it punctuated by variations of fallout, car wrecks and arrests . . . And, yes, the occasional plunge toward sanity;

•Detox.  Somewhere, somewhere, somewhere, there’s a bitty piece of paper with the name of the detox, the number.  A methadone detox.  More than the Tylenol and TLC around here.  Thirty, twenty, ten milligrams of methadone, touch down easy, taxi to the gate in three days.  P.9

•His mom . . . she’s a machine of cope and find. P. 10

•A dog? No, she said. He’d be the main caretaker.  Up early with a puppy every morning?  He promised.  That’s why she finally gave in.  A puppy was to be the instrument of getting his ass out of bed before noon.  Behavior modification.  Of course, that plan had circled the drain of all similar rescues.  Her, out there in the dark on January mornings, freezing, saying, Pee, Luke.  Her, pissed.  But, Luke.  He cracked them up.  He cracked them open.  Luke their buoy out on the black sea.  P.13

•So at Lazarus House, you can’t act like no junkies no more. ‘Cause you don’t act like a junkie, you won’t use dope, Right? . . . You got structure here and rules. . . . if you follow Lazarus House rules for six months, eight months, most of you will leave knowing how to keep it together. P. 139

•Anger stuffed is the first cause of relapse. P. 140

•”What changed it (all) was fishing”.  Ricardo lays his hands out open on the table: nothing to hide.  “I mean, for so long I’d gotten my kicks scamming people so I could get high.  But here we were out there on that river.  Listening to the frogs.  And it wasn’t hurting anyone.” p. 143

•Always there is that major decision:  How honest does he want to be?  Not at all?  Moderately? Extremely? Answer:  All depends.  All depends on whether he’s trying to get in or out. p. 184

• . . . the time between three and six months of recovery is often called the “Fuckits.”  p. 199

•He smokes, drinks his coffee.  Maybe he’s going to make it through this; maybe he isn’t.  He needs something, something to make it semi-bearable.  He could get something, somewhere. Nothing heavy duty.  Just a tok of hope. p. 217

•Got to go through more of the motions.  But he’s going to take what he likes and leave the rest.  p. 235

•Rozmer’s (his sponsor) always got the scam-o-meter running.

•Who can know what someone else is able to do next?  P. 178

Del (mother of adult addict son, Mark):

• . . . how many years has Mark been her main concern?

• . . . when he’s got another knot of infection swelling and she’s driving him to Emergency again, she wishes he’d just go ahead and kill himself and put them all our of their misery. P.7

•Already you’re donning the cape:  only you can save him. p. 179

• . . . she’s itching to find some long-term place that will take hold of Mark long enough for him to learn how to put together a day, stack one hour on top of another, on top of another, without knocking them over.  How many years might that take? P.79

• . . . most of them were probably around his age:  bottom-out time.  p. 138

•She’s got to have the distance in order to stay detached. p. 181

•”Have any interest in making out a contract? A list of guidelines for yourself.  Positive behaviors that are likely to help you avoid slipping into patterns that might lead to relapse.” p.187

•She bets if they did a study of families where there has been a suicide, they would find there had been half as many words as the average the years before the death and one-quarter as many after. p. 276

•A month of yoga stretches will be required to release her from the lock of one phone call. p. 295

•It never feels okay not to try to help.

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