I'm With Stupor
A close friend has a drinking problem. His wife kicked him out, he lost his job, and he's been a lousy father to their 1-year-old son. He begged to stay with me (his only single friend) and has been sleeping on my couch for months. Despite my lecturing him a thousand times, he's still going out and getting wasted -- while trying to talk his wife into taking him back. She called to ask how he's been. I said "pretty good," though the truth is, I just want him out of my apartment.
--Feeling Guilty
No wife, no job, probably no car, and no house -- it's like there's a country song sleeping on your couch.
You have been helping him -- helping him stay exactly where he is. Welcome to the dark side of empathy: empathy that backfires, ultimately causing harm. Dr. Barbara Oakley, who studies this "pathological altruism," explains in a paper that empathy is a knee-jerk emotional response rooted in our fast-responding intuitive thinking system. Empathy jumps right in, shoving us into action. Our slower rational thought system often isn't consulted, isn't given the chance to say, "Hey, wait a minute, Bub. Will you maybe be helping a drunk stay a drunk by turning your living room into the Schlitz-Carlton?"
Perhaps contributing to your unhelpful empathy was the myth (not supported by science) that addiction is a "disease," a condition that, like multiple sclerosis or Parkinson's, people are powerless to overcome. Sociologist Lee Robins first dispelled this disease myth with her 1974 research on heroin-addicted Vietnam vets. Robins found that one-fifth of the American soldiers in Vietnam had become addicted to the heroin or other narcotics they used to escape the horrors and lack of control they experienced while over there. Yet eight months to a year after returning home, about 10 percent had used opiates, and less than 1 percent were still addicted. What made the difference was no longer needing to escape.
Outside a war zone, addiction is adult baby behavior. As clinical psychologist Dr. Frederick Woolverton explains in "Unhooked," addiction involves ducking into a substance or activity to avoid experiencing uncomfortable emotions that are a normal part of adult life. Take a new father's feelings about the ginormous responsibility ahead of him. Understandably scary. But rather than try to figure things out, your friend resorts to child abandonment in liquid form -- instead of running away, floating away: clinging to that worm in the tequila bottle like a rat on driftwood.
You can't lecture a guy out of addiction. To overcome one, a person needs to realize that it "interferes with their deepest values or goals," explains addiction expert Dr. Stanton Peele in "Recover!" Peele gives the example of Phil, a lifelong smoker who'd made numerous failed attempts to quit. After a heart attack, Phil woke up in the hospital longing for a smoke. His daughter said that if he had another cigarette, he'd never see her again. That moment was the end of Phil's smoking. Peele notes that "Phil's core life" was about being a father, not a smoker. When forced to choose, smoking got tossed fast.
Peele says that even someone who isn't a therapist -- you, for example -- can remind an addict of what he values through "Motivational Interviewing," a sympathetic, nonconfrontational questioning technique Peele details in "7 Tools to Beat Addiction." First, draw out what matters to the person -- in your friend's case, maybe how it felt to have a child born, what he wants for his son, etc. Then, gently inquire about how his goals and dreams square with his current life. Don't push; if he's resistant, pull back. Your job is simply asking questions, not judging or criticizing. By getting him to recognize the discrepancies between what he wants and what he's doing, you're getting him to do the math: that he needs to make some changes if he wants more out of life than cirrhosis.
It's also time for some healthy kindness -- the sort that feels bad in the moment but, in the long run, may get him on the road to contributing to a college fund (beyond the one for his bartender's kids). Give him some deadlines. First, he has to tell his wife the truth, or you'll at least tell her you weren't completely honest. Next, inform him that your apartment is retiring from its stint as the Motel 6-Pack. Give him a move-out date, and be prepared to stick to it. Remember, your being cruelly kind is his best shot at getting a handle on more than the sides of your toilet bowl. It's also your best shot at charming a woman into bed without the added challenge of explaining the guy in your living room who can't figure out whether to hit on your plant or vomit into it.
Wow! Another spot-on, tough-love piece of advice, rooted in such stark logic, it makes you wonder how the rest of the world just can't see it.
Nicely done, Amy. If there were ever an Advice Column Hall of Fame, you would have to be the first one inducted.
Ian at September 2, 2014 10:33 PM
A buddy of mine let his alcoholic brother in law move into his basement. Two years later he would up buying him a trailer, paying two months lease on the spot in the trailer park, and hiring movers to get the freeloader out.
Lamont Cranston at September 3, 2014 6:33 AM
I'm a huge fan too, just love the science behind what we all know to be true, just can't figure out how to put it into words sometimes. Bravo.
gooseegg at September 3, 2014 6:33 AM
In my experience the only way an alcoholic will change is if he truly "hits bottom". Anything that keeps him from doing so only enables him to continue his current way of life, and may actually help to kill him. LW, do yourself and him a favor, remove the support and let him find his bottom, then maybe he has a chance. And for you, you might call the good folks at Al-Anon, they have a lot of experience to advise someone in your position.
bkmale at September 3, 2014 7:14 AM
Amy Alkon
https://www.advicegoddess.com/ag-column-archives/2014/09/im-with-stupor.html#comment-5019998">comment from bkmaleStanton Peele points out that this is very damaging thinking, this hitting bottom thing, promoted by AA, leading people to think that they need to/can wait to get help until they ruin their lives.
The values thing is right. 12-step programs are the only thing between some people and dying, so I don't knock them, but I know that they are not a cure for the underlying cause of addiction; merely a way to help some people be dry drunks.
Again, see the values thing and the work of Lee Robins and work from then on that shows how and why addicts transform themselves.
Amy Alkon at September 3, 2014 8:24 AM
Bullshit on "hitting bottom". For at least 4 problem drinkers I've known this was death. I guess it stopped their drinking but it didn't do much for those left behind.
I've had a few drunks live with me over the years and getting them out can be tough! Like Lamont's buddy, I found one an apartment, paid the DD and the first month's rent, filled the cabinets with food and let him go on his own. He ended up in a homeless shelter a few months later, moved in with his mom the following winter and died in his sleep a year later. He was 46.
Finding help for him outside traditional AA was next to impossible as that's the "goto" therapy everyone knows about and believes in...too bad their success rate is so bad!
Niki at September 3, 2014 11:45 AM
The hardest thing for most people to learn about addiction is that there are many people who will never get better. They continue down a path of self-destruction until they die.
The whole "disease" debate is meaningless and divisive; whether you call it a disease, or a condition, or "adult baby behavior" (condescension, like lecturing, is always SO helpful), addiction kills. And there's no silver bullet treatment that will ever make that not so. The addict has to decide that s/he will do ANYTHING to get better. That's what rock bottom means. Many addicts die before they hit bottom, in the same way that many pancreatic cancer patients are terminal before they have any symptoms of disease. 12 Step programs have saved millions of lives. Do we think chemotherapy is a failure because most people who delay treatment until Stage 4 cancer don't survive?
Lucy at September 3, 2014 2:41 PM
Why the sudden trend to compare every human condition to cancer? Depression is like cancer. Addiction is like cancer.
Mel at September 3, 2014 4:40 PM
"Adult baby behavior" is not "condescension"; it's telling it like it is. Addiction is, as I explain above, checking out of adult feelings. The addict has to decide to feel.
I agree, 12-step programs have saved many lives -- by turning addicts into dry drunks. Better than having them go driving drunk but not recovery.
Amy Alkon at September 3, 2014 8:17 PM
Amy Alkon
https://www.advicegoddess.com/ag-column-archives/2014/09/im-with-stupor.html#comment-5022346">comment from Amy AlkonMel, Illness as Metaphor, by Susan Sontag.
Amy Alkon at September 3, 2014 8:19 PM
Speaking as someone who's been there, and done that, the best thing LW can do for his friend is exactly what Amy says he should do. Enabling doesn't help, it only prolongs the process of this guy getting back on his feet. The problem is, he has to want to get better, and that can only come from him, and no one else.
It'l be tough for the LW to watch his friend go through this, but he has to do it for his own sanity. Baby-sitting an adult with an addiction is a tough job and after a while, takes its toll on the sitter. Better to get this guy out while he still can.
Flynne at September 4, 2014 4:46 AM
I agree, 12-step programs have saved many lives -- by turning addicts into dry drunks.
The thing that has always put me off AA is listening to the pitches, and hearing that they drive around town to find a meeting every night. They're not just turning substance abusers into dry drunks, they provide an alternative addiction. It's the methadone for alcoholics.
I don't do a great job of managing my own life, but it's a hell of a lot better than continual self flagellation.
Ltw at September 4, 2014 5:34 AM
Rabbinic literature contains a premise that "kindness on top of kindness destroys," meaning kindness without boundaries / limits / reason can be just as detrimental to the human condition as excessive stringency. Pathological altruism is an excellent way of putting it!
David at September 4, 2014 11:07 AM
Some addicts don't want to get better. Between anything - never seeing a wife or child again, or living on the streets filthy and begging, they would choose their addiction. I would like to think there is something that would motivate someone to stop drinking if they thought they'd lose it if they didn't but I think some people just don't care.
Maybe this gentleman, if he can't drink his life away and have a place to crash, will go into recovery. Maybe he won't. But it is time to put that decision in his hands and see what he chooses.
tango at September 4, 2014 4:11 PM
I couldn't believe your reply to this letter. The only thing you got right was that this is enabling the drinker to continue on his path. To call the FACT that addiction is a disease a myth, in my humble opinion, only points out that you are arrogant to the nth degree. I can tell you from personal experience this is not a myth. Psychologists who study this in books but have no personal experience in this disease cannot help the addicted. Addicts are the best con artists in the world. This is why programs like AA and NA work where others fail. They are full of the same people who need help. I have presently not had a drink in over 35 years, but I still remember the horrible withdrawal symptoms I had when I quit drinking. I also have known people who were clean and dry for 20 years and picked up a drink. The physical addition ALWAYS came back.
Please get off your high horse and study a subject before you stick your foot in your mouth. Having been there, I--and myriad others--know a whole lot more than you on this subject. I suggest you get in touch with one of the 12-step programs to find out what you are talking about.
Maureen Leibich at September 5, 2014 1:57 PM
Amy Alkon
https://www.advicegoddess.com/ag-column-archives/2014/09/im-with-stupor.html#comment-5032592">comment from Maureen LeibichI can tell you from personal experience this is not a myth.
There's a saying in epidemiology, "the plural of anecdote is not data." (Anecdote, as in personal story.)
Feel free to read Peele's work, which is good on science, such as "Recover!" and then tell me if you continue to cling like a rat on driftwood to what you've decided is the case.
I had no horse in this race -- I read the science.
AA, as I've said, keeps some people from dying or killing others, but it is a way to remain a dry drunk, which isn't a cure for addiction.
Amy Alkon at September 5, 2014 2:23 PM
Claiming addiction is a disease when it is a symptom of a deeper problem is like calling your sore knees a disease and ignoring the fact that you weigh 500 pounds.
lujlp at September 6, 2014 1:19 AM
"...it's like there's a country song sleeping on your couch." One of your best, Amy!
bob at September 8, 2014 4:00 AM
An interesting thought exercise. I recently had shingles, and anyone who has had them knows that the pain is intolerable and can drive a person insane. My doctor gave me some very strong pain meds, which actually didn't touch the pain, but they made me so doped up that I was able to tolerate it for periods of time. I took the pills for over 30 days and got to the point where I was thinking about them way too much. I worried that I would be addicted. In talking to a friend, I made the comment that "My life is too full and I have way too much to do to become a pill addict". But still, I had this worry that the pills would take control of me somehow. Then I read Amy's response and I realized that I'm the one who is in charge of my life, not a bottle of pills. It took me a couple of days to feel comfortable without them, but I stopped taking them and all is well. When I hear about people taking dozens of pills a day, I wonder how empty their lives must be.
Laurie at September 8, 2014 2:13 PM
@" This is why programs like AA and NA work where others fail."
Not sure I'd call a 5% to 10% success rate 'working while others fail':
"Peer-reviewed studies peg the success rate of AA somewhere between 5 and 10 percent. That is, about one of every fifteen people who enter these programs is able to become and stay sober. In 2006, one of the most prestigious scientific research organizations in the world, the Cochrane Collaboration, conducted a review of the many studies conducted between 1966 and 2005 and reached a stunning conclusion: “No experimental studies unequivocally demonstrated the effectiveness of AA” in treating alcoholism. This group reached the same conclusion about professional AA-oriented treatment (12-step facilitation therapy, or TSF), which is the core of virtually every alcoholism-rehabilitation program in the country"
http://www.salon.com/2014/03/23/the_pseudo_science_of_alcoholics_anonymous_theres_a_better_way_to_treat_addiction/
Lobster at September 8, 2014 7:28 PM
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1380437/
"Both surveys found that most individuals (77.5% and 77.7%) who had recovered from an alcohol problem for 1 year or more did so without help or treatment."
Lobster at September 8, 2014 7:32 PM
You don't need to "hit rock bottom" if you're an addict - you can start on the road to recovery 'today'. I agree with Amy, advising to hit "rock bottom" is harmful advice that is sure to create a sense of hopelessness and will likely become a self-fulfilling prophecy. Following Amy's advice here is best.
The so-called 'disease model' of addiction has never really been 'proven science' - it's just that, a model, because people felt a need to 'fill in the gaps' where we lack(ed) knowledge.
Lobster at September 8, 2014 7:40 PM
Amy Alkon
https://www.advicegoddess.com/ag-column-archives/2014/09/im-with-stupor.html#comment-5049736">comment from LobsterThanks, Lobster, for your comments. Been working pretty intensively for a week or so, and I hadn't gotten around here lately.
Amy Alkon at September 8, 2014 9:18 PM
Amy: I ordered a copy of Illness as Metaphor, and it arrived in the mail today. Thank you!
Mel at September 10, 2014 12:16 PM
Amy Alkon
https://www.advicegoddess.com/ag-column-archives/2014/09/im-with-stupor.html#comment-5061069">comment from MelWow, Mel, cool! Thanks so much for telling me!
Amy Alkon at September 10, 2014 10:49 PM
Hey, Amy. I shared your column with a friend of mine who is also a drunk. (I'd call him an alcoholic, but he doesn't go to meetings.) I especially liked the suggestion of reminding him of what he wants to be and how does his drinking square up with those goals.
I remember last year at around Christmas time, I did something along those lines. I asked him to think of his young niece, who wouldn't be able to see him on Christmas if he didn't stop drinking. He looked very distraught and ashamed of himself and said, "Don't mention her."
While I have my own problems and don't really have the time to provide him the "Motivational Interviewing" you suggest, perhaps it would be helpful for him to read about it and perhaps even look into getting the books for himself.
Patrick at September 15, 2014 3:59 PM
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