My Plan Versus the Substance Abuse Counselor

pink sunset

Because I’ve known for so long that I was facing down a zombie of a problem I have given a lot of thought to how best deal with my drinking.  I tried some things that didn’t work.  But finally I came up with a plan that I strongly suspect will help me fight this beast back into the ground.  But I needed my psychiatrist to help me because I can’t (or won’t) just go buy antabuse over the counter.

My plan involves zero absolutes.

I don’t believe in many absolutes.  I don’t believe that if you have a drinking problem you necessarily have to become sober for the rest of your life.  I think it’s different for different people.  The trick is being honest with yourself and recognizing where you’re at and what works and what doesn’t.

My relationship with cigarettes was obsessive love at first inhalation.  From the moment I smoked my first cigarette (the second one, actually, because my friend Carrie had to teach me how to inhale it) I was a chain smoker.  There was never a social aspect to it.  It made my brain feel so much better.  Nicotine quieted the noise in my head, quelled the most vicious of black mods, and gave me the perfect way to pretend to be at ease in every situation.  It took many times quitting to really understand that that’s how it was and that I didn’t smoke for pleasure or to be social, I smoked because it performed an important chemical shift in my brain.  When I tried to quit the horrid voices in my head got loud.  My own voice telling me what a piece of shit human being I was got very very loud.   The voices didn’t come as a component of addiction.  The voices were there before I ever smoked.  Smoking was definitely self medication.  It made me feel like crap physically but it was worth it for the relief it gave my head.

I stopped smoking with the help of Welbutrin and stayed on Welbutrin because I had been in need of medication for years and it was a profound relief to not have to fight and struggle with myself every single day anymore.  I did not drink more alcohol to replace my smoking.  The smoking wasn’t what was keeping me from being an alcoholic.  These are things I KNOW.  These are not things anyone else can know to be true or untrue.  They can only speak for themselves.  I speak for myself.

My relationship with alcohol (until the hip-breaking watershed) was a happy part of life.  For the taste and the fun of imbibing with friends, it was always such a delicious and happy thing to stay up late drinking wine or drinking beer and talking politics or food or culture.  I didn’t have the same experience with alcohol that I did with cigarettes.  So I’m not willing to say of myself that it’s not possible for me to bring drinking back to that healthy place of enjoyment.  Not until I know that to be true for sure.

My Plan As Presented to my Psychiatrist:

On January 7th I want to start taking Antabuse.  I would like to take it for at least a month but up to three.  Why Antabuse?  Because disulfarim, when it interacts with alcohol in most people’s systems, makes you feel nauseous at the least but generally makes people vomit and feel wretched like they’ve gotten very very drunk.  I will do almost anything to avoid getting sick to my stomach.

While taking Antabuse I want to be exercising and working on my diet (just clean up the cheese habit and slim my portions down).

Not drinking will make it exponentially easier to get my metabolism moving again so I can lose weight.  Which I will if I’m not drinking and then eating enough to soak it all up so I don’t get drunk – I won’t even tell you how many calories a day that represents because, again, I don’t want to amaze you more than I have to.  If I lose enough weight to feel I’m making good progress then I’ll start having more faith in my ability to get the rest of my weight off.

Not drinking for 1-3 months will give me the chance to reset all my daily habits and my ability to sooth myself and deal with my depression without drinking.  I need a total reset.

I can’t think too far beyond that.  I can’t take Antabuse for too long of a period.  It’s not meant to be used like that.  I need it long enough to establish new habits, and to get the weight loss started.  If I can lose 20lbs I will have created enough momentum to self-motivate.

My psychiatrist thought my plan sounded good.  She made an appointment for me to see a substance abuse counselor to work with me on getting counseling and she was totally supportive of my desire to go with one-on-one counseling instead of doing group therapy.  So the next day I met with the counselor.

Which did not go well for me.  She immediately made it clear that she’s pretty anti-medication and she spent the whole time trying to sell me on group therapy as the only way to recover from substance abuse.  I told her the one thing I absolutely won’t do is go to AA.  I refuse to have to listen to people talking about God all the time (like they did in Nicotine Anonymous) and I have no one to ask forgiveness of but myself.  She told me about the non-religious-based group based on the AA model but without God.  But she talked about how the success of the programs are generally based on people being able to turn themselves over to a “higher power” and I could see how hard she was struggling to sell me on AA.  Who will my higher power be if I’m not spiritual?

I said that I don’t need a higher power to help me.  I need some therapy and guidance from professionals.  By coming in and asking for help I already admitted my own “helplessness” and was asking for help.  What more did she fucking want from me?  Basically she knows one model for helping people.  She didn’t know what to do with me.  She said that most people come to her because their lives are falling apart and they’re on the verge of losing jobs or spouses and it motivates them but here I am with a life that’s not falling apart – where was my motivation going to come from?

How about the fact that I want to vomit and cry every time I see my reflection of my body and it makes me want to drink to soothe those feelings of self-revulsion and then I drink and I feel so much better until the next morning when I realize that I have lost one more day to this awful cycle of self-perpetuating self loathing.

The fat makes me want to drink and the drink is keeping me fat.

The drink also keeps my inertia strong so that other things I might be doing to make myself feel better and get healthier (like exercise and being on a disciplined writing schedule) become exponentially more difficult to force myself to do.  I waste a lot of time on this shit.

The nights when I don’t drink (there have been a few) I ALWAYS feel good the next day – good about myself for not turning to beer and good about the fewer calories and stress on my liver – just really good.  But I can’t keep it up.  One night here or there but I can’t make it the  usual thing – which is why I need help.  I don’t need spiritual intervention – I need a total body and habit recalibration.  I need to make it impossible for me to drink long enough to retrain my body to function without it.  I need to make it impossible to drink for long enough to feel good about my progress and to establish new evening routines and tastes.

The more this counselor talked the less I felt I could put my journey in her hands.  She asked how long I’ve been drinking and I asked if she meant how long I’d been drinking unhealthy amounts or how long I’ve been drinking, period.  She wanted to know how long I’d been drinking, period.  I said “all of my adult life” which she indicated was not normal and an indication that it has always been a problem.  But, er, the majority of people I know have been drinking alcohol at least occasionally their whole adult lives.

Here’s what I got out of this meeting:

This counselor doesn’t approve of taking meds to help control substance abuse.

She believes in only one model for recovery.

She struggles even to sell the non-religious group therapy.

She sees my personality as a hindrance.

She said I was a “medication person” like it was a bad thing.

She seems to think I shouldn’t trust myself as much as I do.

She thinks quitting drinking may bring back cravings for cigarettes even though I assure her that the Welbutrin now serves the part of my brain that needed the chemicals in nicotine.

She doesn’t think my anxiety about meeting with groups of strangers is a problem if it doesn’t actually make me pass out.  (It’s more likely to make me drink)

Part of getting help is admitting weakness, sometimes admitting weakness makes us stronger

Nothing puts my back up faster than a total stranger deciding for me what I am and am not capable of.  The more this counselor inadvertently talked me out of getting help and told me what wasn’t good about my plan, the more connected I felt to that part of myself that knows my own strengths and that stands up for me when I feel very small.  I felt very small having to go to that appointment in the first place.  I felt gross and scabby and vulnerable in a way that makes me want to hurt myself.  When she started telling me all the problems with being a do-it-yourselfer type of person I began to see her weakness and my own strength.

I’m aware that this is a person who is skilled and experienced in dealing with people struggling with substance abuse.  I respect that she can make some strong generalizations about recovery and what most people find useful.  But the minute you see all substance abusers as the same people and assume that the addiction is the same for everyone – and that there is only one way to treat it – you become brittle and closed and you stop listening to people and when you do that you’ll lose them much faster.

We agreed that I have some serious trust issues.  I do.  I can’t disagree with that.  Forcing me to undress myself emotionally in a circle of strangers isn’t going to help that.  Every circle I’ve been forced into has reinforced how much they don’t work for me.  Hippie kids are used to being made to hold hands and say “ohm” and so I have been exposed to sharing-caring-circles my whole life and there are few things I hate more.

The thought of it fills me with dread even now as I’m typing this from the safety of my own home where there are no circles of STRANGERS SHARING SHIT WITH EACH OTHER.

It’s not sharing that’s my problem.  Obviously.  I’m a chronic over-sharer.  My problem is sitting in a room WITH strangers while sharing stories about how low we’ve gone and how helpless we are.  I share when I feel like it, on my terms, and in a way that I can still feel safe.  I already told a psychiatrist and a counselor that I’m pretty weak and in need of help.

The counselor wants me to say I’m helpless.  I don’t feel helpless.  I feel like I need support and guidance.  She thinks there’s no recovery without relinquishing all my illusions of strength to a higher being.  I just don’t believe that’s true for me.  I don’t believe that the only way to get help is to become (or admit to being) powerless.

So I’m having problems with the language around substance abuse.  The black and white lines the substance community draws.  It’s cultish.  I hate that now that I’ve gone to my psychiatrist and the substance abuse counselor I will always wear the scarlet letters for it on my forehead.


Because most people believe once you are one you will always be one.  Which suggests there’s really no real “recovery” about it.  “Recovery” suggests an illness with a cure.  But if being an alcoholic means you can never drink alcohol again in a safe and healthy way – how is that recovery?  Recovery suggests returning to the health you used to enjoy.  If the illness is not being able to stop drinking then the recovery should be about being able to drink again within healthy limitations.

I know, I am very very aware, that for some people the only real goal is to become sober permanently and I completely respect that.  I may even discover that this is true for me.  For some people sobriety feels so much better and healthier they choose it not necessarily because they have to but because they want to.  It’s possible I could discover that for myself too.  I don’t know yet.

I have, for most of my life, had a great deal of self discipline.  I am on an epic journey to rediscover this in myself because I lost it somewhere along the way.

I have also lost a certain level of trust in myself.  This is one the most terrifying things that’s happened as a result of the last several years.  I prize my trust in myself above almost all else – because it is the wheel from which I steer my life.  I trust myself to do the right thing, to make good choices and then to learn from the poor choices I make.  I trust myself to keep getting up off the floor every time something or someone knocks me down.  I KNOW I’ll get back up.  I trust myself to help others get up off the floor too, when they need my help.  I trust myself to be honest with myself.  I trust myself to learn the things that I need to learn even if it takes me longer than some other people.  I trust myself not to take myself too seriously.  I trust myself to ask for help when I need it.

To lose a good portion of that is terrifying because this relationship of trust I built with myself is how I got myself through my suicidal years and the nervous breakdown I had when I was 16 years old.  That’s how I got through it.  Inch by inch learning that no matter what anyone else might do to me – I can trust myself to take care of myself.

For me, the key to recovery, real recovery, is restoring my trust in myself.  To restore my trust in myself I must get support.  I can’t trust that I will not drink tomorrow night just because I say I won’t.  I can’t trust myself to go completely sober for a month, or three months, or for however long I need to be sober.  That’s why I sought help.  Because the one thing I know I need is to not drink for a while and it’s the one thing I know I can’t trust myself to do.

I know I can trust the threat of vomiting to keep me from drinking.  And because I’m motivated to stop drinking I know I can trust myself to take the Antabuse every day until I don’t need it.  It’s perfect.  I take pills in the morning.  That stuff has to get completely out of your system before the risk of alcohol making you violently sick goes away.  Which means that I can’t just give in and drink in the evening.  I would have to not take the pill for a couple of days.  But in the mornings I am most resolved to not drink and feel so good when I haven’t had any alcohol, I can trust myself to take that pill every morning.

So I have no confidence in my substance abuse counselor.  I dislike her for all the assumptions she made about me without knowing anything about me.  I dislike her inability to see me as an individual who may require an individual approach to my goals.

What she did for me was raise my fighting spirit high.  She brought out my strength for suggesting I don’t have any.  She woke the part of myself that will carry me through the finish line.  Perhaps that’s the only purpose she serves on this fresh adventure.


  1. NM says:

    I want to give you a hug. And that counselor a good, hard shaking. But yay for you, for coming out of it strong and determined, instead of ashamed and defeated. … You CAN trust yourself. Look at you, deciding you need help, seeking help, even though it’s horribly hard, and making plans that can work for you, because they’re based on your own needs and personality, and continuing to move forward with the process. That is taking care of yourself. Good for you!!

  2. angelina says:

    I wish I could hug you! I miss you so much! You are one of the very best things that came into my life by living in Oregon. (And you’re not a thing – such an awkward sentence!!!) Lunch at the library, jaunts to local food events, the Hillsborough farmer’s market! Oooh – and hanging out in your kitchen making rose water.

    I emailed my psychiatrist about that counselor and requested a new recommendation. I just hope she gets back to me before my birthday. She’s going on maternity leave soon. We’ll see.

  3. NM says:

    : P I accidentally called my brother’s new baby “it” recently … to him and his wife. Lucky for me, they were kind enough to not revoke my baby-holding privileges.
    I miss you and our adventures, too. Have a new toy; a soy milk maker! And just learned how to make almond milk. I must try roasting dandelion roots! Got as far as digging them up, and then left them in a bag in the garage for a month. I don’t recommend doing that.
    Looks like you have been having some neat adventures, too; the olive curing was especially interesting. I look forward to reading about more of them.
    Let’s hope you get a new referral soon, and that this one is a winner. Personally, I think having to slog through the finding of just the right expert to help with the problem is almost harder than the problem itself. But you can do it! Stay strong!

Leave a Reply

Your email address will not be published.