Pageiii

TheDualDisordersRecoveryBook
ATwelveStepprogramforthoseofuswithaddictionandanemotionalorpsychiatricillness
Whatweusedtobelike,whathappened,andwhatwearelikenow

HAZELDEN
INFORMATION&EDUCATIONALSERVICES

Pageiv

Hazelden
CenterCity,Minnesota550120176
1993byHazeldenFoundation.
Allrightsreserved.Published1993.PrintedintheUnitedStatesofAmerica.Noportionofthispublicationmaybereproducedinanymannerwithoutthewritten
permissionofthepublisher.
BookdesignbyTimothyQuinnMcIndoo
LibraryofCongressCataloginginPublicationData
TheDualDisordersRecoveryBook:ATwelveStepprogramfor
thoseofuswithaddictionandanemotionalorpsychiatricillness.
p.cm.
Adaptationof:TheTwelveSteps.
HazeldenT.p.verso.
ISBN:0894868497
1.DualdiagnosisPatientsRehabilitation.2.TwelveStepprograms.
I.Hazelden.II.TwelveSteps.
RC564.68.D8319939234149
616.86'0651dc20CIP
Thecharactersinthisbookarecompositesofmanyindividuals.Anysimilaritytoanyonepersonispurelycoincidental.
TheTwelveStepsarereprintedandadaptedwithpermissionofAlcoholicsAnonymousWorldServices,Inc.PermissiontoreprintandadapttheTwelveStepsdoes
notmeanthatAAhasreviewedorapprovedthecontentsofthispublication,northatAAagreeswiththeviewsexpressedherein.AAisaprogramofrecoveryfrom
alcoholismonlyuseoftheTwelveStepsinconnectionwithprogramsandactivitiesthatarepatternedafterAA,butthataddressotherproblems,doesnotimply
otherwise.
AlcoholicsAnonymoushasgenerouslygivenpermissiontousequotationsfromAlcoholicsAnonymous[alsocalled"TheBigBook"](NewYork:AAWorld
Services,Inc.,1976).

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CONTENTS
vii

Foreword
CardwellC.Nuckols,PH.D.
HowItWorks

1
Michael'sStory
MichaelJ.

2
HopeandHealing:AComprehensiveApproachtoDualDisorders
A.ScottWinter,M.D.

27

3
TheTwelveStepsandDualDisorders
AbrahamJ.Twerski,M.D.

44

4
WeAgnostics
GennaL.

55

5
RecoveryandRelapse
KateS.

63

6
AbstinenceandSobriety
KateS.

69

7
TellingOthers
JodyN.

73

8
TheStigmaofMentalIllness
JodyN.

89

9
TotheFamily
PaulaPhillips,M.A.,A.T.R.

102

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PersonalStories

Alan'sStory

111

Daile'sStory

118

Donna'sStory

123

Eric'sStory

131

Genna'sStory

135

Jay'sStory

144

Jody'sStory

152

Judy'sStory

170

Kate'sStory

183

Kathy'sStory

190

Raven'sStory

199

Roberta'sStory

202

Scott'sStory

211

Willie'sStory

213

DualRecoveryAnonymous

DualRecoveryAnonymous:ABlueprint
TimothyH.

221

DualRecoveryAnonymous:MeetingFormat

232

Resources

239

TheTwelveStepsofAlcoholicsAnonymous

241

Index

243

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FOREWORD
CardwellC.Nuckols,PH.D.
Thesubjectmatterofthisbookisoneofgreatimportancetome,personallyandprofessionally:Isufferfromthedualdisorderofaddictionandposttraumaticstress
disorder(PTSD).
Twentyyearsago,Ispenttimeinjailforseveralmarijuanamisdemeanors.Beinginjailinasouthernstateforadrugcrimeduringtheearlyseventieswastruly
unfortunate.Thejailersconsideredaddictsmoredeviousandcriminalthanmurderers.Forayoungmanraisedinarural,uppermiddleclassenvironment,my
experienceswereoverwhelming.Duringmyninemonthstay,Isawrapes,aknifing,andothercrimesthathorrifiedme.Foryearsaftermyrelease,Ihadrecurrent
nightmares.Iwouldnottalktoanyoneabouttheseexperiences,andIwasextremelyguardedandangry.Thisundiagnosedposttraumaticstressdisorderseverely
hamperedmyabilitytoenjoymyearlyrecoveryfromalcoholanddrugs.WorkingtheTwelveStepswasimportantandhelpful,butserenitywaselusive.Onlyafter
professionalmentalhealthcounselingwasIfreedfromtheshacklesofPTSD.NowIamfreelyenjoyingmyrecoveryformyself

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andwithmyfamily.Psychologyandselfhelphavebeenpowerfulalliesinmylife.
Manystudiesandstatisticshaveattemptedtoexplainwhyindividualswithalcoholismandotheraddictionssucceedinrecoveringandwhyothersfail.Thestudiesand
thestatisticsmaybedifficulttounderstand,buttheydocumentthelivesofmanywhostrugglewiththedisordersofalcoholismandotherdrugaddiction.
InmanyAlcoholicsAnonymousmeetingsovertheyears,IhaveheardthatonethirdofthosewhojoinAAgetbetteralmostimmediately.Theyseemtobeableto
recoversimplybyworkingtheTwelveStepprogram.Anotherthirdstruggle,oftenforyears,beforerecoverybecomestheirs.Thesepeoplemayhavedifficultiesfor
manyreasons,butultimatelytheygraspAA'sprogram.Anotherthirdrarelyseemtorecover,althoughtheymaysincerelystrivetoworkanhonestprogramof
recovery.Despitetheirgraveandpainfulattempts,recoveryeludesthem.
"TheBigBook"ofAlcoholicsAnonymousdescribestheseindividualsinthefollowingpassage:"Thosewhodonotrecoverarepeoplewhocannotorwillnot
completelygivethemselvestothissimpleprogram,usuallymenandwomenwhoareconstitutionallyincapableofbeinghonestwiththemselves.Therearesuch
unfortunates.Theyarenotatfaulttheyseemtohavebeenbornthatway.Theyarenaturallyincapableofgraspinganddevelopingamanneroflivingwhichdemands
rigoroushonesty.Theirchancesarelessthanaverage.Therearethose,too,whosufferfromgraveemotionalandmentaldisorders,butmanyofthemdorecoverif
theyhavethecapacitytobehonest."*Thisonethirdof
*AlcoholicsAnonymous[alsocalled"TheBigBook"](NewYork:AAWorldServices,Inc.,1976),58.AllquotationsfromAlcoholicsAnonymousarereprintedwithpermissionof
AAWorldServices,Inc.

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individualssufferingfromalcoholismwhorepeatedlyfailseemtohaveacharacterdisorderorothersignificantpsychiatricproblems.Theyhavedualdisorders,and
theyseemtobeincapableofgraspingthisprogramofrecovery.
Ioftenwonderaboutthisfailure.Aretheseindividualsunableorunwillingtorecover?Inmyexperience,I'vefoundthattheyareinnowayunwilling.Overtheyears
Ihavewitnessedthedesperatestrugglesofindividualswithalcoholanddrugproblemswhohavegonefrompsychiatrictreatmenttoalcoholanddrugdetoxcenters
andthenbackagaintomentalhealthtreatmentprograms.Ihaveseentheirwillingnesstotryseveralkindsoftreatmentandhaveempathizedwiththeirpain,frustration,
andfailure.Typicallytheyarenotunwillingrather,theyareoftenunabletoworktheprogrambecauseofpsychiatricproblemsthatcoexistwiththealcoholismorother
drugaddiction.
BillW.,founderofAA,sufferedfromdepressionsosevereastomakehimbedriddenattimes.Hismoodscouldswayfromdespairtoextremeoptimism.Duringthe
mid1940s,hisdepressiondeepenedhewasseldomfreeofdespairingmoodsandsawpsychiatristsonaregularbasis.Butthroughoutthistime,BillW.wasableto
findlastingandsuccessfulrecoveryfromalcoholismintheprogramthatheandDr.Bobinspired.
FromtheearliesthistoryofAlcoholicsAnonymous,arelationshiphasexistedbetweenpsychiatry,psychology,andAA.TheAAterm"spiritualconversion"thatis,
thepointwheregrandiosityanddefiancegivewaytoaninnersenseofharmonyandconnectednessfirstappearedinaletterBillW.receivedfromthefamous
psychoanalystCarlJung.Discussinganindividualwithalcoholismwho,inspiteofthegreatesteffort,couldnotseemtorecover,Jungcredited

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theperson'seventualrecoverytoaconversionofthespiritualkind.Thisletterfirstdocumentedthepotentialforasuccessfulmarriagebetweenmedicine,psychiatry,
andwhatwouldeventuallybecometheselfhelpmovement.
Don'tbediscouragedifyousufferfromalcoholismordrugaddictionandanotherdisordersuchasanxiety,depression,personalitydisorder,orschizophrenia.Many
peoplewithdualdisordershavebeenabletoworkaTwelveStepprogramthathasgreatlyassistedtheirrecovery.Othershavefoundlastingandserenerecoveryin
AAwiththehelpofcounselors,psychiatrists,and,sometimes,medications.
Iamfortunatetoworkwithindividualssufferingfromalcoholismandotheraddictions.Whereelsecouldoneseethemarvelousanddramatictransformationsofearly
recovery?Thesegreatchangesseemlittleshortofmiraculous.Foreighteenyears,practicingmyprofessionhasbeenatruelaboroflove.Forthepasttwelveyears,
workingwithotherswhohavedualdisordershasbroughtmegreatchallengeandhope.Thosewithdualdisordersneednotfail!
IrememberLenny,ayoungschizophrenicwhowasaddictedtoalcohol,marijuana,andheroin.Hehadenduredcountlessunsuccessfultreatments.Overandover,he
waseitherdetoxedandputbackonthestreetorelsesenttoapsychiatriccrisisstabilizationunitforlargedosesofmedication.Neverwashetreatedforboth
problemsatthesametime.
Individualswithdualdisordersmustbegivenintegratedchemicaldependencyandpsychiatrictreatment,treatmentwithintegrity,andtremendousunderstanding.
Althoughsometimesdifficulttolove,Lennyneededlovemorethanmost.UltimatelyhefoundthefamilyhesodesperatelyneededthemembersofanAAclubhouse.
Hissponsorhelpedhimstaycleanandencouragedhimtokeeptakinghismedication.

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Lennyhasmultiplechronicillnessesalcoholismandotherdrugdisordersplusschizophrenia.Hewillbealcoholic,drugaddicted,andschizophrenicforlife.These
problemsdonotgoaway.TosaythatLennyisinrecoveryistosaythathisschizophreniaisstable,orthathehas"compensated."Heremainsfreeofalcoholand
drugsonedayatatime.Lenny'sattendanceatselfhelpmeetingsandhispsychiatrictreatment,includingmedication,areawinningcombination.Henowhasperiods
ofserenity.Isn'tthatthegoalofselfhelpandtreatment?Momentswhenheavendescends?
Whenrelationshipswithpeopleareestablished,andwhencontroloverthealcohol,drugs,andpsychiatricdisordersisgivenup,helpbecomespossible.Asinthecase
ofLennyandsomanylikeus,itisasimple,concreteTwelveStepprogramthatbroughtmeaningtoourlives.
IrememberMargaret,atwentynineyearoldincestsurvivorwhohadenduredanextremelytraumaticchildhood.Shewasaddictedtococaineandalcoholandhad
aneatingdisorder.Margaretalsosufferedfromborderlinepersonalitydisorderheridentitywassoseverelydisturbed,shedidnotknowwhoshewas.Shesuffered
fromdepressionandhadattemptedsuicideonseveraloccasionsherwristswereproofoftheseattempts.Heradultlifehadbeenalongseriesofbadrelationships.
Nomatterhowshetried,Margaretcouldnotstayoutofharmfulrelationships.Shewouldgotoaselfhelpmeetingandimmediatelyfallinlovewiththeunhealthiest
individualthere.Typically,sobrietyforMargaretandherpartnerwouldlastbetweentwohoursandtwoweeks.
WhatMargaretneededsobadlywasaprotectiveparenthermotherwasanalcoholicandherfatherhadabandonedher.Shehadneverknownanyoneshecould
trustandwho

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couldbecountedontohelpher,atleastnotuntilshebeganworkingwithtwospecialpeopleatherapistandasponsor.Hertherapist,whowastrustworthy,helped
herdiscoverherself.Hersponsor,arecoveringalcoholicwhohadonceattemptedsuicide,wasavailabletoMargaretandkeptherawayfromrelationshipsthathad
destroyedherrecoveryinthepast.HersponsorbecametheparentthatMargarethadneverhad.Hereagainisthepowerofconnectionandthepowerofmutualhelp.
Oursistrulyaprogramofhopeandopportunity.
IrecentlyreflectedonatermthatIhaveusedovertheyears:homegroup.Thedictionarysayshomeis''aplaceoforigin,''whereoneis"ateaseorinharmonywith
thesurroundings"onfamiliarground.Groupmeans"twoormorefiguresformingacompleteunit"or"anumberofindividualsassembledtogetherhavingsome
unifyingrelationship."Thehomegroupisapowerfulpartoftheprescriptionfortheindividualwithadualdisorder.
Addictionsandpsychiatricoremotionaldisorders(anxiety,depression,personalitydisorder,andschizophrenia)havemanythingsincommon.Botharepredictable
andtreatable,andbothhavesignsanddocumentableprogressions.Therapists,doctors,andmedicationsmaybeveryimportantforsomewhosufferfromdual
disorders,butthesemethodsworkbestwhentheindividualisconnectedtoaharmonioussurrounding,thatspecialplacethatreallyisahomeforrecoverythehome
group.
MostpeoplewithalcoholandaddictionproblemscomeintoTwelveStepprogramsasloners,rebels,andpessimists.Asloners,wehavedifficultyfittingin.Asrebels,
weneverwanttolookbadinfrontofagroup.Aspessimists,webelieverecoverycanneverhappentous.Theindividualwith

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apsychiatricoremotionaldisorderhasgreatreasontobepessimistic.Wehavefrequentlybeenmistreatedbythosewetrusted.Wecanfeellonelybecauseoftenwe
justdon'tseemtofitin.Butwhenmedicalscienceisintegratedwiththeprogramdiscussedandwitnessedinthisbook,themiracleofrecoverybecomesmorepossible
thanever.
Ibelievetwothingstobetrue:TheTwelveStepprogramsavedmylife,andpsychotherapyandprescribedmedicationcannotreplacetheneedforagroup,whichcan
becomeahavenorahome.Buttogether,medicine,medicalresearch,therapy,andselfhelpoffergreathopetothoseofuswhohavetriedandfailedontheseparate
pathsofselfhelportreatment.
Pleaseopenyourheartandyourmindtothefollowingchapters.Readcarefullythestrugglesofthosemenandwomenwhoseliveshavebeenremarkablychanged
throughtheirwillingnesstoworktheTwelveStepprogramandtoseekprofessionalhelp.
MayGodblessyouandyourrecovery.

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HOWITWORKS
Therearethose,too,whosufferfromgraveemotionalandmentaldisorders,butmanyofthemdorecoveriftheyhavethecapacitytobehonest.
ALCOHOLICSANONYMOUS

Page3

1
Michael'sStory
MichaelJ.
WhatItWasLike:ThePerfectBoy
Iwastheboymostlikelytosucceed.Iwastheperfectkidinaperfectfamily,butmyperfectfamilyandIwere,inreality,somethingotherthanperfect.
MymotherhadherfirstpsychoticbreakparanoidschizophreniawhenIwastwo,andshewasinandoutofmentalhospitalsforthenextthreedecades.Thiswas
beforeantipsychoticdrugs,andshewassubjectedtoelectricshocktreatment,water(torture)treatment,andotherenlightenedtherapies.Shecouldnotgivemelove
andinsteadalternatelyterrorizedandabandonedme.Myscantmemoriesofherincludehernonpsychoticstate,whenshecompulsivelywatchedmyeverymoveto
makecertainIcleanedupaftermyself.
Recently,Irecognizedthatperhapsevenmoresignificantthanmymother'sinsanitywasthesimplefactthatshedidnotlovemeorreallywantmeinthefirstplace.A
politicalactivistbeforeherinsanity,sheranforaseatonthecitycouncilwhileshewaspregnantwithme.Tohercredit,she

Page4

wasthefirstwomantobeelectedtothatpositioninmyhometown.ButIwasaninterruption,abother.WhenIwasababyandtoddler,Iwasfrequentlyleftalone.
I'mtoldthatonetime,thefamilydogandIwandereddowntownandweregoneforsometime.Finally,someonewhorecognizedmebroughtmehomeandlectured
mymotherwhoevidentlyhadnotknownIwasmissing.
FromthetimeIwastwo,mymother'sinsanitydominatedourhome.Shewasseldomphysicallyviolent,buttheatmosphereofangerandviolencesurroundedour
homelikeacloud,andsometimesIhuddledinmybedandwentintospaceinmyheadratherthanhearthescreamingmyparentsscreamingatoneanother,my
sistersscreamingatoneanother,ormymotherormyoldestsisterscreamingatme.Andsometimestherewasphysicalviolence.Mysisterremembers,butIdon't,my
motherbreakingawoodenspoonovermeasateenager,beatingmebecauseIwouldn'tbringmydirtygymsockshometobewashed.
Mymother'sillnesswasafamilysecret,nevertobediscussed.
Myfather,ontheotherhand,lovedme.Unfortunately,hislovewascontrollingandsometimesviolent.Igrewupunderhisthumbthefeelingwasmorelikegrowing
upinapressurecooker.Ihadnoalternativebuttobeperfect(andtobeadoctorlikehim).WhenIwasingrammarschool,hewouldgivemeadollarforeveryA
thatIgotbuttakeawaytwodollarsforanyB.IwouldnothavedaredcomehomewithaC.Helectured,cajoled,manipulated,andfinallyorderedmetoskipeighth
grade,inordertobetterpositionmeforthescholarshipIwouldeventuallywin.HebrowbeatmeintoskippingmyfourthyearofcollegesothatIwouldmovemore
quicklyintothesuccessfulcareerinmedicinehehad

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plannedforme.Ultimately,Iwassupposedtomovebacktomyhometownandtakeoverhispracticeafterheretired.
Dadwasabelovedtowndoctor,buthewassadistictowardhiskids.Herubbedmylipswithhotchilipepperstoseemyreaction.Myreactionwasfearandtears,of
course.Hehitmefrequently,andifIprotestedinpain,hewouldsayitwashiswayofshowingmeaffection,proudlyaddingthatheneverhitmeinanger.
WhenIwasperhapsthirteen,heshotmewithashotguninahuntingaccident.Iscreamed,stungphysicallyandemotionally.Someshotgunpelletshadpenetratedmy
hand,andtherewasatrickleofblood.EvidentlymyfatherthoughtIwaslyingorbeinga"whiner"again.Hedidn'tcometocheckoutmywoundbutyelledatmefrom
adistancetogobacktothecarandwaitforhimtofinishhuntingthehill.Hewasangrywithmeforbeinginthewayofhisshotatthequail.Healwayswantedto
toughenmeup.
TherewasalwayssomethingwrongwithmeIwasalazy,stupidkid,nevergoodenough.
Whilemymothermodeledparanoia,myfathertaughtittomedirectly:TheworldwasfullofNazis,hetoldme.Nearlyeveryonewasafascistunderneath,andwe'd
betterwatchout.Ihadtolearntoprotectmyselfandbesafe.Thewaytobesafewastolearntoshootashotgunandbeadoctor.
Butstrangelyenough,myfatheralsoshowedmethemostloveandkindnessIwastoreceiveasayoungchild.Ihaveapictureofhimholdingmyhandandhelpingme
learntoswimwhenIwasfouryearsold.
ThemostlovingcareIreceivedwaswhenIwasverysick.OneofthefewgoodmemoriesIhaveofmychildhoodisofwhenIhadpolio.Iwasinthepoliowardata
hospitalwithotherboys.Weplayedtogetherandweretreatedwith

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wonderfultendernessandtolerancebythenursesthere.Irecoveredquicklyandcompletely.Ilearnedthatbeingsickandunhealthywasmyonlyhopeofbeingloved
andcaredfor.Thiswastrainingmetolatertakeontheroleofthevictimtobethesmoker,thepsychotic,theidentified"sick"person.
ButinmyyouthIwas"perfect."Theperfectsonwas,infact,perfectlydissociatedthatis,Ihadnosenseofmyownfeelings,nosenseofmyself.Mylifewasa
performance,theobjectbeingtosurvive,withoutmyevenunderstandingthatIwasperforming.Ilivedinvariousstatesoffearwithoutrealizingit.Ihidfrommy
motherandmyviolentoldestsister,andIwouldnotmakeanymistakemyfatherorsiblingsmightcatch.Isteeledmyselfphysicallyandemotionally.Forme,
everythingwasalwaysokay.Whateveritwas,Icouldhandleit.IshovedtheselfhatredandterrorsofardownIhadnoideaitexisted.
Iachieved.IwashighschoolstudentbodypresidentandanearlystraightAstudent(IwasdistraughtwhenIreceivedoneBinhighschool),anallaroundathlete,and
winnerofthescholarshipmyfatherhadwantedmetoget.Iwentontoamajoruniversity,becameengagedtoabeautifulyoungwoman,andwasacceptedtoamajor
medicalschoolafterjustthreeyearsattheuniversity.
Butlivingoutmyfather'sscriptformylifeslowlybegantotakeitstoll.IncollegeItriedtogowild,withoutactuallydoingso.Ipartied,smokedmarijuana,sometimes
drankmyselfintoastupor,tookcoursesinwritingandliteratureinsteadofbiology.Butmycompulsiveachievementheldsway,andmygradeaveragesweregood
enoughtogetmeintomedicalschool.
Whileinmedicalschool,Ibecametorn.Theacademicpressuresofmedicalschoolhadcombinedwiththestressof

Page7

thelate1960sthesocialupheavalandangeragainstthewarinVietnam.Ibegantoboilwithrageatanunjustworld.Ihaddreamsaboutshootingoldermen
presidentsandgeneralsinvolvedinVietnam,mysymbolofinjusticeintheworld.Ibrokeupwithmyfianceinrebellionagainstbeingasettled,stableperson.I
couldn'tstanduptomyfatherIdidn'tevenfeelangertowardhim.IbelievedheknewbestandthatIshoulddowhathewanted.Itwasformyowngood,afterall.
ButIhadthegrowingfeelingthatsomethingwaswrong:Iwasnotlivingmyownlife.
Inmysecondyearofmedicalschool,atagetwentytwo,aftermonthsoftormentandonesemiseriousattemptatsuicidebywayofsleepingpills,Idroppedoutto
joinahippiegroupandtravelaroundtheworld.AftertakingtoomanydrugsinKathmandu,Nepal,Ibrokeintohallucinatingpsychosis.Selfhatredandfearburstout
ofmeandintotheair,becomingtheywhowantedtoconsumemeandturnmeintoazombie,awalkingdeadman.TheywereagiantconspiracyledbytheHindu
goddessKaliandtheinnumerabledemons,spirits,andhumanbeingswhofollowedher.Kali,thefierygoddessofdestruction,worehumanskullsasanecklaceand
dancedonthebodiesofthepeopleshedestroyed.Ihadtobeconstantlyalert,orthevoicesintheairwouldinvademeandtakeovermysoul.Mydaysandnights
wereaconstantstruggleagainstthesedemons:Icouldn'tmove,Icouldn'tspeak,withouttheactionsomehowbecomingpartofthebattleformysoul.
Thestrugglewasmostlytelepathic:IthoughtmostpeoplecouldhearmythoughtsandIcouldheartheirs.Atnight,Ilayawakefighting,struggling,screamingatthemin
mymindtofendthemoff.
ButIwasalone,andtheywereeverywhere,andeveryoneI

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knewseemedtoknowaboutitbutforsomereasoneitherdidn'tcareorwerealliesofKaliandherdemons.
IcouldnottalkaboutthisconspiracytodestroymeitwasanothersecretIhadtokeep.WhileinKathmandu,Iengagedtheinnerdemonsmoreandtheouterworld
less.MytravelcompanionssawmedisintegratingandcoulddonothingformeotherthansuggestIgobacktotheStates.IbecamelessandlesscoherentasIspoke
outloudtothedemonsinthespeciallanguageoftheconspiracy.(Today,whenIwalkbyahomelesspersononthestreetsengagedinavocalstrugglewithinvisible
adversaries,Ifeelastrangemixtureofsadness,fear,andgratitude.)
IlivedinaroominabuildingownedbyaTibetanfamilywholivedintheroomsnexttome.MyTibetanlandlordawonderfulmansawthatIwasintroubleand
decidedthatImustbepossessed.Athisownexpense,hehiredaTibetanmonktotrytoexorcisemydemons.ThemonkandIsatinmyroomandchantedallday.I
hadsomehope,butwhenthemonkleft,thedemonsremained.
ItriedtoalleviatetheterrorwithallthedrugsIcouldgetmyhandson.Itookmethamphetamine(speed)towakeupandfeelbetter,andItookbarbituratestosleep.I
smokedhashishtosmoothoutthespeed.Itookopium,LSD,andcocainewhenIcould.DyingofdrugsanddiseaseinKathmanduwasthefateofmanyyoung
peopleinthoseyears,andIwasalmostoneofthem.PeoplesaidthatIlookedlikeawalkingskull.Icalledmyfather,andhebailedmeoutwithaplaneticketbackto
theStates.
Ididn'trealizethevoicesweredelusionsuntiloneday,monthslaterinCalifornia,Iheardmycousinandherhusbandtobetapingacassettetosendasavoiceletter
tofriends.Iknewtheyweretalkingaboutme,usingthespecial

Page9

TibetanEnglishNepaleselingoIknewpeopleusedbehindmyback.Ilatersneakedintotheroom,listenedtothetape,anddiscoveredtheyweretalkingabout
nothingmoreseriousthantheweather.IdecidedsomethingwaswrongwithmeandthatmaybeIneededtreatment.
AcountypsychiatristwhovisitedmyhometownonceaweeksaidIwasachemicallyinducedschizophrenicandgavemeStelazine,anantipsychoticsimilarto
Thorazine.Ivisitedhimafewtimes,thenstopped.Ithinkhewasakindmanbuthadlittleexperiencewithtreatingsomeoneheprobablythoughtofasa"burnedout
hippie."Iwashallucinatingandprobablyshouldhavebeeninintensivetreatment.OursessionswereawkwardIbecameuncomfortableenoughnottocontinueseeing
himbutIdidcontinuetakingtheStelazine.
ThenextfewyearswerenightmarishasIstruggledwiththevoicesandreceivednoothertreatmentwiththeexceptionofmyfatheryellingatme,tellingmeIhad
ruinedmystupidlifeandifonlyIhadlistenedtohim....Ilivedinisolation,onguardagainstthedemons.Asthevoicessubsided,Igrewmoremiserablethanever.I
wrotepoemsandcalledmycousintoreadthemtoherandlamentmylifeand,blessher,shelistenedtome.Iboughtahandgunandperiodicallyplayedwithit,
loaded,sometimesholdingittomytemple.Iusedfoodanddrugssuchasmarijuana,heroin,andbarbituratestotrytodullthepain.Ihadgainedaboutsixtyfive
poundsonjunkfood.Eatingcannedsoupandbolognasandwiches,Idevelopedanutritionaldisorder,anerveparalysisofmyfacethattookweeksofvitaminsto
cure.
Iwasfunctionalenoughtoholdeasyjobs,andeventuallyIimprovedenoughtogetajobasaninsuranceagent.Inanewenvironmentwithnewhope,Igotcleanfrom
most

Page10

drugs.IhadevenstoppedtheStelazine,butIstillusedmarijuanaandValium.Overthecourseofthreeyears,IthoughtIwascuredandhadanewlife.
Mynewlifeandcareerweretobeshortlived,however.Underthestressofaconflictwithafriendwhowasalsomyboss,Ihadafullrelapse.Thedemonspursued
meagain.SometimesI'dgetupinthemiddleofthenightanddriveahundredmilestotrytolosethem.
AtleastIhadenoughsensetoseekhelp,andsoonIwasinacountyrundaytreatmentcenterasapermanentlydisabledchronicparanoidschizophrenic.Thedoctor
toldmeIwouldneverworkagainandanormallifewasoutofthequestion.ThestaffhelpedmeapplyforandgetSocialSecurityDisability(SSD).Friendshadleftin
tearsafterwatchingmedisintegrateIhadnoideawhytheywerecrying.
ThedoctorprescribedthreetimesthedosageofStelazineIhadtakenbefore.Thedosagemademestiff,blurredmyvision,andfeltlikeananchoronmybrain,butat
leastitquietedthevoices.Beyondthemedication,Ibelieveitwasthegentlekindnessofanurse,Louise,andthesafetyofthedaytreatmentenvironmentthatsaved
mylife.Louisesatonthecouch,toldmetolieonmyback,andputmyheadinherlap.Shestrokedmyforehead,soothingmyburningmind.Shetalkedgentlyto
meIhaven'ttheslightestmemoryofwhatshesaid,butIheardthatIwasokay.Ibelievethishelpedmorethananygrouptherapyorindividualanalysis.
Onceagainthevoicessubsided,thistimeafteronlyseveralmonths.AsIsettleddown,IdetoxeddowntoalowdosageofStelazineandwasdischargedfromthe
clinic.
Comingoutofthissecondandfinalpsychoticbreak,Ibegantopourmyselfintopoliticalactivism.Itwasawoman

Page11

namedLindawhobroughtmetothiswork.Lindalikedmeandwantedmetoworkonapoliticalcampaign.SoonIwasmanagingthecampaign,writingpamphlets
andcampaignliterature,andappearingonradioandtelevision.Icameoutofthepsychosislikeashootingstar.Ihadnothingbuttimeonmyhands,mybrainstouse,
andnewinterests(Lindaandapoliticalcause)inlife.Ibecameahero,becauseLindabelievedIcouldbeahero.Iwasridinghigh.(Iwas''over''myillnessexcept
thatIstilltooklowdosesofStelazine,andIdetoxedentirelyseveralyearslater.)Iwasinloveandachievingremarkablethings.Iwasasuccessstoryonceagain.
Butfindingloveandpurposeonlyinexternalandfemaleform,Iwouldcomebackdownthepathofdepressionandaddiction.Thoughafriendtothisday,Linda
movedon.Iturnedtootherpoliticalworkandothershorttermrelationships.
EventuallyIfoundmyselfworkingfourteenhoursadayormoreinapoliticalcultthatdemandedmylifeandinreturngavemeregular,severecriticismaboutmy
numerousshortcomings.Thecriticismsessionsweresupposedtostrengthenmeforthestruggleagainstthefascists.Theywantedtotoughenmeup.Thiswasfamiliar
abuse,ofcourse.Itfeltjustlikehometome,andmynewcompatriotsevenremarkedthatIwaslikeafishintherightwater.Icontinuedthedroptowardoblivion.
Ifawomanshowedinterestinme,we'dbeinstantlydeepintowhatwouldturnouttobeashortlivedrelationship.Ididn'tknowit,butIwasafraidthatanyserious
relationshipwouldconsumeanddestroymeinarepetitionofmyearliestintimaterelationshipswithmyparents.SoIpretendedatintimacy,andwhenthingsgottoo
closeandIcouldn'tpretendanymore,Ifoundawayout.

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Myterrorofintimacyshowedupasaneedtocontrolandmanipulate.IfIwasincontrolandwasneverhonestaboutmyneedsandwants,Iwasn'tvulnerableorso
wenttheillusion.Myrelationshipswithwomenwerecharacterizedbythefeelingofresponsibilityfortheirlives,guiltifanythingwentwrong,longingforthemtotake
careofmeandfixme,andtheneedtoanalyzetheirproblemsandhealthem.Ihadmanyrelationships,andwhiletheywerenotabusive,theywereshortandoften
stormy,endinginmeaninglessarguments.Iwasdeathlyafraidofbeingclose,whileatthesametime,Idesperatelywantedtobelovedandfixed.
Myrelationshipswithmenwerecharacterizedbyfear,distrust,anddistance,withtheexceptionofafewfriendswhoevidentlydidnotremindmeofmyfather.Ihad
manymale"buddies,"andIrelatedwellinsportsandgames,butifeveramanbecameanauthorityfiguretome,Ihatedhimandwantedoutasfastaspossible.Thisis
whathadhappenedwithmyfriendandbossintheinsurancebusiness.
Inallrelationshipswasthespecterofpsychosis.TobeclosemeantthatImightbesubjectedtostress,andstressmeantthatImightlosemymindagain.
Forme,lifebecameastringoffixes.Thepoliticalworkitselfhadbecomeafix:PerhapsIcouldmakeupforbeinganawfulpersonbysavingtheworldfromallits
injusticeandcruelty.Whennotworking,Iwaseating,smokingdope,orlosingmyselfinthetelevisionset.WhenIcould,Iusedprescriptiondrugsornarcotics.
Afterseveralyearsoftryingtofixmywayaroundlife,Iwasfeelingtheadventofanearlydeath.Iwasatleastsixtypoundsoverweightandgoingupthescale.Iwas
ontwohighbloodpressuremedicationsandhavingoccasionalheartarrhythmiassmokingfourpacksofcigarettesaday

Page13

usingwhateverdrugswereavailableandworkingfourteenhoursmostdays.Iwasdeeplyunhappyandlonelyworkinginthemidstofapoliticalcommunityallday
long.Iwasabasketcaselookingforabasket.
AfteraparticularlymiserableandlonelyholidayseasonIhadtoworkconstantlyforthepoliticalgroupanddevelopedanarrhythmiathatwasfrighteningtomeand
difficultforthedoctorstostopIdroppedoutofthecultandretreatedtomyparents'home.Iwastherealonewhiletheywereonanextendedretirementvacation.I
shotmorphineforacoupleofmonthsbutthenranoutofitandmoney.
WhatHappened:ReachingBottom
Atthattime,Ithoughtofmyselfasacrazy,fatallyflawedperson,amonsterandafailurewhocouldn'tevenmakeupforbeingamiserablepersonbydoinggood
politicalwork.InowunderstandthingsaboutmylifethatIcouldn'thaveknownearlier.Foronething,my"paranoidschizophrenia"wasamisdiagnosis.AsI
understanditnow,IsufferedfromPTSD(posttraumaticstressdisorder).Likeawarveteran,Ihadbeensubjectedtoprolongedtraumaandnotallowedtowork
throughthefeelingsresultingfromthetrauma.ThetraumastartedwhenIwastwo,withmymother'spsychosisitcontinuedthroughoutmyentirechildhoodwiththe
emotionalviolenceandcrueltyinourhomeandIwasallowedneithertoshow"bad"feelingsnordiscussanyofthem.Therewasnoshouldertocryon,nosafeplace.
Asayoungadultawayfromhome,Iblewupandfellapart,andmypsychosisresembledparanoidschizophrenia.Myparanoiddelusionsweren'tthefantastic
inventionofabiochemicalimbalance.Theyweretheexternalizedexpressionofthe

Page14

innerworldIhadlearnedasachild.Theworldwasanevilplacethatwantedtodestroyme,andIwasastupidmonsterthattheworldwouldrightlydestroyifitfound
meout.Thedemonshadexplodedoutofmycoreintotheworld.DrugssuchasLSDhelpedcatalyzethisexplosion,butIhadbeenatimebombwaitingtoblowup.
Similarly,mychronicandsometimessuicidaldepressionwasn'tageneticflawofsomesort.Depressiondidn't"runinthemeninourfamily,"asamalecousinputit.It
may,however,haveruninourfamilysystem.Ifeltawfulalmostallthetime,becausemylifehadbeenawful.Inmychildhood,Ihadtakentoomanydosesof
unprocessedabandonment,fear,andcrueltyconsequentlymyadultlifewascomposedlargelyofinsanity,dysfunction,andaddiction.Theremayhavebeen
biochemicalchangesinmybrainrelatingtodepression,butifso,Ibelievethechangesweretheresults,notthecause,oflongtermemotionaltrauma.Iremember
beingeightyearsold,hearingmymotherandfatherscreamateachother,watchingmyoldersistersfightlikecatsanddogs,hidinginfear,knowingthatatsomepoint
alltheragewouldcomemyway.Irememberthinking,"Whyisanyonealive?Thisisnofun.Idon'twanttobealive."Andthatwasperhapsmyaverageday.My
depressionwasasortofchronic,deepdespair:Itwasmylegitimateresponsetoamiserablelifeexperienceandtodecadesofrepressedanger,fear,andsadness
aboutthatexperience.
Sittinginmyparents'house,though,droppingoutforthesecondtimefromwhatIthoughtwasmylife'swork,Iknewnoneofthis.Instead,Ifixatedonasinglerefrain:
Ihavenopermanenthome,nojoborprospectsforwork,nocar,nomoney,nofriends,nosignificantrelationships.Ihadtakenstrikethree:Therewasnothingleft.
Mylifewasover.

Page15

Withthemorphinegone,Iwassickwithbodyaches,stomachpains,headaches,andanosethatwouldn'tstoprunning.Iwantedtodisappearandreversemybirth,
wipeoutthefactthatIhadeverexisted,butIwasunwillingtoactuallytakemyownlife.Idon'tknowexactlywhyIwasunwilling.Icansaythatthroughoutmylife,
evenintheworsttimes,therewasapartofmethatlongedforlife,longedtoreachoutandconnectwithsomethingreal.Ihadwrittenpoemsandcalledmycousin
insteadofusingthegun.Insteadofdrivingoveracliff,Ihadallowedthenurse,Louise,toreachme.Somehow,Ijustwasn'tdoneyet.
Istillhadmytypewriter.Istartedwritingagain.IwroteapoemaboutwishingI'dhadamother.Writingandredraftingthatpoem,onedayIstartedtocrythefirst
flowoftearsinmyadultlife.Istartedtotouchmygriefformylostlife.Somewhereatthebottomofthatgrief,deepinside,therewashopeandagrowingsparkofwill
tolive.
Inowbelievethiswasthebeginningofmyopeningtomyselfandtosomethinggreaterthanmyself.Iwasbrokenenoughtobegindroppingmywallstomyowngrief
andtoapowerthathadbeenrestingatthebottomofmybeing.
Atthetime,however,Iwasn'tabletorecognizethesourceofmystrength.AsIstartedfeelingbetter,allIknewwasthatIwantedanothershotatlife.Asagoodchild
ofmyfamily,Iputawaythosesilly,unproductivefeelingsofgrief.Afterall,IhadmybrainsandIcouldgetaloan.Imovedoutofmyparents'hometolivewiththe
samegenerouscousinanddearfriendwhohadhelpedmeinthepast.Iboughtacomputer,createdflyers,andcalledmyselfacomputerconsultant.
Overthecourseofthreeyears,Ilandedincreasinglybetterjobs,didgoodwork,andstartedmakingadecentliving.I

Page16

evenfoundmyselfinasignificantrelationship.Sheboughtahome,andImovedtolivewithher.
Afterburningoutonnearlyadecadeoftryingtosavetheworld,Istartedinsteadtolookforanswersaboutmyownlife.Iwaslivingamongpeoplewhopracticedone
formoranotherofspirituality,andIfoundmyselfdrawntoward"innerwork"andspiritualexploration.Icouldn'tbelieveinananthropomorphic,JudeoChristianGod,
butIwasdrawntowardotherpractices:IwenttothewoodswithRobertBlyandthemen'smovementIstudiedtheworksofJosephCampbellIdancedtheSpiral
DancewiththosewhohonoredtheGoddessandtheearthItookinnerjourneysinshamancircles,boughtadrum,andcollectedsmall,preciousobjects.Igained
somethingspecialfromeachofthesepracticesasIjoinedothersreachingforthetruth,reachingtowardthemystery,andIbegantoperceivethattherewasmoreto
theuniversethanthematerialworld.Inolongeruseddrugsandhadgivenupcigarettes,butthefoodaddictionwasgettingmuchworse:Iwasuptoperhaps300
pounds.IhadstoppedweighingmyselfwhenIreached292pounds.
Somethingwasmissing.Icouldn'thavesaiditmyselfandwouldhavearguedwithanyonewhohad,butdespitemynewspiritualpractice,Iwasstillavoidingmylife.
MyinnerworkwasnotyetgenuineIwasstillseekingtheanswersintheexperiences,ideas,andfeelingsofothers.
WhatwasmissingwasthepracticeoftheTwelveSteps.Attheurgingofafriend,IstartedgoingtoOvereatersAnonymous(OA)meetings.AtfirstIhadgreat
resistancetowhatIthoughtwasaChristianfundamentalistcult.Ineeded"translation"servicesintheformofagoodsponsor,andIfoundone.

Page17

Afterafewmonths,theOAprogrambegantoputsubstance,community,andactionintomynascentspirituality.IbegantotransformasIworkedtheSteps.The
StepsgavemeawaytobeginlettinggooftheheavycontrolItriedtopracticeinmydailylife.Ibegantolivemorehonestly,doservice,examinemyownactionsand
behavior,andaccountformyself.Ibegantocleanupmylife.
WorkingtheNinthStepwasaprofoundexperienceforme.Inmakingamends,IfoundIwasnotthepersonIthoughtIwas.NearlyeveryoneIwenttowithamends
wasgladtohearfromme,thoughtofmewarmly,anddidn'twanttotalkaboutmyowingthemsomething.TheylistenedtomechatterabouthowawfulIhadbeen,
toldmeIwasn'tsobad,andaskedwhyIhadn'twrittenlately.Imadenewfriendsofoldfriends,discoveringthatmaybeIwasn'tsuchamonsterafterall.Oneofthe
mostdelightfuloftheseconnectionswaswithmyfianceoftwentyyearspast.Ihadcarriedsomuchguiltandlonging,feelingIhadwrongedherbadlyandshecould
onlyhateme.Icalledherandbrokedowncryinginapology.Shetoldmethatshewasgladtohearfrommeandthatsherememberedmewithloveandwarmth.To
her,ourbreakupwastheresultoftwopeoplecomingtogetherwhoweretooyoungtoknowwhattheyweredoing.
Ibecameabstinentfrommymostdifficultaddiction,food,andbegantoloseweight.Mybloodpressuredroppedtonormal,andIrantwentymilesaweek.Ifeltalive
asIhadneverbeen.Iwasbecominghealthyandactive,engaginginactivitiesskiing,forexamplethatIcouldn'thavedreamedofdoingatthreehundredpounds.
NowthatIwasnolongersoselfdestructive,myrelationshipswithothersbecamehealthieraswell:morehonest,open,andsupportive.

Page18

LifewasjoyousandrosecoloredasIlostonehundredtenpoundsandregainedbreathandvigor.Butitwasn'trosyforlong.PerhapsbynowIcouldhaveseenthe
patternsofmyrollercoasterlife,butitseemsIwasneverreadyforthetripdown.Withmynewfoundstabilityandsafetyintheworld,ayearofabstinence,Step
work,andtherapy,alifetimeofsuppressedfeelingsbegantoriselikeanoceantide.EverythingIhadworkedsohardtokeepdownwascomingup.
Whenthefeelingsfirstcame,Ithoughtthatgodhadenteredmychest,becauseIcouldn'totherwisenamewhatwasgoingoninside.Cryingfrequently,Ishared
seriouslyinmeetingsthatIwashavingmovingspiritualexperiencesabouttwiceaweek.
IbegantorealizethatIwasexperiencingemotionsandthatIdidn'trecognizethembecauseIcouldn'trememberhavinghadany.Ihadbeenlivinginaprolonged,
dissociatedstateoffearand,formysurvival,hadbecomequitegoodatfakingarangeofemotions.Myactmusthavebeengoodbecauseitsurefooledme,butnowI
hadtopracticerecognizingandnamingemotions.
Newrecognitionscameupoverthecourseofmonths.ItwashardenoughtorealizethatI'dbeenlivinginanunconsciousstateforfortyyears,butthenIrealized,with
ashockthatlastedweeks,thatIdidn'trememberanypartofmychildhoodthatincludedbeingwithmyfamily,andmanyotherpartsofmychildhoodweremissingas
well.Ijusthadn'tthoughtaboutitbeforedenialisanamazingphenomenon.IdiscoveredIhadmultipleinnerchildrennotonedissociatedstate,butdifferentego
statesorcombinationsofstatesintowhichIwoulddissociate,dependingonthetypeofsituationIneededtosurvive.Itdawnedonme

Page19

thatIdidnothavetheslightestideawhoIwas,whoalltheseinnerchildrenreallywere,allthesepartsofme,allthesetinyvoicesthatcouldbedemons,giants,and
monsterswhenlifewastoomuch.
ItwasasifIhadcheckedmyselfatthedoorinsteadofmycoat,andIhadbeenmissingforfortyyearswhilethecoathaddinner.Asmysituationbecameclear,I
slowlybecameanopen,rawwound.
SobeganthehardestworkIhaveeverparticipatedin:healingmylife.Therewasalifetimeofrepressedgrief,pain,anger,andfeartorememberandexperience,a
lifetimeoffearbasedbehaviortochange,aparanoidandfragmentedinnerworldtotransform.It'stheworkoftheheartontheheartofallmyaddictions,
dysfunctions,andemotionalproblems.Ithinkit'stheworkthatneedsgodthemost.
Whatisgod?Idon'tknow,butIcantalkaboutmyexperience.TherearetimesinmeditationItouchatinypartofavast,compassionatespaciousnessapresence
thatseemstobemorethelovingspaceforapresencethanapresenceitself.Itseemsdeepwithinmeyetextendsfarbeyond.AtthesetimesIknowthatmyexistence
isagiftandthatmylifehasapurpose.IbelieveIhavetouchedthesourceofmyhealingandmyhumanity,anditissomethingdeathlessandinfinitelykind.Nowthere
aremanytimesinmyeverydaylife,notjustinmeditation,whenIfeelthispresence.Meditationandprayerhavehelpedmeagreatdeal.
Duringthisperiod,Ineededmygodagreatdeal,becausewhenIproceededintomyunexploredinnerworld,thereweretimesIwantedtodietimesIfelltothefloor
paralyzedwithanxietytimesIthoughtIwasgoingcrazyagaintimesIcouldn'twalkdownastreetwithoutthesightofamotherandchildfillingmewithunbearable
sadnessandlossorthe

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sightofacouplefillingmewithjealousyandpain.Iresentedthelifemygodhadgivenme,butItrustedthattherewashealingandmaybeevensomepurposetoitall.I
leftmyTwelveSteporientedtherapistforonespecializinginhealingfromdeepabuse.
Forabriefperiod,Icouldfeelthevoicesontheedgesofmyperception,andIwouldneedtotakeStelazineagainforafewdays.Eachnewmemoryorrecognition
sentmereelingfordaysorweeks.Thoughcloserelationshipswereoverwhelminglypainful,Icontinuallysoughtrelationshipstorelievethepain,andIlearned
somethingaboutlovingrelationshipsandtoxiconesaswell.Witheachdivorcedpartofmyself,witheachinnerchild,therewasabattletogothrough,areconciliation
tobefound,anewandthistimenurturingrelationshiptobeestablished.
Icouldnotbearoundmyparentswithoutgettingphysicallysick.Ultimately,Ihadtoconfrontmyfatherandstanduptohiscontinuingabuse,hisberating,demeaning
attitudetowardme.Thenhediedunexpectedlyinhissleepwhilevisitingmysister,tendaysafterthesignificantconfrontation.Ihadmassivenewguiltandtormentto
workthroughwiththebeliefthatIhadkilledmyfather.
Mylife,nolongerastringoffixes,hadbecomeathunderstormofpain,anxiety,anddesperation.AttimesIlostmysenseofcommunity,lostfriends,lostloving
relationships,lostmyfoodabstinence,andlostmyconnectionwithmygod.IhadfoundanewTwelveStephomeinSIA(SurvivorsofIncestAnonymous).Survivors
feltlikemypeers,eventhoughIcouldremembernospecificsexualabuse.IsometimessharedinthesemeetingsthatIhadonegooddayforeverytendaysoffeeling
miserable,andIstartedsmokingagain.

Page21

ThereweretimesIfeltbrokentomycore,whenIprayedtogodtoletmedie,orscreamedatgodforgivingmethislifeandforansweringmyprayersforhealingonly
withmoredevastatingmemoriesandfeelings.
Luckily,theTwelveSteps,thecommunityofotherrecoveringaddictsandabusesurvivors,awonderfultherapist,afewdearfriends,andtheconnectionwithmygod
wereharborsagainstthestorm.Intheworsttimes,Icontinuedthework,motivatedbythememoryofhope,thememoryoflove,thememoryofthewilltorecover,
andjustplainobstinacy.Myscreamsatmygodweremixedwithprayersforhopeandthewillingnesstotry.Icontinuedmeditation,therapy,andsharingwithothers
evenwhenIcouldnotattendmeetings,andItriedtolivebytheprinciplesoftheSteps.Icontinuedmytechnicalwritingwork,thoughforsomemonthsmyproduction
waslessthangoodIamgratefultohavehadanunderstandingbossatthetime.Ifoundconsiderablehelpintheworkofrecoverywritersandspeakers,andhelpin
thosewhotaughtmeBuddhistmeditationandtofindthehealinginthecenterofpainandgrief.
SlowlytheprocessofhealingcontinuedevenwhenIfeltIwasslidingintodarkness.Theemotionalcrisisthathadseemedonlytodeepenovernearlythreeyears
slowlybegantolift.
WhatIt'sLikeNow:RecoveringMyLife
It'scommonforabusesurvivorstogothroughanextendedcrisissuchastheoneIexperienced.Asthememoriesandrecognitionsfloodup,ourperceptionsaboutour
livesareturnedupsidedownandinsideout.
Yetthereareotherkindsofunderstandingthatalsocarrymeaningforme.Thecrisisliftingwaslikeslowlycoming

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outofafirestorm.IthinkaboutKali.Twodecadesago,Iknewheronlyasthehorrific,multiarmedgoddessofdestructionwhosegoalwastoconsumemysoul.Later
Ibegantopsychologizeherasthecombinedvisionofmymotherandoldersistersattackingme.Iwasyoung,andtheyseemedtobegiants.ButKali,theHindu
goddess,hasmeaningsmoresubtlethandestructionsheisanotherfaceofgod.Herfireistheenergyoflifeanddeath:Itburnsawaythefleshofillusionandleavesthe
bonesofreality.Toburninthefiremaybepainfulbeyondwords,butmaybeitisablessingtohavetheopportunitytolosetheillusions,losethedeceptionsandacts
andaddictionsandthebaggagethatkeepusfromourselves,fromothers,andfromagenuineexperienceoflife.Thefalsehastodie,aseverythinghastodie,tomake
wayforthetruthandfornewlife.Thereisamysteryandawetorealityabeauty,evenapainfulbeautyandapainfuljoyintheexperienceoflifeandtheworld.I
needtotakepartinlife,themystery,thereality.Todoso,Ineededtogothroughthefire.Inordertofullylive,Ineedtofacemylife,andthishasoftenbeen
extremelypainfulandnotundermycontrolbutworthit.
Itisoverayearsincemyfather'sdeathandseveralmonthssinceIstoppedexperiencingmylifeasanongoingcrisis.Theuphillclimbseemstohavebecomelesssteep
fornow,thoughIdon'tdoubtI'llfindsomecliffsandcanyonsonthetrail.
Iamfifteenyearsoutofdaytreatment.It'sbeentwelveyearssinceI'vehadtouseStelazineforanyperiodlongerthanafewdaysandsevenyearssinceI'veused
illegalorlegaldrugsinanysignificantway.ThoughI'vehadmyboutswithfoodaddiction,I'vehadfouryearsoffreedomfromcontinuous,obliviousbingeing,andIam
sixtypoundsbelowmytopweightofaboutthreehundred.Inolongerwork

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myselfintotheground,andIrefrainfromleapingheadlongintorelationships.Ijogforahalfhourtwoorthreetimesaweek,andthedaysIdon'tjog,Itakelong
walkswithmydog,awolfhybridwhohappenstobethesweetest,mostwonderfulanimalintheworld.
Istillcontendwiththeghostsofthepastbutnotsodesperately.Iprayforhelpandwillingnessinlettinggoofcigarettesthisstrugglebringsmefacetofacewithmore
ghosts.Smokingpointsouthowalargepartofmewantstoremainavictim:It'sasurewaytobeunhealthy,butitdoesn'tgetmelovedandcaredfor.
Cigarettesalsoaffirmtheroleofdespairinmylifethey'reaformofsuicide.Theydampenthefeelings,fogoverthefear,createabufferbetweenothersandmyself,
betweenmeandtheawfulworld,thesourceofpotentialdisappointmentanddespair.Lettinggoofcigarettesisbreakingaphysicaladdictionandpsychologicalhabit,
butitisalsopartoftheprocessoflettinggoaskingforandallowingtheliftingofhabitualdespairaboutmyselfandtheworld.
IworktheSteps,andtimewilltellwhetherthecigaretteaddictionwillbelifted.Inolongerwanttoaffirmthedespair,andIwanttostopbeingavictim.
Iamsingle,stillhavefearaboutintimacy,canbeveryinsecure,andhavedifficultyreachingoutsometimesIampainfullylonely.ButIdoreachout,Ihavefriends,and
Imakenewones.Aftersomewellpaidyearsasaselfemployedcomputerprofessional,Itookaleaptobuymyownhome.SomehowIfeelthatmyultimateworkis
notwritingcomputermanuals,andIoftenwonderwhatmylife'sworkreallyisandhowIcangettoit.Butworkisanothermajorissueforme,givenmyfather's
frequentcursethatifIdidnotbecomeadoctor,Iwouldbeafailure.

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Atfortyfour,I'manemotionalteenagerwonderingwhatI'mgoingtobewhenIgrowupandwhetherI'mgoingtohaveasignificantrelationship.
Iamofftherollercoaster,Ihope,andontoalifelongroadtowardhealing,onwhichI'vetakenthefirstfewsteps.Forme,thehealingisfoundinthecourseofthe
thousandsofthoughtsandeventsofeachday.
EachtimethefearcomesorIstarttobeatmyselfuporsteelmyselfagainstmyfeelings,ifIcanbreatheandsoftenmybodyandsendalittlekindnessintomychest,
thereishealing.Thissofteningandopeninghelpkeepmefromreturningtoaddictionorfrombeinga''drydrunk''cleanofsubstancesbutcompulsiveanddrivenin
otherareasoflife.
EachtimeIletgooftryingtocontrolandsimplydomybestatwhatIneedtodo,thereishealing.WhenIwritetogettotheheartofaproblem,whenIamhonest
ratherthanmaskedwiththosetowhomIamvulnerable,whenIlistenopenlytoothersandshareinarecoverysetting,whenIcanhelpsomeoneelse,thereishealing.
WhenIcanrecognizethatIhavedissociatedandbegentlewithmyselfandallowthereturntomybodyinatimeandwayIcannotcontrol,thereishealing.
WhenIletgooflittlewrongs,thehealingisthere.AndwhenIrefusetobeabusedandgetangrywithsomeonewho'strompingonme,it'sthereaswell.Thehealingis
inmyabstinence,inmyexercise,intakingcareofmyselfandmyinnerchildren,inplayingandsingingwhenthemoodhits,ingettingamassageortakingahotbath
whenit'scold.It'sinrelaxingandbeinglazywhenIneedtorelaxandbelazy,andinnotbeatingmyselfupaboutit.It'sinobservingmydysfunctionalwaysandmaking
amendswhenIhavedoneharm,inacceptingandforgivingmyselfformy

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dysfunctionwhiledoingwhatIcantochange,inexploringmylostmemoriesandtherootsofmyconditionsothatIneedn'tcompulsivelyrelivethepast.
Thehealingisinaskinganewfriendtotakeawalkwithmypuppyandme,andit'sinthewarmbondbetweenmeandmypuppy.It'sinlettingmyselffeelloveforthe
puppyandinlettingmyselffeelthepainofknowinghowshortherlifemaybe.It'sintakingrisksandinhonoringthepartofmethatisnotyetreadytotakeaparticular
risk.
WhenImeditatetomakespaceinmyheart,there'shealing,andit'stherewhenIaskmygodforguidanceortoremovemyselfhatredandfear.
Thehealingisintrying,andit'singivingintothepain,anger,grief,andsadnesstofindthehopethatliesunderneath.
Theevidenceofmyhealingistheslowtransformationofmyworldfromaplacefilledonlywithhatred,fear,cruelty,deathandwar,abuse,greed,poverty,and
injusticeintoaplacethathaslove,joy,kindness,andcompassioninthemidstof,despite,andbeyondthetragedies.Andperhapsmyhealingcontributesalittletothe
endofabuseandinjusticeintheworld.
Thereisadifferentqualitytomylifethesedays,agrowingqualityofacceptance,clarity,aliveness,andgrowth.Iamlonely,butIamnotdesperatetoget"fixed,"and
withoutthedesperation,Ibecomelesslonely.Ihavefearsofintimacy,butIamwillingtofacethefearsandtrustmyselfmoreinmovingthroughthem.Imaynotknow
whatI'mgoingtobewhenIgrowup,butIknowmylifehasameaningthatisseekingfulfillment.Evenmypainismyownpainthepriceofbeingaliveandmortal
andnotthesufferingofsomeonetryingtoavoidhimselfandeveryoneelse.Today,I

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wasfeelinglonelyandsadaftervisitingafriendIknewIwouldnotseeagainforawhile,butIthought,Atleastthisisme:Thisismysadness,myloneliness,as
wellasmyhappinessatthethoughtofhavingfriendsIcareaboutenoughtomiss.AndIamnolongerburyingitall,skippingmyownlife.Andtherewasa
softnesstothefeelings,notthehardnessofsomeonesteelinghimselfagainsthimself.
I'mnotfreeofallmycompulsionsanddysfunctions,butmanyarelifted,manybehaviorsarechangedforthebetter,andmostimportant,Iamnolongerdrivenby
addictionsorcrazybehavior.IamlikedandvaluedbyfriendsforwhoIam,notforbeingagoodact.Inmyjourney,IhavegainedinsightandcompassionandIhave
helpedothersonthepath.
NowtherearetimesIknowaquiet,softhappiness.Imaybedrivingdownthestreetorsittingatmycomputer.Iputmyattentioninsidemychestandfeelawarmth
spreadsoftlythroughme,bringingasmiletomyface.IthinkaboutthePromises,aboutcomprehendingserenityandknowingpeace.

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2
HopeandHealing:
AComprehensiveApproachtoDualDisorders
A.ScottWinter,M.D.
Accordingtothedictionary,theworddiagnosismeans"theactofidentifyingadiseasefromitssignsandsymptoms."Whenyouhaveanaggingcough,yourdoctor
examinesyoutofindoutwhat'scausingtheproblem.Isitbacteria,avirus,oranallergy?Togettherighttreatment,youneedtherightdiagnosis.
Dualdisorderssometimesreferredtoasdualdiagnosespresentadoublechallengetomentalhealthcaregivers(includingchemicaldependencycounselors,clinical
socialworkers,psychiatrists,psychologiststheentiretreatmentteam).Whentwoseriousillnessesexistinonepersonatthesametime,eachcancomplicatethe
other.Teasingthesetangledthreadsaparttomakeanaccuratediagnosisandmoreimportant,toprovideeffectivetreatmentbecomesmuchmoredifficult.
Inthenottoodistantpast,caregiversoftenassumedthatanyemotionalproblemsseeninpeoplewithchemicaldependencyweremerelysymptomsarisingfromthe
substanceabuse.Typically,whenpeoplewhoabuseddrugsoralcohol

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alsosufferedfromadisordersuchasdepression,theyweretold,"Theaddictionisyourbasicproblem.Ifyoustopdrinkinganddrugging,yourdepressivesymptoms
willvanish."Theirdoctorswouldhospitalizethem,drythemout,perhapsreferthemtoaTwelveStepprogramandthenscratchtheirheads,wonderingwhythese
peoplewouldrelapse.Ortheymighthavebeentreatedonlyfortheirpsychiatricconditionwhiletheirchemicaldependencywasallbutignored.
Meanwhile,thesufferingofpeoplewithdualdisorderscontinued.Eveniftheystayedsober,theystillwrestledwithdepression,anxiety,orotheremotionalturmoil.
Oftentheirsymptomsweresoseriousthattheybeganabusingsubstancesagain,hopingforrelief,andthecyclewouldbeginanew.Asifthingsweren'tbadenough,
theyalsohadtowrestlewiththesocialstigmaofmentalillness.Throughignoranceorinsensitivity,otherpeoplelookedonthemasweakwilledormorallybankrupt,
ratherthanasaffectedbynotonebuttwodevastatingillnesses.Theywereseenasfailures.Thetruthwas,treatmenthadfailedthem.
Fortunatelythere'sbeenalotofprogressovertheyearsinthetreatmentofchemicaldependency.TheintroductionoftheTwelveStepphilosophyinthe1930swas
thefirstmajoradvance.In1952theAmericanMedicalAssociationrecognizedalcoholismasadisease,aconceptthatthepublichasgraduallycometoaccept.
Federalantidrugefforts,combinedwithincreasedsocialpressureandhealthawareness,havedonemuchtoreducetheabuseofdrugsandalcohol.
Wehavealsogreatlyincreasedourunderstandingofdualdisorders.Todayweinthementalhealthfieldarelesslikelytogethunguponthequestion"Whichcomes
first,thechicken[chemicaldependency]ortheegg[variousotherpsychiatricconditions]?"Instead,weseethatpeoplecanindeedexperiencetwoormorepsychiatric
problemsdrugor

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alcoholabuseandanemotionaldisturbanceatthesametime.What'smore,weknowthatthechemicaldependencydoesnotalwaysappearfirst.Sometimes,for
example,apersonwithagoraphobia(essentiallythefearofleavingthehouse)becomesdependentontheanxietymedicationsprescribedforthecondition.Estimates
arethatthreeoutoftenpeoplewithsubstanceabuseproblemshaveanunderlyingmoodoranxietydisorderaswell.Eachofthediagnosesrequiresitsownformof
treatment.Mostimportant,wenowrealizethatspiritualhealing,inadditiontophysicalhealing,isessentialforcompleterecovery.
RisksandRealities
Peoplewithdependencyproblemsaremorelikelytodevelopotherpsychiatricconditionsthanthegeneralpopulation.Conversely,peoplewithpsychiatricproblems
areatmuchhigherriskofbecomingsubstanceabusers.AccordingtotheNationalInstituteofMentalHealth,ifyousufferfromaphobia,forexample,youarenearly
twoandahalftimesmorelikelytobecomechemicallydependent.Forpeoplewithbipolardisorder(manicdepressiveillness),theriskismorethanfourteentimes
asgreatasthatoftheaverageperson,andmorethanfifteentimesasgreatforpeoplewithantisocialpersonalitydisorder.Thefollowingchartspellsouttherisks
(comparedtothoseofthegeneralpopulation)associatedwithsomeofthemajorpsychiatricillnesses.

Ifyouhaveadiagnosisof...

Yourriskofsubstanceabuseis:

Phobia

2.4timesasgreat

Obsessivecompulsivedisorder

3.4timesasgreat

Majordepression

4.1timesasgreat

Page30

Ifyouhaveadiagnosisof...

Yourriskofsubstanceabuseis:

Panicdisorder

4.3timesasgreat

Schizophrenia

10.1timesasgreat

Manicdepressivedisorder

14.5timesasgreat

Antisocialpersonalitydisorder

15.5timesasgreat

Drugsandalcoholaltermood.That'swhypeopleusethem.Thosewithapsychiatricdisorderdepression,forexamplemaydrinkortakedrugsinanattemptto
alleviatetheiremotionalpain.Thisisknownasselfmedication.Thechemicalstheyusemayprovidesomereliefbutdonothingtocorrectthebasicemotionalproblem.
Assoonasthedrugswearoff,thereitisagain:thatdark,hopelesscloudofdepression.Theypourthemselvesanothershotorlightupanotherjoint,andthecycle
beginsagain.Overtimetheybecometotallydependentonsubstancestoregulatetheirmoods.Inthisscenario,chemicaldependencymasksthepsychiatricillness.
Ontheotherhand,someonemaybeusingdrugsthatpoisonthebodyandbrain.Overtimetheabilitytothinkandfunctionislost.Thepersonfeelssad,hopeless,and
guilty.Sleepandappetitearedisrupted.Onthesurface,theseappeartobetheclassicsymptomsofdepression.Deeperdown,theyarethetoxicresultsofsubstance
abuse.Inthiscase,chemicaldependencymimicsthepsychiatricillness.
Youcanseewhydualdisordersposesuchachallenge.Asapsychiatrist,it'smyjobtoidentifyyourtrueconditionsothatwecanworktogethertohelpyouget
better.Aslongasyouareabusingsubstances,Iwon'tknowiftheemotionaldisordercausesyoutocravedrugsorwhetherthedrugsproducetheemotionaldisorder.
That'swhythekeytosuccessful

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recoveryfromdualdisordersliesinfirststoppingalluseofdrugsoralcohol.Onlythencanwegetaclearpictureofyourproblem.Atthatpointwecanattackdual
disordersontwofrontsbytreatingboththechemicaldependencyandthepsychiatricillness.Ordinarilyitisbesttotreatthechemicaldependencyfirst,but,asI'll
explainshortly,thereareexceptionstothisrule.
PsychiatricDisorders:AnOverview
Atthispointitwillbehelpfulifyouknowmoreaboutsomeofthespecificpsychiatricdisordersthatoftenexistalongsideachemicaldependency.Thelistislong,soI'll
focusonlyonthosethatcropupmostoften.
Mooddisorders:HalfofallthecasesofdualdisordersIhandleinvolveamooddisorderofsomekind.Mooddisordersappearintwobasicforms:depressive
disordersandbipolar(ormanicdepressive)disorders.
Themostsevereofthedepressivedisordersismajordepression.Thiscripplingconditioncausesaperiodoflowmoodaccompaniedbysadness,guilt,hopelessness,
decreasedenergy,lossofenjoymentinlife,andsuicidalfeelings.Depressioncanlastformanyweeksorevenmonths.Eventuallydepressionmayliftbyitself,butgiven
propertreatment,aperson'smoodusuallyreturnstonormalwithinashortertime.Anotherdepressivedisorderisdysthymia,alessintensebutlongerlastingformof
theillness.
Bipolardisorderoccurslessfrequentlythanmajordepression,butitisinsomewaysmoresevere.Themainfeatureofthisillnessistheintensemoodswingsfrom
depressiontoabnormalelation,ormania.(Technically,peoplecanhave

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bipolardisordereveniftheyexperienceonlythemanicphase.)Duringmanicperiods,peopleusuallyfeeleithereuphoric(physicallyoremotionallyhigh)orextremely
agitated.Theymaynotsleepfordaysonend.Theyoftentalkamileaminute,buttheirthoughtsdon'tseemtoconnect.Theymayhavegrandioseideasabout
themselvesortheirwork.Frequentlytheybehaveininappropriatewayslaunchingnewbusinesses,spendingalltheirmoney,havingastringofsexualaffairs,andso
on.
Theothermooddisordersarevariationsondepressionandbipolardisorder.Thedifferencesinvolvetheseverityofsymptoms,lengthoftimetheypersist,orhow
rapidlyandhowoftenthepersonswingsbetweenthedepressedandthemanicphases.
Depressioniswidespreadoveragivensixmonthperiod,nearlytenmillionAmericanswillsufferboutsofdepression.Thistroublingconditionaffectsallaspectsofa
person'slife:thebody,themind,andtheemotions.Depressionisfarmoreseriousthanatemporarycaseof"theblues."Peoplewithdepressioncan'tsimply"snapout
ofit."Theyneedtreatment,love,andunderstanding.
Substanceabuse,especiallyalcoholabuse,makesthemooddisorderworse.Inmyexperience,fullyhalfofthepeoplewhosealcoholisminvolvesdepressionwillfind
theirmoodsaremarkedlyifnotcompletelyimprovedafterthreeweeksofsobriety.Ifthedepressionpersists,therearemanyeffectivetreatmentstrategieswecan
try.Approximately80percentofpeoplewhoseekhelpfordepressiongetbetter.
Anxietydisorders:Anxiety,panic,phobia,obsessivecompulsivedisorder,andposttraumaticstressdisorderareallpartofthespectrumwecallanxietydisorders.A
certainamountof

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anxietyisnormal,evenhelpful,inourdailylives.Inanxietydisorders,however,thebodyseemstohavelosttheabilitytocontrolitsanxiousfeelings.Thebraininturn
maycausethepersontoactinexaggeratedwaysinadesperateefforttorelievethetension.
Ananxietydisorderinvolvesapowerfulandunpleasantmentaltensionwithnoapparentcause.Symptomsincludeshaking,sweating,drymouth,poundingheart,and
rapidbreathing.Peoplewithanxietyoftenworrythatsomethingbadisabouttohappentothemselvesortheirlovedones.Theyareimpatient,irritable,andeasily
distracted.Anxietyisanevenmorecommondisorderamongthegeneralpopulationthandepression.
Panicdisordersaffectmorethanamillionpeopleinthiscountry.Apanicattackisunpredictable.Itproducesintense,overwhelmingterrorfornoapparentreason.
Whenpanicstrikes,manyvictimsthinktheyarehavingaheartattack.
Aphobiaisanintensefeelingofterrorordreadthatsomepeopleexperiencewhentheyconfrontcertainobjects,situations,oractivities.Phobiasarestrongenoughto
interferewithjobs,familylife,andrelationships.Amongthecommonformsaresocialphobia(fearofsituationsinvolvingotherpeople),simplephobia(fearofsnakes,
forexample),andagoraphobia(fearofbeingaloneinapublicplacewithnoescaperoute,suchasamovingbus).
ObsessivecompulsivedisorderaffectsmorethantwomillionAmericans.Obsessionsarerepeated,intrusive,unwantedthoughts,suchasthoughtsaboutviolence
againstalovedone.Compulsionsarerituallikebehaviorsthatthepersoncannolongercontrol.Typicalcompulsionsincludefurioushousecleaning,repeatinga
behavior(suchaswashinghands),orendlesslycheckinglocksondoors.Bothobsessionsand

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compulsionsarewayspeopletrytocopewithsevereanxiety.Nomatterhowmanytimesthethoughtorthebehaviorisrepeated,however,theanxietypersists.
Peoplewithanxietydisordersoftenturntoalcoholandotherdepressantdrugstotrytocalmthemselvesdown.Thetruthis,thesechemicalscanproducetheopposite
effect.Anxietyisalmostalwaysworseaftertheboozewearsoffthanifithadneverbeenused.Thussubstanceabuseonlyworsenstheimpactofanxietydisorderson
aperson'ssocial,personal,andprofessionallife.
Dissociativedisorders:Sometimespeoplesuddenlyfeeltheyarenot''connected''totherealworldinotherwords,theyaredissociatedfromit.Ifthesemomentsof
dissociationoccuroftenenoughandareseriousenough,theycanbecomeatruedisorder.Dissociativedisordersdisturboralterone'sidentity,memory,or
consciousness.Theycancauseperiodsof"losttime"inwhichpeoplesuddenlyrealizetheycan'trememberwhathappenedduringthepastfewminutes.Atonetime
weassumedthesedisorderswererelativelyrare.Inrecentyears,however,we'velearnedthatperhapsasmanyasfiveoutofeveryhundredpeopleexperiencesome
kindofdissociationintheirlivesmemorydisturbance,amnesia,oridentityconfusion.
Oneofthemostwellknownoftheseconditionsisposttraumaticstressdisorder,orPTSD.Thisdisorder(officiallyclassifiedasananxietydisorderbutsharingmanyof
thetraitsofotherdissociativedisorders)affectspeoplewhohavesurvivedseverephysicalormentaltrauma.PeoplewithPTSDsufferfromnightmaresorflashbacks,
emotionalnumbness,anxiety,depression,insomnia,andpoormemory.Theyareeasilystartledandhavetroubleconcentrating.

Page35

Anextremeandstrangeformofdissociationismultiplepersonalitydisorder,orMPD.MPDwasn'trecognizedasanofficialpsychiatricdiagnosisuntil1980,which
meantthatforyearsthemanypeoplewhoexperiencedmultiplepersonalitiesweren'ttreatedatallforthisdisablingcondition.MPDisadirectresultofsevere
childhoodabuseandoccursinwomenthreetimesasoftenasinmen.PeoplewithMPDhavetwoormoredistinctpersonalities,eachwithitsownrelativelyconsistent
patternofperceiving,relatingto,andthinkingabouttheselfandtheenvironment.Also,atsomepoint,atleasttwoofthesepersonalitiesalternateintakingfullcontrol
oftheperson'sbehavior.
Manypeoplewhoexperiencedissociativesymptomsusedrugsoralcohol,hopingtorelievetheterroroffeelingoutofcontrol.Onestudyfoundthat46percentof
peoplewithMPDabusedrugsand42percentabusealcohol.Aswithmostdualdiagnoses,itcanbehardtodistinguishtheeffectsofchemicaldependencyfromthe
symptomsofMPD.Forexample,blackoutsorperiodsoflosttimearecommonfeaturesofbothdissociationandsubstanceabuse.SomeoftheMPDpatientsI've
treatedhaveoneormorealternatepersonalities,or"alters,"whoarechemicallydependentandsomealterswhonevertouchdrugsorwhoaresickenedbythe
slightestsipofalcohol.Also,manypeoplewithalcoholismhavea"drinkingpersonality"thatcomesoutwhentheyareundertheinfluenceofliquor.Thispersonality
maybeangryorviolentorloving.Whenthealcoholwearsoff,thepersonalitydisappears.PeoplewithMPDmayalsodisplaysuddenchangesofpersonality.Ifsuch
peopleabusechemicals,thedoctorwhoisunawarethatMPDispresentwilllikelyassumethatthesebehaviorsaretriggeredsimplybyuseofdrugs.Clearly,insuch
cases,treatmentforalcoholismalonewillnotrelievethe

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problem.Fortunately,thegrowingawarenessofMPDmeansmorecaregiversarelikelytospotthewarningsignsandoffereffectivetherapiesforbothconditions.
Personalitydisorders:Thereareanumberofpersonalitydisordersthatinvolvedeeprooted,inflexible,andharmfulwaysofthinkingandrelatingtootherpeople.All
ofushavepersonalitytraitsthatmaygiveustroubleattimes.Apersonalitydisorder,however,isapersistentpatternthatisseriousenoughtocausesufferingbothto
theindividualandtootherpeople,andwhichmakesithardforthepersontofunctioninameaningfulorproductiveway.
Somepersonalitydisordersaremoreoftenassociatedwithsubstanceabusethanothers.AsthefiguresImentionedearliershow,peoplewithantisocialpersonality
disorderareattremendousriskforusingmoodalteringdrugsandalcohol.Suchpeoplearefrequentlytroubled,tense,andunabletotolerateboredom.Theydrinkor
usedrugstorelievetension.Bydefinition,thesepeopleareantisocialthatmeans,inpart,theyhavelittlerespectforlaws,includinglawsagainstdruguse.Underthe
influenceofalcoholordrugs,peoplewithanantisocialpersonalityoftenunleashtheirangerandbecomeabusiveandviolent.
Peoplewithborderlinepersonalitydisorderarealsopronetoflareupsofangerandviolence,especiallywhensubstanceabuseisinvolved.Borderlinepersonality
describesthosewhohavealotofuncertaintyaboutmanybasiclifeissuessuchasselfimage,personalvalues,friendships,andsexualorientation.Theytendtosee
everythingintermsofblackandwhite.Theycanbecomeveryhostilewhentheydon'tgettheirway.Theymayregardanotherpersonastheirbestfriendonemoment
andastheirmosthatedenemythenext.

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Thesepeopletypicallyabusestimulantstobringonfeelingsofpleasure,ortheymayabusedepressantstorelievedistress.Peoplewithborderlinepersonalitieswalka
thinemotionalline:useofdrugsandalcoholcanpushthemovertheedge.
Anothercommondisorderisthedependentpersonalitydisorder.Thisisdifferentfromcodependency,whichdescribesatypeofrelationshipratherthananactual
psychiatricdiagnosis.Peoplewithadependentpersonalitydisorderhavetroublemakingeverydaydecisions.Theyneedconstantreassurance,prompting,andadvice
fromothers.Fearingrejection,theywillgotoextremeevenunhealthylengthstopleaseothers.Oftentheyfindthemselvesinacodependentrelationshipwith
someonewhoischemicallydependentorwhohasapsychiatricillness.Manytimespeoplewithadependentpersonalitybeginusingdrugsoralcoholinaneffortto
appearsupportiveorlessthreateningtotheirmates.Intimetheyriskbecomingaddictedthemselves.
Schizophreniaisadebilitatingillnessthataffectsperhapsonepersoninahundredinthiscountry.Therearedifferenttypesofthedisorder,butgenerallysymptoms
includebizarrebehavior,nonsensicalspeech,strangeordisjointedthinking,andanimpairedabilitytoexperienceorexpressemotions.Peoplewithschizophreniaoften
havedelusionsaboutwhotheyaretheymaybelieve,forexample,thattheyareAbrahamLincoln.Ortheymaybelievetheyhavespecialpowers,suchastheability
tocommunicatewithaliens.Theyoftenexperiencehallucinations,suchashearingvoicesthatothersaroundthemcannothear.
Thefirestormofschizophreniamakesitsvictimsmoresusceptibletotheuseofmoodalteringdrugs,especially

Page38

depressants.Schizophreniarobspeopleoftheirgriponrealitytheyareunabletothinkclearlyabouttheconsequencesoftheiractions,includingdruguse.Another
problemisthatschizophreniausuallyrequireslifelongmedicaltreatment.Peoplewiththedisorderoftenresenthavingtotakemedicationandmayforgetorrefuseto
doso.Withoutmedicationtheyinvariablysufferrelapse,andtheirsymptomsflareupagain.Inthatstage,theyaremorelikelytoturntoillicitdrugsoralcoholforrelief.
Thesadthingis,theywon'tfinditthere.
Twootherproblemsareoftenassociatedwithchemicaldependency:eatingdisordersandsexualcompulsions.Indeed,foodandsexsometimesserveas
"intoxicants,"inthesensethattheycanprofoundlyaltermood,andthepleasuretheyoffercanbesointensethatsomepeopledevelopinsatiableappetitesforthem.
Therearemanysimilaritiesbetweensubstanceabuseandcompulsiveuseofsexorfood:denial,lossofcontrol,continuedusedespitegrowingproblemsassociated
withthehabit,secrecy,shame,andastrongtendencytorelapseaftertreatment.Onedifference,however,isthatpeoplewithsexualorfoodcompulsionsseldom
developphysicaltolerancethatis,theneedforhigherandhigherdosesoftheseintoxicantstoachievethesameeffects.
Thetwomaineatingdisordersareanorexiaandbulimia.(Compulsiveovereatingisusuallyconsideredaphysicalormetabolicdisorderratherthanapsychiatricone.)
Anorexiaisselfstarvation,arisingfromadesperatedesiretobeasthinaspossible.Bulimiainvolvesovereatingfollowedbyselfinducedvomitingorotherextreme
stepstogetridofthefood.Eatingdisorderssymbolizepeople'sdesiretogaincontroloftheirlivesfoodintakemaybetheonlythingoverwhichtheyfeelincontrol.

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Manypeoplewitheatingdisordersmorethan90percentofwhomarewomenusestimulantdrugstocontroltheirappetite.Theymaybecomedependenton
caffeineordietpillsandoftenprogresstomorepowerful,illegalamphetaminesortococaine.Manyabuselaxativesanddiuretics.Peoplewithbulimiafrequentlybegin
theirbingesbydrinkinganentiresixpackofbeerorabottleofwine.Withtheirinhibitionsandjudgmentgone,theyproceedtogorgethemselvesuntiltheyvomitor
fallasleep.
Forpeoplewithsexualcompulsions,sexlosesitsfunctionasawaytoexpresstenderfeelings.Instead,itbecomesa"drug"usedcompulsivelytorelieveanxietyorto
avoidfacingotherproblems.Inmostcases,sexaddictionarisesinpeoplewhoweresexuallyabusedaschildren.Thissuggeststhat,forthem,sexualcravingisan
expressionoftheirdesireforthenurturingtheydidn'tgetaschildren.
Predictably,theuseofdrugsoralcoholbypeoplewiththisdisorderislikealightedmatchtossedintoaroomfullofdynamite.Stimulantdrugs,marijuana,andliquor
oftenremovewhateverinhibitionspeoplemighthave.Themostnotoriousdruginthiscategoryiscocaine,especiallycrack,whichproducesanorgasmicrushwithin
secondsafteritisinhaled.Manysexaddictsreportthatwithoutdrugs,theycouldhavekepttheirsexualdesiresonthelevelofprivatefantasies.Stimulantsare
especiallydangerousaspromotersofpromiscuitybecausepeoplecanbecomeaddictedtothehightheygetwhentheycombinedrugswithsex.
TheSailboatofRecovery
Forthepersonwhosuffersfromapsychiatricillness,thejourneythroughlifeishard.Foronewhoalsostruggles

Page40

withaddiction,it'sharderstill.Envisiontheprocessofrecoveryasaboatwithfoursails.Eachsailrepresentsadifferentaspectoftheprocess:biological,
psychological,environmental,andspiritual.Allofthesesailsmustbehoistedandtrimmedsothattheboatcanmoveswiftlyovertheroughseasahead.
Thebiologicalsailrepresentstheneedtorestorethebodytoitsnormalleveloffunctioning.Yearsofsubstanceabuseturnthebodyintoatoxicwastedump.Yet,
givenachance,thebodyhasremarkablysophisticatedwaysofremovingthesepoisons.Abstinence,properdiet,andexercisecanrestorephysicalhealthinrelatively
shortorder.
Thepsychologicalsailrepresentstreatmentaimedatstraighteningouttangledthinkingandcorrectingharmfulbehavior.Therearemanywaystoachievethistherapy
withanindividualcounselorandgrouptherapyarebuttwoexamples.
Theenvironmentalsailmeanstreatingthedualdisordersinabroadercontext.Whateverthecircumstances,treatmentmusttakeintoaccountthefactthatwealllive
with,andamong,otherpeople.Makingadjustmentstoimproveourenvironmentmeansimprovingourchancesatgettingbetter.
Finally,thespiritualsailofferstheopportunityforhealingthatisrooteddeepwithintheheartandsoul.Itisthesailthatkeepstheboatofrecoverymovingforward
evenifalltheothersailsaretatteredandtorn.
DiagnosisandTreatment:ABrighterPicture
Mostofthepeoplewithdualdisorderswhocometomeforhelpusuallydosobecauseofproblemsdirectlyrelatedtotheiraddictionandnotbecauseoftheir
underlyingpsychiatric

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problem.Theyarebroughtinbyworriedfriendsorfamilymembers,ortheyhavebeenorderedbytheirbossesorajudgetogettreatment.Eveniftheyhaven'tbeen
caughtintheactofusingdrugsoralcohol,theirlivesareobviouslyfallingapartasaconsequence.Theymaylooklikehell:puffyfaces,redeyeslinedwithpain,
unkemptoruncleanappearance.Ortheymaybecompletelyunabletofunctiononthejoborathome.Inmostcases,thesepeopledon'tcomeoftheirownaccord.A
crisismustusuallytakeplacemedicalemergencies,threatsofdivorce,lostjobs,orjailtermsbeforetheywillputthemselvesinthehandsofacaregiver.
Thefirsttaskisusuallytoaddressthechemicaldependency.Theexceptioniswhenpeoplearebroughtinbecauseofapsychiatricemergency,suchasaseveremanic
episode,suicideattempt,oracompletebreakwithreality,asinschizophrenicpsychosis.Insuchcasestheimmediatecrisismustbedealtwithfirst.Themanicmood
ortheschizophreniamustbebroughtundercontroltreatmentforsubstanceabusehastotakeabackseat.Onethingthementalhealthfieldhasbecomemoreawareof
inrecentyearsistheneedtoaddresseachperson'sindividualsituation.Arigidapproachwon'tworkthegoalistofirsttakecareoftheproblemthatmostthreatens
theoverallwelfareoftheperson(orinsomecases,thefamily).
Often,though,treatmentbeginsbyaddressingtheaddiction.Thefirstprioritythebiologicalsailisdetoxification,whichistheuseofmedications,diet,rest,fluids,
andgoodoldfashionedtenderlovingcaretobringthebodybacktonormal.Detoxfromthehighlyaddictivedrugs,suchasalcohol,barbiturates,heroin,andcocaine,
isachallengebecauseoftheirseverewithdrawalsymptoms.Recently,though,it's

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beendiscoveredthatamedicationcalledclonidineblocksthesymptomsofnarcoticwithdrawal.Bromocriptineisusefulinassistingwithdrawalfromcocaine.Other
medicationsshowsimilarpromiseinhelpingsmooththepathwaytoadrugfreebody.
OnlyafterdetoxiscompletewillIbeabletogetaclearlookatthepersoninmycare.Thisprocesstrimmingthepsychologicalsailcantaketwoorthreeweeks.
DuringthisperiodIwillspendhoursinconversationwithmypatients(and,ideally,withasmanymembersoftheirfamiliesaspossible)tryingtofindoutwhatmakes
themtick.Iwillporeovertheresultsofpsychologicaltestinglookingforcluesthatshowmehowtheyfeelaboutthemselvesandtheirlives.
DuringthistimeIalsolookattheperson'sentireworld.Problemsinthemarriageoronthejobmayneedtobeaddressed.Perhapssomeoneelselivinginthepatient's
homecontinuestoabusealcohol.Adjustingtheenvironmentalsailpreparesthepatienttodealwithproblemsheorshemayfaceafterleavingthesafe,shelteredworld
ofthetreatmentcenter.
And,assoonaspossible,Iraisethespiritualsail:IencouragepeoplewithdualdisorderstoattendmeetingsoftheTwelveStepgroupmostsuitedtotheirneeds
(AlcoholicsAnonymous,NarcoticsAnonymous,OvereatersAnonymous,andsoon).MosttreatmentprogramsnowrecognizethetremendousvalueoftheTwelve
Stepapproach.ManyhospitalsevenofferTwelveStepprogramswithintheirownwalls.
ThegeniusoftheAAfounderswasthattheydevisedaprogramwhoseprinciplesandphilosophycanbenefitanyoneseekinganewandbetterlife.Overtheyears,
suchprogramshavehelpedthousandsofchemicallydependent

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peopleovercometheiraddictions.TheTwelveStepprogramoffersthestrength,support,andunderstandingthatonlycomesfromotherswhohavewalkedthatroad
before.Inmeetingspeoplefeelfreetoexpressandexploretheirfeelings.Theygainperspectivebyhearingfromotherswhoarestrugglingwithsimilarfeelingsand
issues.Byattendingmeetings,peoplewithdualdisorderscangetsoberandstaythatway.Theyarethenbetterequippedtodealwiththepsychiatricdisordersthat
mayhavecontributedtotheirchemicaldependencyinthefirstplace.
SomepeopletendtoseeTwelveStepprogramsandthemedicalpsychiatricapproachasincompatible.Whilethatmighthavebeentrueinthepast,itiscertainlyless
truetoday.Mostselfhelpprogramsrecognizetheneedforappropriatetreatmentinthehandsofaprofessional.Likewise,mostofusinthementalhealthfieldnow
realizethatongoing,selfdirectedspiritualhealingisessential.Asapsychiatrist,IseetheTwelveStepphilosophyasoneofmygreatestalliesinhelpingpeoplerecover
fromdualdisorders.
Mentalhealthcaregiverstodayaremorealerttothespecialneedsofpeoplewithdualdisorders.Weoffereffectiveteamtreatmentaimedatresolvingnotjustonebut
twoormorecomplexandseriousillnesses.Whetheryourjourneyofrecoveryhasjustbegun,orwhetheryouarecontinuingyourjourney,knowthatthereishope.
Healingliesahead.

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3
TheTwelveStepsandDualDisorders
AbrahamJ.Twerski,M.D.
Justasrecoveryfromaphysicalillnessrequiresthatwemakechangesinthewayourbodyworks,recoveryfromadualdisorderanaddictionandanemotionalor
psychiatricillnessrequiresthatwemakechangesinhowwethink,feel,act,andreact.Someofthesechangesmayrequirespecific,nonaddictivemedicationssome
mayrequirepsychotherapyandsomemayrequirereworkingourcharacter.
Duringthepasthalfcentury,theTwelveStepsoftheAlcoholicsAnonymousandNarcoticsAnonymousprograms,amongothers,haveprovedeffectiveinbringing
aboutthecharacterchangesnecessaryforrecoveryfromaddiction.
AlthoughweusuallyassociatetheTwelveStepswithaddiction,theymayalsohelppeoplewhohaveneverbeenaddictedtheStepsareguidelinestoawayofliving
thatcanbenefiteveryone.Andwhiletheycanbelifesavingfortheaddict,theycanalsobeavaluableadjuncttorecoveryfromvariousemotionaldiseases.
ButTwelveStepprogramsmaynotbeaseffectivewhenthere'sacoexistingemotionalorpsychiatricdisease.This

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shouldn'tcomeasasurprise,becausetheTwelveStepsprimarilyaddressthediseaseofaddiction.Justastheyarenotexpectedtotreatpneumoniaordiabetes,
neithercantheStepsbeexpectedtofullytreatcoexistingemotionaldisorders.
Thecombinationofanemotionalconditionandaddictioncallsforacarefulevaluationofsymptoms,becausesomeofthesymptomsthatweassumetobeduetothe
addictione.g.,anxiety,lethargy,moodchangescanactuallybeduetotheotherconditions.Oncewecanidentifythecoexistingdiseasesandbeginproper
treatmentforthepsychiatricillness,wecanthenapplytheTwelveStepstorecoverymuchmoreeffectively.
Sometimeswemayusealcoholoraddictivedrugs(prescribedorillegal)inanefforttogainrelieffromanxiety,panic,depression,orcompulsions.Herearethree
scenariosthatcouldprecipitatesuchfeelings:(1)Standinginthecheckoutlineatthesupermarket,wearesuddenlyovertakenbyanintensefeelingofimpending
doom.Weexperiencetightnessinthechest,heartpalpitations,andshortnessofbreath.(Thiscouldevenoccurintheprotectivecalmofourlivingroomoraswesit
quietlyinchurchordrivealonganuncongestedhighway.)(2)Wefindourselvesabruptlythrustintoaseveredepression,feelingsolistlessandlethargicthatwecan't
getoutofbed,orwefeelsoagitated,dejected,anddespairingthatwethinkofsuicide.(3)Wefindourselvesobsessedbystrangethoughtsordriventoperform
ritualsthatappeartobesenseless,butwhichwecannotresistdoing.
Someofusfoundthatalcoholordrugstemporarilyrelievedourdistress.Butwhentheeffectofthechemicalhadwornoff,thesymptomsrecurred,andwereturnedto
usingthechemicals,usuallyinincreasingamounts,eventuallyresultinginaddiction.

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Whenaddictionandanotheremotionalconditioncoexist,it'snotthatimportanttoknowwhichcamefirstwhatisimportantisthatbothconditionsreceivethe
appropriateattention.Weneedtobecome(andremain)stablewithourpsychiatricconditionandabstinentfromouraddiction.ThisiswheretheTwelveStepscan
help.
STEPONE:Weadmittedwewerepowerlessoveralcoholandotherdrugsthatourliveshadbecomeunmanageable.*
Manyofusfightsuchanadmissiontoothandnail.Wetryvariousmethodstocontrolouruseofaddictivechemicalswithoutoutsidehelp,butnothingseemstowork.
Formany,itmaytakeaneardisasterorevenatotalonetomakeusrealizethatwehavelostthebattlewithchemicals.Wetryrepeatedlytogaincontrolofourlives,
butwearemuchlikethedriverofacarinwhichthesteeringmechanismhasfailedfranticallyturningthesteeringwheelwon'tchangethedirectionofthecar.
Whenwefinallyrealizethatweareoutofcontrolandstopourdrinkingorusing,wemayexpectthingstofallneatlyintoplace.Buteveninanuncomplicatedcaseof
chemicaldependency,theconsequencesofyearsofabusedon'tevaporateinamatterofweeksormonths.Aperiodofabstinenceandagradualreturntorational
thinkingandresponsiblebehavioreventuallyeliminatemanyoftheemotionalandbehavioralproblemsoftheactiveaddiction.
Thoseofuswhohaveadualdisorder,however,mayfindthatevenafterlongperiodsofabstinence,wearestillsubject
*AdaptedfromStepOneofAlcoholicsAnonymous,whichreads:''Weadmittedwewerepowerlessoveralcoholthatourliveshadbecomeunmanageable.''Thecomplete
TwelveStepsofAAappearonpage241.

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toemotionalandbehavioralsymptoms,suchasseveremoodswings,episodesofanxietyorpanic,obsessivethoughts,orcompulsiveactions.Thedualdisordermay
seemlikeadoublewhammy:Wearenotincontrolofouraddiction,norcanwecontrolsomeofouremotions.Acknowledgingthatouremotionalsymptomsare
beyondourcontrolcanhelpusunderstandthatouraddictionisadiseasethatisalsobeyondourcontrol.Thisrealizationcanhelpusacceptourpowerlessnessover
alcoholanddrugs.
Beingpowerlessovertheemotionalsymptomsofadualdisordermayrequirethatweturntoasourceoutsideourselvesforhelp.Wegenerallydon'tperceiveour
inabilitytocontroldepressionandanxiety,forexample,asamoralweakness,nordoweconsiderithumiliatingtoaskforhelpfromacompetentprofessional.When
weturntoanoutsidesourceforhelpwithanemotionalillnessofanykind,wearetakingthesecondoftheTwelveSteps.
STEPTWO:CametobelievethataPowergreaterthanourselvescouldrestoreustosanity.
Ifweunderstandaddictiontobeadiseaseandacceptthattreatingitrequireshelpoutsideourselves,itmaybeeasiertoseethatweneedoutsidehelpwithourdual
psychiatricdisease.
Somediseases,suchasthecommoncold,runtheircourseandimprovewithouttreatment.Butotherconditionsrequireexternalhelp.Forexample,thesymptomsof
recurrentanxiety,depression,orcompulsionscanbethoughtofasakindofinsanitythatmayrequireprofessionaltreatmentandspecificmedications,bothofwhich
are,infact,sourcesofpowergreaterthanourown.

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It'shumblingtohaveadiseasethatrequiresustoseekhelpfromanoutsidesource.(Somepeoplewithexcessiveprideandarrogancehavebeenknowntorefusehelp
evenforaheartattack!)Butaskingforhelpforanyconditionthatisbeyondourcontrolshouldn'tbeconsidereddemeaning.Twocornerstonesofspiritualityarethat
werealizeourhumanityandacceptthefactthatwemustalldependonothers.
Theideaofspiritualityisvitaltorecovery,anditmaybegoodtosayafewwordsaboutithere.
Humanbeingsdifferfromanimalsinmanyways.Whileanimalsgrowprimarilyinbody(biggerandstronger)andinphysicalfunctioning,peoplegrowincharacter
developmentaswell.Characterincludesnotonlyintelligencebutalsothewaysinwhichwethink,feel,andbehave.These,inturn,areinfluencedbyabilitiesthatare
uniquetohumansandthatmakeupthehumanspirit.
Humanbeingshavetheuniqueabilitytolearnfromthepasttothinkaboutthepurposeofexistencetothinkaboutandimplementselfimprovementtoreflectonthe
longtermconsequencesofouractionstodelaygratificationandtodistinguishrightfromwrongandactaccordingly.
Whenweexercisetheseabilities,weimplementourspiritwearethenspiritual,andourspiritualityinfluencesthewaywethink,feel,andbehave.
Wegrowincharacterwhenourthoughts,feelings,andbehaviorareinfluencedbyvaluablelessonsfromthepastnotonlyfromourownmistakesbutfromhistorical
mistakesaswell.Wegrowincharacterwhenwereflectonwhetherwearealreadyasgoodaswecanbeorwhethertherearesomethingswecandotomake
ourselvesintobetterhumanbeings.Thinkingaboutourgoalsandpurposesinlifeencouragesustoimproveourselves,andthisenhancescharactergrowth.

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Someofourbehaviormayhavebeendestructivebecauseweactedwithoutthinkingaboutthelongtermeffectsofouractionsorbecausewewereunabletodelay
gratifyingourdesires.Wemayhavedonethingsbecausewehadanurgetodothem,withoutconsideringwhethertheywererightorwrong.
Charactergrowthbeginswiththeawarenessthatweallstartoutimperfect.Justasweneedteacherstoincreaseourknowledge,weneedoutsidehelptoachieve
charactergrowth.WhenwetakeStepsOneandTwo,weplanttheseedsofthisgrowth.Werecognizethatsomeaspectsofourlivesarebeyondourcontrolandthat
theymayrequireoutsidehelptobringthemundercontrol.
Togaincontrol,abstinenceiscritical.Aslongasweuseaddictivesubstances,whichaffectthewaywethinkandfeel,wecan'tseethisclearly.Wemaythinkthings
areokaywhenthey'renot.Moodalteringchemicalschangeourperceptionofreality,andweloseournormalclarity,or"sanity."Adualdisorderdistortsrealitytwo
ways:throughtheaddictionandthroughtheemotionalillness.
SomeofusmayresistStepTwo.Althoughwerecognizethatweneedhelpfromapoweroutsideourselves,wemayassumethatthewordpowerimpliesGod.Some
ofusmayhavedifficultyorfeeluncomfortablewiththeideaofGod.WhilesomeofusdobelieveinGod,manyofushavegrownupwithanadorationofmodern
science,andwedismissanythingthatcannotbedemonstratedandproved.SomeofushavebeenbroughtupwithreligionbuthavelostfaithinGod.Theinjusticeswe
haveseenintheworldmayseemtoogreattoallowbeliefinajustGod.Someofushavebeendisillusionedbythosewhorepresentedreligion,andnowweconsider
religionhypocritical.WhenwehearthatrecoveryrequiresbelievinginaPowergreaterthanourselves,weback

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off,thinkingthatifrecoveryrequiresbelievinginGod,thenit'sbeyondourmeans.
WhilesomeofusequateaHigherPowerwiththetraditionalconceptofGodandareperfectlycomfortablewithit,thisisnotessential.Torecover,weneedonly
acceptaPowergreaterthanourselves,whateveritmaybe.Asonerecoveringpersonaptlyputit,"WhenIcametorealizewhatamessmylifewasin,Ifiredthe
personwhowasrunningit."Ifwefireourselvesasmanagers,someoneorsomethingelsemustbeassignedthejob.
Tosummarize:Whenwehaveadualdisorder,weneedhelpfromsourcesoutsideourselves,andeachconditionmayrequireadifferenttypeofhelp.
Sinceourliveshavebecomeunmanageablebecauseofthedualdisorder,wetaketheThirdStep.
STEPTHREE:MadeadecisiontoturnourwillandourlivesovertothecareofGodasweunderstoodHim.
Atfirstglance,wemaythinkthatwemustmakeacommitmenttoreligion,becausetheStepsnowreferto"God."Butthephrase"asweunderstoodHim"allowsusa
broadchoiceofwhatwewishtothinkofasGod.
Considerfirsttheideaofturningourlivesover.SubmittingourlivestoaPowergreaterthanourselvesisnotthatunusual.Wedoitwhenweaccepttreatmentforan
illness,trustingthatthedoctor'sknowledgeandcarewillmakeuswell.Wedoitwhenweundergosurgery,turningourlivesoverevenmorecompletely.Forthe
psychiatricpartofadualdisorder,wearelikelytoaccepttreatment(includingprescriptions)fromacompetentprofessional,inwhichcasewereallyareturningour
livesovertohisorhercare.Whenweturnour

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livesovertoaHigherPowerforrecoveryfromourdualdisorders,wesimplyexpandouropennesstohelp.
Whileturningourlivesovertoothers'careisnotunfamiliar,theideaofturningoverourwilldoesappeartobeanewideapsychiatristsorcounselorsgenerallydon't
askustoturnourwillovertothem.YetturningourwillovertoaHigherPowerisn'treallysounusual.Aschildren,wemayhavewantedthingsthatwerenotgoodfor
us,perhapscandybeforedinnerorsharpedgedtoyswhosepotentialforharmwedidn'tunderstand.Ourparents,whowerethena"powergreaterthanourselves,"
toldusthatthesewerenothealthychoices.Similarly,adoctormaytellapatientwithstomachtrouble,"Youcaneatanythingyouwantandhereisalistofthingsyou
canwant."Inotherwords,sometimeswewantthingsthataredetrimentaltoourwellbeing.Therefore,weaskforhelpfromaHigherPower,saying,"Iwantbuthelp
metolearnwhatisbestforme.''
Ouraddictionaffectedourwill,andwemaynotbeabletoseethatwhatwedesireisharmfultous.Aswerecover,welearntowillhealthierthings,andweturntoour
HigherPowertohelpuscorrectthedistortedwillthathaskeptouraddictiongoing.
Tolearnwhere,how,andwhywehavemadeunhealthychoices,wetakeStepFour.
STEPFOUR:Madeasearchingandfearlessmoralinventoryofourselves.
Weknowthatwearedrivenbypowerfulinstincts:selfsurvival,security,prestige,sex.Theymaybeexpressedinwaysthatcontributetohealthandgrowthorinways
thatharmourselvesandothers.Takinginventorymeansthatwe

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takestockofwhatwe'vedoneandreviewourassetsandliabilities.Thenweanalyze,asbestwecan,whywedidcertainthingsandwhattheconsequenceswere.
Thisprocesshelpsusidentifyourhealthyandunhealthyactions.Justasabusiness'sinventoryshowswhichproductsgenerateaprofitandwhichresultinlosses,a
moralinventoryhelpsustoseeourcharacter's"profitsandlosses."
Focusingonourassetsandliabilitiesenhancesourcharactergrowth,butoureffortsmaybederailedifweblameothersforallouradverseexperiences.Ifweare
preoccupiedwiththewrongsthatothershavedone,wedonothingtohelpimproveourselves.Onlywhenweidentifyourownmistakescanwemakechangesthatwill
helpusgrowincharacter.
Forexample,perhapswereactedwithangerandresentmentwhenwefeltthatoursecurityorselfesteemwasattacked.Butacloserlookmayrevealthatwe
exaggeratedthethreat.Orwemayfindthatweweredepressedbecausewefeltdeprivedofsomethingwecraved.Acloserlookmightsuggestthatthedeprivation
wasnomoreseriousthannotgettingicecreambeforedinnerwhenwewerechildren.Inotherwords,wewantedsomethingthatwecouldn'tseewasnotinourbest
interest.Aninventorycanhelpuseliminatesomeoftheanger,resentment,andfrustrationthatwemaybeharboring.Itcanhelpusdiscoverthatsomeofour
disappointmentsandfailuresmayhavebeencausedbyourownselfdefeatingattitudes.
Aswedoaninventory,wemaycomeacrossactionsweregret,andthismayarousefeelingsofguilt.Suchguilt,whichresemblesthephysicalpainwefeelwhenwe're
injured,canbehealthywhenitdetersusfromrepeatingtheseactsandleadsustomakeamends.Forthosewithdualdisorders,

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however,guiltyfeelingsmaynotalwaysberelatedtoactualmisdeedsrather,suchfeelingsmaybeasymptomofacoexistingpsychiatricillness.Thoseofuswho
obsessaboutguiltyfeelingswithnobasisinrealitymayrequirespecialtreatment.
Whilethepurposeofaninventoryistoenableustoweedoutourfaultybehaviors,itcanalsohelpusdiscoverourcharacterassets.Indualdisorders,however,the
coexistingillnessmayrenderusunabletoseeourassetsit'sonlywhenthepropertreatmentforthecoexistingconditioniseffectivethatweareabletodoawell
balancedinventory.
Howdoweputaninventoryintoaction?Justaswewouldifweweretodoabusinessinventory.Wegetridofthoseproductsthatareunprofitable,andweputthe
profitableproductstothefore.Takinganinventoryhelpsusidentifydesirableandundesirablebehaviors.Whenwebringthemoutintotheopen,wecanmaximizeour
desirabletraitsandtrytoeliminatetheundesirableones.ThisbringsustotheFifthStep.
STEPFIVE:AdmittedtoGod,toourselves,andtoanotherhumanbeingtheexactnatureofourwrongs.
Unlesswearticulatetheitemsonourinventory,theundesirablethoughtsandfeelingsmaycontinuetofesterwithinusandgiverisetounhealthybehavior.Whenwe
readourinventorytoanotherhumanbeingaswellastoourselvesandtoGod,webringmanythoughtsandfeelingsoutofhidingandtheybecomemoremanageable.
Thepersontowhomwedisclosethemmustbesomeonewecantrustwithourinnermostsecrets,whocanlistentousobjectivelyandbeagoodlistener,andwho
mayhelpusovercomesomeof

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thedistortedperspectiveswemighthaveaboutourfeelingsandactions.
Becauseacoexistingpsychiatricconditionmaycauseanxiety,worry,moodchanges,andfrustrationswhosetruenaturecanbedetectedonlybyatrainedspecialist,
wemayneedhelpfromacompetentprofessionaltoidentifythoseinventoryitemsbasedinrealityandthereforesubjecttocorrectionbyworkingtheTwelveSteps,
andthosethataresymptomsofthecoexistingillnessandrequiretreatment.
Thecoexistingpsychiatricillnessesthatwe'vementioned(e.g.,anxiety,panic,depression,orcompulsions)arecharacterizedbydistressfulsymptomsbutdon't
constitutealossofcontactwithreality.Thereare,however,psychiatricillnesses,suchaspsychoses,inwhichtheremaybedelusionalthinking,mania,or
hallucinations.ImplementingtheTwelveStepsmustwaituntiltheabilitytoreasonhasbeenrestored,lestthedelusionormaniadistorttheconceptofpowerlessness,a
HigherPower,ormakinganinventory.
ProperlyworkingStepsOnethroughFivehelpsusclarifythevariouselementsofthedualdisorder,sothatwecanmakebetteruseofthecharacterenhancingSteps
SixthroughTwelve.This,togetherwithappropriatetreatment,willhelpusachievesobrietyandemotionalwellbeing.

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4
WeAgnostics
GennaL.
Formanyofus,StepsTwoandThreeloomasstumblingblocks.HavingacknowledgedinStepOneourpowerlessnessinthedualfacesofaddictionandmental
illness,wedon'tknowwheretoturntofindthatpowergreaterthanourselves.StepTwoasksthatwebelieveinaPowergreaterthanourselvesStepThreedirectsus
toturnourwillovertoGod.HowcanweturnourlivesovertoGodifwefirmlydon'tbelieve,orevenifwearesimplyuncertain,thatGodexists?
Yetjustaswearenotaloneinourstruggleswithadualdisorder,wearenotaloneinourskepticismoruncertaintyconcerningtheconceptofGod.WriterFlorida
ScottMaxwelldescribeshumanity'sancientsearchforGod:
InsomecentralpartofusmankindmustalwaysbetryingtounderstandGod.Inthatpoignantcorewherewecalloutourquestions,andcryforananswer.Itisineachofus,even
ifthequestionandanswerarebothdespair.WearealwaystalkingtoGodevenwhilewearguehimoutofexistence.*
*FloridaScottMaxwell,TheMeasureofMyDays(NewYork:PenguinBooks,1979),111.

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ThoseofuswithadualdisorderhaveexperiencedthesemomentsofdespairwhenwecalledouttoGodunsureifoneexistedtoberescuedfromourillnessand
addiction,onlytobeansweredwithsilence,withnewdaysofpainandstruggle.
ManyofushaveindeedarguedGodoutofexistence.Andwhynot?Despiteourpleasandprayers,thesweepingmoodswingsorthedepressionremained,the
cravingforadrinkreturned,ortheurgetobingebecameoverwhelmingagain.Overandoveragain,ourmentalillnessandaddictiondrewaviciouscirclearoundus,
propellingusfromonecycleofdespairtoanother.
Whatwastheretobelievein?NotonlydidourpersonallivesmakeusdoubtthatGodexisted,buttheproblemsofthelargerworldarounduspoverty,
homelessness,violenceseemedtoreinforceourdoubt.TheGodthatmayhavebeenpresentedtousinthereligionsofourchildhoodseemeddistantandpunitive.
Traditionalorganizedreligiondidn'toffertheanswerstothequestionsthatweasked,oneitherapersonaloraphilosophicallevel.Withnoresponsetoourneeds,no
answerstoourquestions,andnotangible,quantifiableproofthatGodexisted,therewasnothinginwhichwecouldfindfaith.
Now,asnonbelieversorskeptics,weareaskedtomakewhatinitiallyseemstobeanimpossibleleapoffaith:tobelieveinthepossibilitythataHigherPowerwill
restoreus.Fortunatelyforus,thisleapisnotaslargeorasdangerousasitmayinitiallyseem.SincetheTwelveStepprogramwasintroduced,hundredsofself
describedatheistsandagnosticshavesuccessfullymadethisleapandbegunthespiritualjourneyofrecovery.
TheTwelveStepprogramdoesn'taskthatwewillourselvesintobelievingsomethingwedon't.Ifyoulookcarefully

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atStepThree,you'llseethatallthisprogramrequiresisthatweturnourwillsandlivesovertoaHigherPower,asweunderstandthatHigherPower.Hereisyour
bridgeforthatleapoffaith.YourHigherPowerdoesn'thavetobeGodasdefinedbytraditionalreligion,yourfriendsorfamily,orevenfellowTwelveStepfollowers.
ItisuptoyoutoconceptualizeanddefineaHigherPowerforyourself.
Inordertofullyunderstandandembracethisconcept,stopworryingabouttheexistenceofGodforaminuteandjustlookatthewordsHigherPower.Tryto
imagineapowerorforcethatisstrongerthanyourindividualwill.Startwithsomethingsimpleandclear.Whatabouttheforcesofnature,suchasthespeedingwinds
oftornadoes,fiercemovementofearthquakes,orrapidsearofaforestfire?Whateverbrutestrengthwepossessasindividualscannotcomparetothestrengthsof
thesenaturalforces.Earthquakes,tornadoes,hurricanestheseareeventswecan'tcontrol.Instead,werespondtotheiroccurrence.Wereactbyseekingshelteror
movingtosafety,butwearepowerlesstostoptheforcethatfrightensus.
Similarly,rememberthetimeswepromisedourselves(andperhapsfriends,familymembers,physicians,ortherapists)withcompleteconvictionthatwewouldtakethe
prescribedmedicationorwouldneverdrinkalcoholagain?Remembertheironcladdeterminationthatwewouldnotletourselvesslideintodepression,thatwewould
simplywillourselvesintonormal,activelifestyles?Wehaveallassuredourselvesatonetimeoranotherthatrecoverywasamatterofwillpower,thatifonlywecould
tryhardenough,individualstrengthanddeterminationwouldconquerourproblems.
Thatresolveshakesandcrumblesinthechaosofamanicepisodeorthedesperationofdepression.Inaninstantor

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afterlonghoursoffighting,wereachforthedrink,thefood,thedrug.Itisnotthatourwillsareweakorourresolveartificial.Instead,wearesimplypowerlessover
ourdualdisorder.Alloftheindividualdeterminationintheworldwillnotwardoffdepression,stopamanicepisode,orsaynotococaine.Aswedowiththetornado
orearthquake,werespondtoaforcewecannotcontrol.Thetornadosendsusrunningtobasementsinsteadofclimbingintoourcarstodrivetoworkaswehad
planned.Thesingleshotofbourbonbecomesawholebottle,thedrinkingslidesusbackintodepressiontheordinarytasksandpleasuresofourlivesdisappearas
ouractionsonceagainbecomegovernedbyourdualdisorder.
Acknowledgingthatpowersgreaterthanourselvesexistisanessentialmovementawayfromthepowerofthedualdisorderthatoverwhelmsus(thepowerwe've
triedtofightandtodeny,tonoavail)towardtheHigherPowerthatwillcarryeachofusthroughrecovery.Thisacknowledgmentitselfrequiresnofaithorbelief,
simplyreason.Isitactuallyreasonabletobelievethatanyonepersonisthemostpowerfulforcethatexists?Thatnoforce,power,orknowledgegreaterthanthe
singlehumanmindexists?FromCarlJungtoAlbertEinstein,thegreatestmindsofthiscenturyhaveacknowledgedthelimitationsoftheindividualmindandspeculated
abouttheshapeorformthatahigherintelligencemighttake.
DefiningtheparticularHigherPowerthatwillcarryeachofusthroughourrecoveriesisahighlypersonalandindividualrightandresponsibility.Manyagnosticsand
atheistsbeginningaTwelveStepprogramhavenodesiretodiscover''God"inthetraditionalsense.Manypeopleconsidertheirtherapists,supportgroups,or
supportivecommunitiestheirHigherPowers.

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Amy,whowasbulimicandhadbipolardisorderwithseveremanicanddepressiveepisodes,describedthediscoveryofherHigherPowerintheseterms:
Ididn'tbelieveinGod,ortheenergyoftheUniverse,oranyofthetermspeopleinmyOAgroupused.ButIdidbelieveinlogicandeducation.OnedaywhenIwasparticularly
depressed,feelingunabletogoonatall,mytherapisttoldmethatIdidn'tneedto"muster"upenergyormotivationthatIcouldn't.Shesaidthatshecoulddotheworkformefor
awhile,givemethethingsIneededtocontinuewhenIdidn'thavethepowertogetthemformyself.
Itwasanincrediblerelieftogivemyselfovertoherexpertiseandtraining.SheknewhowmuchLibriumIneededshehadyearsofexperienceworkingoutmealplansthatbulimics
usedsuccessfully.Mydualdisorderwasbeyondmyabilitytounderstandandmanage,butitwasnotbeyondhers.

Atthispoint,Amylethertherapisttakeover.Sheacceptedthehelpofferedher,theyearsoftrainingandexperienceofaprofessional.Thisisespeciallyimportantfor
peoplewithdualdisorders.Theinteractionofmentalillnessandaddictioncanbecomplicatedandvolatile.Ourtherapistsandphysiciansoftenhavepowerswedo
notthepowertoprescribeappropriatemedication,tounwindandinterpretchaoticemotionsbehindaddictivebehavior.Aspeoplewithdualdisorders,wecanbe
blindedandboundbytheirforceprofessionalswhoexistoutsideofthestormsofourlivescanseeclearlywhenwecannotandcanguideus.
Thestrengthwedon'thaveasindividualscanalsobefoundinsupportgroups.ManypeopledefinetheirHigherPowerasthecaringforceofcommunity.JeanC.
writes

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aboutfindingherHigherPowerinherAAgroupwhenshecouldn'tbelieveinGod.
ThiscounselortoldmetogettheattributesofmyHigherPowerfromthegroup:"ThegroupisgoingtobeyourGodforawhile."SoIstartedwatching.Whatdidthegroupgive
mebesidesacceptance?TheygavemesharingandcaringIcouldgoonandonaboutwhatthatgroupgaveme.SotodayIhaveaHigherPowerthathasnoeyes,noarms,no
face,justauniversalpowerthatisfilledwithlovethathasmercyonusall....TakingmyideaofaHigherPowerfromthegroupitselfwasmarvelous.NowmyHigherPowerhas
monumentalattributesandgrowseveryyear.*

Jeanfoundlove,support,andsomethingstrongerthanherselfinthepeoplearoundher.Whereassilenceultimatelyweakensusandisolationstokesthefireofourdual
disorder,openingourlivestopeoplewhosharethesameproblemswillopeneachofustoanabundanceofloveandenergyimpossibletoimagineordescribe.People
unitedinacommongoalofrecoverycreatepowerfulcommunities.
Itisimportantthatthoseofuswithdualdisordersutilizeallavailableresourcesforsupport.Ourneedsarecomplex,becausewearenotdealingwithmentalillnessor
addictionalonebutwiththecomplicatedconsequencesoftheinteractionbetweenthesetwo.Sometimeswewillneedmorethanonesupportgroupinordertocreate
acommunitythatcanbecalledaHigherPower.OurHigherPowerscanbepersonal,combinedcommunitiesofsupportgroups,therapist,friends,andperhapsfamily.
*

RachelV.,ed.,AWomanLikeYou:LifeStoriesofWomenRecoveringfromAlcoholismandAddiction(SanFrancisco:Harper&Row,1985),188.

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AtheistsandagnosticsalsofindtheirHigherPowersinthingsorinideas.OnemandecidedthatasmoothgreenstonewouldbehisHigherPower.Healwayscarried
thestone,andwheneverhelookedatit,hesawthepain,struggle,andeventualhopethatitsymbolizedforhim.Duringdifficultmoments,heheldtightlytothatstone,
allowinghimselftobecarriedawaybythedreamforabetterlifehesawinitsflatgreenshine.
HigherPowersareasdiverse,creative,anduniqueasthepeoplewhodefineandbelieveinthem.Somepeoplefindpowerinthebeautyandforceofnature,inputting
themselvesinperspectiveasoneintegralpartofourliving,breathingplanet.OthersvisualizetheGodoftraditionalreligionastheinfinityoftheuniversesomeofour
HigherPowersexistasthetangibleenergythatguidestheworldsomeseeGodinaformthey'refamiliarwith,suchasfemale,black,Asian,andsoon.Onewoman
studiedEasternandWesternreligionsuntilshehadenoughinformationtovisualizeapowershetrusted.
HowwedefineourHigherPowerisinourcontrolourdualdisorderisnot.Isn'tittime,asLarryEisenbergsaysinNightLight:ABookofNighttimeMeditations,
to''resignasgeneralmanageroftheuniverse?"*UnderstandthatrecoveryrequiresaPowergreaterthananyindividualwill.GivingourwillsandlivestoaHigher
PowerisessentialtoworkingtheTwelveStepprogram,essentialtorecovery.
TheTwelveStepprogramdescribesturningourlivesovertoaHigherPowerasembarkinguponaspiritualjourney.Manyofusoriginallycringedatthewordspiritual
becauseitremindedusofthetraditionalreligiousdefinitionswe'd
*AmyE.Dean,NightLight:ABookofNighttimeMeditations(CenterCity,Minn.:HazeldenEducationalMaterials,1986).

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rejected.However,wearenowredefiningthisawakeningtofitourpersonaldefinitionsofaHigherPower.
TheAmericanHeritageDictionarydefinesspiritas"thevitalprincipleoranimatingforce...withinlivingbeings."Thisspiritresidesineachofus.Thespiritual
journeywebeginbyacknowledgingaHigherPowerisnotajourneyofsuddenconversionorinstantreligiousinsight.Instead,recoveryitselfisthejourney.Our
spiritualjourneyscanbetheprocessofunleashingthevitalityoflifethatlieswithineachofus.Thisvitalityissimplytherichnessofanauthenticandhonestexistence
anexistencedirectedbyourHigherPowers.
TheTwelveStepprogramoffersushopebyprovidingapathoutofthechaosoflivesruledbydualdisorders.Allweneedtodoisredefinethepowerthatguidesour
lives.Insteadofbeingoverwhelmedbythepowerofourdualdisorders,weareeachinvitedtofindadifferentHigherPowerthatwillguideusthroughrecovery.Our
individualHigherPowerscanleadeachofusaswediscoverandunleashourindividualspirits,ourhealthyselves.

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5
RecoveryandRelapse
KateS.
Chapter5oftheBigBookofAlcoholicsAnonymous,"HowItWorks,"talksaboutpeople"whoareconstitutionallyincapableofbeinghonestwiththemselves.There
aresuchunfortunates.Theyarenotatfaulttheyseemtohavebeenbornthatway."*Idisagreewiththesestatements.Eventhecraziestpeoplehaveperiodsoflucidity
inwhichtheycanbehonestwiththemselves,recognizetheiraddictions,worktheTwelveSteps,andtryforrecovery.
Torecover,however,apersonwithadualdiagnosisofalcoholorotherdrugaddictionandmentalillnessneedsastrongsupportstructure.ThismeansnotonlyAA
(oranotherTwelveStepgroup)butverylikelyamentalhealthsupportgroupthataddressesthedisorderfromwhichthepersonissuffering,suchasamanic
depressivegroup,OvereatersAnonymous,orEmotionsAnonymous.Formeitmeantjoininganobsessivecompulsiveselfhelpgroup.Whattheobsessive
compulsivegroupdidformethatAAcouldnotwastogivemeanextendedfamilythatunderstoodmylimitations,frustrations,andvictoriesinmyparticularmental
illness.IneededmosttofeelthatIwasnot
*AlcoholicsAnonymous,58.

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alone,andgoingtoaweeklygrouphelpedmerealizethis.
Therearemanypeoplewithamentalillness.Someofthemalsosufferfromanaddiction.IfoughtforyearstoprovethatIwasnotanalcoholic,onlyadepressedand
suicidalvictimoftraumaticabuse.Perhapsyou'vefeltthiswayalso.ItwasonlywhenIreachedtheabsolutebottomofsufferingwithmydrinkingthatIrealizedmy
problemhadtobetwofold:IwasmentallyillandIwasanalcoholic,andthetwowerenotindependentofoneanother.
Ihavediscoveredmanythingsaboutmydualdisorderoverthelasteightyearsandoneofthemisthis:Iampowerlesstocontroleithermymentalillnessormy
alcoholism.Oneaffectstheotherjustassurelyasthesunwillrisetomorrow.IfindthatwhenIaminthemidstofapsychoticepisodehallucinatingandfeeling
anxiousIwillentertainsuchstrangethoughtsasIfIhaveadrinknow,allwillbewell,which,ofcourse,isnottrue.IfIdrinkwhenIampsychotic,Iamdoubly
likelytothinkofawaytoendmylifeifIamnotgoingthroughapsychoticepisodeandIdrink,thealcoholalmostalwaystriggersone.
Thetwodisordersareinterdependent,andthatiswhyitisamusttofindmorethananAAgroupforsupport.ItmightbeeasytosaytoAApeoplethatwearesome
ofthoseunfortunateswhocannotgetsober,butpullingthewoolovertheeyesoffellowsufferers(thosewhoareduallydiagnosed)isjustaboutimpossible.
Atherapistisanothersourceofsupportforpeoplewithanaddictionandanemotionalorpsychiatricillness.Whetherthatpersonisapsychotherapist,psychiatrist,or
psychologistdoesn'tmatter.Whateverworksisgood.Ihappentorelyonallthree,andovertheyearsIhavediscoveredthatjusthavingsomeoneinmycornerisa
greathelpinovercomingthe

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problemsofmentalillness.Atherapistcankeepmeawareofreality,canbelieveinmewhenIcan'tbelieveinmyself,andcaneitherprescribeneededmedicationor
findsomeonewhocan.Justknowingtheyarethereandcantalkmethroughabadtimeisworthdaringtotrustsomeone.
Forthoseofusfortunateenoughtohavefamilieswhounderstandourillnessesandcanofferconstructivesupport,homeisalsoagoodplacetogowhenthingsget
overwhelming.Afamilycanbeastrongbackbonewhenaboutofmentalillnessrendersusdefenselessandinclinedtodrinkorusedrugstofeelbetter.Family
membersknowuswell,andtheycandrawfromexperiencethewordsweneedtohearinordertorallyandmakeitthroughthebadtimes.
Friendscandothesamework,andforpeoplelikemewhocan'tdependonfamily,friendsarethenextbestthingtoatherapist.Manytimes,whenI'vebeenburning
myarmswithcigarettes,I'vecalledadearfriendinthemiddleofthenight,afraidtogotosleepbecauseIthoughtIwasgoingtodieandshewasalwaystherefor
me.Shemayhavebeenalittleupsetatthelatenessofthehour,butshewasgladthatItrustedherenoughtoturntoherforhelp.
Andyet,sometimeseverythingmaystillseemtofailAA,mentalillnessgroups,therapists,family,andfriends.ThingscanbegoingalongswimminglywhenPow!
somethingseeminglyoutofthebluestrikes,andwearevulnerabletousingagain.
Forexample,Irecentlywokeuponemorningbelievingthatmymedicationsweredepressingmeandthatalcoholwouldcheermeup.IthoughtIcouldbuckallthe
rulesandbehappyasacreativedrunkard.Iheardmessagescomingthroughmyradio,tellingmethatIshouldfollowinthefootstepsofHemingway:Icoulddrinkand
writeandprobablyavoidthecrackupintheend.HowwrongIwas.

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ThatdayIactuallydrankonecanofbeer.Immediatelyfollowing,Isawlightscomingthroughthewindowaimedatmyhead.IfiguredGodorsomethingwastryingto
reachme,soIlaydownonthecouchandwaited.AllthathappenedwasthatIfellasleep.NothingmorecameofthebeerexceptaslightheadachewhenIawoke.I
wasluckythattime.
Thepointisthis:Iwasdepressedatthetime,feelingsobadIreallywantedtodie,andIthoughtthealcoholwouldmakemefeelgood.Whatitreallydidwastriggera
boutofmania,whichendedinmoredepression.Soyousee,alcoholandmentalillnesscanaffecteachotherseriously,andtheupanddownrollercoasterrideIgo
onisagreatdeallessthanfun.TheonlywaytobesurethatIamdealingstrictlywithmymentalillnessistostayawayfromdrugsoralcohol.Ifnothingelse,matters
don'tgetsocomplicated.
Relapsetoaddictionforthepersonwithadualdisordercanalsobecausedbyproblemswithmedication.Irememberthatwhenthedoctorsweretryingtogetmy
medicationsright,Ioftenturnedtoalcoholtocounteracttheirsideeffects.Ithoughtthatbyusingalcohol,Iwasnullifyingtheeffectsofthedrugs.WhatIwasreally
doingwasplayingadangerousgameofRussianroulette.Ishouldhavekeptthedoctorsinformedofmystateofmindandtakensometimeoffworkwhilethe
chemicalsinmybodyadjustedthemselves.
NowthatIamregulatedbutstillhaveboutsofpsychosis,IneedconstantremindingthatIhavemedicationsthatwillhelpmecopewiththeupsetcausedbymental
illness.InolongerfeelaboutmymedicationsasIoncedidthattheyaremindalteringanddangerousbutacceptthatIneedtotaketheminordertobewellandto
haveenoughpresenceofmindtostayawayfromthedrugofmychoice.
AnotherbigfactorinpreventingrelapseonethatIforgetnearlyeveryotherdayistoeatrightandgetsome

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exercise.Justsittingaroundthehouse,hangingontomystateofmindorlettingmythoughtswhirl,isgoodforneithermybodynormymind.Theprognosisispoorfor
someonewhositsinoneplaceallday,eatingorsmokingorsleeping.Allthatsittingisboundtoendupinlistlessness,andtoomuchtimetothinkortoomuchextra
energycaneasilyresultinausingbinge.It'sbettertogetup,stretch,takeawalk,ordosomethingthattaxesmealittlebit.Sedentaryandsoberdon'tgotogether,but
exerciseandrecoverydo.
OtherthingsIlookatifIfindmyselfclosetoorinarelapsearemymoods.AmIangry?Resentful?Selfpitying?Unabletoacceptmycondition?Asaddictswetend
torunawayfromfeelings.Beforewestoppedusing,werantointoxicatingchemicalsforhelp.Now,withoutthem,we'realonewithourfeelings,andtheyaren't
alwayspleasantones.Butthatdoesn'tmeanthey'rebad.Foreveryemotionthereisareason,andwewouldbewisetolookintoit.RecentlyIbecameangrybecause
Ihavesomanypsychoticepisodeseverymonth.IfiguredthatIdippedlowaboutfourtimesamonth.Thisseemedunfairtome,andimmediatelyIthoughtofdrinking.
ThankgoodnessIdidn't.That'sonethingaboutfeelings:Ifyoudrinktocoverthemup,theyactlikebubblesinawatercooler.Theyalwayscometothesurface.
AnotherthingIhavelearnedtodoisfindsomeoneIreallytrust,andwhenIgetsickItellthatpersonhowIfeelandwhatIwanttodo,andthenIpromisenottodo
anythingthatisbadforme.OnceIwantedtodrivemycarintothegarage,sittherewithabottleofalcohol,anddrinkuntilthecarbonmonoxidegottome.WhatIdid
insteadwascallmybestfriend,andthenmytherapist,andtellthemwhatmyplanswere.Eachmademepromisetodonosuchthing,so

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insteadIspentthedayreadingandlisteningtomusic.JustcallingsomeonemademefeelasthoughIhadsomecontrolovermyactions.IfIcouldcallsomeone,thenI
couldavoidattemptingsuicide.Itallmadesense.Ijusthadtolisten.
Keepingajournalhasalsobeenhelpfulovertheyears.IfoundoutearlythatifIwrotedownwhatIwasfeelingatagiventimeandthenkeptwriting,Icouldfindmy
wayoutoftheabyssIwasin,justasIdidintalkingtosomeoneonthephone.(ButsometimeskeepingajournalworkedbetterthanthephonebecauseIhadbrought
myselfoutoftheslumpandcoulddoitagain,anytime,ifnecessary.)It'sagoodfeelingtokeepajournal,anditdistractsmefrombadfeelingsImaybehaving.When
IlookbackonstuffIwrotethreeorfouryearsago,I'mamazedathowfarI'vecome.
WhenthingsarereallygoingbadanditlooksasthoughImaytakeupdrinkingagain,thefinalrabbitIpulloutofmyhatistoorganizemylife.Idon'tmeanmakea
fiveortenyearplan.Imeanbalancingmycheckbook,takingoutthetrash,catchinguponcorrespondence,entertainingmyselfwithahobby.Thereissomuchtodo
inlife,butwhenIampsychotic,Ihaveahardtimerememberingthat.ButifIdosomethinglikecleaning,Iperkuprightaway.Keepingoccupiedislikemagiconly
betterbecausethereisnoillusioninvolved.It'sasafetynetinmylife,andI'vedependedonit.
Sotherereallyarethingsyoucandotoavoidarelapseifyouarechemicallydependentandmentallyill.Youdon'thavetobeterriblycreativeorsmart.Havecoffee
withafriend,puttheloosestampsintoyourstampcollection,takethedogforawalk,orcleanouttherefrigerator.Thissortofthingmaysoundsimplebut,believe
me,itmaybejustthethingtosaveasufferer'slife.

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6
AbstinenceandSobriety
KateS.
Asapersonwithadualdisorderwhodoesn'tdrinkortakeunprescribeddrugs,Imustbelievethatthegoodfeelingswilllast.Andnotonlythattheywilllast,butthatI
deservethem.
AfterIsoberedup,Ihadahardtimebelievingthatanyonecouldfeelsohappy.Ifeltsofree,socapableofdoingwhateverIsetmymindto.Itwasn'tjustmania
talkingtomeeither.Ihonestlyfeltgood.ThelongerIstayedawayfromalcohol,themoreIfeltmymentalillnessseemedtoimprove.
ItisnosecretamongthoseofuswithadualdisorderthatwehavewhatIcalla''forgettery."Weforgetthebenefitsofsobriety:thatwithoutdrugsoralcohol,our
problemsareonly"troubles"whichwecanmanageandthatdisastersinourlivescanusuallybeavoided.Weforgetthatafterthebadtimes,therewillbebetter
timesandthatevenwhenthebadtimeshit,theywillnotbeasbadastheywerewhenweweredrinking.Perhapsthisisaconvenience,butIprefertothinkthatour
illnessescloudourmemories.Tocompensate,I'veplacedahugenoteonmyrefrigeratorthatsays,ThisTooShallPass.(YoumightrecognizethisasanAAslogan.)

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IalsohaveaPostit noteonmybathroommirrortoremindmethatmentalillnessandchemicaldependencyarenotseparateentitiesandthatsobrietybegets
stabilityandstabilitybegetssobriety.Thenotesays,"Foreveryaction,thereisanequalandoppositereaction."(YoumightrecognizethisasoneofNewton'slaws.)
Ifyouhaveahardtimebelievingyouareworththegoodfeelingsthatcometoyouwhenyougetstraight,youarenotalone.I,too,usedtobelievethatIwasevilor
badandthatIdeservednothinglessthandeathfromcirrhosisoftheliver.OrIthoughtabusshouldrunmeover.I'veusedsuchlogicwhenI'vewantedtostart
drinkingagain.I'dtellmyself,"Whattheheck,Idon'twanttoliveforeverandIprobablywon'tanyway.SoImightaswelldrinkandenjoymyself."ButwasIreally
enjoyingmyself?NowthatIhaveenjoyedsomesobrietyandhaveawakenedinthemorningfeelinglikethedayaheadheldpromise,IknowthatIwasonlykidding
myself.NothingfeelsbetterthantowakeupsoberandknowIhavenothingtoapologizefor.
Withthegoodfeelings,ormaybebeforethem,comestherealunderstandingthatwearenotaloneintheuniverse.Sometimesafriendcallsusjustwhenwemostneed
it.Orthesunpopsoutwhenwe'refeelingdown.Orthere'salightandcheerfulsnowfall.Whateveritis,thereisalwaysproofaroundusthatwearenotalone.I
discoveredonceagainthatIwasnotaloneonthenightaftermylastdrunk:IgotdownonthefloornexttomybedandprayedtomyHigherPowertohelpmewant
tolive.ThenextmorningIgotaphonecallfrommymother:Shejustwantedtotellmethatshelovedme.Howsimple.
Butthat'sjustthewayourHigherPowerscanwork.Noonecandependonhimselforherselftoalwaysbethere

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whenthehardtimeshit.Everyoneofusneedshelpatsometime.TrustthatthereisaHigherPowerthatwillcarryuswhenwecannotwalk.
AsforwhatyourHigherPoweristhatdoesn'tmatter.Iusedalittlemarbleturtleforfiveyears.MyfirsttherapistgaveittomeIkeptitonmybureauandtouchedit
ortalkedtoitwhenIwashavingroughtimes.IhonestlybelievethattheturtlecontainedaHigherPower.Ihaveheardsimilarstoriesofpeopleusingglassescases,
lightbulbs,orfigurines,aswellastheirAAgroup.Anythingthatworksisfine.OnlyyoucandecidewhatyourHigherPoweris.
ThemostimportantthingIlearnedacoupleofyearsagowasthatmyHigherPowerisnotanenigma.Itworksthrougheverythingaroundme.IfI'monthestreetand
awomancomesuptomeandsays,''Isn'titagreatday?"I'mquitesurethatit'smyHigherPowerremindingmetoenjoytheworldIlivein.Morethanahandfulof
timesI'vebeensittinginarestaurantandthewaitresshascomeupandtoldmeit'sgoodtoseemeagain.ThisismyHigherPowerremindingmethatIamnot
invisible.It'snotmysticismormagicit'sjustaseriesofeventstoremindmethatIamnotalone.Mostofallweneedtoknowwearenotalone.
Downthelinetherewillbeaspiritualawakeningforyou.Thereisnotellingwhatformitwilltake.Itmaybesuddenorgradualnoonecantell.ButIcanassureyou
thatonceyouhaveaspiritualawakening,you'llbechanged,andtherewillbesomethingaboutyourrecoverythatattractsothersufferers.
Iwaswaitingatthebusstoponedaywhenthisyoungmanapproachedmeandsaid,"Hi.I'maschizophrenic."Iwasfloored,butthenIsensedhehadapproached
meforareason.Irodewithhimonthebus,anditturnedouthewas

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nottakinghismedication.Itriedtotellhimthiswasnotagoodidea.Whenhedeparted,hesaidsimply,"Thankyoufortalkingtome."Helpingotherscanbevery
rewarding.
TheonlythingIamcautiousaboutisendangeringmyownsobriety.Idrawthelinewhenitseemssomeoneistryingtotalkmeintodrinking.ThisIcannotdo.Inthese
instances,Irememberthatitismyjobtocarrythemessage,notthealcoholic.Ifsomeonewhoismentallyillwantstotalktome,Iwilltalk.Ifthatpersonissoberand
wantstostaythatway,IwilldoallIcantosupporthimorher.Butfirstofall,IhavetotakecareofmyselfAAhastaughtmethat.Mymentalillnesshastaughtmeto
honormylimitations.KeepingmylifeinorderismyjobclearingtheshardsoftemptationfrommypathisuptomyHigherPower.Itrust.Youwill,too.

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7
TellingOthers
JodyN.
PersonalRelationships
Publicknowledgeofaddictionhasbecomewidespread,andtellingothersaboutourchemicaldependencydoesn'tposethesameprobleminrecoveryasdoestelling
othersaboutourpsychiatricdisorderandtreatment.Shouldwetellpeoplewhoareclosetousthatwehaveadualdisorder?Shouldweinformpotentialemployersor
thebusinessesforwhichweareworkingthatwehavebeendiagnosedwithchemicaldependencyandapsychiatricdisorderorhavebeenhospitalizedforapsychiatric
disorder?Forthoseofusinrecoveryfromaddictionandmentalillness,theanswerswegivetothesequestionscanmakeacrucialdifference.
Generalguidelinesmaybeproposedastowhetherweshouldtellpeopleaboutourdualdisorderand,ifso,whentotellthem.Buttheseanswersdependupon
individualcircumstancesaswell.Asstatedinthenextchapter,"TheStigmaofMentalIllness,"greaterstigmaisattributedtomentalillnessthantoaddiction.
Iwouldnowthinktwicebeforementioningtoanyone

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thatIhadbeendiagnosedwithabipolardisorder,exceptunderthemostpressingofcircumstances.(However,Idon'tfeelasstronglyaboutmentioningthatIama
recoveringalcoholicifthesubjectcomesup.MostofthepeopleIknowareeitherinTwelveStepgroupsorknowsomeoneinrecovery.)Withnewfriends,I'dwait
untilasubstantialtrustlevelhadbeenreachedandIfeltthattheyknewmewellbeforeI'dtellthemaboutmybreakdownandrecoveryorthatItakelithium(the
medicationprescribedformania).I'vefoundthatonceI'vebeen"labeled"byothersoronceI've"labeled"myselfmanicdepressive,itbecomesdifficulttocorrect
perceptionsoftenmisperceptionsofmybehavior.Ihaveonlyopenedmyselfuptodiscriminationandprejudice.
BynowI'vegainedenoughknowledgeofmyself,andofhowmyillnesscanaffectmybehaviorinsomesituations,thatI'mconfidentIcanhandlemyownlifemuchas
IdidbeforeIexperiencedmyfirstmanicepisode.Idon'tneedtodiscloseinformationaboutmyillnesstoanyone,andIseefewbenefitsindoingso.Familymembers
understandthenatureofmydualdisorder,andIcanrelyupontheminemergencies.Inaddition,mydoctorknowsmymedicalhistorybyandlarge,heallowsme
completeindependence,butIcanalwaysgetintouchwithhimduringacrisis.
WhenIfirstfoundoutthatthenumerousdifficultiesinmylifecouldbetraceddirectlytoacombinationofalcoholismandmentalillness,Iwasstunned.Thechemical
dependencydidn'tthrowmeoffbalancebutIpanickedwhenIlearnedIwasalsomanicdepressive.Creativeandartisticcircles,withwhichIprimarilyassociate,are
lesslikelythanmostofsocietytobejudgmentalaboutmentalillness,particularlymanicdepression.Nevertheless,Icouldn'tquiteacceptthatIhadbeenlabeled
"mentallyill."

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Thisattitude,ofcourse,reflectedmyownfearsandignoranceatthetime.Ihadadisease.Iwasprescribedmedicationforthedisease,andinmycase,Iimmediately
respondedtothemedication.However,foracoupleofyears,ItoldjustabouteveryoneImetaboutthisillnessandwhatithaddonetomylife.NowIrealizethatI
reactedinshock.
"Youwon'teverhavetotellanyoneaboutitagain,"mymothersaidtomeoneday,midwaythroughthecrisisyearsofmyrecovery.(Ithinkittookmeafulleight
yearstofeelthatIhadreachedtheserenityandacceptanceofmypastthatallowedmetolivefreely,withouteitheroneofmydiseasescontrollingmybehavior.Atthis
point,Icouldapproachrecoveryonamoreserenelevel,withoutinterruptionfromeventsthatevolvedfromthemajorbreakdown.)Mymotherwasawiseand
discreetwoman.Shemeantmyillnesswasnotreallyanyone'sbusinessbutshewasalsoassuringmethatnoonecoulddiscernthatsomethingwaswrongorthatIhad
spentyearsinturmoil.Medicallyspeaking,takinglithiumandnotdrinkinghadstabilizedmyemotions.True,itdidtakeyearstoprocesswhathadoccurredinthepast
asadirectresultofanundiagnoseddualdisorder,butmylifewasnowstable.Noonewouldsuspectathing.Whytellanyone?Whyopenacanofworms?
WhenIdidtellothers,Idiscoveredthatmostofthesepeopledidn'thavemuchinterestinthesubjectandthatthegreatmajoritydidn'thavetheabilitytounderstand
thenatureofmyillness.Therehadbeenlittlepointinselfdisclosure.ButIdidn'tgetdownonmyselfforhavingblurteditoutsooften.ApparentlyIhadneededtolet
theworldknowwhatIwasstrugglingwithuntilIhadreachedaplateauinrecovery.
Inafewinstances,tellingothersdidmakesomesense.Mybehavior,bothdrunkandmanic,hadaffectedother

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individuals.Tellingthoseindividualsaboutthemedicaldiagnosishelpedmetomakeamendstothem.Byandlarge,thesepeoplewerereceptivetotheinformationand
understandingaboutmyillness.
ThefoundersofAlcoholicsAnonymousrecommendedanonymityforareason.Partofthereasonhadtodowiththehumilityweneedtorecoverfromchemical
dependency,butsurelyanotherpartofithadtodowithselfprotection.Forthoseofuswhohavebeendiagnosedwithapsychiatricdisorder,thegoalofrecovery
shouldcomefirstiftellingothersaboutyourillnesswillkeepyoufromregainingyourfullpotentialinrelationshipsandinwork,thendon'ttellthem.Restrictyour
confidencestoyourdoctorandafewfamilymembersandfriendswhomyoucantrusttohaveyourbestinterestsatheart.
Itmaytakeusyearsoftrialanderrortodiscoverwhomtotrustwithsuchintimateknowledgeandwhen.Butwhenwedofindoutwhatworksbestforus,we'llknow
alsothatwehaveregainedourselfconfidenceandcanfaceafearfulandunreceptiveworldwithoutjeopardizingourrecovery.
AQuestionofTrust
Forthoseofuswhohaveadualdisorder,learningtotrustothers,aswellaslearningtotrustourselvesagain,maynotcomeeasily.Ouractionshavebeeninfluenced
bythingsbeyondourcontrol,anditmaytaketimeforustolearnourowntruemotivesandtrustourinstinctsagain.Trust,acornerstoneofrelationships,islikelyto
havebeenshatteredbyouractionsduringillness.We'vedonethingsthatthepeopleinourlivesfoundupsettingmostofushavenotbeenreliableinourbehavior.
Rebuildinglevelsoftrustbetweenourselvesandfamilyandfriendswilltaketime.

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Aswebegintorecover(thisincludesnotonlyourintellectualabilitiesandphysicalstrengthbutalsoouremotionalstabilityandspiritualbalance),ourfriendshipsand
familyrelationshipswillnaturallyimprove.
Peoplewhoknewusbeforeourproblemsdevelopedwillbepleasedtoseeusreturntotheresponsibleadultstheyonceknew.However,wealsoneedtoacceptthat
somerelationshipsmayhavebeendamagedpermanently.Somepeoplewhowitnessthesymptomsofposttraumaticstressdisorder,mania,depression,orother
disordersmaynotbeabletounderstandthatthisbehaviorwascausedbytreatablediseases.Theymayblameusforouractionsandmaynotwanttoconsiderthe
natureofourdualdisorders.
Forexample,whenIexperiencedmymanicbreakdown,whichwasexacerbatedbychronicalcoholism,Iactedinsuchawaythatmanypeopleinmyprofessionallife
thoughtIwascrazy.(Otherpeoplejustthoughtthatthiswasthewaythatwriterswhodrankbehaved.)Sincethen,Ihaveexplainedtokeypeopletheunderlying
causesofthatbreakdown,butIwouldn'tattempttoexplainthediseasebehindthebehaviortootherswhoserelationshipsarenotcrucialtome.
AsIbegantorecoverandreturntothetypeofbehaviorthatcharacterizedmylifebeforethedualdisorder,myfamily,closefriends,andprofessionalcolleagueswho
caredaboutmecouldseethatthewildextremesofbehaviorIhadexhibitedwereduetosomethingoutsideofmycontrol.Priortomydrinkingyearsandmyfirst
experiencewithmania,Ihadbeenacontrolled,responsibleperson.WhenIquitdrinkingandwentonmedication,thisbehaviorreturned.Obviously,myactionsatthe
heightofmydrinkingandmanicepisodeshadbeencausedbythosediseases,andpeoplecouldperceivethis.Theyforgavemeforactionsthathadaffectedthem
negatively.

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Butthepeoplewhowerenotintimatelyacquaintedwithmebeforethebreakdowndidn'thaveastandardof"normal"behavioragainstwhichtojudgemyactions
duringmaniaanddrunkenness.I'mnothappyaboutthepossibilitythattheymayalwaysperceivemeassomeonewhohaslittlecontrolofherlife,butthere'slittleIcan
doaboutthatexcepttomoveon.WereItoreturntotheprofessionIoncehad,Imighthavetoprovemyselfbeforemycolleaguestrustedmeonaprofessionallevel
againbutinmostinstances,itwouldseemselfdefeatingtoexplaintoanyoneincidentaltomyownlifewhathappened.
Earlyintheprocessofrecovery,whenwe'regettingtoknowsomeone,wemaywanttoevaluatelevelsoftrustbyaskingourselvesthefollowingquestions:Howlong
haveweknowntheperson?Howdoweknowthispersonthroughworkorasocialactivity?Inwhatcontextdowehopetohavethispersoninourlifeasa
friend,lover,orworkcolleague?Whyarewethinkingaboutconfidinginthispersonaboutourillness?
Oncewetellpeoplethatwehavebeendiagnosedwithapsychiatricdisorder,wewon'tbeabletotakebackthatinformation.Weprobablywouldn'trevealother
intimatedetailsofourlivestomostpeople,unlesswethoroughlytrustedthattheywouldn'tusetheknowledgeagainstusoruseittojudgeusunfairly.Unfortunately,
consideringthestigmasurroundingmentalillnesses,we'llwanttoevaluatecarefullythereasonsandpossiblerepercussionsofdisclosure.
SomeOtherConsiderations
Thebackgroundsandlifeexperiencesofpeoplevarywidely.Whensomeonehashadyearsofexperiencethatmight

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includehardshipandtragedy,thelikelihoodisgreaterthatheorshewillplacemyownexperienceinperspective.
Wemayfindinthecourseofanewacquaintanceshipthatmentalillnessisanissueinothers'lives,too.Thebondthatresultsinsuchacquaintanceshipmaybesimilarto
thebondformedbetweenpeoplewhoarechemicallydependentitcanstrengthenrecovery.
DecidingNottoTellFamilyandFriendsAboutOurDualDisorder
Mostofuswouldliketothinkthatfamilymemberswillsupportuscompletelyinourrecovery,butthismaynotalwaysbetrue.Ourbehaviorandactionsmayhave
triggeredresentmentsthatfamilymemberscannot,ordonotwishto,forgiveandforget.
Ourownrecoverytakesfirstpriorityinourlivesatalltimes.Someofthesefamilymembersmayacceptusagainwhenwebehaveinsaneandresponsibleways.The
chapterintheBigBooktitled''ToWives"*offerssoundsuggestionstofamilymembersingeneral.Thesesuggestionsalsoapplytothefamiliesofthoseofuswhosuffer
fromdualdisorders.
Wecannotchangeotherpeople,onlyourselves.Thebestpolicyremainstostayguardedaroundpeoplewhocanhurtus,evenwhenthosepeoplewereoncecloseto
us.Iffamilymembersorfriendsharborresentmentstowardus,theymaykeepusfromfullrecovery.
Sometimesfamilymemberswillhinderourrecoveryeventhoughtheythinktheyarehelpingus.Wehaveadualdisorderthatisn'teasytounderstand.Caretaking
servesapurposewhenwe'retoovulnerabletofendforourselves,butwedo
*AlcoholicsAnonymous,104.

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hopetoachieveindependenceeventually.Familymembersarestronglyurgedtolearnaboutthepsychiatricdisorderthatafflictsalovedone.Tellingfamilymembers
whocannotorwillnotunderstandthepsychiatricdisorderserveslittlepurposeinourrecovery.
Ihaven'tfacedtheseproblemswithmyownfamily,butIsincerelywishthatIhadn'ttoldsomepeoplewhowereonceclosefriendsofmineaboutmyillness.For
reasonsoftheirown,theyusedthisknowledgetoputmedownandtokeepremindingmethatsomethingwas"wrong."Ihadnochoicebuttodropthesefriendsin
ordertostayonmyrecoverycourse.HadInevertoldthemanythingbutwhatwasobvious(thatIwaschemicallydependent),Iwouldn'thavehadsuchpainful
experiencesthatheldbackmyrecovery.OnceIwaslesssensitivemyselftowhatothersthoughtaboutmydualdisorder,Iwasbetterabletodealwiththosewho
stigmatizedme.
ConsequencesofTellingorNotTellingFamilyandFriends
Thoseofuswhohavebeendiagnosedwithadualdisorderwillneedhelptorecover,andwemayfacecrisissituationsthatarebeyondourcontrol.Whenthatoccurs,
we'llwantsomeonewetrusttobethereforus.It'sobviousthatweneedtotellatleastonepersonwetrustaboutourpsychiatricdisorderthispersonshouldalsobe
awarethatwearechemicallydependent.
Sometimeswe'llmakemistakesaboutthosetowhomwetellthisinformation.Learningfromthesemistakeswillenableustogainpersonalinsightintothenatureofour
disorderanditseffectonothers.

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Weliveinatimewhenfullpublicknowledgeandacceptanceofpsychiatricdisordersisnotwidespread.Somedisordersaremorereadilyacceptedthanothers.
Anxietydisorders,forexample,receivepopularpressmoreoftenthanothermentalillnessesandseemlessthreateningtoothers.Also,theseverityofpsychiatric
disordersvarieswidely.AVietnamveteranmayexperienceposttraumaticstressdisorderinawaythatfrightensotherpeopleheorshemayappearviolent.Others
whoexperiencePTSDmaydosoinawaythatnoonearoundthemnotices.
Whatmattersisthatweknowwhoweareandhowourdisorderaffectsourownlives,sothatwecanfunctionatourfullestlevelagain.Mostofuswillbefortunate
enoughtohaveoneortwopeoplewetrust,otherthanourdoctor,andthatwillbeenoughforustofullyrecover.
TellingPeopleinYourSupportGroup
ThereareseparateTwelveStepsupportgroupsforsomeofthepsychiatricdisorders.Eachofuswillhavetomakeourownjudgmentaboutwhetherornottotellan
AlcoholicsAnonymousorNarcoticsAnonymousgroupaboutourdualdisorder.Thesamegeneralrulesconcerningtrustlevelsapplyinthissituation.
Alongwithmedicalcounsel,TwelveStepsupportgroupscanaidusinrecoveryfromapsychiatricdisorderandchemicaldependency.Thesegroupshavebecome
moreenlightenedaboutmemberswhohavedualdisorders,buteachgroupofeachfellowshipisdifferent.Wemaywanttoattendseparategroupsforbothour
chemicaldependencyandpsychiatricdisorder,unlesswearefortunateinfindingonegroupwherebothcanbediscussedopenly.

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ProfessionalRelationships
Shouldwetellouremployersaboutourdualdisorder?Notifwecanhelpit.
That'sasimplisticanswertoacomplicatedquestion,obviously.Myownexperienceleadsmetobelievethat,ingeneral,it'sinourbestinteresttokeepknowledgeofa
dualdisorderfromanemployer.Personally,I'vehadterribleexperiencesfromtellingmyemployerthatI'vebeendiagnosedwithbipolardisorder.Inanycase,
whetherImentionedthatIwasbipolarornot,ifIhadanepisodeofmaniaonthejob,Iwasdismissed.
I'vealsobeendismissedforbehaviorduetodepressiononotheroccasions,depression,whichthreatensotherpeoplefarlessthanmania,didnotresultinajobloss
forme.Otherpeoplehavenotfaredsobadlyintheworkplace(maniaisprobablyoneofthemostdisruptiveofpsychiatricdisorders)whetherwementionourdual
disorderdependsonthetypeofbusiness,thepsychiatricdisorderinquestion,andthedurationofouremployment.
Ontheotherhand,whenIinterviewedrecentlyatatheatercompany,Ididmentionmybipolardisorder.Becauseofthemanywellknownpeopleinthetheaterand
filmindustrieswhohavebeenopenabouttheirbipolarconditions(PattyDuke,JoshuaLogan,andTedTurner,forexample),Ifeltcomfortablementioningthisin
responsetoaquestionaboutstress.Bipolardisorderisrelatedtostress,andIdon'tliketocoverupthetruthifIcanhelpit.
AnegativeexampleoftellingpeopleaboutmyconditionisillustratedbyarecentexperienceIhadwhenIwasworkingwithmedicaldoctors.Duringmyemployment
interview,IblurtedoutthatIwasmanicdepressive.Thisadmissiondidn'tkeepmefromgettingthejob,butwhenI

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beganhavingproblemsatworkthatweren'tactuallyrelatedtomania,thedoctorsinterpretedmybehavioralongtheselines.Havingstigmatizedmyself,I'dleftmy
behavioropentomisinterpretation.Iwaseventuallydismissed.
Formanyofuswholoseourjobsastheresultofapsychiatricdisorder,theemploymentissueislikelytobecomeaminefield,similartotheproblemsthatveterans
faceinreadjustmenttocivilianlife.Ihaveneverheldagrudgeagainstanyemployerwhohasletmegoforreasonsofmaniaordepression,althoughIamusuallyangry
untilIfindmynextjob.Recoveryfromadualdisordertakesyearsinmanycases.Ididn'tfeelthatI'dreachedaplateauofstabilityuntilmyeighthyearofrecovery.
EvenwhenIwasn'tawareofit,I'msurethatangerandshameandalloftheotherfeelingsassociatedwithrecoveryfromaddictionandmentalillnessmademea
difficultpersontoworkwith.IhadbeendisplacedfrommyprimarybusinessandwasworkinginbusinessesaboutwhichIcaredlittle.
Furtherproblemsinourrecoverystemfromfinancialstressandfeelingsofdislocation.AVietnamvetwithyearsofdifficultyinreadjustingtosociety,adrinking
problem,andPTSDwouldbeanexampleofsomeonefightingtheoddsforaninterminabletime.I'mnotsurethatthementalhealthsystemorthemedicalprofession
providesanswerstotheseproblems.WewoulddobettertofindsupportandspiritualacceptanceinsupportgroupsandintheTwelveSteps.
Finally,whenwehavebeenemployedforarelativelylongperiodoftimeundermostlystableconditionsandwefindourselvesexperiencingtroublerelatedtoourdual
disorder,wecanapplythesamenotionsoftrustlevelstoouremployersaswedotoourfriendsandfamily.Seekoutsomeoneyoutrustatyourcompany.Ifyoudon't
haveacolleagueyou

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trust,you'llfindmanylargerbusinessesofferemployeeassistanceprogramsthatcanreferyoutomedicalassistanceandtherapists.Mostbusinessestodayunderstand
thatpsychiatricdisordersandaddictionareconsideredmedicalinnatureandmaygrantyouleaveordisabilitypayifyouneedadditionaltimetomoderateyour
behavior.
Ifyoursupervisorormanagerpointsoutproblemsonthejob,thatpersonshouldn'tattributetheseproblemstoaspecificillnessmorethanlikely,heorsheisnot
qualifiedtodoso.Asupervisor'sresponsibilityistoisolatethebehavioraltroubles,andourresponsibilityistochangethebehavior.Ifthebehaviorisrelatedtoadual
disorder,thenweareresponsibleforoursobrietyandforattendingtoourmedicalneeds.
Onceweknowthatwehaveadualdisorder,itisourresponsibilitytobreakthroughdenialifproblemssurfaceagainandtoseekwhateversupportweneedtocorrect
problemsonthejob.Ifwedonotandaredismissedaccordingly,weneedtoworkthroughresentmentsalongthelinesproposedintheBigBookandhonestlyassess
ourrolesincausingourdismissal.When,onoccasion,wearediscriminatedagainstbecauseofourillnessandweknowthatwehavedoneallwecantocontrolour
behavior,wemaywanttoseeklegalhelp.Whatmattersmost,though,isourrecoveryandthereturnofourselfesteeminspiteoftheseemploymentproblems.
PeterJ.isanexampleofsomeonewhohaslearnedtoovercomehisresentmentsregardingwork.Diagnosedwithschizoaffectivedisorder(athoughtdisorderwith
symptomsofaffectivedisorderandschizophrenia)andhospitalized,PeterwasabletoreboundafterhisfirstbreakdownandjoinedAAtomaintainhissobriety.He
wasjustoutofcollegeand

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foundajobasastaffwriterforamagazine.Threeyearslater,whenhislongtermgirlfriendbrokeupwithhim,Peteragainbegantohaveproblems.Hewasfiredfrom
hisjobandhospitalizedagain.
Afterleavingthehospitalthistimearound,hedidnothaveaneasytimefindingwork.Therewasarecession.Peterfoundhimselfworkingasawaiter,delivering
newspapers,doingwhatwereessentiallystudentjobs.Hisangeroverhislostcareerpotentialharmedhim.Hesoughtcounselingtodealwiththisangerandkeephis
recoveryintact.Althoughheendedupspendingnearlythreeyearsdoingoddjobs,losingsomeofthem,andfacingdifficulttimesbecauseofhissituation,Peter
eventuallyregainedtheserenityheneededtokeephisdualdisorderinremission.
Whenhereachedthisplateauinrecovery,Peterwasfinallyabletomoveoninhiscareer,too.Withtheaidofgrantsandloans,hewentbacktoschooltopursuehis
interestinhighereducationandworktowardhisPh.D.Henowfindsthatheenjoysteachingandtheflexibilityitoffersmorethanhedidjournalism.Inauniversity
setting,peopleunderstandhisillnesstoagreaterdegree,andhecanbetterarrangehistimeifhestartstoexperiencestressonthejob.Allthingsconsidered,Peter's
eventualcareerchangemadeasaresultofhisillnessworkedoutforthebetter.
Ihaveyettomeetanyonewithadualdisorderwhohasnotexperiencedsevereemploymentproblems.Formanyofus,theseproblemsbeganthefirsttimewe
experiencedourpsychiatricdisorderbeforewewerediagnosedorhadadmittedourchemicaldependency.Onedayatatime,wecanrebuildourlives,acceptour
losses,andbegintotrustothersagain.

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MattersoftheLaw
Whenweareinrecoveryfromadualdisorder,weneedtoknowtheemployer'slegalresponsibilitiestousandourownresponsibilitiesinregardtotheworkplace.
Somestatesmandatethatemployeeswhosufferfromchemicaldependencymustfirstbeofferedtreatmentundertheemployer'sinsuranceplanifitisknownthat
problemsinthejobaredirectlyrelatedtochemicaldependency.Iftheemployeerefusestreatmentandsignsaformstatingthisrefusal,thentheemployer's
responsibilitieshavebeenmet.
It'sillegalforanemployertodiscriminateagainstusonthegroundsofmentalillness.Whatthelawstatesandwhatemployersdo,however,aretwodifferentthings.
Wewanttobehonestwithourselves:Areweatastageofrecoverywherewecanhandlethepositionforwhichweareapplying?Ifthejobisofferedtous,willstress
onthejob,ordifficultyfittingin,onlyaddtodifficultiesinrecovery?Asmuchaspossible,wewanttocontrolemploymentsituationsandprovideastablebaseforour
spiritual,physical,andmentalhealthtoprosper.
Ifwefeelthatwehavebeenseverelydiscriminatedagainst,wemaywanttoseeklegalcounsel.TheAmericanswithDisabilitiesAct(ADA)protectsusaswellas
otherswhosufferfromdisabilities.Wealsowanttoconsider,however,howmuchstrifewouldbeinvolvedintakinglegalactionagainstanemployer.Dowereally
wanttodwellonthesituation,ordowewanttomoveon?Again,dependingonpersonalbackgroundandtypeofemployment,wewillwanttodiscussthese
questionswithclosefriendsandfamilyoroursupportgroups.

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TheEmployer'sRole
Theemployeewhohasadualdisorderpresentsspecialproblemsformostemployers,dependingonthestageofrecoverytheemployeehasreachedandtheamount
ofselfknowledgeandcarethatheorshecanapplytothesituation.
TheBigBookdealspracticallywiththeemployer'sdilemmaconcerningthealcoholic:''Alookatthealcoholicinyourorganizationismanytimesilluminating.Ishenot
usuallybrilliant,fastthinking,imaginativeandlikeable?Whensober,doeshenotworkhardandhaveaknackofgettingthingsdone?Ifhehadthesequalitiesanddid
notdrinkwouldhebeworthretaining?Shouldhehavethesameconsiderationasotherailingemployees?Isheworthsalvaging?"*It'sinemployers'bestintereststo
offerthesameconsiderationtothoseofuswhosufferfromdualdisorders.
Unfortunately,therealdisruptionsintheworkworldthatoccurbecauseofmanydualdisorders(particularlywhensomeonehasnotyetfacedthenatureofhisorher
diseases,orisintheearlystagesofrecovery)mayspelldisasterforboththeemployerandemployee.
Fallingthroughthecracksinthementalhealthsystemappearstobetherule,nottheexception,forpeoplewhosufferfromdualdisorders.Naturally,thismakes
recoverytwiceashardforthoseafflicted.Exceptforthemostenlightenedbusinesses,thecombinationofaddictionandmentalillnessseemstobemorethantheycan
handlethatoncewastrueforchemicaldependency,too.Let'shopethatemployersofthefuturewillhavegainedenoughsophisticationtorealizehowtheycanbest
managetheirbusinessesandretaingoodemployeeswhohavepsychiatricdisorders.
*AlcoholicsAnonymous,13940.

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Somemedicaldoctorswillworkwithcompaniestoassistoneoftheirpatientsinkeepingemployment.Theywilladvisetheemployertoprovidewhattheemployee
needstogetthroughabadtimeandtoperformatthebestofhisorherability.
Employerslosethepotentialofthousandsofworkerseveryyearbytheirlackofunderstandingofmentalillness.Thesituationhasimproved,butthereisstillalong
waytogo.
AFinalWord
Themedicalrevolutionhasalreadyoccurredintermsoftreatmentofpsychiatricdisorders,butthesocialrevolutionlagsbehind.Forthoseofuswhohavedual
disorders,keepingourserenityinspiteofthemanygravedifficultiesthatwefaceincomingbackfromadualdisorderremainsthefirstpriority.

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8
TheStigmaofMentalIllness
JodyN.
WhenthefoundersofAAwrotetheBigBook,theyunderstoodthattheywerebreakingnewgroundindeclaringalcoholismanillnesslikebutunlikeanyother.
''Anillnessofthissortandwehavecometobelieveitanillnessinvolvesthoseaboutusinawaynootherhumansicknesscan.Ifapersonhascancerallaresorry
forhimandnooneisangryorhurt.Butnotsowiththealcoholicillness,forwithittheregoesannihilationofallthethingsworthwhileinlife,"*thefounderswrotein
chapter2,"ThereIsaSolution."Sincethattime,manypeoplehavecometounderstandthataddictionisarealdisease,andtheymightnotattachastigmatoit.
AlcoholicsAnonymousitselfhasbecomewidelyacceptedandrespectedaroundtheworld.
However,thisnewunderstandingofaddictivebehaviordoesnotseemtotranslateformanypeopleintoanunderstandingofmentalillnessastigmaisstillattached.
Thescientificandmedicalevidencethatpsychiatricdisordersresultfrombothphysiologicalandenvironmentalcausesisaspersuasiveformentalillnessasitisfor
chemicaldependency.
*AlcoholicsAnonymous,18.

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Butthebehaviorinducedbythesediseasesseemstoinvokegreaterfearthanalcoholicordrugrelatedbehavior.Thisfearmayhavetwosources:(1)Theredoesnot
appeartothelaypersontobeareasonforthebehavior.Theinternalworkingsofthebrainremaininvisible,whereasanyonecanattributeintoxicatedactionstothe
imbibingofalcoholorthetakingofdrugs.(2)Somebehaviorcausedbypsychiatricdisordersissimplylessfamiliartothepublicatlarge.Manypeople,eventhose
whodonotsufferfromaddiction,knowwhatitistobedrunk.Notasmanypeoplewillexperienceapanicepisodeoramanicepisodeoraposttraumaticepisode.
Whenthesebehaviorsaremademoreseverebyintoxicationofanykind,theoutwarddisplaysofdistressareevenmoreexaggeratedandmayappearviolentor
terrifyingbeyondeithersimpledrunkenordruginducedbehaviororthemanifestationoftheotherdisorderbyitself.
BeingCalled"Crazy"
Onesurewaytostigmatizementalillnessistoapplypejorativetermstothebehaviororcharacteristicsofit.Weallknowthetermspeopleusewhentheymeantoput
downorstigmatizesomeoneofanotherracebeingcalled"crazy"isasimilarpejorativeforpeoplewhobehaveinthebizarreorunusualfashionthatcharacterizessuch
disordersasmania,panicattacks,orposttraumaticstress.
Sometimespeopleusethewordtomeanmerely"strange"peopleinartisticcirclesprobablydon'tuse"crazy"inastigmatizingfashionasoftenaspeopleinsociety's
mainstreamdo.Manypeoplewhoremainvulnerabletochangesinbrainchemistryorwhosufferfromotherdisorderswillseemcrazytoothers.Evenfamilyand
friendsmightavoidtheafflicted

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personorpenalizehimorherfortheillness,ratherthanseekhelpforthevictim.
Thestigmaofmentalillnessbecomesquiteclearwhenplacedinthecontextofthenowrelativelyfamiliardiseaseofchemicaldependency.Onewomanrecently
diagnosedasmanicdepressivewonderedwhattotellherAAgroup.Certainly,astheBigBookalludestoquiteoften,drunkenbehaviorcanbeconsidered"insane."
Buthersponsor,alsoduallydiagnosed,warnedherthatitwouldbebestnottomentionit."They'llthinkyou'recrazy,"thesponsorsaid.
Theonlyreasonableinterpretationofthisstatementisthatevenwhenpeopleareenlightenedaboutchemicaldependency,someonewhohasatreatablementalillness
mayfrightenthem.
TheStigmaofMentalIllness
Historically,peoplehavefearedandattachedastigmatothementallyillandtheiractions.Nodoubtpeoplehavedrunktoomuchanddonefoolishthingsforaslongas
menandwomenhavepopulatedtheworld.Butthestereotypeofthedrunk,andthewayinwhichsocietieshavehandledpublicintoxication,seemtamecomparedto
theattitudetowardmentalillnessheldbymostcultures.
Onlyrecentlyhaveorganiccausesbeendeterminedtobethesourceofmostmentaldisorders.Inthepast,superstitionsubstitutedforsciencetoexplainthebizarre
actionsofpeoplesufferingfrommentalillness.Isolatingthesepeopleremovedthemfrompublicsight.Sometimesfearofthesupernaturalpropelledthisstigmatization
peopletrulybelievedin"demons"and"possession."Oftenthementallyillwouldbetreatedcruellybyothers.

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Bedlam,theinfamoushospitalinnineteenthcenturyLondonwherementallyillpeoplewastedawayinneglectandabuse,isnotfarbehindus.Thediscoverythat
medicationscouldcontrolextremebehaviorinpeoplewhohavedisordersofthebrainisrecent,onlydecadesold.Muchofourliteratureandmanyofthefilmsreflect
thepastandtheinhumanetreatmentofpeoplewhosufferedfrompsychiatricdisorders,causingconfusionaboutthecauseandtreatmentofsuchdisordersevenamong
today'spublic.
Greatintellectisnotgenerallyrequiredtounderstandpsychiatricdisorders.Butthecausesandtreatmentoftheseillnessesaremoredifficultforthelaypersonto
comprehendthanthoseofmostphysicalillnesses.Whatwedon'tunderstand,weoftenfear,anditisthisfearthatproducesprejudice,discrimination,andstigma.
(Chapter2ofthisbookexplainsmorefullythevariouspsychiatricdisordersthatprecede,accompany,orfollowchemicaldependency.)
Thoseofuswhoareafflictedwithadualdisorderneedtoriseaboveanystigmathatmayinterferewithourrecovery.Itmayfeellikeswimmingagainstthetidetodo
so,butgivingintoothers'stigmatizationwillhinderourrecovery.Whenourfullpotentialisagainreached,wecanhelpeducatetheignorant,ifwewish,bybeingopen
aboutourillnesses,thuseasingthewayforotherstorecover.
RecoveryMustRemaintheFirstPriority
Itprobablyseemsthatcomingtotermswithyourdualdisorderandworkingthroughtheproblemsthathaveresultedinyourlifearemorethanenoughforoneperson
tohandle.However,recoveryfromadualdisorderisdoublycomplicatedbythemisperceptionsandignorancebasedonoutdated

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notionsthatsocietyandperhapseventhoseclosetousstillascribetomentalillness.
Thefirstpriorityinrecoveryistoadmitthatwehaveaproblem,andthatbysurrenderingtoaHigherPower,recoveryispossible.Inthecaseofadualdisorder,we
mustseekmedicalhelpaswell.Formanypsychiatricdisorders,medicationscanhelptorestoreequilibriumthatnolongercanbereachednaturally.Neurologists
knowhowthebrainworksingreaterdetailtodaythaneverbeforebutbeyondthisprofessionalhelp,mostlikelyyou'llneedtofosterthesametypeofspiritual
acceptanceandgrowthnecessarytobeginyourrecoveryfromchemicaldependency.
Atthispoint,too,wemaywanttoadmitthatwedon'tcontrolotherpeople'sopinionsofmentalillnessandtheirprejudicesregardingit.Allwecandoisworkonthe
changeswearebringingintoourlives.TakingprescribedmedicationandfollowingtheTwelveStepsinmostcaseswillresultinperceptiblechangesinbehavior.
Thesamepeoplewhooncestigmatizedorostracizeduswillreconsidertheiropinionswhenwechangeourbehavior.Somemaynotchangetheirmindsandmay
continuetoputusdown,butthatisn'tourproblem.Wemaynotbeabletocompletelycontrolsomesymptomsofpsychiatricdisordersthemedicationthatweneed
mayresultinvisiblesideeffectsthatcanalsocreateastigma.Nevertheless,ourrecoveryshoulddependonlyonoursenseofwellbeing.Peoplewhohavebeen
physicallyinjuredsometimeslivewithvisiblehandicapsandlearntofunctionattheirfullestpotentialwithoutappearingtobevictimsorlessthancompletehuman
beings.
Onewaytokeepselfesteemhighinspiteoftheobviousproblemsinvolvedinadualdisorderistothinkaboutthe

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blessingswehaveinourlives.Someofushavebeenhighachieversinvariousfields,someofusgreatathletesallofuscanthinkofsomeareainwhichwe've
demonstratedcapabilityinthepast.It'simportantnottoforgetwhatwearestillcapableofdoing.AstheAAfoundersstressed,recoverytakesplacedaytoday.
We'llhavebaddayslikeanyoneelse,butit'simportanttocongratulateourselvesonthegoodthingswedoandremembertheblessingsinourlivesasweworkon
recovery.
IfwereadwhattheAABigBookhastosayaboutresentment,we'llseehowwecanforgivethosewhocontinuetostigmatizeusorbehavebadlytowardus.Where
appropriate,itmayhelptoplaceintoperspectivehowourbehaviormighthavefrightenedthemormadethemwaryofus.Makingamendstopeople,astheAA
philosophysuggests,mayalsohelpinsomecases.It'snotgoodtoputourselvesdownbecausewehavebeenafflictedwithapsychiatricdisorder,however.Tryingto
explaintopeoplehowwehaverecognizedthatwehaveanillnessandthatwehavetakenresponsibilitytocontrolitwillaidourrecoveryfarmore.
Thepersonalstoriesofthoseafflictedwithdualdisordersvarywidely.Yetindividualstoriescanhelpusseeourownsuccessesandfailures.Overcomingstigma
proveddifficultforJanet,whosestoryistoldhere.Butshemanagedtoplaceintoperspectivetheattitudesofothersandtomoveonwithherlife.
Janet'sStory
Abrilliantstudentallherlife,Janetattendedcollegeduringthe1960satalargeuniversityintheMidwest.Shedrank,butherdrinkingdidn'tseemtointerferewithher
scholastic

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abilitiesorherlife.Inadditiontohergoodgrades,Janetalsoachievedareputationasabuddingplaywright.
WhenJanetgraduatedfromcollege,shedecidedthatshewantedtopursuehertheatricaltalents.Shemarriedafellowstudent,andwhileheattendedgraduateschool,
sheworkedataseriesofjobsandwrote.BeingresponsiblefinanciallyforthefamilyworeJanetdownafteracoupleofyears.Shestartedtodrinkheavily,which
strainedherrelationshipwithherhusband.
Janetbegantoexperiencesymptomsofabreakdown.Shehadtroubleeatingandsleeping.Hermindfeltasifitweretakingoffonitsownattimes.Herhusband
noticedthatnowandthenhersentenceswouldoccasionallytrailoff.Janetbegantopanicwhenshefoundthatshecouldn'tmakesenseofherwritingherthoughts
simplydidnotconnect.Shedrankmoreofteninanefforttocontrolthesesymptomsofhermentalandemotionaldistress.
Eventually,Janet'sbehaviorbegantoappearstrangetoothers.Shehadalwaysenjoyedthewritinggroupstowhichshebelonged.Butwhenshebegantoapproach
peopleatoddmomentsandtalkexcitedlyinwhatsomeperceivedasa"crazy"manner,manyofherfriendsandacquaintancesatthesegroupspulledawayfromher.
"Thishurtmemorethananything,"Janetsaysnow."Iwasn'tsooutofitthatIcouldn'ttellthattheywereembarrassedbymybehavior.ButIdidn'tknowhowtostop
it."Shestillrecallsthetimesheenteredarestroomduringabreakatoneofherwritinggroups,andthewomentherestoppedtalkingwhenshecamein."Iknewthey
weretalkingaboutme.Itwasn'tparanoia,"Janetremembers.Humiliatedandashamed,shewithdrewfromthegroups.
WhatJanetexperiencedwasstigmatization,beingcastout

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forheractionsandbeinglabeled"crazy"forbehaviorthatwaseventuallydiagnosedassymptomaticofatreatablepsychiatricdisorder.Buteventheknowledgethat
shegainedofherownillnessdidn'tmakethepainofthosemomentsdisappearforJanet.Overcomingherresentmentandangeratthepeoplewhohad"thrownstones"
atherforbecomingillprovedalmostasdifficultforherinrecoveryasdidlearningtomanageherpsychiatricillnessandremainsober.
Asherbehaviorhasbecomemodifiedandstable,Janethaslearnednottomentionher"breakdown"tomostpeople.Theyhaveacceptedheratfacevalueand
becausehercurrentbehaviorseemsnormaltothem,whenshedoesmentionherillness,theyacceptitassomethingthathappenedinthepast.Sheremainsafraidof
howtheywilltreatherifsheexperiencesanotherepisode.Mostofthepeoplewithwhomshe'dpreviouslyassociateddidn'ttakethetimetoreconsidertheiropinion
asJanetbecamewell,andshedidn'ttrytoforceherselfbackintotheircircles.
"Ithinkitmademeamorecompassionateperson,"saysJanet."Iammoreconsciousnowaboutnotjudgingpeopleonexternalappearances.Iknowwhatitmustbe
liketobeaminority,tobefat,tobeanoutcastinthissociety.Others'ignoranceonlyreflectstheirowninsecurities,butIwishtheyknewwhatpaintheycausedme
whenallthatwaswrongwassomethingthatcouldbetreatedbymedication,hardwork,andunderstandingontheirpart."
ComingtoTermswithStigma
Noonereallywantstobedifferentfromothers.Insecuritiescauseallofustoseekoutotherswho'llacceptusasweare.If,foronereasonoranother,wefindthat
we'reinagroupof

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peoplewhoostracizeorstigmatizeusforourpsychiatricdisorder,hereareafewapproachestokeeprecoveryongoing.
Trytounderstandtheirpointofview.Dotheyfeartheillnessbecauseitremindsthemofsomeonetheyonceknew?Remember,itisonlyrecentlythatresearchinto
mentalillnesshascausedgreatstridesinunderstandingandtreatment.Asocialrevolutionlagsfarbehindthisresearch.
Aretheycriticalbecausetheyneedtoputdownsomeonewhoseemsvulnerable?Wecan'tchangetheworld,onlyourselves.Peoplewhostigmatizeothersarebest
leftalone.Wemayencounterbulliesnowandthenitisbesttosteerclearofthem.
ThinkoftakingthesameapproachadvisedintheAABigBookifyourbehaviorduringanepisodeisthereasonthatsomeonehasmadejudgmentsabouttheillness.
Makeamendsinthatcase,butonlyifdoingsowillnotharmyouortheotherperson.
Finally,keepinmindthatourownprejudicesmaycauseustobeoverlysensitivetoremarksbyotherpeople.Wemaybefarmoreconsciousoftheillnessthanothers
actuallyare,andwemayreadourownfearsintotheircommentsandactions.
Trylistingyourfearsinregardtoyourmentalillness.Whatarethecausesofthesefears?Whatisthetruthabouttheillnessthatyouhavelearnedinyourrecovery?If
yougiveothersachance,youmayfindthemfarmoreforgivingthanyouhavebeenofyourselffortheunfortunatecircumstanceofbeingdiagnosedwithadual
disorder.
Sometimesourownfearscankeepusfromtreatingandpreventingoutburstsofourillnesses.Insomecases,thisleadstotragedy.Ginny'sstoryshowshowone
woman'soversensitivitytowhatothersmightthinkledtoapreventableoutcome.

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Ginny'sStory
Ginny'slifebeganfallingapartwhenshewasthirtysix.Inherearlythirties,shehadbeendiagnosedashavingananxietydisorder,characterizedbypanicepisodes
withresultingagoraphobia(fearofpublicplacesorplacesfromwhichitseemsdifficulttoescapeifneeded).Thesetwodisordersoftengohandinhandtheperson
whoisvulnerabletopanicepisodes(afeelingofbeingoutofcontrol,markedbydifficultyinbreathingandafastbeatingheart)oftenfeelsashamedofthem.
AlthoughGinnytookherprescribedmedication,shedrankheavilyaswell.Shedrankbecauseshethoughtitmadeherfeelmorerelaxedinfact,drinkingonly
increasedheranxiety.Ginnyhadalwaysmadeherownway.Maintainingcontroloverherfamilyandhomeseemedtohertheonlythingthatmatteredwhatshe
couldn'tadmitwasthattheillusionofcontrolmaskedtheterrifyingfeelingsshehadoflosingcontrolaltogether.
MostofherfriendsperceivedGinnyasatoughandpracticalbusinesswoman.Tallandstriking,shehadexperiencedtwofailedmarriages.Withmen,aswithher
friendshipswithotherwomen,shemaskedanyvulnerability.Ginnyknewshehadaproblemwithherpanicepisodesandknewthatalcoholwasbeginningtotakeover
herlife.Shethoughtthatifshetalkedaboutherfearsandinsecurities,however,herfriendsandfamilywouldthinkshecouldn'tholdherlifetogether.Thetruthwasthat
Ginnyregardedherproblemswithmoreshameandfearthananyoneelsedid.
NoonehadthenervetoconfrontGinnywithconcernsaboutherdrinkingonceitbecameapparentthatshewaslosingcontrol.Theyknewhowmuchitmeanttoher
tobe

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makingitonherown.Untilshelostherjobatanadvertisingagency,Ginnylivedaliesuccessfully.
Butwiththelossofherjobandsubsequentrepossessionofherhomeandcar,Ginnybegantocavein.Theslidedownhillwasquick.Evenwhenherexhusband
petitionedforandwoncustodyoftheirson,Ginnycouldnotcryforhelp.Shealreadyfeltstigmatizedasadivorcedmotherbysociety,andherimaginationledherto
believethatpeoplewouldthinkhercrazyifshesoughtthehospitalizationsheneeded.
Soon,allGinnycouldfeelwashumiliationandasenseofpowerlessness,butsheblamedthosefeelingsonasocietythatdidn'ttreatwomenwithrespect.Twosuicide
attemptsthesignalofapersonwhoisoutofcontroltakingcontroltheonlywayheorshecanandanemergencyhospitalizationstillcouldn'tpersuadeGinnyto
change.
Finally,Ginny'slifedidendwithanoverdoseofpillsandalcohol.Onthenightshedied,sheapparentlyalsoexperiencedapanicepisodeandranintothehallwayof
herapartmentbuilding,whereshecollapsed.Shehadtriedtocallforhelp,butitwastoolate.
Ginny'sfearsaboutstigmatizationwerenotirrationalcertainlytherearemanypeoplewhowouldn'thaveunderstoodthemenaceofherdualafflictionandthestruggle
tocometotermswithherillnesses.Theymighthaveblamedherforherfailures.
ButthosewholovedGinnyhadalwaysseenthatbehindhertoughexterior,therewasascaredandvulnerableyoungwoman.TheyadmiredGinnyforwhoshewasas
apersonandwouldhavesupportedherinrecovery,hopingtofindonceagainthelovingmother,daughter,andfriendtheyhadknown.

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Conclusion
Ifwehadchronicdiabetesandchemicaldependency,orifwewerechemicallydependentandafflictedwithchronicheartdisease,wewouldprobablynothesitateto
gethelpandfollowaprescribedmedicalplantomaintainourhealth.Mostpsychiatricdisordersaren'tmuchdifferentfromphysicalillnessessuchasdiabetes.
Acceptingthatfactourselves,andhelpingothersclosetousacceptit,willresultinourrecoveryfromadualdisorderifwealsofollowtheTwelveStepsofAA.
Peoplewhoarethreatenedbyourbehaviorwhenwe'reill,orwhocannotorwillnotunderstand,won'treallymattertoourrecoveryifwechoosenottoletthem.
Ultimately,noonecantakeawayourdignity.Aswebecomehonestwithourselvesandgainpeaceofmindputtingourpastactionsintoperspectiveandlearningto
differentiatebetweenourdualdisordersandourtrueselvesotherswillbegintoseeusinadifferentlightaswell.
Beingawareofthemanypeopleinoursocietywholearntocopewithbeingstigmatizedforthingsbeyondtheircontrolmayalsohelpusrecoverourselfesteem.
Someotherillnesses,suchasAIDS,alsocarrystigmas.AlthoughmentalillnessafflictsmillionsofAmericans(someestimatesstatethatatanyonetime,morehospital
bedsarebeingusedbypeoplewhosufferfromemotionalormentalillnessesthanphysical),peopleinthepasthaven'ttalkedopenlyaboutpsychiatricdisorders.
Secrecyandmysteryshroudtheseillnessesthewaytheyoncedidalcoholism.
Takenliterally,diseasemeans''withoutease.''Whocanarguethatapersonwhosementalbalancehasbeenunhingedandhisorherbasiccharacterchangedisnot
withoutease?Fortunately,weknowfarmoreaboutmentalillnessnow

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thaneverbefore,andifweattendtoourspiritualrecoveryaswellasourphysicalone,westandagoodchanceofregaininganevenbetterlifethantheonewe
previouslyknew.
VincentVanGoghsufferedfromamentalillness,manicdepression.Almostcertainlyhisdrinkingexacerbatedhisepisodesofmania.VanGoghhimselfunderstood
therealityofwhatitmeanttobeafflictedwithanillnessthatendedupcontrolling,andultimatelytaking,hislife.
Hewrotetohisbrother,Theodore,"Ifsomebodysaystoyou:'youareill,'thatdoesnothelpyoumuch,butifhesays,'dothisorthatandyouwillrecover,'andhis
adviceisnotmisguided,thatisthethingthatwillhelpyou."*
Forourselvesandthosewhocareaboutus,whatremainsimportantisthatwereceivehelpandfollowittothebestofourabilitynotthatwehavebeen,ormay
again,becomeill.Don'tgivestigmacredibility,anditwilldisappearaswemoveonwithournewlives,strongerforhavingcometotermswithadualdisorderand
achievingserenitydespitealltheobstaclesinourpath.
*MarkRoskill,ed.,TheLettersofVincentVanGogh(NewYork:Atheneum,1963),131.

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9
TotheFamily
PaulaPhillips,M.A.,A.T.R.
QuestioningOurFate:AStrengthinAdversity
Asfamilymembers,weareassailedwithtwoquestionswhenwehearthatourlovedonessufferfromseriousandpotentiallylonglastingmentalhealthandchemical
useproblems:Why?andWhatdidwedowrong?Welongforanswerstothesetroublingquestions,andwelongtounderstandourcontributiontotheirsuffering.
Thisisadmirable,atestimonytoourcareandconcernforothers.Ideallythesequestionswouldguideustolearnnewwaystoresolveproblemsandtoliveourlives.
Butquestioningourselvesaboutthecauseofourlovedones'coexistingmentalhealthandchemicaluseproblemsandourroleintheirevolutionisoftentransformed
fromastrengthintoapunishmentwhenit'saccompaniedbyshock,confusion,fear,shame,anger,andgrief.Thesefeelingsarecommontopeoplewhoarechallenged
byunexpectedanddistressingsituations.Initiallyit'sarelieftoknowanameandadiagnosisforthealteredmood,thoughts,andbehaviorofalovedoneinthethroes
ofanacutecrisis.Yetthesewordsmayalsoconfirmarealitywe

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don'twanttobetrue,arealitythatsentencesourlovedonesandourselvestoanuncertainfuture.
BeyondShameandAbandonment
Ournaturalneedtobestrong,whole,andinchargeofthedirectionofourlivesinterfereswithopenacceptanceofthisuncertainfuture.Whetherwediscusswith
othersorspeakquietlytoourselvesaboutwhathashappened,wefeelthestigma,ourcollectiveshameofbeingflawed,weak,andvulnerable.Wefearthe
disapprovalandjudgmentofothers.Wepullawayfromourlovedonesasiftheirproblemswerecontagious,andthusweriskabandoningthemwhentheymostneed
oursupportandaffirmationoflove.
Maintainingtheillusionofnormalcybecomesacruelmasterandpromotestheabandonmentofourlovedonesonmanylevels.Wemaydenythetruthoftheirdual
disordersandattributetheirbehaviortomoresociallyacceptablecauses,suchasimmaturity,stress,lowmotivation,orhangingaroundwiththe"wrong"crowd.We
maydiscourageopendiscussionbychangingthesubjectwhenourlovedonesdescribetheirproblemsandexperienceswithtreatment.Werefuseinvolvementintheir
treatmentforfearofhowwemaybejudged.Wemaycutoffcontactwiththeminanattempttoprotectourselvesfromtheimpactoftheirimmediatedistressandthe
enduringchallengeoflearningonceagainhowtoliveinthefaceoflimitations.Andinthatabandonment,weloseourlovedonesandourselves.Fortunatelythat
abandonmentneednotbepermanent,especiallyifweallowourselvestobegentlyguidedbythequestionsWhy?andWhatdidwedowrong?

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From"Why?"toUnderstandingandSupport
AskingWhy?directlyandopenlyencouragesustoparticipateinthesufferingandrecoveryofourlovedones.Havingthecouragetopursueinformationinthefaceof
ourfearsandworrieswillultimatelyleadtoanswersthatmaycomfortus.Awonderfulplacetostartistoaskourlovedones,"Telluswhatit'slikeforyou,"andto
waittoheartheiranswers.Itissoeasytojudge,muchhardertolistenandlearn,yetthatiswhatisrequiredofus.Inaddition,wearechallengedtosetasideourneed
totakechargeandreturnlifeto"normal."Wemayneedtoreadjustourexpectationsandhopesforourlovedonesandfamilies.
Wemayalsofindanswerstoourquestionsthroughreadingandotherpeople.Medical,mentalhealth,andchemicalhealthprofessionalsofferindividualappointments
andinformationalpresentationsinmanysettings.Butit'suptoustosetasideourfeelingsofshame,embarrassment,anxiety,andfear,andtoaskwhatwewantto
knowaboutourlovedones'dualdisorders.Professionalsareoftenwillingtosharewhattheyknowandtodirectustoothereducationalopportunitiesinour
communities.Butyoumightnotbeabletoparticipateinthetreatmentprocess.Rulesonconfidentialityandprivacyoftreatmentofteninterferewithfamilyinvolvement
inthetreatmentprocess.Ourlovedonesmaychoosetopursuetheirtreatmentindependentofourparticipation.Don'tdespair.Wecanstillseekanswerstothe
questionWhy?forourselves.Ifwecommunicateourdesiretounderstandandtolearnforourownbenefit,weopendoorstoprofessionals.Theymaynotbefreeto
talkaboutourlovedonesspecifically,buttheycansharecurrentinformationaboutdualdisordersandprovidesuggestionstopromotegreaterhealthforourloved
onesandforourfamiliesasawhole.

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Ourlovedones'mentalhealthandchemicalhealthproblemscanisolateusfromourfamiliesandcommunities.Buttherearesupportgroupstoprovideuswith
informationandopportunitiestolearnthroughacompassionateacceptanceandunderstandingofoursuffering.Otherpeoplebecomeabalmtoourwoundstheycan
helpusseethatourpreconceptionsofmentalillnessandchemicaldependencywerebasedmoreonourdistressthanonreality.Ourisolationdissolveswhenwetalk
aboutsharedexperiencesandexchangepracticalsuggestionsforgettingonwiththebusinessoflivingwithoursufferinglovedones.
Thesesupportgroupsareoftensponsoredbyhospitals,outpatientclinics,advocacygroups,churches,andothercommunityagencies.Somegroupsfocuson
educatingfamilymembersinastructuredformataboutmentalillnessandchemicaldependencyothersfocusonsupport,withgroupfacilitatorsprovidinginformation
requestedbymembers.Somegroupsarefacilitatedbyprofessionals,othersbyfamilymembers.Disappointmentmaytemptustogiveuponoursearchforanswers
andsupport.Butwemustbepatientandwillingtotrymorethanonegroupuntilwefindonethatmeetsourneeds.Acommitmenttoregularattendancemaymultiply
thebenefitsforourselvesandourfamilies.
FromSelfBlametoConfidence
ImpliedinthequestionWhatdidIdowrong?isthepersonalblameweassumeforourlovedones'mentalhealthandchemicalhealthproblems.Turninginwardwe
searchourmemoriesfortimeswhenwemayhavefailedourlovedones.Andbeinghuman,wediscovertimeandtimeagainourimperfectionsinpastinteractions.
Convincedthattheir

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sufferingisourfault,wemaypunishourselvesbylistingallofthe"IfonlyI..."times,timeswewishedwehadbehaveddifferently.Temptingasitmaybetoblame
ourselves,it'sessentialthatwestoptormentingourselves.Punishingourselveswiththoughtsofourownfailurewillnotchangetherealityofourlovedones'dual
disorders.Selfblameisactuallyoneofthemanyformsofdenialwemayexperience.Ifwepersistinsearchingwithinourselvesandourfamiliesforthecauseofthe
dualdisorders,wewillthwartoureffortstolearnwhathashappenedandhowtocopewiththesituation.Effectivebehaviorinthepresentdependsonourgraspofthe
followingfact:Familiesarenotthecauseofmentalhealthandchemicaluseproblems.ThequestionWhathaveIdonewrong?isbestusedtomotivateusto
learnwhattodotoinfluencethecourseofthedualdisordersinthebestwaypossible.
Aswemovefromdenialtoacceptance,wewillbechallengedtotransformtheurgetoblameintotheexcitementofdiscoveringuntappedstrengthsandresources
withinourselvesandourfamilies.Wewillaskinstead,WhatcanIdotopromotethefunctioningofmyfamily?andWherecanIlearntheskillsthatwillhelp
meaccomplishthisgoal?Theemotionalturmoilwillfadeaswedevelopconfidenceinournewfoundskillstosolveproblems,managecrisissituations,and
communicatemoreeffectively.Shamewillturntoprideaswedevelopourabilitytoshedoldhabitsandlearnnewbehaviorsthatpromoteamorestableandjoyous
familylife.Trustingthegoodwillofotherpeople,wewillturntoprofessionalsandsupportgroupstoencouragethedevelopmentoftheseattitudesandskills.Reliefand
comfortwillcomeasourquestionsareaddressedintheseopendiscussionsofdualdisorders.Asweenterintosupportiverelationships,wewill

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developgreateropennesstonewideas,newbehavior,andnewexperiences.Thecompassionandkindnesswefreeinourheartsmayleadustoadvocateinour
communitiesformoreunderstandingandhumanetreatmentforindividualssufferingfromdualdisordersandfortheirfamilies.
Mentalillnessandchemicaldependencybeginasunwelcomestrangersinourhomes.Ourlivesaredisruptedandchaotic.Weforgethowtolaughandrecognizethe
joyinourlives.Painfulanduglyemotionsdirectourdecisionsandbehaviorsasthelovewehavefeltforourlovedonesischallengedasneverbefore.Likechildren
frightenedofthedark,wecloseoureyesandpullthecoversoverourheads,hopingagainsthopethatthiscrisiswillgoaway.Yetmorningfailsus,wedon'tgetthat
wish,andthingsdon'tmagicallyreturntonormal.Shameandignorancepushusintogreaterisolation.Itistemptingtocloseoureyesandseverthebondsofaffection
toourtreasuredlovedones.Ourlearningstopsandlifegoeson,somewhatreduced.Butwecanchoosetoopenoureyestotherealityofoursituationsand,inour
pain,rediscoverourjoyandresilienceincrisis.Questionsthatplagueuswillbeansweredaswepushourselvesbeyonddenial.Wewilllearnhowtotakecareof
ourselves,ourlovedones,andourfamilieswithskillandwarmth.Oureyeswillseeandourheartswillreachouttowelcomethosesufferingfrommentalhealthand
chemicaluseproblemsbackintoourfamiliesandourcommunities.

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PERSONALSTORIES
Ourstoriesdiscloseinageneralwaywhatweusedtobelike,whathappened,andwhatwearelikenow.
ALCOHOLICSANONYMOUS

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Alan'sStory
MynameisAlan.Iamthirtytwoyearsold,arecoveringphobicandalcoholic.Ialsosufferfromanxietyandpanicrelateddisorders.
Lookingbackatmychildhood,whichwasn'tveryhappy,Icanrecallalwaysfeelingalittledifferentfromotherkids.Iwasalwaysnervous,afraidofelevators,closed
inplaces,openspaces,andpeople.Iusedtohyperventilatealot.IwasoftenafraidthatmybladderwouldlockuponmeandIwouldn'tbeabletourinate.
SometimesIwouldletalittleurineseepout,justtobesurethatmybladderwasworking.Thiscausedalotofembarrassment.ThenthereweretimesIwasvery
consciousofmyheartbeating.SometimesIthoughtitwasbeatingtooslowlyandthensometimesitwouldraceoutofcontrolorevenbeatirregularly.
WhenIwasfourteen,allhellbrokeloose.Iexperimentedwithhashishoneday,andmybrainwentintochaos.Thingsaroundmenolongerseemedreal.Mybody
wentnumb.Myminddetachedfrommybody.Ifellintoacompletestateof
1991.TheInstituteforPhobicAwareness.PhobicsAnonymousWorldServiceHeadquarters,P.O.Box1180,PalmSprings,CA92263.

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panic.Ididn'tknowwhatwashappeningtome,andIwasunprepared.Ithoughtthatifthiswaswhatitwasliketobehigh,Iwantednopartofit.Afteracoupleof
hours,realityfinallyreturned,butonlybyreadingandprayingcouldIbringmyselfoutofthepanic.Readingandprayingwouldbecometoolstobringmeoutofpanic
stuporsinthefuture.
Aboutayearlater,ImarriedagirlI'dgottenpregnant.AndthenallthefeelingsI'dexperiencedayearbeforeinthatdruginducedpanicreturned.
Iwasatalocalshoppingcenterwhen,outoftheblue,ithitme,afullblownpanicattack.IhadjellylegsmyheartwasracingandpoundingandIwassweating,
dizzy,andbecomingdetachedfromrealityagain.Whyisthishappeningnow?Ithought.Ihaven'ttakenanydrugs.Whatisit?Mythoughtswerelikethewindsof
ahurricane.AllIcouldfocusonwasthatIhadtogethome.Ileftmygroceriesinthecheckoutlineandranoutthedoor.AthomeIfinallystartedtocalmdownand
realitybegantoreturn.MyGod,whatishappeningtome?Iscreamed.IremembertellingmyselfnottotellanyoneaboutthistheywouldthinkIwascrazyandlock
meupinsomementalinstitution.
Thenextdayinschool,Ithoughtaboutwhathadhappenedthenightbefore.ThemoreIthoughtaboutit,themoreIcouldfeelmyheartstarttogallop.Iimaginedit
gallopingrightupfrommythroatandoutmymouth.Iwantedtogetupandtelltheteacher,butmylegswouldn'tmove.TheharderItried,theweakertheygot.Itfelt
likeIwashavingaheartattackandwasparalyzed.ButImanagedtogetup,stumbledtotheteacher,andcollapsedintoherarms.Ifinallymanagedtosay,''Ithink
I'mhavingaheartattack.''Iwasrushedtotheemergencyroomanddiagnosedashavinga"nervousdisposition"with"lightanxiety."Cause:unknown.

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Thusstartedaseriesofpanicattacks,anxietyattacks,suicidaltendencies,andadrinkinganddrugginglifestylethatwouldlastforseventeenhellish,torturous,terrifying
years.
Atsixteenandseventeen,Icouldn'tleavemyhouseIwastooafraidtogoout.Iwasnewlymarried,withachild,andIcouldn'tevenwork.Iwasalwaysfearfulthat
the"bigone"wouldhit.Thehousewasmysafetyzone,butIwasaprisonerofmyownmind.ItwasatthattimethatIfirstthoughtofsuicideIthoughtIcouldescape
theinescapable.Isatwithaloadedshotgunatmyhead,readytopullthetrigger,whileprayingtoGodforreliefIwaspreparedtohearthetipofthehammeronthe
firingpin,butIonlyheardthetappingatthedoor.Itwasafriendofminecomingtotalkaboutsomeanxietythathehadbeenexperiencingrecently.Coincidenceor
what?Idon'tknow,butthiswasthefirstofmanyreprievesthatweretointerferewithmyobsessivesuicidalthoughts.Suicide,itseemed,wastheonlycontrolIhad
overmylife,theonlywayoutofmyprisonofmentaltorture.InowknowthatGodhadbeenintervening.
Overthenextyear,Ipulledmyselfoutofmydepressionsomehow,justenoughtostartanewjobatafactorymakingtires.IthoughtIhadfinallygottenholdofmylife
andthatthingswouldbeokayfromthenon.
Abouttwelvemonthsintothejob,thediseasehitagain.Ifeltcrazy.Iwasmissingtoomuchworkbecauseofanxietyandpanicattacks,andthecompanywas
threateningtofireme.Thinkingmyheartwascausingallofmypanicattacks,Iwenttoaheartspecialist.Iunderwentmanytests.Icouldn'tfinishthetreadmillstress
testIthoughtIwouldsurelyhaveaheartattackanddieifIdid,becausemyheartwasalreadyracingahundredmilesanhour.Itoldthedoctorsthatmylegswouldn't
holdupandIhadtoquit.(This

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wasoneofthemanyliesIwouldtelljusttosurvive,becausenooneunderstoodthisfreakydisease.)Thetestsindicatedthatmyheartwasashealthyandstrongasan
ox,thattheirregularandracingheartbeatwastheresultofstress.(Shit,Ithought,thecrazyheartbeatsareduetosomeunknowndiseaseandI'mdying.)
Referredtoapsychiatrist,Igotcounseling,prescriptionsforminortranquilizers,andreassurancethatmyproblemwascommonandwouldgoaway.Iwastoldthat
betablockersandtranquilizersshoulddothetrick.Butnoneofthisexplainedmyfeelingsoftotalpanic,detachment,andunreality.
Well,thepanicwentaway,onlytocomebackafewdayslaterwithunmercifulvengeance.SoonIrealizedIcouldn'thandletheattacksanymore.Ilostmyjob.What
didIeverdotodeservethisformoftorture?Icried.IsGodpunishingmeforsomethingIdidinthepast?
Iwentfromdoctortodoctor,psychologisttopsychiatrist,lookingforacure.Buttherewasnone.
Acoupleofyearsearlier,Ihadexperimentedwithalcohol,andIrecalledthatithadbroughttemporaryrelief.NowIthought,WhatifIdrinkconstantly?Won'tthat
easetheanxiety?Irationalizedthatthishadtobetrue,andalcoholbecametheescapemodethatIprescribedformyselfoverthenextfourteenyears.Themore
anxietyIexperienced,themoreIslippedintothegraspofalcohol.Ididn'trealizeitatthetime,butalcoholwasthecauseoftheincreaseinanxietyandpanicattacks.
Theseyearsbroughtdrunkenness,moresuicideattempts(sixtobeexact,somenearlyfatal),accidentsduetoalcohol,myabuseofmyfamily,and,finally,divorce
frommywife.Ilostcountlessjobsbecauseofthepanicattacks.Icouldn'tfunctionanylonger.Iwaslabeledas"justalazyexcusefora

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humanbeing"whodidn'twanttoworkandwhousedanxietyasanexcusefornotworking.(Ithinkpanicdisordersareharderonmeninthisrespect,becausesociety
looksonmenaspeoplewhoshouldnevercryorhavementalproblemsandwhoshouldalwaysholdajob,nomatterwhat.)
Finallyitbecameimpossibletoholdanyjobforlongbecauseofthepanicattacks.SoIsignedupfordisabilityandgotit.(IhadlostsomanyjobsthatitwasobviousI
reallydidhaveaproblem.)ButIsoonrealizedthatnotworkingwasn'ttheanswereitherinactivityjustbroughtonmoredepression.SoIfiguredIwouldjustlie
backandwaitI'djustdrinkmyselftodeath.Butitdidn'tworkthatway.Iwasslowlylosingmysanitybydrinkingandusingdrugs.
ThenImadeanothersuicideattempt,earninganothertriptothepsychiatricward.ThereIfinallyfoundanameformyproblemwhenthepsychiatristhandedmea
bookonanxietydisease.Iwasecstaticandrelieved.IfinallyknewwhatIwassufferingfrom.
ThebookexplainedthatIhadarealdisease,adiseasethatwascomingfromwithin,notjusteverydayanxiety.Withthisinformationinhand,Icouldholdmyhead
highandclaimthatIwasn'tjustalazy,rottenhumanbeing,butthatIhadarealdisease.IwonderedhowIwasgoingtobringitundercontrol,although,inaway,I
didn'tcare,forIwasbeingheldprisonerbyalcoholandtranquilizers.
ItallcametoaheadtheyearIturnedthirtyone.FirstIgotaDUIinJanuary,andImademysixthsuicideattemptinJune.Theseventeenyearsoftorment,panic,and
alcoholabusehadtakentheirtoll.Myhealthwasfailing.Mysanitywasallbutgone.Thedoctorsweretalkingabouthavingmecommitted.Iwasdrivingmyfamily
furtherapartfromme.Mydepressionhadfallentoanewlow.Lifewasn'tworth

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living.Thedemonsinmymindwerehavingtheirway.
Idon'tknowexactlywhy,butIstartedtofeelspiritualatthistime.PerhapsIhadhitbottom.PerhapsGodhadseenthatIhadfinallyhadenough.Icametobelieve
thattherehadtobebeawayout,apositivewayout.Iwonderedwhatmypurposeinlifehadbeenandwhatitwouldbe.IsensedGod'spresencearoundme.Ifelt
afireinmyheartnotpanicthistime,butaglowofdesire,becauseItrulydidhaveapurpose.IfeltthatmysufferinghadnotbeeninvainbutthatIhadexperienced
itforareason.
Icheckedmyselfintoasubstanceabusetreatmentcentertoembarkonanewjourney,anewplanfromGodformylife.Whilethere,IwasintroducedtoPhobics
Anonymous(PA).IdecidedtoputmyeffortintothisprogramasI'dneverputeffortintoanythingbeforeI'dfinallyfoundmypurposeinlife.ImetothersinPAwho
weresufferingasmuchasIwas.Godbroughtustogethertohelpeachotherwithonecommonproblem:thedebilitatingeffectsofpanicdisorders.
MylifehasimprovedmiraculouslysincecomingintoPAsixmonthsago.Thesehavebeenthemostsereneandthehappiestmonthsofmylife.Mydepressionislifting.
Myzestforlifeisreturning.Mysanityisback.Myselfesteemandconfidencearehigh.I'mgoingbacktocollege.I'mgoingbacktowork.I'moffalltranquilizersbut
one,whichItakeonlyasneeded.I'mgoingplacesIcouldn'tgobefore.I'mnolongerafraidofpeople,places,andthings.
ByworkingtheTwelveStepsofPA,I'vegottenridofmyoldnegativeideasandcatastrophicwaysofthinking.I'vegainedafeelingofcontrolovermylife,notfear.
BeforePhobicsAnonymous,IwouldgatherevidenceforwhyIshoulddieInowgatherevidenceforwhyIshouldlive.I'm

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learninghowtoprayandmeditateI'mchangingmydietandI'mregularlysayingpositiveaffirmations,visualizingchange,goingtocounseling,andimprovingmy
relationships.Irecognizethatmanyofmyanxietiesstemfromresentments,soIamlearningtoforgivethosepeopleIresent.
ThroughPA,I'malsodevelopingthecouragetomakechangesandthehonestytosharemysecretsandproblemswithothers.Irealizeit'sanongoingprocess,
learningwhoIamdevelopinggoalsandlearningtolovemyselfandtoletgoofmyaddictions,obsessions,faultycopingtechniques,negativebehavior,andself
defeatingattitudes.
IknowthatIwillexperiencesomeanxiety,butit'sokay.Acceptingmyself,thinkingpositively,keepinggoodcompany,practicinglove,andexpectingmiraclesare
nowpartofmylife.
ToparaphrasesomethingIreadsomewhere:"Ifeelthatprovidence,nature,God,orthepowerofcreationseemstofavorhumanbeingswhoacceptandlovelife
unconditionally."
Theuniversesupportsme,andIamworthyofthatsupport.AllIcansaynowis"Freeatlast,freeatlast,freeatlast."ThankGodandPA,Iamfreeatlast.

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Daile'sStory
Hi,I'mDaile,andI'masurvivor."That'showIidentifymyselfatmeetings.Iamrecoveringfrommultiplepersonalitydisorder(MPD)andalcoholism.Mytherapistand
IbelievethatIhavebeen"multiple"sincetoddlerhood,andIbelieveI'vebeenalcoholicsinceIwasveryyoung.I'vecometoacceptthatIhaveanaddictive
personality:If"it"changeshowIfeel,Iwilluseitandabuseitwhetherit'salcohol,medication,food,oractivities.Myrecoveryhasbeenalong,continuingprocess
thathasreliedontheTwelveStepstobeginhealingtheeffectsofmyabusive(incestuous)childhood.
IbegandrinkingwhenIwasstillstrugglingtoacceptmydiagnosisofmultiplepersonalitydisorder.Iwastryingtostiflethepainofthereturningmemoriesofmyviolent
childhood.Withinthreemonths,alcoholismhadmeatabottomdrivingdrunk,lyingtofriendsandfamily,stealingmoneyforalcohol,passedoutinmyownvomit,
drinkinglargeamountsofboozewhileonpsychiatricmedications.
Attwentyeight,amotherofthree,Iwasabouttoloseitall.Myhusbandwasthreateningdivorce,andIwascontemplatingsuicide.Mysystemofpersonalitieswasin
turmoil.

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Thebodywasoutofcontrol.AlcoholicsAnonymousfeltlikemylasthopeofgaininganycontrolovermyneedtodrink.Ihadnoexpectationsoflearninganewway
tolivethroughtheprogramIsimplywantedtostopdrinking.
ThefirstthingIdidinthoseearlyAAmeetingswasto"yeah,but..."everythingIheard.Iknewthatnoonetherecouldunderstandmypain,mystruggletohealfrom
myabusivepast,mymanypersonalities.Iwasdifferent.
ThenImetAl.Alwasafixtureatareameetings.Hehadseventeenyearsofsobrietyandagentlewayofseeingthewinnerineveryone.Heencouragedmetotalk
aboutwhateveritwasthatcontinuallycompelledmetodiveheadfirstintoanalcoholichaze.AlalwaysspokeoftheTwelveStepsnotassimplyawayofnotdrinking,
butasawayofliving.ItwasfromAlthatIfirstfeltcompleteacceptance.Itwasthefirststeptowardthepersonalitiesacceptingeachother.
AlwasthefirstAAmemberthatIevertoldaboutthemultiplicity.Hedidn'tbataneye,saying,"JustteachtheSteps,theprogram,toallofyou."Hemadeitsoundso
easy,soacceptable.That'swhatIdid:AllofthepersonalitieslearnedtolivetheTwelveStepwayoflifetothebestoftheirabilitieseventhechildren.
Altaughtmethesimplethings:howtousetheSerenityPrayertoregainmyfocusandcurbanxietyattacks.Howtocopeassometimestheonlywomaninaroomof
twodozenmen.HeurgedmetobreakOneDayataTimeintoOneMinuteataTime,ifthatwaswhatIhadtodotoavoiddrinking.WhenInearlystoppedattending
meetingsbecauseofmyreactiontotouch,Alsupportedmydecisiontowearanametagthatread,"Iamanabusesurvivorpleasedon'ttouchme."Allthe
handshakingandhuggingtriggeredmemoriesofphysicalandsexualabuse.AsIfeltsaferinthe

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fellowshipofmyhomegroup,heencouragedmetogrowpastthenametagandtoriskgivingandacceptingtouch.
Intheearlydaysofmysobriety,IthoughtthatI'dnevermanageevenaweekofsobriety.Oneofthepersonalitieswouldalwaysblowit,andtherewe'dbe,starting
over.AndhowcouldIexplainittoanyone?Itsoundedlikeanexcuse:"Well,I'wokeup'andI'dbeendrinkingbutitwasn'tme."Convenient,right?ItfeltlikeIwas
livingonelieafteranother.Afterall,Iwasn'tsurethatIbelievedIwasmultiplehowcouldIexpectanyoneelsetounderstand?
Butonepersonality,Berta,consistentlyattendedthemeetingsandreallybegantheprocessoflearningtheStepsandteachingthemtotherestofus.Alencouraged
Bertatohaveherownsobrietydate,soweobservedtwodatesoneforBertaandoneforthephysicalbody.
Thephysicalbodysobrietydatewasimportantformedicalreasons.Myfamilydoctor,whofollowedtheprogresswemadetowardsobriety,wasalwaysconcerned
abouttheeffectsofthealcoholandthemedicationprescribedbythepsychiatrists.Iwasonamerrygoroundofantidepressants,antipsychotics,andmajorandminor
tranquilizers.Nothingworkedforverylongwhichiscommonformultiplepersonalities.Anditwasdifficulttobecertainthatthemedicationwastakenproperly.At
onetime,severalpersonalitiesallthoughtitwastheirresponsibilitytotakethemedicinesotheywouldeachtakeadose.Eventually,thebodywouldreacttothe
unintentionaloverdosage.Sobrietywasnotmaintained.
OnceIarrivedverydrunkforanappointmentwiththepsychiatristwhoprescribedmedicationsforme.HeaskedmeifIhadbeendrinking.Isaidyes.Nevertheless,I
walkedoutwithprescriptionsforamonth'sworthofantidepressantsandatranquilizer.Thisdoctordidn'tacceptmytherapist's

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diagnosisofMPD,andheknewthatIwasalcoholicandaddictive.
Itwasthefourthandfinalpsychiatristwhovalidatedmytherapist'sdiagnosisofMPDandprescribedmedicationthattookintoaccountthatIwasalcoholicand
addictive.
Uptothispoint,Ihadn'tdonemuchworkonmyrelationshipwithmyHigherPower.Oh,IwasdoingthestandardAAroutineofstartingandendingthedayin
prayer.Butinthefaceofthereturningmemories,itwasdifficulttobelievethatmyHPcaredaboutme.Anditwasabouttogetworse.
First,myhusband'sjobsituationforceda160milemoveawayfromhisfamily(ourmajorsupportnetwork),myAAandACA(AdultChildrenofAlcoholics)
recoveryfamilies,andmytherapist.Second,wordcamethatIhadbeendeniedmedicalinsurance.Itriedtostaygrateful,astheprogramtaught,butitwasdifficult
no,itwasimpossible.
Themonthsofreestablishingmyfamilyandadjustingtoanewjob,anewhome,andthekids'newschoolsleftlittletimeformyrecovery.Ihadtofindanewtherapist
(I'dhadenoughofpsychiatrists)whowouldseemewithnoinsuranceatareducedfee.Ihadtolearntomanagemylifewithoutmedications.Ihadtobuildatotally
newsupportnetwork.IcursedmyHigherPoweronadailybasiswhileattendingmeetingsandwearinga"workingtheprogram"mask.
ButIdidfindatherapist.AndIdidcontinuetoattendmeetings,althoughbythistime,IhadswitchedfromAAmeetingstoISA(IncestSurvivorsAnonymous).By
nowIhaddiscoveredfeelings,andIfeltunacceptedandjudgedbytheconservativeAAbeliefthatmyangerandpainindicatedIwasa"drydrunk."SomeoftheAA
doctrinetaughtinmynewAAmeetingswasinconflictwithmytherapyyetI

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wantedandneededtheTwelveStepprograminmylife.Forme,ISAwastheanswer.
Throughoutthisprocess,IrecognizedthatIdidn'tsimplyneedtonotdrink,IneededtohealthepainthatIwasattemptingtomedicatewithalcohol,food,andsoon.
MytoolsforhealingbecametheTwelveSteps,theslogans,theSerenityPrayer,thebeliefinaHigherPower(evenwhilecursinghim),thesupportofthefellowship,
andworkwithanexcellenttherapist.
Onmyoneyearanniversary,Aldiedofbraincancer.Idrovethreehourstohisfuneral,wishingIcouldgowithhim.Thereisnodoubtinmymindthatthecaringof
thisonemanlaidthefoundationformyrecovery.Hebelievedinmyabilitytoheal.Heacceptedmeallofme.HepatientlytaughtmetheTwelveStepprogram,as
heunderstoodit.HeencouragedmetoseekarelationshipwithmyHigherPowerevenifitwasstilloneofangerandquestioning.Heneverjudgedmeormy
program.
Iamnowintheprocessoffinalintegrationofallofmypersonalitiesandfragments.Iambynomeansfinishedthereisnograduationtohealth.Iwillalwaysstruggle
toavoiddissociatingwhenIamstressed.Iwillalwayshaveanaddictivepersonality.ButtheTwelveStepshaveindeedbecomeawayoflifeforme:WhenIsuffered
fromstressinducedamnesiaduringthetherapysessionthatledtofinalintegrationofmymultiplepersonalities,Irememberedtheslogansandpromisesfirstbefore
thenamesofmyhusbandandchildren.
TodayIamDaile,arecoveringalcoholicwithqualitysobrietytimeandanintegratedmultiplepersonality.IliketobelievethatsomewhereAlissmilingandsaying,''I
knewyoucoulddoitIsaidyouwereawinnerallalong.''

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Donna'sStory
Here'smycurrentsituation:I'vebeenmarriedforalmosttwentythreeyearsandhavethreesons.Myhusbandisarecoveringalcoholichewentthroughtreatmentbut
didnotgotoAAortherapy.Ijustturnedforty.I'vebeensobernowforthirteenyears,smokefreefornineyears,freeofbulimiaforeightyears.Lastbutnotleast,I
ammanagingamentalillnesscalledcyclothymia(moodswings).
Myfamilybackgroundgoeslikethis:Mymotherisachronicparanoidschizophrenic.Iamthesecondoldestamongthreebrothers.Fromagefouron,Ilivedwithone
setofgrandparentsortheother.Socialworkerswouldvisitfromtimetotime.Mymomwasinandoutofhospitals.Iwasafraidofherfrequentpersonalityswitches.I
didn'tlearnhowtocook,cleanhouse,orevenbabysit.Iwasafraidmostofthetimeandnevertalkedaboutit.
WhenIwasfourteen,Itookmyfirstdrink.Ididn'tlikethetasteofalcoholandhadahardtimekeepingitdown,soItrieditonlyacoupleoftimes.Inthosedays,I
wasalwaysonadiet,althoughwhenIlookback,Ireallywasn'toverweight(butflatstomachsandTwiggywereinstyle).Just

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beforeIturnedfifteen,Igaveupmyvirginitytomyeighteenyearoldboyfriend.Itwaspainful,bothphysicallyandemotionally.Ifeltguilty.IknewIwastooyoung,
butItoldmyselfIwasinlove.
ThenIbegantodrinkagainandfoundtheescapeIneeded.IfIdidn'tdrinkontheweekend,Ifeltthewholeweekwasaloss.
Ilearnedacoupleofthingsearlyoninmydrinking.IlearnedthatifIwasn'twithmyboyfriend,IwouldflirtanddothingsIwouldlaterregret.Then,andthroughout
mydrinkingcareer,IalwaysgotsickandvomitedsometimesIwouldputafingerdownmythroattohelp.IalsodidthiswhenIwasnauseated(whichwasoften).I
realizedthattherewasapayofftotheseepisodesIfeltthinsoitwasworthit!
EventuallyIbrokeupwithmyboyfriendtogooutwithBill.Bytheendofmysenioryearofhighschool,atageseventeenandahalf,Iwasthreemonthspregnant.So
BillandIgotmarriedthatJuneandlivedwithmyinlawsforthirteenmonths.Heworkedfivetosevendaysaweek,intwelvehourshifts.(Itwasn'thowIthought
marriagewouldbe!)SinceIcouldn'ttoleratesmokingordrinkingduringthatfirstpregnancy,Iatetonsoffood.Aftersevenmonths,Ihadgainedalltheweightmy
doctorwouldallow.HeputmeontheWeightWatchersprogram,andIhadtobeweighedonceaweek.Idevelopedhugestretchmarks.(Therewentbikinisand
smoothskin!)
Aftermyfirstsonwasborn,Iwentbacktosmokingcigarettes,drinking,andpartying.Ialsousedspeed,LSD,andpot.Myhusbandwasdrinkingallthistime,and
wemovedseveraltimes.SoonIwaspregnantwithmysecondson.Gettingpregnantseemedlikeawayofstartingoverbutmyproblemsalwaysfollowed!

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Inmyearlytwenties,IsawthemovieJesusChristSuperstar.IweptafterwardbecauseIrealizedthatI"believed"again.Afterseeingthismovie,Ifelttotallyforgiven
forallthethingsIhaddonewrong.MyhusbandandIjoinedachurch,andIprayedwiththepastor'swifethatIcouldstopgettingdrunk.Itdidn'twork,andIsoon
lostmyfaith.
Wehadourthirdson.Whenhewasthreemonthsold,ourinlawsboughtaresortandinvitedustohelpthemrunit.Theyhopedtogetmyhusbandawayfromhis
currentjobsothathewouldstopusingspeed.Withthecombinationofboozeandspeed,hewasbecomingscarytobewithattimes.
Weagreedtohelpthemand,forasecondtime,livedwithourinlaws.Myhusband,myfatherinlaw,andIwerealldrinking,leavingmymotherinlawtodealwith
us.Igotverydepressed:Icouldn'tevenkeepmyapartmentclean,andnowIhadtocleanotherpeople'srooms.ThetownhadonlyfivehundredpeopleandIfelt
theyjudgedus.Myselfesteemwasverylow.Imissedmyfriendsandfamily.
OnedayIjoinedawomen'sbowlingleagueandthemembersweredrinkers!Ilovedit!Infact,itgotsothatallIlookedforwardtowasthatonenightout!I
promptlyexperiencedmyfirstblackoutandthenactedinawayIwasn'tproudof.Duringthenextthreeyears,IblackedouteverytimeIdrank.ThereweretimesI
droveintoditches,didn'trememberdrivinghome,orcouldn'trecallwhatIhaddoneforwholeevenings.Finally,Iwasalmostraped.Thatwasmybottom.
Forsevenweeks,IwenttoAAmeetingsandstayedsober,eventhoughIwasworkinginabarfulltime(tome,thiswasamiracle).Bythesixthweek,I'dbegunto
getdepressedagain.ItalkedtoBillaboutmygoingtotreatment

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butheflatlyrefused.Iwenttomyboss,andhesaidthatalcoholismwasallinaperson'sheadandthatyoujusthadto"makeupyourmind."SoIprayed:"God,if
you'rethere,thenyou'regoingtohavetohelpme,becauseI'vedoneeverythingIknowhow."Ifeltveryguilty,andmylifelookedbleak.Idranktwomoretimes.
Finally,halfdrunkandsick,Idrovethirtymilestothetownwheremycounselorhadherofficeandthenhadherdrivemeanothertwohourstotreatment.Godtruly
hadansweredmyprayer!
Myhusbanddidn'tsupportmygoingintotreatmentheeventhreatenedtodivorceme.Hethoughtitwasthestrawthatbrokethecamel'sback.Ifeltlikewewere
strangers.
IntreatmentIlearnedtolaughagain,andIlovedhavingpeopletotalkto.WhenIlefttreatment,IfeltaglimmerofhopethatmaybeIcouldchange.Sixmonthslater,
Iconfrontedmyhusbandabouthisdrinkingalthoughveryangry,hewentintotreatment.
Thoseweretoughyears.IwastryingtofindoutwhoIwas,beamother,learntobeassertive,andattendalotofmeetings.Myhusband,stillangryaboutmyprevious
drinkingbehavior,wasoftensarcastic.
Withoneyearofsobriety,Igotajobasaunitassistantatachemicaldependencyinpatienttreatmentcenter.Myheartwasreallyinmywork.Butsixmonthslater,my
inlawscametolivewithus(togetheragainforthethirdtime),andIgotdepressedandwantedtodrink.Iendedupgoingintotherapyforawhile,andthatwasvery
helpful.GoingtoAAandhavingasponsorthroughtheyearshavebeenmygreatesthelps.
Nowthatmydrinkingwasmanageable,foodbecameanissueagain.Forthefirstthreeyearsofmysobriety,Ididnotdiet.IfeelGodgavemethegracetoletgoof
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becausestayingsoberwassodifficult.ButthenIwentonaneighthundredcaloriedietwithafriendanditwassoeasy.IthoughtI'djustloseafewpounds.
Instead,Ibecameobsessedwithgettingthinner.NolossofweightwasenoughIstillfeltfat.IhadheardaboutbulimiaandsinceIwasusedtovomiting(dueto
nausea),ItriedvomitingafewtimeswhenIthoughtIhadeatentoomuch.ItworkedbutthenIcouldn'tstop.
MttherapistsuggestedIgotoOvereatersAnonymous.Iwentthreetimes,buteachtimeIgotaheadache.IdecidedagainstOAandinsteadwenttotheuniversity
hospitalforoutpatienttreatmentformyeatingdisorder.ThereImainlylearnedaboutgoodnutrition(andvomitedonlyonceduringthateightweekprogram).
Afterward,Istartedactingbulimicagain.Iwassimplynotready!
ButmyHigherPowerhadanotherplanforme.Oneday,mybestfriendcalledandinvitedmetoanopenOAmeeting.BeforeIknewit,Ihadsaidyesandshe'dhung
up.Iwent,listenedtothespeakers,butdecideditwastoohardandthatIstillwasn'tready.Thenmyfriendtoldmethatourrelationshipwasover,becauseshe
couldn'twatchmebingeandpurgeanymore.Icriedallthewayhomefromthemeeting.OnceagainIsurrenderedtoGodandsaid,"Okay,God,takethesugar!But
Iwon'thaveanythingtogotoandmymarriagewillfallapart."
SobeganmyjourneyintorecoverywithOA.WorkingtheOAprogramhasallowedmetostopbeatinguponmyselfoverhowmuchIweigh,overhowmuchI've
eaten,overdietafterdiet,andovervomiting.InOA,Ihavetrulycometoknowmyself.
ThroughOA,I'velearnedtobemoreofapartnertomyhusband.Ourmarriagenearlybrokeupaftermyfirsttwo

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yearsinOA,becauseIwasgettingclearonsomesexualityissuesandrealizingwhenIwasangry.Butwecamethroughthestormandcelebrated.
WiththehelpofGodandthesupportoffamily,friends,andTwelveStepprograms,I'venowfacedalcoholism,smoking,andbulimia/compulsiveovereating.Butthe
lasttwoyearshaveactuallybeenthehardest.
Inalltheseyearsofrecovery,mygoalhasbeentoensuremymentalhealth.MygreatestfearwasthatIwouldenduplikemyschizophrenicmother.I'vealwaysbeen
asomewhatmoodyperson,withperiodsofdepressionnotunlikemostpeople,Ithought.Iwouldbereallybusyforawhile,andthenafterafewdaysoraweek,I
wouldcrash.I'dcryonmybedandfeelIcouldnotgiveoreventalktoonemoreperson.Thatmoodmightlastaday,andthenIwouldgearupagain.
Butabouttwoyearsago,severalstressfulthingsallhappenedaroundthesametime.Intherapy,Istartedtalkingaboutchildhoodissues.AtworkIhadatwoweek
stretchwhereIputinnearlyeightyhours(andthenwenthomeandspentfourorfivehoursafterworkonmyhobby,makingrecoverydollsIfeltsocreative!).I
crashedandgotlow.Ididn'tfeelgoodagainexceptforperhapsoneweekoutofamonth.IthoughtitwasPMS.Sooneachdaywasagreateffort.Iwenttothe
doctorandhadbloodtests.Thedoctorcouldfindnothingphysical.Iwasreferredtoatherapist.AsIdescribedmyuptimesanddowntimes,thetherapistdecidedI
neededtoseeapsychiatrist.Thatscaredme.
Iwenttothepsychiatristand,forthefirsttime,heardaboutcyclothymia.Sincetherehasbeenalotofdepressionandmanicdepressiveillnessinmyfamily,he
suggestedItakeanantidepressant.Ifelttheeffectrightaway.(Forsome

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reasonIdidn'tmindtakinganantidepressant,butIdidn'teverwanttotakelithium!)IthenhadaboutathreemonthperiodwhereIfeltveryuninhibitedandsexual.It
wasgreat!
Beforeantidepressants,IwouldfeelgreatforshortperiodsbutneithermyhusbandnorIcouldfigureoutwhathadtriggeredit.Duringthosetimes,Ialmostfelt
possesseditwassounlikeme!NowIseetheyweremanicepisodes.Eventually,Ifelttoomuchquiveringenergyinside,soinordertobemyselfagain,Iwentoff
theantidepressant.
Forthelastyear,Ihavegoneonandoffmedication,notwantingtobelievethatIwaspowerlessoverthesemoodswings.Itriedtoworktheprogram,todoallthe
thingsIknewhowtodoinordertofunction.Iwasabletodomyjobforquiteawhile(althoughIkeptdroppingshifts).Butfinally,Icouldn'ttolerateitanylonger.I
quitmyjoboftwelveyears.Myselfesteem,howIsawmyselfonthejob,wasworsethanhowotherssawme.
ThedifferencethesedaysisthatIcan'tseemtopullitalltogether.Ikeepfallingapart.Inthepastyear,I'vehadtoleaveworkthreetimesandleavemyOAmeeting
twice.Istartedtohavethatquiveringfeelingagain,andsoIwentoffmedication,thinkingthatwasthecause.Nosuchluck.Thequiveringgotworse.ItgotsoI
couldn'tsleepmuch.Inpain,IwentbacktoeatingsugarproductsandgainedweightforthefirsttimesincecomingtoOA.
IwasgettingscaredaboutthequiveringfeelingIworriedthatitwasmemoriescominguporevensomething"evil."Iaskedpeoplefrommychurchtoprayforme.
Mymoodswentupanddownoveratwentyfourhourperiod.Iwasunpredictable,anditwasverydifficultformyfamily.Finally,Iwentbacktothedoctor.
Defeated,Iwentonlithium.Itrieditforonemonth,butIfelttiredallthetime

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(andalsomissedtheuptimes)soItookalowerdose.Mymoodsquitfluctuating.RecentlyIalsowentonalowdoseofadifferenttypeofantidepressant.This
combinationoflithiumandantidepressanthasbroughtbackmysanityandthe"real"me.
Thethingthatbotheredmemostoverthesepasttwoyearswasthatmylifehadfinallybecomegood.Mymarriagewasbetterthanever,mychildrenwerealmost
grown,andIwasinsolidrecovery.ItmadenosensethatIwashavingsuchproblems.
I'vebeenbackatworknowforacoupleofmonths,andIbelieveagaininmyabilitytodomyjobanddoitwell.I'mgoodatit!IfeelmyfeetarefirmlyplantedIfeel
stronginmyabstinence,mysobriety,myabilitytowork,andmyfaithinGodandinwhoIamabeautifulwomaninherfortieswhohasabipolardisorder.

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Eric'sStory
Iwastwentythreeyearsoldwhenagoraphobiadepositedmeintoablackholeofterror,fragility,andfrustration.
Asaboy,Iwasterrifiedoftheuncertainelementsaroundme.Myparentsdrankconstantlyandusedviolenceasameansofpunishment.Asachild,Ineededattention
andlove,cravedasmileorfriendlyword.Myhomelifewasaconstantbattlegroundofangrywordsandfists.Keepingtomyselfandstayingoutofthewayofconflict
wastheonlywaytosurvive.Justkeepingmymouthshutwasthebestwaytoavoidanangrywordorabeating.IwasabedwetteruntilIwasthirteenyearsoldIhad
painfulheadachesdailyandcouldn'treaduntilIwasseven.Asan"imperfectchild,"IneverfeltworthyIalwayswantedtobetwentyyearsolder.Tome,childhood
wasonlyforkids.
Attheageoffifteen,strugglingwithdoubtsaboutmysexuality,Iescapedahomeofterrorthroughmytwentythreeyearoldgirlfriend.Thedoubtsaboutmy
heterosexuality
1991.TheInstituteforPhobicAwareness.PhobicsAnonymousWorldServiceHeadquarters,P.O.Box1180,PalmSprings,CA92263.

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caughtupwithme,though,andIbeganalifeofgayprostitutionandalcoholanddrugabuseatseventeen.Ithoughtthatinthislifestyle,Ihadfinallyfoundawayoutof
myfears,tears,anddoubts.Mylifewasspentavoidingmytrueselfthroughsex,alcohol,anddrugs.Itwasawonderfullifeofirresponsibility,control,andadventure.
Thehidden,scaredlittleboywasfinallygone.Ihadwashedhismemoryaway.AbusingchemicalshelpedmetofindthecontrolIsodesperatelyfeltIneeded.Icould
beanypersonIwantedtobe.ButIwasconstantlyintroublewiththelawforalcoholrelatedincidents.Iwouldgetoutofjailandthendomoreofthesame.Iwason
anendlessjourney,lookingforloveandcompanionshipanywhereIcouldfindthem.AslongasIkeptupthebingesofalcohol,sex,anddrugs,fearneverenteredmy
mind.ButIhadlockedupthispowerfulemotionwithinmefortoolong,andIknewthatitwouldraiseitsuglyheadeventually.
ThatdaycamewhenIwastwentythreeyearsold.
Ihadquitdrinkingtheyearbefore:ADUIhadscaredmeintorealizingthatalcoholcouldbeaproblemforme.Ididn't,however,believeIneededtreatmentfor
alcoholism.NeedinganykindofhelpwasasignofweaknessasignthatIwasn'tincontrol,andIdemandedthatIalwaysbeincontrol.
SoIcontinueddoingdrugsandthinkingthatalcoholwasmyonlyproblem.
Oneevening,afterdoingaboutthreedays'worthofdrugs,Iexperiencedmyfirstpanicattack.Itfeltlikedoom.IwassurethatIwasgoingtodie.Myheartwas
palpitating,anditwasalmostimpossibletobreathe.IthoughttheworldwascollapsingandthatIwasgoingtocollapsewithit.ThenextdayIdrovetothebeach,
blamedtheepisodeonbaddrugs,andputmynightoffearcompletelyoutofmythoughts.

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Overthenextthreeweeks,stilltakingmydrugsasusual,Iagainexperiencedtheattacksofterror,theheartpalpitations,andtheurgetorunaway,butagainIrefused
tolistentomybody.IwassureIwasgettingbaddrugs,butIcouldn'tsitbymyselfwithoutbeinghigh.TheworldwastooquietIneedednoisetocoverupthe
feelingsofextremeloneliness.
AroundthistimeIwasdiagnosedHIVpositive,andmyworldwentblack.IfeltIhadnolifeleft.IwassurethatIwasgoingtodiebeforeIwasthirty.Ihatedmyself
forbeinggay,andIhatedmyparentsforhavingagayson.Ididn'tcareaboutmyselforanyonearoundme.Ineededdesperatelytorunfromthepainandfear.
Eventuallymybodyandmindcouldn'ttakeitanymore.
Onenightwhilelyinginbed,veryhighoncocaine,Idisappeared.Mysightwentblack.Ifeltgreatpain,asifsomeonehadtakenahotironrodandrunitthroughme,
frommytoestothelaststrandofhaironmyhead.IwassureIwasdying.
Foreighthours,Ilayonmybed,unabletomoveforfearoftheheartpalpitations.EachtimeItriedtogetoutofbed,myheartwouldbeatasifIwererunninga
marathon.Thepanicattackshadbeguntocontrolme.Iwashousebound.
Overthenextfewyears,Itriedtofindreliefinselfhelpbooks,doctors,friends,andanyonewhowouldlistentomycrazystories.IwassurethatIwouldhavetolive
mylifeasaprisonerofmyownmind.
Afterthreeyears,itallgottobetoomuch,andItriedtofindreliefagaininalcoholanddrugs.Mypanicattackspromptlydisappeared,andIwasoverjoyed.Butmy
joywasshortlived.Afterjusttwoweeksofselfmedicationwithalcoholanddrugs,mypanicattacksreturnedonehundredfold.

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NomatterhowmuchalcoholIdrank,nomatterhowmuchcocaineIsnorted,itwasnotenough:Thepanicwasknockingonmydoor,saying,''Ihaven'tleftyet.''
Afterthreemonthswithnorelief,thepanichadbecomesodebilitatingthatIcouldn'tbatheordressmyself.Thelivingroombecamemybed.Icouldn'tmoveI
couldn'tspeak.Fearhadwon.
ItwasonlythenthatIwentintotreatmentformyalcoholism.
TodayIhavebeeninrecoveryfortwentytwomonths.Thepanicattackscomeandgoonaprettyregularbasis.WhenIstrayinmyrecoveryprocess,Iknowthatthe
attacksgetworse.Iknowthatalcoholisn'ttheanswerit'stheenemyandthatmyproblemsonlygetworsewhenImedicatemyworldwithchemicals.Istillsuffer
fromdailyanticipatoryanxiety,butitdoesn'tscaremeasmuchandIstillhavealotofworktodo.IknowtodaythatIcan'truntheshow,thatIneedpeople.And
that'sokay.
PhobicsAnonymoushastaughtmethatI'mnotalonewithmyfearsanymore.Therearepeopletotalktoaboutwhatisgoingonwithme,peopleIknowhavebeen
therebeforeme.JustbeingabletoopenmymouthandtalkaboutEricisawonderfulgift.Ihavelearnedthatit'sokaytobeme,animperfecthumanbeing.

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Genna'sStory
Foralmostadecade,Iworkedhardtomakemylifemiserable.Diagnosedwithanorexianervosaatnineteen,Istruggledfirstwithanorexia,thenbulimia,andfinally
withdepression.Ultimately,afteryearsoffightingagainstmyselfandwiththeworldaroundme,IbegantorecoverfrommydualdisorderbyworkingtheTwelveStep
program.
Ibecameanorexicduringmysenioryearinhighschool.Theoldestchildinahighlyintelligent,competitivefamily,Iwassimplyoverwhelmedwithanxietyabout
provingmyselfincollege.BecominganorexicwasagoodwaytoavoidprovinganythingotherthanthatIcouldbethinnerthananyoneelse.Myfamilymembers
watchedmydeteriorationinsilence.MymotherworkedfulltimeandhadbeenouronlyparentsincemyalcoholicfatherleftuswhenIwasfour.Mysisterappeared
isolatedfromthefamily,secureinherworldofhighschoolfriends,andmybrotherescapedbyattendingaprivateboardingschoolonascholarship.
Duringmyfouryearsatcollege,myliferevolvedaroundmybodyandfood.WhileIreceivedmanyacademichonorsandearnedgradesthatlandedmeinthetop10
percentof

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myclass,Ididn'tmarkprogressbywhatappearedonmytranscript.Instead,Imeasuredthemeritofmylifebythenumbersonascaleorthemarkingsofatape
measure.
Bymysenioryearincollege,Ididn'tcareenoughaboutanythingotherthansustainingmyillness.Ihadsystematicallyisolatedmyselffromthepeoplewhocaredabout
me.Myfriendswereexhaustedfromfouryearsoftryingtohelpmeandreceivingonlyhostilityfortheirefforts.Ihadminimalcontactwithmyfamilyandhadfinallycut
myselfofffromthemaltogetherwhenmymotherdemandedthatIgointotreatment.
Whileothercollegeseniorswereoutlookingforjobs,Ioccupiedmyselfwithkeepingmyweightbelowseventyfivepounds.ThistookupanytimeImighthavehad
forextrahomework,jobsearches,orfriendships.AllIcouldthinkaboutwasfoodandthebonesofmybody.
Isetmyalarmfor3A.M.everyday.Takingajumpropewithme,Icreptthroughthesleepingdormhallwaystothewomen'sshower.Theemptyroomwasdimlylit,
cold,andgrayinthemiddleofthenight,andIwouldjumpropeforfortyminutesonthecrackingconcrete.Afterreturningtobedforacoupleofhours,Iwouldgetup
at5:30or6A.M.tojog.Therestofmydaywasusuallyspentstudyingandfightingofftheurgetoeatinthelibrary.Ibroughtpotatochipsorcandyintothe
librarywithme,occasionallygivingintomyhungerandthenrunningtothebathroomtovomit.
OccasionallyIwouldbingeandvomit.Moreoftenthannot,Istolemoneytofundthesefoodfrenzies.Once,Istolemyroommate'smoneyandsomeofour
belongingstomakeitlookasifsomeonehadbrokenintoourdormroom.Ifoneofmyfriendstookmeouttodinner(aspeoplewereprone

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todo,tryingto"help"meeat),IwouldeatwhatmostpeoplewouldcallanormalmealandthenthrowitupwhenIreturnedtomydorm.Thissatisfiedmyneedto
pleasethepeoplearoundmebyfeigningsomesortofmotiontowardrecovery.Butitwasanact.Iconsideredanyamountoffood,otherthanahandfulofcarrotsor
anapple,tobeabinge.SoeverytimeIate"normally"inpublic,IvomitedassoonasIcould.
Mostofmyfriendswatchedinbewildermentasmyillnessescalated.Onetoldme,withmuchloveandsadness,thatshecouldnolongerbearoundme.Shecouldn't
standbyandwatchmyselfdestruction.Slowly,manyofmyfriendsdriftedaway.
Ultimately,afteryearsofstarvationandabuse,itwasmyownbodythatdemandedIseektreatment.Ifaintedaftermydailymorningjog.WhenIwoke,Ifound
myselfinahospitalemergencyroom,surroundedbyblinkingredlights,plastictubes,andpeopleinwhitelabcoats.Theemergencyroomstaffconvincedmethatmy
lifewasindanger.IfIwantedtolive,Iwouldneedtogointotreatmentforanorexia.
Idid.Myhospitalstaylastedalittleoverayear.Initially,Iwaseagertorecover,simplybecauseIwantedtolive.However,whenIsawthatrecoveryentailednot
onlygainingweight(whichwasbadenough),butchangingfundamentalbeliefsIheldaboutmyself,Ibeganresistingrecoveryandfightingthehospitalstaffasfiercely
asIhadfoughtmyfamilyandfriends.
Goingthroughthemotionsoftreatment,Ibegandrinkingwateranddietsodatoboostmyweight.ItapedscissorsandpadlocksaroundmychestbeforeIwas
weighed.SoonIwasvomitingwhateverIateintogarbagecans,plastic

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bagswhateverIcouldfind.Everytimetherewasanopportunitytosneakoffthehospitalwardtobingeandvomit,Iseizedit.
Myliferevolvedaroundtrickingthepeopletryingtohelpme.Itseemedsoeasy,almostlikeagame.
Butthestakesskyrocketedsuddenly.IrippedasmallholeinmyesophagustryingtochokeoutthesingleappleIhadeatenearlier.Longshotsofpaintorethroughmy
throatandbeganspreadingthroughoutmyback.Iknewsomethingwasterriblywrong,andIwentbacktotheeatingdisorderward.Thestaffrushedmetosurgery.
ThesurgeoninformedmethatIhadabouta50percentchanceofliving.Theripinmyesophaguswasallowingairtospreadthroughouttheinteriorofmybody,
seepingintoplacesairdidn'tbelong.Thepainwasincredible.Thesurgeonwasreluctanttooperatebecausemypotassiumlevelandelectrolytesweredangerouslylow
fromvomiting.
Ihadtomakeadecisiontakemychanceswithsurgeryorhopethattheholeinmythroatwouldhealitselfspontaneouslybeforetheairseepagedidpermanent
damage.Withthesurgeon'sadvice,Ichosethesecondoption.IspentaweekwithanIVinmyarm,stayinginthesurgeryunitincasetheholedidn'tclosebyitself
andthedoctorswouldbeforcedtoperformemergencysurgery.
Theripinmyesophagusdidbegintoclose.Itwasaslow,painfulprocess.Mybodyached.MythroatwassofragileandsorethatIcouldn'tevenswallowwater.Any
movementwasdiscouragedasitcouldjaropentheslowlyhealinghole.Ifelttrapped,utterlyhopelessandabandoned.Therewerenofriendslefttovisitme.My
motherrefusedtocomeandseeme,sayingshe'dhadenough.Everyday,thedoctorswhocameintomyroomtoldmethatIwasluckytobealive.

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Thepossibilityofdeathsuddenlybecamerealtome.Thisbecameaturningpointinmyillness.SometimeduringthoselonghoursIspentalone,Idecidedtobegin
fightingformylifeinsteadofagainstit.Notonlydidthatmeanaphysicalrecovery,Irealized,butapsychologicalandspiritualoneaswell.Havingnowhereelsetogo,
IaskedGodforhelp.EvenwhileIwastalkingto"Him,"Ididn'tquiteknowwhatImeantby"God,"butIknewthatIneededsomethingstrongerthanmyself.Forthe
firsttimeinmylife,Iacknowledgedmyownweakness,myownpowerlessness.
Whenmyphysicalstrengthreturned,Ileftthehospitaldeterminedtofindawaytoendthechaosanddespairthathadtakenovermylife.Itwasimportanttometo
beginmyrecoveryinanewplace,withnewpeoplewhowouldhelpmehealpsychically,aswellasphysically.Ispentalmosttwomonthsinterviewingtherapistsand
visitingtreatmentcenters.
Eventually,Ibegantherapywithawomanatasocialserviceagency.MyrelationshipwithBethlastedalmostthreeyears.Forthefirsttime,Iwascommittedtomy
recoveryandeagertogetonwiththebusinessofliving.InadditiontomyindividualtherapywithBeth,IbeganattendingBulimics/AnorexicsAnonymous(BAA)
meetings.
IhadlearnedabouttheTwelveStepprograminthehospitalbutonlynowbegantoreallyunderstandanduseit.InsteadofstudyingtheSteps,Ilivedthem.Stillunsure
aboutthewordGod,IletmyBAAgroupandBethbecomemyHigherPower.Iworkedhardintherapy,diggingintothecornersofmylifeandinvestigatingevery
incident,everyemotionIfoundthere.MyresponsibilityasamemberofacommunitybecameimportanttomeItookprideinparticipatinginmyBAAgroupas
completelyandauthenticallyaspossible.Duringthistime,Igainedweight,myeating

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habitsstabilized,andIbegandevelopingstrongfriendships.Ihadmanydifficultmoments,butIwasabletosurvivethembyturningtomyBAAgroupforguidance.I
alsohadmomentsofgreatjoy,timeswhenIwasoverwhelmedwiththebeautyoftheworldaroundmeandthepeopleinit.
Onceoutoftherapy,Icontinuedmyrecoveryonmyown.Mycircleoffriendscontinuedtogrow,andIstartedidentifyingmyselfinwaysotherthan"anorexic."I
begangraduateschool.SoonIhadastronggroupoffriends,asupportivelover,andapromisingacademiccareer.IreadeverythingIcouldgetmyhandson
regardingcodependency,recovery,eatingdisorders,andspirituality.Inmanyways,Iwasstartingmylifefromscratch,rejectingthereligionIwasraisedinandthe
behaviorpatternsthatIhadestablishedovertheyearsofmyillness.Morethananythingelse,Ienjoyedthisprocessofrebuildinganddiscovery.
Yet,aftermorethanayearofthisnewlife,Ibegantobeovercomebyperiodsofexhaustion.Ididn'tfeelstrong,asIhadduringtheearlystagesofmyrecovery.
GettingoutofbedinthemorningsbecamedifficultIneverfeltentirelyawakeorrested.ItseemedthatIalwaysneededjustalittlemoresleep,nomatterhowmuchI
hadsleptthenightbefore.Eventually,sleepbecameimpossibletocontrol.Ibeganfallingasleepinthelibrary,onbuses,duringclasses.
Islowlybecametootiredtocareaboutmaintainingmyrecovery.TherewasnoenergytocallafriendwhenIfeltlikeskippingamealortochallengemyownthinking
whenIdecidedtoloseafewpounds.Whilemyworkasagraduatestudenthadbroughtmeopportunitiesandrewards,Iwastootiredtofollowuponanything,to
takethenextstepsinmycareer.Myweightdropped.IstoppedcaringabouteverythingthatIhadworkedsohardfor.

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Butsomethinginsideofmewasstillstrongenoughtomakemeseekcounselingagain.Thistime,thetherapistattheuniversityIwasattendingconcludedthatmy
primaryproblematthismomentwasdepression.ThedepressiondrainedmeoftheenergyIneededtosustainmyrecoveryfromanorexia.Thereturnofmyanorexic
thoughtsandbehaviorsaddedtomydepression.Thetherapistprescribedanantidepressant.
AlthoughIhadtoldmyselfthatIwoulddoanythingtofeelenergeticandhappyagain,Iwasreluctanttotakethemedication.Intellectually,Iunderstoodandagreed
witheverythingthetherapisttoldme.Depressionevenraninourfamily.Mymotherhadtakenantidepressantsforyearsmysisterbegantakingthemafteranearly
successfulsuicideattempt.Ihadseenthesymptomsofdepressioninmymotherandsisterandnowsawtheminmyself.Whenotherpeopletookprescription
medicine,Isawitastheintelligent,healthythingtodo.Whenfacedwithfillingmyownprescriptionforantidepressants,Isawitasasignoffailureandweakness.
Mytherapistpatientlyhelpedmeworkthroughthisresistance.Shesuppliedliteratureaboutdepressionandrecountedstoriesofpeoplesheknewwhohadturned
theirlivesaroundwhentheybegantakingappropriatemedication.Slowly,IrealizedthatIcouldn'tsimplywillmyselfoutofwhatIhadbeencallinga"slump."
Depressionwasamedicalproblemthatrequiredmedication.JustasIhadtrustedmyBAAgroupandBethtoguidemewhenmyownvisionfailed,Idecidedtotrust
thisnewtherapistandbegintakingthemedication.
ThefogIhadbeenlivingunderliftedeventually.AsIbeganfeelingmorehopefulandenergetic,Ibeganentering

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intoanewlevelofmyrecovery.ThedepressionultimatelyforcedmetoreassessthecourseIhadmappedformyrecovery.Iwasabletoidentifysomedestructive
patternsandunhealthyrelationshipsthathadreemergedinmylife.IwasalsobetterabletoseeandappreciatealloftheprogressIhadmade,thestablerelationships
thatIhaddeveloped.
Moreimportantly,IconfrontedafactthatIhadbeenvaguelyawareofandreluctanttoface:Duringmydepression,Ihadbecomesoapatheticthatsomeofmyold
eatingpatternshadsurfaced.Withthehelpofmymedication,IhadtheenergytoagainaskforthehelpIneededwithmyeatingdisorder.Withthelove,support,and
patienceofmyfriendsandBAAgroup,Iwasabletorestabilizemyeatingandmyweight.
Finally,duringthistimeIwasgivenanimportantspiritualgift.Afteryearsofstrugglingtodefine"God"throughreadingaboutspiritualityandreligion,Ithrewasidemy
booksandsimplylookedattheworldaroundme.GivingupmyresistancetotheantidepressanthadsomehowpushedmethedistanceIneededtogoinorderto
abandontheintellectualcontrolImaintainedovermy"spirituality"andtoexperiencemyspiritinstead.Withoutbookstoreadortheoriestotest,Ibeganunderstanding
spiritualitythroughtheexperiencesofmyownlifeandthroughmyrelationshipswithotherpeople.
TodaymylifeisinfinitelymorecomplexandsimplethanIhadeverimagineditcouldbe.Lifeissimpleinthatitexistsonlyonedayatatimeforme.Eachday,Ido
whatisessential.Itakeonegreenandwhitepill,feedmybody,andtreatmyselfandthepeoplearoundmewithlove,respect,andcompassion.Thesearethebasics.
Thecomplexitiesstemfromallofthis.Ihavediscovered

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hundredsofthingsIenjoydoingfromwriting,reading,andpainting,tosailing,swimming,andbiking.IhavefriendsIlovedeeplyandwhoseliveshavebeenintimate
partsofmyown.Myworkisgoingwell,andeachdayImakeprogresstowardcompletingmyPh.D.Everydayisrich,fullofsmallandlargepleasures.
Icanmanageandenjoythecomplexitiesofmylifebecausetheyareallextras.Underneaththebooks,thefriends,theacademicprojects,andcampingtripsarethe
basics:takingmymedication,eatingwell,andrespectinglifemyownandotherpeople's.Thisfoundationprovidesthebaseofethicsandhealthinmylife.Thetwo
arenotunrelated.

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Jay'sStory
TheplacetostartiswiththeamazingfactthatI'velivedtobefortyyearsold.TheonlyexplanationisthatthereisaGodandthatTwelveSteprecoveryprogramsand
therapyarelethalweaponsagainstdyingmomentbymoment.Andifpeopleworkreallyhardatit,theycangetallthewaytoOneWholeDayataTime.
Istoppeddrinkingandusingattwentyfourforme,thatwastheeasypart.Iwenttomeetings,gotasponsor,anddidwhatIwastoldmostofthetime.Theproblem
wasthatmyhairwaspastmyshoulders,myfavoriteblackTshirtread''Kill'EmAllandLetGodSort'EmOut,''Iworemydarkglassesallthetime(evenin
meetings),andIwassixfeetsixinchesandweighed235pounds.Nobody(notevensuicidalpeople)wouldconfrontmyantisocialbehaviorinanyTwelveStep
meetings.
Iremainedthiswayforeightyears.Atthetime,itwasn'tobvioustomethatanythingwaswrong.Ihadmadesomechangesboughtsomenicesuits,gottenajobasa
salesmanand,surprisingly,didwellforawhile,"acting"sociallyacceptable.

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ThenImetmywifetobe.(We'restillmarried.Iamamazedandextremelygrateful.)Sevenyearsago,wesaidour"Ido's."Shehadasteadyjob,butaboutaweek
beforeourwedding,Ibecameunemployed.
IthenbegantoisolatemyselfIstartedreactingtoeverythingshesaidanddidattimesgrabbingher,yellingandcussingather,throwingthings.Ifeltlikeawolf
caughtinatrap.(Mywifeisonlyfivefeettwoinchestall,andshe'spleasantunlessprovoked.)Ibecamecold,distant,andvolatile.
Bythetimewe'dbeenmarriedaboutthreemonths,I'dgonethroughtwojobsbecauseofmybehavioratwork.Oneplaceevenaccusedmeofbeing"drunk."(Not
soit'sjustthatanantisocialpersonalitylooksthatwayto"regular"people.)Atthispoint,mywifesuggestedtreatment,andsinceIhadneverbeentotreatment,I
knewthiswasa"communistplot"afterall,I'dbeensoberfouryearslongerthanshe!"She'ssick"iswhatIheardfrommysponsorandfourotherpeoplewhoknew
usinthefellowship.SoIcontinuedwithmeetingsandcontinuedtobeantisocialandblametherestoftheworld.Ihadlotsofenablerswithintheprograms,bothAA
andNA.
Threemoremonthswentby.Bythistime,Iwasonmyfourthjob.WithsixyearsofcollegeandaB.A.inpsychology,Iwasworkinginawarehouse.Iworkedalone,
whichwascomfortable,exceptthatthelonelinesswaskillingme.
LateoneFridaymorning,finallyintears,Icalledafriendwhoworkedintheaddictionsfield."I'mlosingit,"Isaid.Hecameandpickedmeup,andwecalleda
treatmentcenter.Formeitwaseitherastatehospital,arubberroom,orsuicide.(Iknewenoughnottoverbalizethelastoption,oritwoulddefinitelyhavebeenthe
rubberroom.)Thetreatment

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centersaiditcouldtakemeonSunday.IstoppedbackbyworkandtoldmycoworkerswhereIwasgoing.IwaspetrifiedIwouldn'thaveajob.Iwasgratefulto
beworkingagain,butIthoughtIwasalsobeingused(thatwaspartofmyproblem).
Iwentthroughthetwentyeightdays,andthankGodIgotatherapistwhowasbiggerthanmeandcouldcommunicatewiththeantisocialpartofme.Hesuggested
thatIwouldn'tknowafeelingifitbitme!HeaskedmehowIfelt.Myresponsewasfullofanger,hatred,andrage.Hebegantoteachmeaboutmyantisocial
reactionstomyfeelings.Andhebegantoteachmewhatwasgoingonbelowtheantisocialbehaviorthesadness,loneliness,insecurity,andinadequacytheterrified,
hurt,trapped,used,unloved,unaccepted,andshamefulfeelings.IsoonrealizedthatIhadlearnedthreerulesgrowingupinmyhome,onthestreets,andinmyculture:
Don'tTalk,Don'tTrust,Don'tFeel.IespeciallylearnedDon'tFeel,becausefeelingproducesnothingandwastestime.Afterall,bigboysdon'tcry(feel),dothey?
WhenIgothomeaftertreatment,Iwasworriedaboutbeingunemployed.ButIwasamazedwhentwotreatmentcenterscalledandwantedmetodomarketingand
publicrelationsforthem.Itookoneofthepositions.Withinninetydays,anotherfacilitycontactedmeaboutbecomingatherapistthere.Itookthatjobandhavebeen
doingtherapyeversince(bothforothersandformyself).
Fiveyearsago,Iwasgivenanopportunitytodevelopacodependencyprogram.InordertodosoIparticipatedinasimilarprogramasapatient/clinicalobserverand
wasintroducedtotheconceptofthe"childwithin."
Thisprograminvolvedalotof"angerwork,"whereyou

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takean"encounterbat,"screamatthetopofyourlungs,andbeatthehelloutofsomething.Thenyouhugyour"childwithin,"beingkindandcaringandlovingtoward
thatpartofyourself.(Developmentally,this"child"fallsintheagerangeofzerotoeightyearsold.)
WhenIstartedtodevelopmyownprogram,Ibegantorunintosnagsnotonlywithotherpeople(andwithnegativedoublemessagesthattherapistsandco
therapistsandadministrativepeoplegive),butwithmyownantisocialbehaviors.Theybegantoshowupallover,whichterrifiedme.SoIreviewedalltheworkIhad
donethusfar.Selfdoubtaboutmyabilities,aboutlife,andaboutpeopleranthroughme.Ispentnightsathomewantingtoquitmyjob,getdivorced,andblame
theworldbecauseIwasstillfeelingtheantisocialreactionsinfullforce.
SoIgotintotherapyonmyown.(Therapy'snotbadstuff,it'sanothertool.BillW.spentalotoftimeintherapy.)Ibelievethatpersonalitydisordersandother
psychiatricproblemswhich,contrarytosomepopularbeliefs,alcoholicsandaddictsdohaverequireattentionaboveandbeyondtheTwelveSteps.ButIdidn't
knowwhatIwaslookingfor.Ijustknewthingsweren'tcompleteandthatitwasastruggletooperatewithintheframeworkofsociallyacceptablebehaviorandkeep
ajob.
Bythistimemyattitudehadchangedto"Staylowandkeepmovin'."Atworkpeoplereferredtomeas"unprofessional"and"crazy,"butIhaddevelopedareputation
asadamngoodtherapist.Theonlypersonwhowouldsaymuchtomeaboutmybehaviorwasmycotherapist.Nobodyelsewouldconfrontmeforfearofmy
reaction:Iwouldwinbyintimidation.I'dintimidatepeoplewithalookIhaddevelopedoutoffearasakidonthestreetsyourbasicpsychopathicglare!

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OnedaymycotherapistandIwerediscussinghowwecouldmakeourcodependencyprogrammoreeffectivewhensheasked,"Whatareyougoingtodoaboutthe
adolescentinyou?"Ireplied,"Whatthehellareyoutalkingabout?"
ButIcalmeddown,andwekeptontalking.Afterawhile,thepersonalpartofhermessagebecamecleartome.Wehadbeenlookingatthedevelopmentalagerange
ofzerotoeightyearsasconstitutingtheyearsofthechildwithin,butwhycouldn'ttherebeaseconddevelopmentalagerange,sayfromninetotwentyoneortwenty
fiveyears?Wecouldcallitthe"adolescentwithin,"whoisrebelliousandveryantisocial.Weagreedthatitfitourmodel,and,moreimportant,itfitmepersonally.
Icontinuedwithindividualtherapy,andoneeveningmytherapistdidaguidedimageryexercisewithme.Insteadofmeetingmychildandtakinghimbacktowherehe
grewup,wetookmyadolescentback.Hewasseventeenyearsold,sixfeetsixinchestall,235pounds,wearinghisleathers,andridingaHarleySportster.Whenhe
arrivedatthehousewherehegrewup,hesawthatithadbeenburneddown!EverythingwasgoneMom,Dad,hopes,dreams,ambitions,wishes,everything!He
walkedintothemiddleofthecharredrubble,satdown,andbegantosobuncontrollably!
IrememberthatthepainandsadnesswerebeyondanythingIhadeverexperiencedbefore.Deathwouldhavebeeneasiertoaccept.Depressionsetin.Itwasreal
anditwasdevastating!Lifefeltlikeswimminginmolasses.Icouldnolongerrun,and,mostterrifying,IfeltIcouldnolongerfight.
Butinworkingthroughthisdepressionwithmytherapist,twothingshappened.First,IbegantodevelopabroaderunderstandingofStepSeventhroughthebook
TwelveStepsandTwelveTraditions.Ittalksabouthowoncewegeta

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handleonhownottodrink,wewillwanttoheaveagreatsighofreliefandsay,"Well,thankGodthat'sover."TwelveandTwelvegoesontosaythatwe'veonly
gottentothefirstmilestoneandthatinordernottorelapse,itbecomescriticaltogobackandfindoutwhatcausedustobecome"problemdrinkers"(prealcoholic)in
thefirstplace.
Second,mytherapistreferredmetoapsychiatristwhospecializesinpeoplewhoarechemicallydependent.(Knowthatyouhaveanobligationandarighttocheck
thesecaregiversoutthoroughly.)Afterseveralvisitswithbothmytherapistandpsychiatristandafterextensivepsychologicaltesting,Iwasgivenaprescriptionfor
antidepressantmedication.
Iwas(andam)verycautiousaboutmedication:Itcanbelifethreateningbutalsolifesaving.ButItrustmytherapist,whotrustsmypsychiatristadoctorIliterally
trustwithmylife.
Itookantidepressantsforaboutsevenmonths.Formostofthistime,Iworkedonaranch(thefacilityI'dworkedforhadjustclosed),rested,workedonmyself,
spenttimewithothertherapists,andspenttimeinTwelveStepmeetings.
Duringallthis,mywifechosetogothroughitwithme.(Ican'tthankherenoughforthesupport!)Iknowtherewerealotofdayswhensheaskedherself,Why?And
Ioftenaskedmyselfthatsamequestion:ThereweremanytimesIwantedtokillmyself.
TheotherimportantpartofmystorybeganwhenIgottiredofpeopletellingmetoreadpage449intheBigBook.(Forexample,"UnlessIacceptlifecompletelyon
life'sterms,Icannotbehappy.Ineedtoconcentratenotsomuchonwhatneedstobechangedintheworldasonwhatneedstobechangedinmeandinmy
attitudes"and"Iwasalwaysabletoseetheflawineveryperson,everysituation.AndIwasalwaysgladtopointitout....")Ihadanantisocialreactionto

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thesmartasseswho'dsaythisIwantedtojackthemupagainstawall,ripoutpage449,andmakethemeatit.Thatwoulddemonstratehowacceptanceasthe
answerwasnotsofunorsimple.(Theirintentionswerepure,I'msure,butincomplete.)
Fortunatelyforall,Ihavegrownbeyondactingoutthesefantasies,andIdon'tevensaythemoutloudmuchanymore.WhatIhavefinallyrealizedaftermuchresearch
isthis:"Acceptanceistheanswertoallmyproblemstoday."*Buttogettoacceptance,Ifirstmustgothroughshock,denial,anger,bargaining,and
withdrawal/depression.Inotherwords,Imustgothroughthegriefprocess(whichhappensanytimethereisachangeinaperson'slife,nomatterhowbigorsmall,
whetherpositiveornegative).Ialsoneedtoaccuratelyidentifyandexperiencemyfeelings.AndifIcry,it'sonlynatural.Tolashoutorreactangrilyistomisrepresent
what'sreallygoingoninfact,it'salie,andthefeelingsremainstuffedandtheissuesunresolved.
Tosummarize,Ihavediscoveredthis:Myantisocialpersonalitycanbearrested(nopunintended)andheldincheckwithacombinationofapproaches.
DoingStepsFourthroughNine.InStepFour,Ilearntoaccuratelyidentifyandexperiencemyfeelings.InStepFive,ItakeariskandadmittoGod,myself,and
anotherhumanbeingtheexactnatureofmywrongshereIreacttomyfeelingsratherthanaccuratelyidentifyingandexperiencingthem.InStepSix,Ibecome
willingtohaveGodremoveallthesedefectsofcharacter.InStepSeven,Iallowmyselftogobackandidentifymyselfdefeating,antisocialbehavioralpatternsin
StepsEightandNine,Imakeamendsforthosepatterns.
*AlcoholicsAnonymous,449.

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WorkingStepsTen,Eleven,andTwelve.ThesethreestepsallowmetoavoidabuildupofgarbagefromthediscoveriesI'vemadeandfromthechangesandgrief
I'vegonethrough.
Usingtherapy.Itcontinuestohelpmewithrealitychecks,becauseIstillneedassistanceinworkingwithintheframeworkofsociallyacceptablebehavior.
Trustingmypsychiatrist.(Overtime,he'simpressedme.)Aftermuchdiscussionitwasfrighteningwhenhesuggesteditheplacedmeonlithiumasareaction
stabilizer.ThemedicationgivesmethefewextrasecondsIneedtoheartheotherpersonallthewaythrough,toaccuratelyidentifywhatI'mfeeling,andtorespondin
asociallyacceptablemanner.OtherwiseI'dbeaslave,reactingtomyfeelingswithantisocialbehaviorsthatruinmylife.(Ontheotherhand,Ihaveusedalcoholand
otherdrugs,food,orsomeothercompulsivebehaviortostuffmyfeelings.Ibelievethatstuffingmyfeelingsistheessenceofmyillness.)
I'vefoundthebestspecialistsIcanItalktothemaboutmysymptoms,IletthemknowhowIfeelaboutwhatwearedoing,andIfollowtheirrecommendationsto
theletter.
IknowtodaythatIdeservetolivemaybenothappilyeverafter,butwithasmuchbalanceasIcanachieveonanygivendayatanygivenmoment.
IamalsogenuinelygratefulthatIamabletohaveareasonablybalancedrelationshipwithmywife,stepchildren,andgrandson.TodayIcanbeapartoftheirlives,
sharingbothjoyandsorrow,ratherthanisolatingandexperiencingnothing.

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Jody'sStory
Iamthesecondinafamilyofsixchildren.MyparentsmovedtoMinnesotawhenIwasfiveyearsold,andIgrewupinasmalltown,secure,comfortable,andfilled
withenthusiasmforschoolandplay.Althoughmyfatherwasasurgeon,hepaidagreatdealofattentiontohisfamilybothofmyparentsfocusedtheirlivesonuskids
totheextentthatwefeltabletoaccomplishanythingwechosetodo.
Asaresult,Iwasalwaysahighachiever,gettingtopgradesandexcellinginathletics.Ialsopursuedmyinterestinwritingandtheartsfromayoungage.Myinterests
didn'tkeepmefromhavingfriends.Homeservedasagatheringplaceforboysandgirls,sincemybrothersandsistersandIcamesoclosetogetherinage.
Idon'trememberalcoholplayinganimportantoranypartinmyfamily'slivesuntillateinmyteens.Butwhenseeminglyoutoftheblue,alcoholismhaddescended
uponourfamilylikeaplague,myfatheradmittedthathisfatherhadbeenabingedrinker.
WhenIdrankforthefirsttime,Iwassixteenandhavinganinnocentslumberpartyatmyparents'lakecabinwhen

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theywereoutoftown.SeveralgirlfriendsandIdecidedthatitwouldbeadventuroustobreakintomyparents'liquorcabinet.Wewereall"goodgirls,"thetop
students,thepopularallaroundleaders.
Thatnight,Imadeafoolofmyself,emptyingthevodkaandscotchandeverythingelsecompletelyandproclaimingtomygirlfriendsmyundyingloveforaboyinour
class.
TheboyIlikedwasdisgustedwhenheheardabouttheincidentmyfatherreprimandedmeforraidingtheliquorcabinet.ForaweekIvomiteddaily.Ilostten
pounds.Theboysnoticedmeastheyneverhadbefore.
Iwentontobecomeoneofthefirstwomeninthestatetoplayonavarsityboys'teamIgraduatedfromhighschoolasvaledictorianandIwasacceptedatYale
University,oneofthefirstwomentoenterasundergraduates.Theseachievementsbothexhilaratedanddepressedme.
ThedepressionIexperiencedthespringofmysenioryearwas,infact,aclinicaldepression.Ichangedfromayoungwomaninterestedinlifetoanirritable,
argumentative,spoiledwoman.Isucceededinalienatingmychildhoodfriends.OneofmyboyfriendsbluntlytoldmethatIneededtoseeapsychiatristIwasclinging
tohimlikealiferaft.Whenhebrokeupwithme,Ifeltlikekillingmyself.
Onmygraduationnight,Idrankforthesecondtimeinmylife,downingeverythinginsightuntilmyotherboyfriend(whohadn'tabandonedme)endedupcarryingme
homeoverhisshoulder.Iwasincapableofdrinkingmoderately.Ialsodisplayedanexcitedmannerclosetomania.
IwasleavingoneworldthatIknewandlovedforanother,foreignworld,thefirstbiglossIwouldknow.ButIkeptmygazeforward.Thealcoholicboutsandthe
depressionabated.Iseemedtohaveanaturalresilienceandagreatdetermination,orsoIthought.

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Ittakesgreatlossoragreatstresstofirsttriggerthediseaseknownasmanicdepression.AlreadyIhadexperiencedthedepressivesideoftheillness,andinmyfirst
semesteratYale,Iwentintoamanicphasethattookonitsownmomentum.
MyfirstsemesteratYaleImanagedA'sinadvancedcourses,becamethefirstpersoninmyclasstowriteforthecollegenewspaper,andmadethewomen'svarsity
tennisteam.MyroommateswereannoyedwhenIwouldjumpoutofthetopbunkat5A.M.,raringtogo.EventuallythewoundupenergythatIwasexhibiting
begantospinmeoutofcontrol.Forthefirsttime,Istartedto''goinalldirections,''asIlaterlearnedtocallit.ByNovember,IfoundmyselflosingthingsIlocked
myselfoutofmyroomconstantly.Ibecamehypersensitiveandoveranalyzedcasualremarks.
Eventually,afterarelaxingChristmasbreakinmyhometown,Isloweddown,whichtooktheedgeofftheadjustmenttoYale.LittledidIsuspectthatIhadtriggereda
deadlydiseasethatnowcouldrulemylifeintimesofstressandthatwouldprogressivelyworseninitsmanifestations.Changesinmybrainchemistryhadbeensetoff
bythepressureIhadencountered.Justaswithacaseofheartdisease,itbecomeseasiertosetoffthischemicalimbalanceeachtimeacertainamountofstressis
encountered.
Idrankalcoholonlyonceduringmyfirstsemesteratschool,andthatwasclosetotheChristmasvacation.NeedIsaythatIdrankexactlyasIhaddrunktwice
before?Iwasaccompaniedbynewfriends,allmen.Idrankthemunderthetable,butthenIvomitedontheirshoesandmadeafoolofmyself."Iknewyouwere
different,"saidonefriend,"thefirsttimeIsawyoudrink."
AlthoughIalwaysbecamequiteillaftertheseisolatedbouts,IlovedthefeelingIgotwhendrunk.Theeuphoria

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andtotalabandonmentseemedtobeapartofmysoul.Drunkenecstasy,likesexualorgasm,seemedawaytoescapetheemotionalpainofmybreakingawayfrom
Minnesotaandmovingintoanewlife.
ItwasallornothingineverythingIdid,andinthewayIwas.Evennow,whenIknowthattodrinkistocourtdeath,Icanhonestlysaythatrealityisneverquite
enoughonlynowadaysItrytodevelopspirituallyandconsciouslywhatmaniaandboozemanufacturedformebackthen:aheightenedawarenessofthe
possibilitiesinlifeandpeople.
Idiscoveredtequilawiththegraduatingseniorsthatyear,andbytheendofmysophomoreyear,Iwasspendinghalfofmytimeoncampusatthebarwheretherugby
playershungout(myboyfriendplayedrugby).IalsostartedapatternthatpersisteduntilIfinallybecamesobertenyearslater:Allofmyboyfriendswerealcoholic.
MysexualactivityduringthoseyearsmirroredthetrendsIobservedinmostofmyfriends.Inmycircles,therewasnevermuchofadoublestandardconcerningsex,
andIdon'tfeelguiltyaboutthefactthatIhavesleptwithsomanymen.ButIdidviolatetheprincipleIhadheldasayoungwoman,whichwasthatsex,ifnot
marriage,wassacred.IknowIlostsomeselfesteembytryingtohavesexintheseeminglycasualmannerthatmendid(althoughIdon'tknowmanymenwhocan
reallydothateither).
IlovedsexthewayIlovedgettingdrunk.Beingadmittedtoaschoolthathadonlyrecentlygonecoedwaslikebeingletlooseinacandystore.Iretainedenoughof
myCatholicinhibitionsthatitwasdifficultformetosleepwithmenunlessIwasmanicordrunkorboth,butsinceIwasalwaysdrunk,Itookfulladvantageofthefact
thattherewereagreatmanyyoungmenaroundwithraginghormones,and

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veryfewwomen.Ononedayduringmysenioryear,Isleptwiththreemen,oneinthemorning,oneintheafternoon,andthenmyboyfriendlaterthatnight.AfterI
toldhimwhatIhaddonethatday,allhesaidwas,"Doyoustillhaveyourdiaphragmin?"
OnceIbecamesowoundupoveraschoolassignment,IwenttothehealthcenterforadviceandastaffmembergavemeValium.Iwentbacktomyroomandtook
thewholebottle.Itwasn'tasuicideattemptIjustknewthatIneededthatmuchtocomedown.Isleptforadayandahalf,gotup,andwenttodinner.
NoonenoticedthatIappearedanydifferent,whichallowedmetothinkthatIcouldhandletheseupsanddownsonmyown.Iwasconsciousthatsomethingwas
wrongwithmebutIwasevenmoreselfconsciousthatIshouldappear"normal"tomyclassmates.
Anothertime,withoutbeingonanymedication,Iexperiencedafullblownhallucination.ItwasdifferentfromanydreamorimaginaryvisualizationIhadeverhad.A
threedimensionalphantomofagirlfromanothercenturyappearedbeforemyeyes.Ishookmyselfcompletelyawake,butIknewthenthatIhadapowerfulvisual
abilitythatcouldcontrolmeifIletit.
AnindicationofhowmyillnessaffectedmylifeoccurredonedaywhenIcasuallytoldmyboyfriendthatImightkillmyselfsomeday.Ididn'treallymeanit.Ihadbeen
thinkingaboutVirginiaWoolf,my"heroine"atthetime,andmyboyfriendandIwerewalkingbytheocean.Hewasverydisturbedbythiscommentandsidestepped
outoftherelationshipwithoutfurtherdiscussion.Inonewayoranother,eithermyalcoholismormybipolardisorderinterferedwithmyromanticrelationships.

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Lookingbacknow,Iamabletoaccepttheselossesasbeingcausedbyillness,butatthetime,suchquickcutsinrelationshipshurtagreatdeal.HadIknownthen
whatIknownowaboutdualdisorders,IthinkImighthaveavoidedbreakupsandhadadifferentlifealtogether.
Whencollegeended,Ifeltlost.IdecidedtogotoNewYorkCitywithmycollegeroommateandbreakintobookpublishing.Mydrinkingwasalreadybeginningto
strainourfriendship.WhenwearrivedinNewYork,werealizedthatwehadmadetoobigajumptoofast.Shelefttolivewithherboyfriend,andIpromptlygot
pregnantbyafriendfromYale.Ididn'twanttogetmarried(andneitherdidhe),soIleftNewYorkaftertwomonths,returnedtoMinnesota,andhadanabortion.
BythetimeIreturnedtoMinnesota,everyoneinmyfamilyhadturnedouttobealcoholic,whichbecameclearthefirsttimeanyofusdrank.Thewholefamilywas
veeringtowarddisaster.
ThetwoyearsIspentinMinneapolisarelostinablurofboozeanddrugs.Ifoundagroupofgraduatestudentswhowereintodrugsofallkinds.AlthoughIhadnever
experimentedwithanythingbutalcoholbefore,Inowfoundthepleasuresofcocaine,acid,andmushrooms.Multidrugnightsbecameanormonweekends,where
everyoneatpartiesendedupsleepingwitheveryoneelse.ThereseemedtobenolimittothedecadenceIwouldindulgein,andyetnoone,Ithought,couldseethis.I
couldstill,anytimeIcaredto,putonthegoodgirlstudentactandgetawaywithit.
Duringthoseyears,mymanicdepressionwasmostlyinhiding,butcocainewouldbringitout.Icouldlosetwelvepoundsintwodaysafterdoingonehitofcocaine,
becausecokewouldtriggeramanicreaction.Comingdownfrom

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thesemaniaswoulddropmeintoaclinicaldepression,andsleepingaroundwastakingitstollonmyselfesteem.
AftertwoyearsoflivinginMinnesota,takingonejobafteranother,becominginvolvedwithonemanafteranother,makingstabsatwritingbutneverbeingvery
clearheadedaboutit,Ifoundmyselfsuicidallydepressed.Iwascomingoffadrugandboozebingeandfacingthefactthatmyprimaryloverhadfalleninlovewith
anotherwoman,whenoneofmycollegefriendscalledmefromNewYork.Hewasbeingpromoted,hesaid,andhethoughtIcouldgethisoldjobasanassistant
editor.
Igotthejob,butIlostmyself.WithinsixmonthsofarrivinginNewYorkCity,IhadwhatIthoughtIhadalwayswanted.Myliterarytalentsreceivedimmediate
recognition,andIdiscoveredthatI'dfinallyfoundabusinessIenjoyedandexcelledat:bookpublishing.Ihadalover,atalentededitor,whodrankasmuchasIdid.
Forthefirsttimeinmyadultlife,Ifellinlovewithsomeonewhofellinlovewithme.Wemovedintogether.
Thefactthatmyloverwasmarrieddidn'tbotherme.Hiswifehadmovedoutofstate.AllofasuddenIhadaninstantfamily,withhistwodaughtersvisitingusand
stayingwithusduringsummervacations.IfoundthatIenjoyedtheroleof"stepmother,"andIwashappywithmypersonallife.Workalsocontinuedtogowell.
Withmyfirstattemptatwritingabookproposal,Iacquiredanagentandgotabookcontract.AfriendandIstartedamagazineandfoundourselvesbeinginvitedto
thehomesoffamouswriters.
WhileIhadalltheelementsofagoodlife,mycontinueddrinkingbegantochangehowImanagedthatlife.Myconflictswithotherpeopleintensified,andIbeganto
lose

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friends.MyloverandIwererowdydrunks,turningovertablesinrestaurants,gettingthrownoutofbars.Butwealsopiledupcreativesuccessaftercreativesuccess.
Ouronlyfightsoccurredwhenmymania"brokethrough"andtheamountofalcoholIwasconsumingcouldnotcoverupthesechangesinmood.Iwouldgo
overboard,throwingjealousfitsabouthiswife,andfinallythrowingthingsaroundtheapartment.
WeseparatedforthefirsttimethemorningafterIthrewanashtraythroughawindowinadrunkenrageandheputmyheadthroughaglassdoor.Iwentbackto
Minnesota.ThereIdrankeveryday,butinMinnesota,alowerkeyenvironment,themanicsurgesdieddown.MyfriendsinMinnesotatookonelookathowIwas
drinkingandcalledmeanalcoholic.IlaughedandtoldthemaboutthewildtimesinNewYorkCity.Mylovercalledandwroteconstantly,andweagreedtogetback
together.SoIflewbacktoNewYorkCitytomoveinwithhimandtofindanewjob.
Thenextyearandahalfwerethemostconventionalyearsofmyadultlife.IwaslivingwithamanIloved,webothworkedinthebookpublishingbusiness,andwe
bothwereadvancinginourcareers.Ilovedmynewjob,anditremainstheonlyjobthatIthinkofasaplacewhereIcouldhavemadealifeandfoundacareer.But
evenwiththeseoutwardlyacceptabletrappingsoftradition,incidentsprecipitatedablowup.Wedrankeveryday,butwehadreachedthesamelevelofalcoholism
togetherandfunctionedwithit.
Irecallthatonsomemornings,I'dstopbehindbuildingsonthewaytoworkandvomit.MyloverandIwouldbeginourweekendsbyeachdrinkingaquartofhard
liquor.Thenwe'dgoouttodinnersandtopartiesseveraltimeshehadtocarrymehomeafterward.Wehadfightsliketheonethat

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hadbrokenusup,buttheydidn'tbecomephysicallyviolent.Thenextdaywe'dwalkthroughRiversidePark,andI'dbeghimtotellmethathelovedme."Idon'tlove
thatpartofyou,"he'dsay.Themaniawasbeginningtotakeonitsownpersonality,andhecouldseeit.
OneSundaynight,afterdrinkingseveralmartinis,Ipickedupthephonetocallmylover'swifeinNewMexicotodemandthatshesignthedivorcepapers.Mylover
tookthephoneawayfromme.IpickedupaseltzerbottleandbroughtitdownforcefullyonhistoehepushedmeandIfellfaceforward,knockingmytopteeth
againstthekitchenfloor.Thatpush,thatfall,andthefragmentsofmyteethflyingbecameametaphorformybrokenlife.
WhenIleftourhomethenextday,itwasforthelasttime.MyloverandIfoughtandsawoneanother,butweneveragainlivedtogether.
Somyofficebecamemyhomeinessence.IttookmemonthstoresettleinManhattan,andIwashappyneitherwithmynewroommatenorwithmyphysical
surroundings.Ispentasmuchtimeaspossibleintheoffice.ItsoonwasapparentthatIwasn'tadjustingtothebreakupofmyrelationship.Afterdrinkingeverynight,I
couldbarelymakeittoworkontime.Ilostweightrapidly,droppingtoaweightthatIhadn'tbeensinceIwasakid.PeoplesaidthatIwasactinglikeachild,thatI
hadsomehowregressedtoanemotionalagemuchyoungerthanIwas.ButIkeptgoingbecauseIwasmanic,andmanicshaveextraordinarystaminaandenergy.In
fact,Ibarelyslept.Myheadbuzzedlikeamosquito.Istalkedmyexlover,breakinginatouroldhome,interruptinghisnewrelationship.
IknewIneededhelp.MybossagreedtoletmetakeallthetimeoffIwanted.Iaskedhimifthecompanyinsurance

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coveredinpatienttreatmentforalcoholism.Hedidn'tknowanythingaboutthediseaseofalcoholismandsaidhethoughtIwasdrinkingtoomuchbecauseofmy
relationshipbreakup.Atruealcoholic,IimmediatelyacceptedthisnotionsoIcouldexcusemyownbehavior.
Meaningwell,mybossdecidedthatIwouldbebetteroffwithabetterpayingjobelsewhere,sinceIhadreliedonmylover'sincometolivewellinManhattan.Had
mybosshadanyinklingofthedifficultiesinvolvedinbeingplacedonthestreetinthemidstofamanicdepressive/alcoholicbreakdown,hewouldn'thavedonethatto
me.
MylastmonthsinNewYorkCitythatyearremainlost.Ifoundonejobafteranotheranddidwell,despitethefactthatIwasdrinkingabottleofwineforbreakfast.I
wasofferedapromotionatonejobafteramonthanindicationofhowmanicbrainactivitycan,ifdisciplined,actuallyhelpachievement,butIturnedthatjobdown
totakeanotherjobatapublishingcompany.ThereIwascannedwithinweeksforbeing"crazy"thecontinuedstressofjobjumpinghadpushedthemaniapastthe
productivestage.IwastalkingoffthetopofmyheadtoanyoneImet.Ispenthoursatbarsatnight,andIoftencouldn'trememberhowIgothome(whenIdidget
home).IsleptwithdozensofstrangemenandwouldwakeinpartsofthecityIdidn'trecognize.Ihadwrittenaneightpagepoemandwouldreaditatbars.Ikept
gettingthinnerandthinner.Ihadnocontrolovermydrinkingorthemania,andbytheend,Iwasawalking,talkingpathology.
It'sextremelydangerousforawomanalonetotakesubwaysat3A.M.fromManhattanintoBrooklynwhenIdidso,Iwasdeliberatelytauntingstreetgangs.The
onlyreasonIdidn'tgetintomoretroubleisthatpeoplewholiveonthe

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streetsknowwhensomeoneisnuts,andtheyleavethatpersonalone.IwassoboozedupthatIwasonlyhalfconsciousofmyownactionsthefullmemoryofthese
eventsreturnedtomelaterinflashbacks.Itwaslikelivinginadream,anightmare.Themanicactivity,combinedwiththealcoholIwasconsumingdaily,insulatedme
almostcompletelyfromtherealityoftheworldinwhichIwaslivingandthethingsIwasdoing.Becauseofthis,Iwasn'tevensuicidaltherealme,theconsciousmind,
wasdrownedinbooze,andthemaniawasnearlyfullinsanity,whichfortheonlytimeinmylifewouldbecomeapsychoticbreak.
Whenthemanialedtopsychosis,Iwasstayingovernightattheplaceofmynewboyfriend,afriendofacollegefriend.Iwokehimupinthemiddleofthenight.Iwas
completelyconfused,neitherinthisworldnoranyother,mixingupbooksIhadreadwithmyownlife.ThenextdayIcontinuedtobehavestrangely.Myboyfriend
calledmyfatherthatday,whothencalledmeandtoldmetotakethenextplaneoutofManhattan.HadInotobeyed,thereisnodoubtinmymindthatIwouldhave
endedupeitherhospitalizedforaverylongtimeordead.
Whenmyfathercalledme,Icametosomesenseoftherealdangerofmysituation.Icontinuedtodrink,butIdidleaveNewYorkCity.IhavenomemoryofhowI
gottotheairport,howIgotontheplane,oranythingthathappenedbetweenhiscallandmyarrivalinMinneapolis.I'dlefteverythingIownedatmyplacein
Brooklyn.
Whenmymothergreetedme,IspoutedquotesfrombooksIhadread,completelydisoriented.Iwasalsoverydrunk.Myparentsimmediatelytookmetoahospital,
butIrefusedtoseeadoctor.It'squitecommonforthoseofuswhohavemanicdepressiontodenythatweneedhelp.I

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insistedonrecuperatinginmyhometown,andmyparentsagreed.GiventhetraumaofthemonthsIhadenduredinNewYorkafterbreakingupwithmyloverand
losingmyjob,returningtomyhometownwasmysubconsciouswayoffindingsafety,offindingmyself.
IblockedoutmostofthetraumaticeventsinNewYorkCityandsimplypickedupmylifeinMinnesota.Butdenialcharacterizesbothdrinkingandmania.Iquickly
feltphysicallyfine,andImanagedtofindjobsinMinneapolis.ButIkeptondrinkingforthenextyearandahalf.Ihadruninswiththelawandoutburstsofanger.I
couldn'tholdajobformorethanamonth.Myfriendsallbutgaveuponme.Myfatherkeptfundingme,hopingagainsthopethatIwouldcometomysenses.
Onenight,afterdrinkingforhours,Iwenttovisitafriend,wholivedinthesuburbs.Itookthebus,andnotknowingMinneapoliswell,Igotstrandedinasuburb.My
aggravationandfrustrationovermylifereachedaboilingpoint.Verydisoriented,Iwenttoapayphoneboothandcalledafriendfromhighschool.Shepickedmeup
andwasveryconcerned.Iwasrantingandraving,andshesympathizedwithmebutdidn'tknowwhattodo.Wedrovetoherplace,andIcalledmylastloverinNew
YorkandwentonandonabouthowawfulmylifewasinMinnesotaandhowIcouldn'tholdajob,allbecausehehadinterferedbycallingmyfatherandtellinghim
thatIcouldn'thandlethingsthere.IlovedNewYorkCityIhatedMinnesota.IwasgoodinpublishingIwasn'tgoodinanythingelse.Ithadtakenmeyearsofhard
earnedachievementtogetthejobsIhadbeforemyloverhadruineditall.
Helistenedtomeandthensaidterselyandemphatically,"Iknowwhyyoucan'tholdajob.Youcan'tholda

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jobbecauseyouarearavingalcoholic!''Thenheslammeddownthephone.
Noonehadeversaidthistomeinquitethesamewaybefore.Ihadn'tfallenoutoflovewithhim,anditdisturbedmegreatlythathesawmeasanalcoholic.Who
knowswhytheobviouscameassucharevelation?Thenextday,withthehelpofanotherfriend,Ifoundmyselfsittinginachairattheadmissionsdeskofatreatment
center.Therewasn'tasinglequestionaboutalcoholismtowhichIdidnotansweryes.AfterIhadrecitedalittleofmyrecenthistory,theadmissionspersonstaredat
meandsaidbluntly,''Ifyoudon'tgethelp,youaregoingtodie.Fast."NotonlywasIanalcoholic,butapparentlyIwasattheendstageofalcoholism,aprogressive
disease.
Eventhatfirstday,havingbeenadmittedforoutpatienttreatmentonagovernment"HeartGrant"forlowincomepeoplewithoutinsurance,Ifeltfreeleavingthe
treatmentcenter.Theimpulsetodrinklifted.Idon'tknowwhatIwouldhavedonehadthestaffalsotoldmethatIhadnotonebuttwodiseases,thatthedemonIhad
isolatedhadaneviltwin,andthatitwouldtakeanothertwoyearsbeforesomeonecalledthatdemonbyitsname.
ItrulythoughtthatmyproblemswouldendwhenIleftthetreatmentcenterandattendedAAmeetingsonaregularbasis.Itallmadesuchsense.Ibelievedmy
counselorwhotoldmethatifIstoppeddrinking,myproblemswouldgoaway.ThealcoholismhadcreatedtheturmoilinmylifeallIneededtodowasnottodrink,
onedayatatime.
Myolderbrotherhadquitonhisownandremainedsober.Everyoneinmyfamilywasgettinghealthy.
IreturnedtoNewYork,foundworkasaliteraryagent,andagainattainedafalsesenseofwellbeingfromtheesteem

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thatmyliterarytalentsgenerated.Ifellrightbackinwiththesamecrowdofwriters,artists,andwannabes,andbeforesixmonthshadelapsed,Idrankagain.This
time,though,Iknewthatsomethinglaybehindmytakingthisdrink,somethingthattookholdofmynervoussystemandchangedit.BeforeIfelloffthewagon,Icould
feelthetensionofmania,andIwasconsciousforthefirsttimeoftheincrediblepowerofthatdisease.WhenIwalkedintoabarandorderedthefirstwinethatIhad
hadinayear,thepersonsittingnexttomewatchedmegulpitdownandsaid,"Well,thankgoodness,nowyoulooknormal.Whenyouwalkedin,Ithoughtyouwere
goingtogothroughtheceiling."
OnceIstartedlosingweightandbegantohallucinate,seeingthestreetsofNewYorkCityasVanGoghlikesmearsofcolorandshapes,IknewthatIwasintrouble.
Forsomereason,IevenknewwhatIwouldcallthetroublethistime."IthinkthatImaybemanicdepressive,"Itoldmytherapist.BythenIhadstartedthebed
hoppingthatcharacterizedmyearlierbreakdown.
Icouldn'tkeepgoingIcouldtellthatmythoughtswerenolongerconnecting.Afterathreedaybinge,duringwhichIlostfifteenpounds,Ishowedupatmyoffice,
butIwasbarelystandingup.Ihadfeltlikefaintingintheelevator.AnyonecouldhaveseenthatIwasveryill.ItoldmynewemployerthatIwouldhavetogotoa
hospitalrightthen.
Ilefttheofficeagainstherwishes.Mybosshonestlythoughttherewasnothingreallywrongwithme.Ilookedfinetoher.ButIcouldhardlywalkthetwoblocksto
thehospital.Myfeetwerelikeleadweights,andmyeyestoldthewholestory.I'velookedintotheeyesofotherpeoplewhoareinmanicstates,andthoseeyes
belongtosomeoneorsomethingelse.Thenurseusheredmeintotheofficeof

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twodoctors,whosawthewholepictureinaflash."You'llhavetodetox,"thedoctorssaid."Andthere'sprobablysomethingelsewrong."
IhadneverbeensogratefulinmylifeasIwastohearthesewords.IhonestlythinkIwouldhavecollapsedhadsomeonenotfinallynoticedtherealdistressIwasin.
MyphysicalstrengthhadkeptothersfromreallyseeingthatIhadhadthisdiseaseforyears,butthedoctorscouldseethatIwasingreatpain.Theyshotmefullof
somethingthatputmetosleep,andIsleptformorethanaday.WhenIawoke,adoctorstoodatthefootofmybed."Doesyourmindeverrace?"heasked."You
thinkI'mmanicdepressive,don'tyou?"Ianswered.Hesmiled,andthenhewroteoutaprescriptionforadrugthatwouldsavemylife,lithium,whichdeflatesmaniaat
itsmostextreme.
IreboundedfastandleftthehospitalbeforeIwasready.Mybosshadfiredme,butIacceptedtheseverancecheckandsteppedbackoutontothestreetsof
Manhattan.Worriedaboutmoney,wonderinghowIwouldfindyetanotherjob,themaniahitagainthemomentIlefttheofficeithadneverreallyleft.Ihadn'tfilled
theprescriptionyet,andIcouldn'tgettothedoctortowhomIhadbeenreferreduntilafterthelongMemorialDayweekend.
IwentbacktothehotelwhereIlivedandfellintodespair.Icalledmyexboss,theonlypersonwithwhomIhadn'treconciledyet,andIsetupatimetomeetwith
him.Italkedfastovercoffee,andforthefirsttime,hewassympathetic.Theemotionalbondbetweenusremainedstrong."Trytostayoffthebottle,"hesaid,when
weparted.Ilaughedandpromptlywenttoabartofindsolaceandconsolationformymiserableexistence.
Whensomeoneisinamanicdepressivestate,thehighsandlowscomesofastandsofuriouslythatit'slikebeingon

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aFerriswheel.AlthoughIbelongedtoaregularAAgroup,bythenIwassocaughtupinmyotherillnessthatIwouldnothavethoughtofattendingit.Ididtalkto
onefriendfromthegroup,whoalsohadadualdiagnosis."Don'ttellthemthatyouaremanicdepressive,"hesaid."They'llthinkyou'recrazy."
Walkinghomefromthebarthatnight,IwaspulledbythearmbyayoungmanwhomIhadseenaround.Iblackedoutfromthetimehegrabbedmyarmtothe
momentwhenIcametoinhisapartmenttofindwewerehavingsex.Ipushedhimoffmeandran.Hefollowed,andashegotcloser,Iturnedaroundandsaid
somethingcrazy,myeyesglaring.Hebackedoff.Mania,ifnothingelse,wasadefenseagainsthostilestrangers.
Inmyroomfollowingtherape,Ipackedmybagsandcalledhome.Myfathersaidhe'darrangeairfareformethenextdayandthatIshouldgettotheairportand
ontoaplanewithoutstoppingforadrinkinbetween.Ididn'tfightitthistime.IknewthatIwasn'twell.Myenergycameinbursts.Ileftawill,thinkingImightdiefrom
overexertion.IwassothinIcouldbarelyliftmybags.IhadalmostnomoneyandnoideahowIwouldgettotheairport,butIwassupposedtomeetsomeonefrom
MinnesotaintownforthedayandIhopedhewouldgivemealift.AlthoughIdidn'tknowthispersonwell(hewasawriterwhoseworkIhadagreedtorepresent),
simplyknowingthatIwouldseesomeonefromhomehelpedtorelaxme.ThestressesofNewYorkbythenweresoextremetomethatIfeltsaferinthecompanyof
themanyMinnesotansIknewwhoalsotraveledfrequentlybetweenNewYorkandMinneapolis.
Thisacquaintancemetmethenextdayanddidn'tquestionmyobviouslyfrenziedstate.HecouldtellthatIwas

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highstrungtothepointofcollapseandimmediatelyagreedtoletmeshareacabtotheairportwithhim.
Isteppedofftheplanesmiling.Iwasreasonablysane,andIknewwhatIneededtokeepsanefromnowon.Offbooze,onlithium.Withthatcombination,Icouldn't
lose.
Onedayatatime,withthehelpofafamilythatsupportedmefinanciallyandemotionallyonmyreturn,IregainedmybalanceandImanagedbetterthanIhadsince
mybreakupwithmyNewYorkliveinrelationship.Evenonlithium,though,themanicdepressionpersisted,andIhavesinceexperiencedacoupleofboutsof
disruptivedepressionandonemajormanicepisode.I'velostjobsbecauseofit.InevitablyIslipwhenIgotoofar"up,"andthelasttimethathappened,Inearlydied
fromdrinkingtomedicatemyotherillness.Drinkingonecarafeofwineduringthatlastepisodeledtoa4.0bloodlevelthiswasduepartlytothemania,butalso
becauseIreturnedtothelastpointofmyalcoholicprogression.
Thetriggersareusuallythesame:conflictswithmen,remindersofmypast,jobproblems,andfinancialstress.Onlysincethelastmanicepisodewhichlastedsix
monthsandincludedthreebadalcoholicboutsbeforefinallylandingmeinahospitalhaveIfinallyreachedanacceptanceofmypastand,withthatacceptance,
serenity.Somethinghappenedthelasttimethatintegratedthefragmentsofmypast:Adoctorassistedmeinhandlingflashbacksbroughtonbyposttraumaticshock.
WebroughttogetherepisodesinmylifethatIhadneverprocessedorthatIhadblackedout.IfeltasthoughI'dawakenedfromatwentyyearnightmare.
WithallofthepainIhaveknownandtheupsanddownsinmylife,IbelieveIhavegainedasmuchasIhavelost.IknowthereisaHigherPower,becauseIfeelthat
onlyamiraclewouldhaverelievedmeoftheangerand

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selfdestructivebitternessIhadharboredforyears.Onlyamiraclewouldhaveplacedinmypathpeoplewhoextendedtheirhandstomethoughtherewasnothingin
itforthemthesepeoplehelpedmeoutwhenIappearedtothemtobeindistress,eventhoughIcouldn'tgivethemmuchback,eitherfinanciallyoremotionally.
IfeelbetteraboutmyselfthanIhavesinceIwaseighteen,whenIsetouttoconquertheworld,eagerandcocky,believingthatIhadsomethingthatnooneelsedid.
HumilityisaqualitythatIcherish,peaceofmindthemostsignificantachievementIcanimagine.Whenmyfatherdiedfiveyearsago,Ikeptgoing.
Iknowmyself,astartingpointthatIcouldn'treachuntilIhadpushedbothmydemonsbackintothedarknessfromwhichtheycame.
ForgivingothersandunderstandingthestigmaandlackofinformationaboutmanicdepressionhavebeeneasierformethanforsomeotherpeopleIknow.Nearly
everyoneinmylifewhohasmattered,whetheratworkorinsocialrelationships,haslearnedtoputmydiseasesinperspective.Theynolongertakecareofme,but
theyalsodon'tblameme,andtheyhelpmetomoveonfromepisodesiftheydooccur.I,inturn,takeresponsibilityforattendingtoachronicmedicalillnessand
encouragingthespiritualbalancethatwillkeepmefromtakingadrink.
Allinall,Ifeellucky.GratefultobealivewhichnoonewhohasnotbeenneardeathcanfullyunderstandIamrenewedinmycommitmenttomakethemostof
life.Ihavemuchlesscontroloverthemanicdepressionthanthealcoholinthelongrun,butInolongerfearhospitalizationwhenitisneeded.Icanbreatheinand
breatheoutandfeelfree.Thisfreedomincludestheabilitytolove,somethingIhadthoughtwaslosttomeforever.

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Judy'sStory
Iwasaprettytypicalyoungster,lovedalot,spoiledalittle,andplayfullyscornedbylovingrelativeswhofoundmetoointenseformyyears.Mymother,anursewho
hadn'tworkedoutsidethehomesinceIwasborn,hadtriedmostofthoseyearstohaveasecondchild.Finally,whenIwasinthethirdgrade,shehadmybrother,a
blond,smilinginfantwhogoogooednoisilymostofthetime.Myfatherwasacop,handsomeandcheerfulinhisscratchywooluniform.
Welivedinabig,dirtyEastCoastcitywheregrassandtreesweretheexclusivepossessionsofthepark.Mymother,whofirmlybelievedthatchildrenneededtobe
exposedto"greenstuff"daily,wouldmeetmethereeachdayafterschool.I'drunfromtheschooltooneoftheshadypathswhereIknewI'dfindherpushingmy
brotherintheoldfashionedbabycarriage.Iwasinthefourthgradethen,andIdelightedinthisafternoonritual,itstimeforsharing,andmaybeacookieortwo.
Butoneparticularfalldaytherewerenocookies,nohugs,nostoriesaboutspilledmilkorgoldstarsonlessons.Icouldseethatmymotherhadbeencrying,andI
askedwhathad

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happened.Desperateandconfused,sheblurtedoutthatmyfather,whohadrecentlyexperiencedsomebackproblems,hadjustbeendiagnosedwithbonecancer.I
askedifthatwasbad.Shetoldmeitmeantmyfatherwasdying.Iremembermymindracing,myheartbeating,mystomachfeelingsick.Ihadneverexperienced
panic,butwhattookovermyemotionswassurelypanic,anditwouldn'tletmebelieveher.Ithoughtoftheotheroptionsthatwecouldstillexplore:moredoctors,
morenurses,medicines,surgery.ThenIconsideredthesupernaturalavenues:Massesofferedbypriests,prayersbythenunstothesaintsandtheBlessedVirgin.All
thesewouldstillhavetobeexplored.
Andtheywereexplored,buttonoavail.Myfatherworsened,andwhathadbeensoftmoansinthenightrapidlybecameagonizingscreamsofpain.Imadeitthrough
thisawfulnessbecauseofmyfaith,whichtoldmesomethingthattheothersdidn'tknow:GodwouldmakemyfatherwellagainforChristmas,wellenoughtobuythe
electrictrainthatmybrotherhadseeninthedepartmentstorewindow,wellenoughtositonthefloorwithmybrotherandplaywithhimonChristmasmorning.
MyfatherdiedonDecember16hewasfortyone.Iwaseleven,andIhadlostmybestfriendandGodinonenight.Myfather'sdeathandmyensuingloneliness
taughtmemanylessons.Oneoftheearliestwastheimportanceofprayingwithsincerityanotherwastherealizationthathappinesswasimpermanent.
MymotherdecidedtomoveourlamedfamilytoasmallcommunityinKentucky,nearhersister.LonelinessforthenurturingauntsandunclesI'dgrownupwithwas
overwhelmingattimes.Duringthoseyears,Irememberbecomingeasilydistraughtbythetragediesoftheworldstarving

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children,war,povertytooeasily,toooften.Readingandmystudiesseemedtotakemymindoffsuchissues,andtheysoonbecamemymosttrustworthy
companions.
Afterabrighthighschoolcareer,IbeganstudiesattheUniversityofKentuckyinLexington,whereIfoundthathonorsandawardsrequiredlittleemotionalinvestment
andofferedgreatpleasure.Iwasoneofthefewwomenatthenotoriouspartyschoolwhohadcometostudy,ratherthanfindahusband,butattheendofmyjunior
year,ahusbandfoundme.Whilehomeonspringbreak,Imetmybrother'sscoutmaster.Bob'sIrishgoodlooks,maturity,andeasylaughseemedtheperfect
prescriptionfora"littlegirllost."
Byoursecondyearofmarriage,MeganandBobIIIhadbeenborn.Iwasbusyandhappy.Cooking,keepingupwithtwoyoungones,refinishingfurniture,and
transferscausedbyBob'sjobfilledmostofmytwenties.Rightaftermytwentyninthbirthday,weweretransferredfromSanFranciscotoKansasCity(wherewestill
live),butIbecameterriblyhomesickforthecitybythebay,itsmuseums,concerts,andcosmopolitanlifestyle.Iblamedmylessstimulatinglifeforthedepressionand
emptinessIcouldfeelsettlinginonme.Ihavesincelearned,though,thattheonsetofmajordepressiveillnesstypicallyoccursinthelatetwenties.
Withthechildreninschoolfulltime,IjoinedthePTAandabridgegrouptooccupymytime,butIneverfelttotallyaccepted.Whenseriousboutsofcolitisand
debilitatingheadachesbegan,myinternistorderedaminortranquilizer.Itquicklythrewmeintoevendeeperdepression.Soon,whathadbeenanunsureshynesshad
blossomedintoantisociability,whichinturnbecameisolation.
Oneautumnafewyearslater,Ienrolledinafullloadofdifficultcoursesattheuniversity,hopingtoquicklyfinishan

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undergraduatedegree.Aneightyearabsencefromstudiesandtheeffectsofthetranquilizersleftmewithlittleaptitudeforscholarship.IwasterrifiedthatIhadlost
theabilitytostudyandlearn,whichhadlongbeenasourceofcomforttome.Ipushedmyselfthroughseveralweeksofthesemestereventhoughpanicattacksforced
meintotakingmoreLibrium,andinsomniaornightmaresfilledmostofmynights.
Whiledrivingtoclassoneday,afogoffearandanxietyovercameme.Icouldseethewhiterockwallthatsurroundedthecampus,andIcouldfeelthecarmoving
towardit.Icanrememberwantingtomergewiththoserocks,tobecomeasstrongastheywere.Ifeltmyhandsturningthesteeringwheeltowardthewall,butasI
wentoverthecurb,Ijammedonthebrakes.IknowthatIwasn'tinjured,butIcan'trememberifanydamagewasdonetothecar.Idorecallthatasthecarcameto
astandstill,IbecamesuddenlyawarethatIneededmorehelpthanIwasgetting.
Idrovetoalocalhospital.Doctorsandnursesgavemesomekindwords,moretranquilizers,andaprivateovernightroomcompletewithmyowndutynursewho
urgedmetopraymorepooradviceforawomanwhostillregardedprayerasanexerciseinritualisticfutility.
Emotionallybeaten,Iwithdrewfromallclassesandretreatedtothesafetyofhome,wheremyemotionalhealthcontinuedtodeteriorate.Theholidayscameandwent,
butIrememberlittleaboutthembesidesthefactthatIlearnedmybrotherhadbecomeaddictedtodrugs.Thepreviousyear,wehadbeenthrilledtofindthathehad
beenassignedtoGermany,escapingdutyinVietnam.HowshockedweweretorealizethatwesternEuropemayhavebeenfarfromthefighting,butitsdrugtraffic
madeVietnam'slookpaltry.Thisnewsdrovemedeeperintodepression.

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Bobeventuallyhadtoforcemetoleaveourbedroom,whereIhadvirtuallyimprisonedmyselfshadespulled,nolight,littlefoodforthedrivetoaprivate
psychiatrichospitalinmymother'shometowninKentucky.Inpoorphysicalhealthandconsiderablyunderweight,Iwasunabletotakemostofthemedications
traditionallyprescribedformycondition.Withthem,myhypotensioncausedmetofaintfrequentlywithoutthem,anxietypreventedmefromengagingineitherprivate
orgrouptalktherapy.
Aftersixweeksofunsuccessfulattemptsto''fix''thissituation,doctorsadvisedBobandmymotherthatelectroconvulsivetreatmentwasprobablytheonlyalternative
tolongterminstitutionalizationforme.
Ididn'targueIcouldn't.Offmedication,mymindspunconstantly,jumpingfromfearsforworldpeacetoobsessivecompulsivereligiousworries.Icouldfeelmyself
spiralingdownwardintogreaterandgreaterhopelessness.Iwouldhavetriedanythingthatofferedrelief.Shocktherapygavemethatrelief.Mytreatmentswere
humanelyperformedunderanesthesiatheycausedfewunpleasantsymptoms,andfromtheonset,theybegantohavepositiveeffects.Soon,Iwasabletotalkwith
therapistsandingroups.Sincemyneedforsedativesdecreased,Iwasabletobegintricyclicantidepressants,whichgraduallyrestoredmyemotionalbalanceandlet
meseelightattheendofthetunnel.InAprilIwastransferredtoaKansasCityhospitalforafewweeks,thenfinallyreleasedinMay.Provocativetreatment,
prescriptionmedication,andalotofloveallowedmetomakeanamazingrecoveryfromthementalillnessthatIhadfearedwouldendmylife.
FeelingasifIwerebackontrack,Idecidedtotakemytherapist'sadvice:seekachallengingjobandthebeginningofacareer.InthefallIbeganworkinalargead
agencyasa

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copywriter,andIlovedit.Promotions,salaryincreases,andfulfillmentcamequicklyafterthat,butBobwaslessfortunate.Hehadbeentransferredagain,butthistime
withoutus.Inhisnewassignment,helivedandtraveledoutofChicagoforayearorso,returninghomeonlyonweekends.Iwaitedandwatchedasthejobtookits
toll.
Havingburiedbothhismotherandfatherfromearlydeathsrelatedtoalcoholism,Bobhadalwaysrejectedheavydrinking.Butnow,lonelyforfamilyandfriends,he
spentmostofhisnightsinbars,andhecarriedafifthwithhiminhisluggage.Dulledbyhangovers,desensitizedbyhisresponsibilities,andcontinuallyhomesick,Bob
wassoondismissed.Hisdrinkingonlyincreasedafterhistermination,andmoredrinkingledtomorefailure,whichledtosubsequentjoblosses.Iworkedharderand
hardertomakethemoneyhenolongerdid,butthisonlydrovehimdeeperintoalossofselfesteemthatkepthimfromenjoyinganyofmysuccessesorthoseofthe
kids,whowerenowactivehighschoolers.
Bob'sjoblossesnineintenyearsasurprisefinancialslowingofmycompany,andgrowingpersonalproblemshauntedourmarriage.Nolongercomfortedby
booze,Bobusedviolencetoboosthisego.Myfacebecamefamiliarinthehospitalemergencyroomsmyemotionalpainseemedunbearable.Desperate,Istarted
drinkingatnighttocurbanxietyandgetsomesleep.
Myfallwasrapid.UnlikeBob,abigmanwhosedrinkingcareerseemedstillinitsprime,myfemalephysiologybegantocrumbleundertheeffectsofnightly
drunkenness.Sincealcoholcounteredtheeffectsofmymedication,mydepressionreturnedmyweightclimbedtoalmost200pounds,andIwasfrequently
overwhelmedbymixedfeelingsofparanoia,anxiety,andfear.Myworkslippedmiserably,althoughIpridedmyselfonnotdrinkingduringtheday.

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Twophenomenahastenedmycollapse.Mymotherwastakenterminallyill,andthesixtyyearoldcompanyIworkedfor,unabletoweathertherecessionsofthe
times,graduallymovedtowardbankruptcy.MotherdiedinMay,butthecompanyIworkedfordidn'tdissolveuntilAugustofthefollowingyear,amonthafterIhad
beensentaformalletteroftermination,citingexcessiveabsenteeismandinferiorworkasreasonsfordismissal.Signedbythevicepresidentwhohadpromotedme
fouryearsearlier,theletterwasbroughttomeinahospital,whereIwasbeingtreatedforalcoholicpneumonia.EventhoughIhadbeenhospitalizedthreetimesinthe
previoussixmonthsforsimilarillnessesorforsuicideattempts,Isawnoconnectionbetweenmyphysicalandmentalillnessesandmydrinking.
IwasreleasedfromthehospitalonaTuesdaymorning,andIwasdrunkthatafternoon,neverhavingreturnedhome.Nolongeremployed,Ioccupiedmyselfwith
stayingjustsoberenoughtofunction.Icouldnolongersleepwithoutdrinking,andI'dawakenseveraltimeseachnighttodrinkalittlemorefromthebottleIkept
besidethebed.OnemorningIawoketonoticebloodonthebedlinens.Irushedtoamirrortoseemyfacecutandbruised,andIcalledBobatworkforan
explanation.(Inthewakeofmyuncontrolleddrinking,hehadbeenpracticingatypeofcontrolleddrinkingthathadallowedhimtoholddownajobforawhile.)He
toldmethatIhadfalleninthemiddleofthenighttryingtogettothebathroom.
AsIstaredattheswollenandbloodyfaceinthemirror,Iwasovercome.IknewIhadtotrysomethingsomethingbesidesthebriefhighIcontinuallydrankfor
somethingbesidesbotchedsuicideattemptsthatsoughthelpfrompeopleIhadalreadyshovedawayfromme.

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MydaughterhadleftAAliteraturearoundthehouse,someofwhichI'dreadandconsideredfairlysound,thoughwaytooreligious.Idecidedtotakemychanceswith
the"Godfolks"atleastuntilIcouldlearntodrinksocially.Soaround10:30thatmorning,eventhoughallIreallywantedwasadrink,IreachedfortheYellow
PagesanddialedanAAgroupfarfrommyhome.Tothisday,thatgroupdoesnothaveanansweringservice,butascoincidencewouldhaveit,anelderlyman
answeredandtoldmethatthenextmeetingwasatnoon.
IwasabletostaveofftheurgetodrinkuntilhalfanhourbeforeIleftforthemeeting,whenIpouredmyselfaskimpyscotch,thesoleremainsofahalfgallonIhad
openedonlythepreviousday.IcheckedtoseethatIhadanotherfifthinreserve,threwonsomewrinkledwhiteshorts,triedtocovermycutfacewithmakeup,and
leftthehouse,glassinhand.
ItwasasultryJulymorningwithtemperaturesalreadynear100.Iturnedthecar'sairconditioningonhighandheadedforthebankbuildinginwhichthegroupmet.I
enteredasmallroom.Therewerelessthanadozenpeople,yetIhadthefeelingofbeingsuffocatedbyacrowd.Myheartracedandthepaininmyside(whichIwas
latertolearnwasfromanenlargedliver)thrustitselfdownintomylegs.Ted,anoldermanwithacane,cametowardme,tookmytremblinghands,andmotionedfor
threewomentotakemeintoasideroomwiththem.There,theyaskedquestionsaboutmyhealthandurgedmetogotoanearbyhospital,butIrefused.WhenIleft,
Icouldtelltheyneverexpectedtoseemeagain.
Idrovehometremblingbutresolved.Insidethehouse,Ilonginglythoughtoftheunopenedfifth,butIbeganmycallsandfoundthatIstillhadmedicalcoveragefor
another

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month.Ithencalledthehospital,onlytolearnthatithadnobedsavailable.Afterswallowingmypride,IconfidedintheunitclerkthatIreallydoubtedthatIwould
everagainfindthecourageIhadatthatmoment.Shebelievedme,andshesooncalledbacktosaythey'dtakeme,evenifitmeantputtingabedinthehall.Ihadput
offcallingBobbecauseIsuspectedhewouldagaintrytopersuademetoadopthis"controlleddrinking"efforts,whichhadneverworkedforme.Mycalltohim
provedmecorrecthethoughthospitalizationwasunnecessary,andheconvincedmetowaittomakemyfinaldecisionuntilhecamehome.
AssoonasIagreed,panicsweptoverme,andIrealizedthatdespitethetremorsIhadbeenexperiencing,asmalldegreeofpeacehadbeenwithmethroughoutmy
effortsthatmorning.Encouraged,yetknowingmycouragewoulddissolveinthewakeoffullblowndetox,Igrabbedtheunopenedfifthandstarteddrinking.
IthinkitwasthenthatIcalledmydaughterandmaybemyson,butmymemoriesarefuzzy.Bobarrivedhome,determinedtochangemymind,butIhadalready
packed.Hemusthaverecognizedthatanargumentmightshovemefrommymelancholystubbornnessintothedrunkenangerhehadseensomuchoverthelastyear.
IthinkhealsosensedthatIwasondeath'spath.So,knowingthathewasabouttolosethebestdrinkingbuddyhehadeverhad,Bobacquiesced,kindlyhelpedme
intothecar,handedmethescotch,anddrovemetothehospital.At4P.M.Iwaswheeledintoadmissions,inthemiddleofthemainlobby,wearingthedirtywhite
shortsandclenchingthefifthtightlybetweenmylegs.Around4:30,Ifinishedthebottleontheelevatortotheeighthfloortreatmentcenter.Andso,onthetwentythird
ofJuly,eightyearsago,Ibeganthelongtrekto

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recoveryfromadualdiagnosisofalcoholismandmajordepressiveillness.
TreatmentwasnotwhatIhadbargainedfor.DoctorscoldlyannouncedIhadlivermalfunctionthatwould"probably"goawayifIstayeddry.Psychiatristsrefusedto
counselmeuntilmysystemclearedofalcoholandthemedicationsreachedatherapeuticlevel.Therapistsinsistedonprobingintomylife,pastandpresent,tellingme
thatIcouldneverdrinkagain.TheywarnedmehoweasyrecoverywasinsideatreatmentcenterandtoldmethatmyfourweekstherewouldbeworthlessifIdidn't
followthemwithregularAAmeetings:ninetymeetingsinninetydays.IhadneverplannedtobethatfaithfultoAAIhadseenitmoreasacrutchthatwouldbeuseful
foraweekortwoafterhospitalization.
The"God"thinginAAscaredme.IfearedthatIwouldbeforcedbackintoformalreligion,whichhaddisappointedmesomuchforcedtofacetheGodwhohadnot
wantedtoletmyfatherliveforcedintotheritualandguiltthathadmadeupmyearlyfaith.Icelebratedmyfortysecondbirthdayinthetreatmentcenter,andBob
cametovisitme,halfdrunk.Nightafternight,whenhe'dvisit,Icouldsmellalcoholonhisbreath,and,ofcourse,thestaffcouldalso.Theytriedtopreparemefor
whatitwouldbeliketogohometoadrinkingspouse,andtheyaskedmetoconsiderseparation.Bobretaliatedwithanger,affirmingformethefactthathis
controlleddrinkingwasnotworking,thathisearlierviolencestillremained.
ItwasthenthatIlearnedhowtopray,inthemidstofatreatmentcenter,surroundedbyatheistsandagnostics,streetaddictsandhookers,bluecollarworkersand
collegeprofessors.Ilearnedtoprayforguidance,not"things."IwouldlieinbedandaskforthehelpIneededtomakeit

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throughthemorningor,onbaddays,throughthenexthour.WhenIlearnedtoletothersknowmyweaknesses,Iwasabletotalkwithpeopleagain.TheFridaynight
sobrietypartyontheunit,whichIhadscorneduponarrival,becamesomethingIfoundmyselflookingforwardto,andasmyalcohollevelsdecreased,muchofthe
intensityofmydepressionlightened,andIwasabletosleepthroughmostnights.Ibegantosensethemiraclethatwashappening.
IwasreleasedfromtreatmentonAugust20,feelingrockybuthopeful.Onthewayhome,IwenttoanoonmeetingofthesamegroupIhadattendedtwentynine
daysearlier.Tedandthethreewomenbarelyrecognizedmebutheartilywelcomedmeback.TheyurgedmetoreturnfrequentlyandIdidnearlyonehundredthirty
timesinthefirstninetydays.Ifaithfullyattendedthethreenoonmeetingsandtheseveneveningmeetingsthatgrouphadeachweek.Butmycravingtodrinkwasso
strongandmyfearssounsettling,IhadtofindotherAAhallsthatwereopenallday.Thesehallswereconvenientforthecourtsandthecopswhowouldbringinthe
lessviolentdrunksfromthestreet.Iwouldgoandsitinthehall,watchingsomemenplaycardsorsomeyoungstersbataPingPongballaround.SometimesIwould
surreptitiouslystareatthecourtorderedfolkswhowerestilldrunk,knowingIwasonlyadrinkawayfromtheiragony,prayingthatIcouldstayadrinkawayforthe
restofthatday.
Bob,hopingto"makeiteasierformeatfirst,"decidednottodrinkforawhileafterIreturnedhome.Isawhimgothroughdetoxonhisownthatfirstweek,buthe
wouldadmittonodifficulty.HehadjoinedAlAnon,anditswisemembersurgedhimtocomeregularly,whichhedid.Andthen,afterIhadbeensoberaboutfour
months,onecrisp

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fallmorning,hewalkedintooneofmymorningAAmeetingsandsatdown.Whenitcamehisturntotalk,hesaidsimply,"I'mBob,andI'malcoholic."Histwenty
yeardrinkingcareerendedthatquietly,andoursoberlifetogetherbegan.
TodayBobandIarebothactivemembersofAA.OurdaughterMegan,whohaslongbeenavitalpartoftheAdultChildrenofAlcoholics(ACOA)movement,lefta
careerinretailseveralyearsbacktoworkforthehospitalIhadgonetothatJulyafternoon.Shecontactsinsurancecompanies,seekingmedicalcoverageforpeople
whowanttoenterchemicaldependencytreatment.Whileinsuranceprovidersgrowlesswillingeachyeartopayforinhospitaltreatment,Megandoesn'twearyof
arguingforthosewhoreallywanttochangetheirlives.Shehasrecentlyreturnedtoschoolandisconcentratingonstudiesinvolvingthegeneticsandpsychiatryof
alcoholics.
Ourson,BobIII,stayedprettydistantfromtheACOAmovement,notwantingtorememberhowmuchalcoholismhadtouchedourfamily.Aftergraduation,he
marriedandtookajobinmarketing.Soonhehadbecomeaworkaholicwhosedrinkingfrequentlywentbeyondsociallimits.BobandItalkedfranklywithhim,but
wesensedadenialabouthisowndrinkingthatwassimilartohisviewsonourpastalcoholism.RelyingonourHigherPowersinsuchcases,weturnedyoungBob's
problemsovertothosecompetenthands.Imagineoursurprisewhenayearago,stilldrinkingregularly,heannouncedthathehadacceptedapositionmarketingthe
chemicaldependencyandpsychiatricprogramsofthesamehospitalthatemployedhissister.Andonlyafewweeksago,hetoldmethathenolongerenjoysnights
outwiththefellowswhenthepurposeoftheeveningisto"getwasted."Iguesstherereallyarenocoincidences.

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Ihavetrulybeenpartandparceloffamilyrecovery,butrecoverymustalsobesingularjustforoneself.
Sevenyearsago,Iresumedmyundergraduatework,twentythreeyearsafterIhadleftschooltomarry,andIgraduatedwithhonorstwoyearslater.Ayearanda
halfago,Icompletedmymaster'sdegree.NowIteachattheuniversityfromwhichIfledinsuicidalfrenzyalmosttwentyyearsago.Icanlookoutmyofficewindow
andseethewhiterockwallit'sreallyquitebeautiful,butInolongerwanttobecomeapartofit.
Mygratitudehasnotdiminishedinmyeightyearsofsobriety.Despitebankruptcy,bogglingworkandstudyloads,andtheargumentsandemotionaltraumasthat
accompanytwoadultssoberingupinthesamehome,mygratitudelevelrunshigh.WhenIcantaketimefromthetaskofearningaliving,Irevelinwriting.Ihave
muchtosharewiththosewhoaretryingtoclimboutofthedepthsofdualdiagnosisandontothepathsofrecovery.Itrytotouchthemandmaketheirroadalittleless
rocky,lesssteep.
ItisinthisspiritthatItellmystory.

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Kate'sStory
FromthetimeIbecameawareofmybeginnings(abouttheageoffive)untilIwaseleven,lifewasachaseandcapturegame:aseriesofphysicalabuseand
intermittentmolestation.Despitealltheevidenceofabuse,Icouldn'taccountforwhyIcouldn'tsitstillorwhyIhyperventilated,heardvoices,andhadperiodsoftime
thatIcouldn'trememberanythingabout.Thiswentonandon.EventhoughIcomplainedofthe"losttime"nowandthen,nobodyinapositionofauthoritywouldlisten
tome.(Ididn'thearanyonesayit,butIexpectthewords"activeimagination"wereusedhere.)ThosesixyearsweresimplyhellonEarthIthoughtnothingwouldbe
worsethanbeingyoungandhelpless.
Thesummerofmyeleventhyear,Ibegantakingamildtranquilizer.ThoughIdidcalmdownabit,Ijustdidn'tfeellikemyself,soonedayIflushedthetabletsdown
thetoilet.InevermentionedthatIwasn'ttakingthemanymore,andmyparentsdidn'tseemtonotice.Lifecontinuedwithmanyhyperactivemishaps,andthenIwent
offtocollege.Eventuallymywholeworldturnedupsidedown.

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Ididn'tadaptwelltocollegelifeatfirst.Ishunnedthepeopleandthestudyhallsandtheparties,andmainlystayedtomyself,readingsciencefictionbooks.Inthe
beginning,Ihadnorealfriends,butIwaseagertobelongsomewhere.Iwantedtobealone,yetIwantedtobelong,acontradictionthatwouldsparkmanycrisesin
mylife.Incollegeitsparkedthemostdangerouscrisisofthemall:asuicideattempt.
MyfirstfriendwasCindy,abigcitygirlwholikedtosmoke,drink,andhitchhike.Upuntilnow,Ihaddonenoneofthosethings.Sheinitiatedme.Ismokedcigarettes
anddrankwiththewildestofthem.IhitchhikedtosmalltownsnearbyandmadeoutwithmenIdidn'tknow.SometimesI'devensmokealittlemarijuanaifsomeone
happenedtohavesome.Iwasquiteawildchild.
Buttherewasaclocktickingwithinme.IalwaysfeltIhadverylittletimetolive.Andthenonenighteverythingfellin.
Iwaslyingonmybedreading,whenthelosttimesyndromecameoverme.Ihadbeenneitherdrinkingnordoingdrugs,butthefeelingwasthesame,andsuddenly
thelightswentout.WhenIwokeup,Iwasonmybackstrappedtoabedinahospitalroom.Myparentswerecalled.Thedeansoftheschoolwerenotified.Drug
testingwasdone.
ApparentlyI'dhadsomesortoffit,andmyroommatehadcalledthepolice.Everyone,theysaid,wasscaredtodeath.Ihadnomemoryoftheincident,andexcept
forfeelingabittired,Iwasokay.
Nevertheless,testswererun,fromEEGstoXrays,andIwenthomeafteraweekwithabottleofminortranquilizers.Thediagnosiswaschronicanxietywith
psychomotordysfunction.
Afterrecuperating,Ireturnedtocollege.SoonIwasbacktomyoldtrickswithCindy.Onlythistime,thingsnever

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wentasplanned.Ihadblackoutswhiledrinkingandevenbecamesuicidalattimes.Encouragedbymyfriendstotakechances,thatyearIbeganmixingmoreand
moreofmytranquilizerswithalcohol.Attimes,Iwouldseetwo,three,four,andevenfiveofeverything.Thegamegotmoreandmoreserious.
Bymysophomoreyearofcollege,Iwasthoroughlydepressed.IhadstuckwithCindyandherfriends,buttheyweren'tthesortyoutalkedtoaboutpersonal
troubles.So,listeningtothevoicesinmyheadoneday,Istoppedatadrugstoreandaskedforabottleofoverthecountersleepingpills.Combiningthemwithabout
eightytranquilizers,Iswallowedthem.
Idon'tknowwhatI'dexpectedtofeel.I'dthoughtIwouldfeelsadandmaybealittlebitangry.AllIfeltwasfull.Ilaydownformylastsleepandgavenothoughtsto
anythingintheworld.
Thesoundoftheschoolcounselor'svoicewokeme.Throughakaleidoscopeofcolors,Isawherholdinguptwopillbottles.Iheardhersay,''Ifyou'dreallytakenall
ofthese,you'dbeinthehospitalonaslab.''
ThenIpassedout.
Thenextmorning,Imiraculouslyawokeat6A.M.,inthesameclothesI'dwornthroughthenight.Istruggledfromclasstoclass.Cindywasagreathelp.WhenItold
herhowI'dtriedtokillmyself,shemimedholdingaguntoherhead."Nexttime,justshootyourself,"shesaid.
Mytroubleswithalcoholcontinued.Iwasmuchmorecarefulaboutmymedicationbutcombiningit,sometimeswithtwelvebottlesofbeer,wasdangerous.Inever
knewhowI'dreact.ButIseemeddrivenbyfeelingsIcouldn'texplaintoanyonetodestroymyselflittlebylittle.

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MyparentsweredivorcedbythetimeIfinishedschool,soIlivedwithmymotherforawhile.Toherdismay,Icontinuedtodrinkandrunaroundwithnonetoo
acceptablefriends.Iopenlysmokedpotinfrontofmyyoungersisters,andoftentookoffdrivinginthesmallhoursofthemorning,hellbentondestruction.IthoughtI
wasdoingjustgreat:Ihadajob,acar,astereowhatmorecouldayoungpersonwant?
Eventually,inevitably,therooffellin.Again.
Ihadpurchasedabrandnewbike.Itwasabeauty,ahighqualitytwelvespeed.Igotithomeandtookitoutforaspin.IgotonlyhalfwaydowntheblockbeforeI
noticedthechainwasrubbingonthederailleur.Iwasreluctanttomesswithanewbike,yetdriventodistractionbythisflaw,Igotoutmydad'soldtools.
ForonehourIsweatedoverthechain,anditrefusedtomove.ThenafeelingcameovermeanoverwhelminglydestructivefeelingandIbegansmashingand
rippingatthebikewithmybarehands.Ididn'tquituntileventheframewasbent.ThenIwentintothehouseandtoldmymotherIneededhelp.
Forthenextfiveyears,Ibouncedinandoutofdetoxcenters,treatmentcenters,andpsychiatricwards.Ioverdosedmorethantwentytimes.Iwentthroughthree
differentcounselors.BythetimeIturnedtwentysix,thehelpingprofessionalsconsideredmenotjustahighriskbutdownrighthopeless.EvenIfeltthistobetrue.
Downonthebottom,crawlingfromrocktorock,Iprayedasimpleprayer:Please,God,helpmetowanttolive.
Foralongtime,noanswerscame.Thenamiraclehappened,apsychotherapistnamedEtta.Shehadbeenrecommendedbyacounselorinatreatmentfacilitywho
saidshewasthebest.

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Reluctantly,IwenttoseeEtta.AndthenIsawheragain.Andagainandagain.WetalkedatfirstaboutmypastIhadmuchtotalkaboutandthenwemovedon
tothepresent.WhydidIthinkIwassoselfdestructive?Ididn'tknow.Wasitinmypast?Partly.Whatabouttherestofmybehavior?Ireally,reallydidn'tknow.
Ettaconvincedmetoseeapsychiatrist.Iwasscaredwitless.Heprescribedsomenonmoodalteringmedications,andIpromisedtotakethem.ButIhatedtheway
theymademefeel.ItoldEttaso,andshesaidtojustkeeptakingthem.Istillworriedaboutthepast,somuchsothatItoldEttaaboutmyfears.Shesaid,"Iwon'tlet
anythinglikethateverhappentoyouagain."Justlikethat.IcouldrelaxbecauseIwasingoodhands.
ButIdidn'trelax.Ifoughtandfought.IcriedandyelledatEttaandthreatenedtocommitsuicide.Whenthatdidn'twork,Ithreatenedtostartdrinkingagain.When
eventhatdidn'twork,Igaveup.IhadfinallymetsomeoneahellofalotstrongerthanIwas,andIwasstrangely,deeplyhappy.
ThenonedayEttaquietlysuggestedthatIwas"predisposed.""Predisposed?"Iasked."What'sthatsupposedtomean?"Butthen,muchmorecamecleartome.The
losttimemeantperiodsofdissociating.Theselfdestructive,outofcontrolepisodesandthevoicesIheardhappenedduringperiodsofpsychosis.Mywantingtobe
alonewasanantisocialtendency.
Tocutthroughthejargon,IaskedEttajustwhatwaswrongwithme.Softly,shesaidthatIhadborderlinepersonalitydisorder.
Iwasblownawayformonths,alternatelycryingandyellinguntilIthoughtevenEtta'ssaintlypatiencewouldbewornthin.Ipoundedonblanketsandpillows,and
evenon

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myselfwhenIfeltparticularlyangry.Ithoughtthefeelingofhelplessnesswouldneverleaveme,butitdid.Onlytheprogresswassoslow,sopainstaking,thatifIhad
theoptionnow,IthinkI'dratherdiebysuffocationthanrelivethatperiodofmylife.ButIdidpassthroughit.Andontheotherside,Ifoundasolidbutsadrealization:
Mentalillnessisforever.
IcontinuedtoseeEttaand,withherencouragement,attendedAAmeetings.Iwastimidatfirst,andonceagainfeltlikeanoutsider,butIgottoknowafewpeople
andfeltbetterastimewenton.TheonlythingthatreallybotheredmeaboutAAwasthatwheneverIbroughtupmypsychoticepisodes,everyonetriedtogetmeto
talkaboutsomethingelse.TheywantedmetosticktoAA.IarguedthatAAwasforallofme,notjustthedrinkingpart.Argumentsbrokeoutonemanyelledatme.
Evenmysponsorsaid,"Ijustdon'tunderstandbeingproudofyourselfformerelytakingashowerandeatingdinner."
Pandemoniumhadbeenloosed,andIwasatfault.Mysolution?LeaveAA.
ItalkedwithEttaatlengthaboutmyexperienceinAA,andshesaiditwasn'tuncommonforpeoplewithamentalillnesstohavetroublewithotherAAmembers.I
wantedtoknowwhy.Ettasaiditwassimple:absolutelyanyonecanwindupmentallyill,andIwasaconstantreminderofthatfact.
SonowI'mabstinentandtryingtolivebytheAAprinciplesandslogans.Iapplythemtomymentalillnessaswellasmydrinkingproblem.Ifindthatthesaying"This
tooshallpass"helpsmetremendouslyduringmypsychoticepisodes,andStepTwoisinvaluablewhenIfeelselfdestructive.
IalsokeepanopenmindasfarasAAgoesandhopethatsomedayIwillhavethecouragetorejoinmyfriends.IfI

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couldwearasignthatsaid,"I'mmentallyill.Begentlewithme,"Iwould.For,withthehelpoftheTwelveSteps,I'velearnedawayoflivingwithamentalillnessthatI
couldn'thaveacquiredthroughtherapyalone.Whereasbefore,whenIwasdrinking,IwouldwakeupdreadingthedayandfeelinglikeIshouldendmylife,Inow
haveenergyandthebadtimesdon'tseemsobadanymore.Asonemantoldme,"Iusedtohaveproblems,butnowIonlyhave'troubles.'"Troubles,Icanhandleit's
theselfloathingcombinedwithanoutofcontrolfeelingthatIdon'tneedanymore.There'saspecialjoyinovercomingapsychoticepisodewithoutalcohol.
SincethedayinmytwentysixthyearwhenIgotdownonmykneestosayaprayer,mylifehasturnedaroundcompletely.Ettahasmovedtoanotherstate,butI
haven'tforgottenabouther.Irememberallthehardtimeswehadintherapy,andIsmiletothinkthatIwasonceconsideredhopeless.I'dliketogivethathopeback
now.EveninmynarrowwanderingsI'vemetpeoplewithmentalillnessesandalcoholism,andI'veheardtheirstoriesofpain,confusion,andlonging.Justlikeme,they
deserveachancetoo.

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Kathy'sStory
Iwouldn'thavebotheredtogetsoberifIhadn'tgottensomerelieffrommydepression.WhenIdidgethelp,IfeltlikeIwascrawlingoutfromunderawetwoolen
blanketandintoanewworld.I'vemanagedtostayrelativelyfreebycontinuallyworkingonmyrecovery,butrecoverydependsontreatingbothmydepressionand
myalcoholism.
AAsimplycannotdoeverythingforme.Ihavetotakeantidepressants:Ihaveanimbalanceinmybrainchemistry.Somepeopletakeinsulin,Itakeantidepressants.
I'vehadtolearntoacceptthatItrulyneedthemandthatthereisnoshameinthis.I'vestoppedlisteningtothecommentsofpeoplewhodon'tunderstandthat
antidepressantsarenotuppersrather,theyrestoremetothestartingpositionthatpeoplewhohaven'tbattleddepressiontakeforgranted.Istillhavethedailystruggle
everyonehas,butnowIsleepthroughthenight,Ihaveanappetiteatmealtimes,morningsaren'tagony,Idon'tleavetheroomashamedthatI'vestartedtocryagain,
andInolongerwishIweredead.
Icomefromafamilyoftwelve.Therewasahighlevelofstressinmyfamily.Depression,manicdepression,and

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alcoholismcanbetracedbackseveralgenerations.Bothmyparentssufferedfromuntreateddepressionneitherofthemhadselfesteemtopasstotheirchildren.
Maritalinfidelityandcompulsivegamblingalsohitmyfamilyhard.
John,myoldestbrother,attemptedsuicidebyoverdosingonpillsandalcoholwhenhewaseighteenyearsold.Hewasnarrowlysaved.Rick,oneyearmysenior,
wentintotreatmentattwentyfourbecauseofhisaddictiontodrugsandalcohol.Doctorstoldhimthathisliverwasbarelyfunctioning,thatinanotherfewweekshe
wouldhavedied.Thomas,oneyearyoungerthanI,solddrugs.Michael,twoyearsmyjunior,becameillatfifteenwithmanicdepressionbutwasundiagnosedfor
severalyears.
Amidallthisunhappinessandchaos,Idevelopedexpertcaretakingskills.Isteppedforwardasthefamilyhero,gettinggoodgrades,babysitting,cooking,doing
housework,tryingtomakemymomhappyandavoidmakingmydadangry.Idevelopedtheskillofminimizing.Comparedtoalltheotherfamilytroubles,my
moodinessseemedminor.Infact,IfeltIwasuntouchedbyitallIthoughtIhadittogether.Ilefthometogotocollegeandeventuallybecameateacher.Iwantedto
changelives.Iwasconcentratingallmyenergyonotherpeopleinsteadofmyself.
Ididn'tstartdrinkinguntilIwaseighteenyearsold.IthoughtthatifIwascareful,Icouldavoidwhatmybrothershadgonethrough.Still,Iplainlyrememberthefeeling
ofreliefIgotfrommyfirstdrunk.IfeltlikeIhadfoundsomethingI'dbeenmissingallmylife.Idranktotakecareofmyfeelings.Idranktoshedloneliness.Idrank
forcourageandthentoquietanxietyandguilt.Idranktosleep.Idrankmyselfintostrangers'beds.Imademoneydecisionsaccordingtothecostofasixpack.I
drankeveryday.Later,whenImovedtoanewcitybymyself,Idrankalone.

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Onesummer,oneofthemostimportantpeopleinmylifewasdiagnosedwithterminalbreastcancer.Shehadbeenaprofessor,amentor,andafriend.Iwas
devastated.Iwantedtostopeverythingandjustbewithher.Shewouldn'tallowit.ShetoldmeitcouldbemanyyearsyetandthatIwastogoonwithmylife.So,
withnojobstobehadlocally,Ileftthestatethatwinter,determinedtobeasbraveasshewas.
Iworkedasasubstituteteacherduringthedayandworkedinabookstoreatnight.TheonepersonIdidknowinmynewhometownpromptlybecameengagedand
movedoutofstatetobemarried.
Oneyearlater,Iwastwentysixyearsoldandateacher.Ifellintoarelationshipwithamanwhowasthirtyfourandashortordercook.Iagreedtolivewithhim,
thinkingIwouldsavemoneyonrent.Hebecameemotionallyandsexuallyabusivephysicalviolenceshadowedourinteractions.Ourrelationshipstartedwithalcohol,
anditcontinuedwithasteadystreamofbooze.Histhirteenyearoldsonmovedinwithus(asonIhadn'tevenknownexisteduntilaboutamonthbeforehemoved
in).Iwaslefttocareforthisnearlysixfoottallboy,whilehisfatherworkednightsandwouldcomehomedrunkorhigh.
Therelationshipwentfrombadtoworse.Myloverliedtomeandmanipulatedme.I,sobluntedbyalcoholandunhappiness,wasunabletochangecourse.I
continuedintherelationship,openingmycheckbookoverandoveragain,takingcareofhisexpensesandneglectingmyown.
Hesenthissonbacktolivewithhisexwifeanddecidedhewantedtogobackandfinishhisdegree.AnexMarine,hetoldmehewasentitledtoaGIloan,soIpaid
mostofhistuitionandlivingexpenses,expectingtoberepaidwhentheloancamethrough.

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WhatIdidn'tknowwasthathehadbeendishonorablydischargedand,infact,owedthegovernmentmoney.TherewouldbenoGIloan.
WhenIbeganfearingformysafety,IslowlystartedtorealizethatIhadtogetoutwiththehelpofafriend,Icarefullybegantomakeplans.Itoldmyloverthatatthe
endoftheschoolyear,Iwasgoingtospendthesummerwithmyfamily.Sohetalkedaboutfindinganotherapartment.Irentedastoragespaceandstartedpacking
upmythings,takingaloadoverafterworkwhenpossible.Iblamedmyselfforourproblems,andIthinkIconvincedhimhe'dbebetteroffwithoutme.I'msurehis
egotoldhimhewouldeasilyfindanothermealticket.
Iwaslucky.Ididgetawayfromhim.
ThatfallIwentbacktoteaching.Ifoundastudioapartmentandtriedtostartover.Theonlythingthatkeptmegoingwasdenial.Ifelthelplessaboutmyfriend
sufferingfromcancer,andIcouldn'tdealwiththeshameIfeltabouttherelationshipIhadjustleft.IavoidedthefewpeopleIdidknow.AllIwantedtodowasstay
homeandwatchTVanddrink.
Ilostweight.Intheshower,myhaircameoutinhandfuls.ThedarkcirclesundermyeyesreflectedthefactIcouldn'tgettosleepatnightandcouldn'twakeupinthe
morning.WhatsleepIgotwaspunctuatedbyviolentnightmaresandlegcramps.
Atwork,myshorttemperturnedintoangryoutburstssometimesI'dyellsoloudlythatmyvoicewouldcrackandI'dneedtohangontoachairtohidetheshakingof
myhands.Insteadofsavinganyofmystudents,Iwasbecominganabuser.(IfeltasifIwerewatchingmyparentstrytocontrolourfamilyoftoomanykids.)Ihated
myjob,andIhatedmyselfmore.Icouldn'tkeepupatworkordigout

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fromunderneaththeclutterinmyapartment.Iwasashamedofmy"laziness,"myinabilitytoevencleanupmyapartment.Theguiltandfrustrationwereoverwhelming.
Insidemyheadwasagrowingpressure.Iusedtowishitwouldjustbecrushed.OftenIfeltIcouldn'tstandit.Itseemedonlydrinkingandtelevisionhelpedreduce
theanxietyandcrazinessthatbuiltupinsideme.Icouldn'tmakedecisionsmyconcentrationwasbad.Mydrivingworsened.WhenIdrovethroughyellowlights,Ifelt
Iwasdaringothercarstohitme.Stillmydenialwasstrong:Iwasnotsomeonewhocommittedsuicide!Iwasjuststressedoutandnotcopingwellwithmyfriend's
cancer.
Tomaintainmyteachinglicense,Ihadtotakeahumanrelationsclass.Theinstructor,Mildred,hadworkedwithcancerpatientsandtheirfamilies,butshe'dalso
workedwithindividualsonstressmanagementandassertivenessskills.IwasresentfulthatIevenhadtotaketheclass,butInowbelieveitwasnoaccident.Ihadno
ideathatMildredwouldbeinstrumentalinsavingmylife.InNovemberIbeganseeingheroutsideofclassforhelpinstressmanagement.Istillhadnoideaofthe
extentofmyownproblems.
InevergavemyselfenoughofabreaktoevenconsiderthatImightbeill.Iblamedhormones,PMS,stress,homesickness,andbrokenrelationships.IthoughtIwas
justweakanddisorganized.Ineverfeltupandenergetic.SoItriedharderandhardertogetmylifetogether.Iwouldgetonthephoneandcallmysisterslong
distancetohelpmegetthroughanotherday.Inoneconversation,IaskedMary,"Don'tyoufeellikeIdo?"Ithoughteveryonefeltlifewassimplytobeendured.
Shesaid,"No.Idon't.Everyonegetsdownonceinawhile,butyou'realwaysdown.It'snotnormal.Somethingiswrongwithyou."Hercommenthitadeepchord,
andI

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startedquestioningmyself.(Icanseenowthatmydepressiveepisodesstartedineighthgrade,ifnotearlier.)
ThatwinterIhadtoldmymotherIwasn'tfeelingright.Sheencouragedmetoseeadoctor.AnappointmentwasmadefortwomonthslaterIbracedmyselfforthe
wait.Mydenialkeptmefromlookingatmybehavior.IfeltasifIwerelosingstrengthinmyhands,andatthesametime,Ithoughttherewassomethingwrongwith
mycar'ssteeringwheel.Onthewaytowork,mycarseemedtoflyaroundthecurvesoftheinterstate,barelyundercontrol.ByearlyMarch,Idecidedtostop
drinkingforawhile,sincealcoholseemedtohavenoeffect.Everythingwasflat.
OnaMondaynightinMarch,IhadanappointmentwithMildred,whoaskedhowIwasdoing.ItoldherIwasn'tfeelingverywell.Shelookedstraightatmeand
said,''You'renottellinganyonehowyou'rereallyfeeling.Nooneknowsjusthowbadlyyoudofeel,dothey?''
Istartedtosob.Thebigsecretwasout.Ifeltthatshemustknowhowbaditreallywas.SheaskedmeifIthoughtImighthurtmyself.Ikeptcrying.
Inasmallvoice,Isaid,"Ijustwantsomehelp.Ican'tstandthisanymore.Ijustcan'tstanditanymore."
Sheofferedtodrivemetothehospital.ItoldherIcouldn'tgo,Iwasn'tready,Icouldn'tleavework,IhadanappointmentinApril,andmymotherthoughtIshould
gotoaspecialclinic.MildredtoldmesheknewofagoodhospitalrightintownandthatIcouldgetadmittedbeforeApril.ShetoldmeIhadarighttomakemyown
decision.
Idecidednottowait.ItwasthefirsttimeinmylifeI'dmadeadecisionjustforme.
ThatnightIcouldn'tstopcryingandIcouldn'tsleep.At6A.M.,IcalledmybossandtoldhimIwasn'tcomingin.I

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criedallday,unabletogetoutofbed.Thehospitalcalled:Thedoctorhadsaiditwouldbegoodformetocomeinassoonastherewasabed.Laterthenursecalled
andtoldmeabedwouldbeavailableThursday.ItwasnowTuesday.Icouldn'tbelieveallthiswashappening.Whycouldn'tIjustsnapback?Ihadspentmywhole
lifetryingtobegood,andnoweverythingwasfallingapartwithoutmyconsent.
IwenttoworkWednesdayandmadearrangementsforasubstitute.Ionlytoldthepeopleitwascrucialtotell.Afterwork,Idroveovertoafriend's.Shedrovemein
mycartomyapartmenttopacksomeclothes.Theworldwasmovinginslowmotion,yetinsidemewerepanicanddesperation.Ididn'twantanyofthistobe
happening,butIcouldn'tstopit.ThursdaynightIwasadmittedintothehospital.
IfeltIwastheultimatefailure.IhadnocontrolovermyselformylifehereIwas,checkingintoapsychiatricunitofahospital.Bythistime,myvisionwasdimming
thelightsanddistortingtheshapesoftherooms.EvenIwasmovinginslowmotion.Icouldn'tstopsighing.WhoeverIthoughtIwas,wasrecedingdownadark
narrowtunnelnothingseemedtomatteranymore.
Theestimatedtendaysofinpatienttreatmentstretchedintothirtydays,withanothermonthofoutpatienttreatmentandthreemonthsofdisabilityleavefrommyjob.I
thoughtImightneverworkagain.
Thehospitaldayswerefilledwiththerapy,learning,andhealing.Gettingtoknowtheotherpatientswithsimilarstruggleswasveryhelpful,too.
Whileaninpatient,Iaskedforanassessmentofmyalcoholuse.Afteryearsofwondering,Idecidedtoseewhattheexpertshadtosay.Ididn'tliketheanswer.They
saidthatnotonlywasIsupposedtodealwithmydepression,butI

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wasalsosupposedtogiveupwhatIfeltwasmyonlytruefriend,booze.Idon'tknowhowlongIlayonmybedandsobbedthatday.
Iremembersayingtomynurse,"Idon'tthinkIreallyhaveaproblemwithalcohol.Myproblemisjustdepression.Idranktomedicatemydepression."
Shereplied,"Yourproblemisdenial."
Still,IfiguredIhadmanymoregooddrunksinme.Iwasonlytwentyeightyearsold,andI'dhadsomegreattimesdrinking.ACDcounselor,Bonnie,helpedme.
Bonniewasoldenoughtobemymother,withakindnessandgenerosityIcouldn'tgetenoughof."Ididn'tthinkIhurtanyone,"shesaid."Isuccessfullyranour
household.Ijustquietlygotdrunkeverynightfortwentyyears.You'reluckyyou'refacingthisnow.IwishIhadthoseyearsback."
IknewIcouldeasilydrinkawaytwentyyears.Icertainlyhadtheheartache.Nowthequestionwas,DidIhavethehearttostartanewlife?WherewouldIfind
thestrength?
EventuallyIfoundthestrengthinrecognizingthatIwaswinningatoughbattle.Theprogramatthehospitalwasintensive,andIhadtobeanactiveparticipantinmy
recovery.IfeltIwasbeingaskedtochangeeverythingIknewinmylife,withnoideaofhowitwouldallturnout.
AllIknewwasthatmylifehadtochangeandthatIhadtotrustthatthingswouldimprove.AndslowlyIsawandfeltmyselfgettingbetteritwasalltheproofofa
miracleIneeded.Iwasfindinghopeagainaftermorethantenyearsoffeelingnone.Imadefriendswithsomeofthepatients,dearfriendsIstillhave.IlearnedthatI
couldreachoutforhelpandsomeonewouldbethere.Iwasbornintoanewexistence.If,astheysay,happinessisdirectlyproportionaltohowgratefuloneis,Iam
happy.IhavegainedafaithinmyselfIneverhad.

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Still,Ihavethoughtsofsuicideoccasionally,especiallywhenIamfeelingstressedordown.Ironically,ithelpedtohearthatIwillprobablyhavethesethoughtsallmy
life.ItislikemyattachmenttoalcoholIstillthinkaboutdrinkingfromtimetotime.IbelieveitismorethanthefactthatthediseasesIhaveare"cunning"and
"baffling."Ibelievethatmymindhaschosenalcoholandsuicideascopingmechanisms,andso,asitsortsthroughoptionsonhowtodealwithsomething,thosetwo
"remedies"comeforward.Fortunately,Inowseethemasthoughtsracingpastlikeafastscrollingmessageacrossacomputerscreen.Icanreadthem,butIdon't
havetoactonthem.Ihavechoices.Ireservetherighttochoosethematalaterdate,butrightnow,thisday,Idon'thaveto.Ican'tpreventthoughtsfromarisingin
mybrain,butIdon'thavetoletthemcommandmybehavior.Icanwatchthemflickeracrossthescreeninmyhead.
Myrecoveryisongoing,andIneedcompanyalongtheway.Beingintheprogramhashelpedmetothinkdifferentlyaboutlifeandtochangemybehavior.Goingout
toanAAmeetingeachweekhelpsmeparedowntheisolationIwassodeeplyenclosedinfromtheyearsofmyillness.I'vedevelopedabondwiththepeopleinmy
AAgroupthathasletmeseetheimportanceofthecommitmentI'vemadetomyselfIdon'twanttoletmyselfdown.
IamfiveyearssobernowwhichisfarlongerthananyromanticrelationshipI'vebeenabletomaintain.Iseemypsychiatristtomonitormymedications.Isee
MildredonaregularbasisbecauseIamstilllearningfromher.Ikeepajournalandwritepoetry.Istayincontactwithfriendswhoareworkingthroughtheirown
mentalhealthissues.Ihavestartedgraduateschoolandamlookingintoacareerchange.Daybyday,Iamfindingcontentmentinmylife.

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Raven'sStory
Iamanalcoholicandaschizophrenic,andIhavedealtwiththisdualdiagnosisforthepasttwelveyears.WhatfollowsisthestoryofhowIcametobediagnosedwith
amentalillnessand,later,toacceptmyalcoholismandstartontheroadtorecovery.
Mychildhoodwashappy,andIdidwellinschool.Inmysenioryearofhighschool,Iwaselectedstudentbodypresident.Asaresultofthisandotheractivities,Iwas
awardedscholarshipstoattendaprivatecollegeinLosAngeles.WhileIhadexperimentedwithdrugsinhighschool,thefreedomfrommyparentsatcollegeledme
toapartyinglifestyleinwhichIsmokedmarijuana,droppedacid,tookdownersforfun,andtookupperstostayuplateandstudy.Ialsodrankalot.Despiteallthis,I
graduatedwithaBaverage.
Mychildhooddreamwastobecomealawyer.IwasadmittedtolawschoolinSanFrancisco,butmydrugandalcoholusebegantotakeitstoll.Halfwaythroughthat
firstyear,Igotverydrunkonenightand,whilewalkinghome,becameviolent.TheSanFranciscopolicetookmetoapsychiatrichospitalandplacedmeinrestraints.
Thiswasthe

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firsttimeIfoundmyselfinapsychiatrichospitalitwouldnotbethelast.
Needlesstosay,mygradesweremostlyF'sforthatfirstyearoflawschool.Inordertocontinue,Iwouldhavehadtorepeatmostofmyclasses.Atthatpointinmy
life,tocontinuewouldhavebeenawasteofmoney.
IreturnedtoPortlandandwenttoworkasalaborerforaconstructioncompany.WhenIgotoffwork,Iwouldhangoutinthepark,drinkingcheapwineandbeer
withstreetpeoplebeforegoinghometomyroachinfestedapartment.Aftershowingupatworkseveraltimesdrunkorwithahangover,thecompanyletmego.
WhenIquitpayingrentonmyapartment,Iwasevicted.Iwasdrinkingupallmymoney.
Ipackedmybackpackandtooktothestreets,sellingmybloodformoney.IhitchhikedtoSeattle,whereIwasarrestedforassaultduringablackout.Ireturnedto
Portland,checkedintoacheaphotel,anddecidedIneededtogobacktowork.Ilandedajobatanicehotelasaprepcook.Icontinuedtodrinkandtosmokemy
drugofchoice,marijuana.Sixmonthsintomynewjob,Ihadapsychoticbreak,broughtonbymycontinuousintoxication.Onceagain,Iwoundupinapsychiatric
hospitalafterhearingvoicesandthinkingIwasgoingtocommitsuicide.
MypsychiatristwhomItrusted,sinceIwasdesperateandhadnowhereelsetoturnfirstprescribedThorazineandlaterhaloperidol.HetoldmeIsufferedfroma
chemicalimbalancethatcouldbecorrectedwithmedication.Iwasextremelyparanoid,andthemedicationdidseemtohelp.
Forfouryears,Iwasstableandabletoworkataminimumwagejobforthehotel.ButthenIhadanotherpsychotic

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break.IbelievedIwasgoingtokillmyselfandthistimetakesomepeoplewithme.Backtothehospital.
ThistimeIwasputonsomethingdifferent:atimereleaseinjectionofProlixin,whichIgoteverythreeweeks.AgainIwasstabilized.Icontinuedtodrinkandsmoke
pot,however,againstmydoctor'sadvice.
Itwasn'tuntilfouryearslaterthatIwenttoanAAmeetingandbegantorealizehowpowerfulthedenialofmydrugandalcoholaddictionreallywas.ThethingsI
heardatAAmeetingsreallymademewanttoquitusing,butIcouldnot.Somethingwouldalwayshappen.Iwouldquitgoingtomeetingsonaregularbasisand,soon
thereafter,relapse.ItriedAntabuse,buteventhatdidn'tstopmefromdrinkingitjustmadeitlessenjoyable.Besides,Icouldstillsmokepot.
Finally,Iquitmyjobatthehotelandtravelednorth,takingajobataresortinanationalpark.ThereIpickedupaDUIandanotherarrestforvandalismwhileina
blackout.
OnceagainIwoundupinthepsychiatricwingofahospital,thistimeforonlyaweek.Sincemyprivatepsychiatristwouldnolongerseeme(Ididn'thaveinsurance),I
wentonwelfare,wenttoliveinagrouphome,andgotintotreatment.
Finally,threeandahalfmonthsago,Igaveuppotandalcoholforgoodatleastsofaronedayatatime.YoumightsaythatIgotsickandtiredofbeingsickand
tired.
IhopethatonedayIwon'tneedanantipsychoticinjectionlikeIdonow,buttherewasatimewhenIbelievedthediagnosismydoctorgavewouldsticktomeforlife.
TodayIthinkofmyselfasarecoveringalcoholicwhoneedstotakemedicineforamentalillness.
Iambackinschool,studyingtobeaparalegallasttermIearnedstraightA's.Iaminasemiindependentlivingsituationandhopetobedrivingagainbytheendof
theyear.

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Roberta'sStory
I'mleavingoutagreatdealbecauseIdon'trememberalotandwhatIdoremembereithercausesmegreatpainorissomethingIamunabletointerpret.
Myfather,thesurvivorofawartimeprisoncamp,wasaheavydrinker.Mymotherwasbothalcoholicandschizophrenic.Herinsanity,schizophreniccommunication,
andbizarrebehaviorconfusedmesomuchthatIdidn'tknowwhatwasreallygoingon,letalonewhattomakeofit.Therewasagreatdealofabuse,mostly
emotionalbutpartlyphysical.
Imarriedandquicklyhadthreechildren.IwasdivorcedbeforeIwastwentyandhadlostmychildreninacustodyfightbytwentytwo.TheseveredepressionIhad
atthetimeprecludesspecificmemoriesofthatstruggle.WhatIcanrememberisthatIhadbeenonValium,byprescription,sinceIwasseventeen,andthatmy
alcoholicdrinkingbeganduringthecustodyfight.I'vealmostcompletelylostmymemoryofthetimebetweenlosingthechildrenandmeetingandmarryingmysecond
husbandwhenIwastwentyfive.WhatIdorecallishavingaseriesofjobsthatdidn'tworkoutand

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aseriesofunsuccessfulrelationshipsthatIendedinarage,asIhadendedmyfirstmarriage.
ThefirstTwelveStepmeetingIwenttowasforAlAnon,anditwasbecausemymotherandsecondhusbandwere"theproblem."Ididn'tstaywithAlAnon,Ididn't
"get"theprogram,andmyhusbandandmothercontinuedtobetheproblemforme,eventhoughIdranktoo.Twoyearslater,ImadeitintoAA,butonlybecauseof
myhusband.Hewasforcedintotreatmentbyhisemployer,andhesimplyrefusedtogototreatmentwithoutme.SoIwenttomyfirsttreatmentcenter
codependently,andIdidn'tdrinkforaboutsixmonths.Thenmymotherdied,andIdrankagain.Afterall,Ireasoned,I'mnotthealcoholic,myhusbandis.AfterI'd
beendrinkingforlessthanamonth,Istarteddoingsomestreetdrugstoo,redsandpot.Afterabouttwomoreweeks,Iranawayfromhomeinanger.
Ialwayskeptasuitcasewithafewclothesinmycartrunkincasemyhusbandgotdrunkandabusive.TothatIaddedmyvaluables,acoat,andsomenecessitiesand
tookoff.IwasdrunkandloadedonweedasIheadedourbrandnewcartowardLosAngeles.Athermosofcoffee,abottleofscotch,andhalfbaggieofweed
wereonthefrontseatbesideme.IindulgedinthemfreelyasIdrove.SinceIdidn'tmakeitallthewaytoL.A.thatnight,Itookanexpensivehotelroom,butIdon't
rememberwhere.
AfriendofminehadabrotherwholivedintheL.A.areaIcalledhimfromthehotel.I'dthoughtthatsomehowthisguywouldbetheloveofmylife,andI'dplanned
somekindofseduction,butIalsorememberhavingoneofthosefamousmomentsoftruth.WhenIdidreachthebrotheronthephone,ItoldhimIneededhelp.He
cametomyhotel,tookmetohishome,andthenescortedmetoAAmeetings

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everynightforaweekasitturnedout,hewasarecoveringmember.
Butinthespaceofaweek,withoutboozeandweed,Iwenttopieces.Frommomenttomoment,Icouldn'trememberwhereIwas.Ialwaysworesunglasses
becausewithoutthemIcouldn'tlookatpeopleIwasparanoidandthoughteverypersonIsawwaslookingatme.MymemoriesofthoseAAmeetingsissketchyat
bestitwasoneofthetimeswhenIcouldn'tconcentrateonwhatwasgoingon.
Thesamesortofproblemcameupathome.OnetimeIstoodinthebathroom,confusedaboutwhethertobrushmyteeth,washmyface,orbrushmyhair:There
werethreechoices,allatonce,andtherewasnosequenceIcouldfollow.Itwastoomuchforme.Ijuststoodthereandcriedandfeltashamed.Isoonfeltlowerthan
asnake'sbellywhateverIwasdoingwasn'tworking,andIwasfullofselfloathing.Myfriend'sbrother,realizingIwasintroublebeyondanythinghecouldhelpwith,
checkedmeintoahospital.Iwasexhaustedfromlackofsleepandtryingtomanagetheterrorsofthelastsevendays.
IrealizenowthatifyouplottedonagraphhowcrazyIwas,thelinewouldgooffthepaper.Ionlyrememberfragmentsofcertaineventsofthatperiod.Ican'tsay
howwegottothehospitalorwhatIdidotherthangotoAAmeetingsduringthatweek.Mymemoryofmytimeinthehospitalisjustaslimited.ButIdoknowthat
beforeIleftthehospital'sprogramagainstmedicaladviceIwasfeelingbetter.IstayedsoberthattimeforthreeandahalfyearsinAA.
Duringthefirstseveralmonthsofmynewperiodofsobriety,mysecondmarriagebrokeup,sotheonlystabilityIhadwasmysobrietyandmyjob.Lookingback,I
thinkIavoideddrinkinganddruggingduringthosethreeplusyears

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becauseIusedeveryothercrossaddiction.Ishopped,ate,traveled,changedrelationshipsandapartments,andsoon.
TheyearIturnedthirtytwo,myfatherwashospitalizedwithcancer.Thedayhedied,Idrankandsmokedpottooblivion.Iwasoffandrunningagain.
Iinheritedalargeamountofmoneyfromhimandbeganspendingitonanyandeverythingmyheartdesired.ItworriedmethatIcouldn'tseemtostopspendingor
drinking.ItriedtogetsoberagainbyattendingAAmeetings,butIcouldn't.IknewIneededhelp,soIsoughtanoutpatientalcoholtreatmentprogram.Iwenttoone
group.Inthemiddleofthesession,Iwasaskedtoleavethegroupandtoseeapsychologist.Isawapsychologistseveraltimesaboutmydepressionsandwasthen
referredtoapsychiatristformedicationassessment.ThepsychiatristsaidthatIhadcyclothymia,amooddisorderlikemanicdepressionbutwithlesssevereperiods
ofdepressionandhypomania.Iwasstartedonlithiumcarbonate.
IknownowthatIwasaskedtoleavethegroupbecauseIwastalkingnonstopIwasmanic.Ofcourse,Ididn'ttellthedoctorthatmymoodswingsweresevereI
hadlivedwiththemforyears,believingthatthedepressionwasapunishmentformymisbehaviorduringthemanicperiods.Iwasashamedandreportedwatered
down,rationalizedversionsofmyselfandmyreality.Ididn'twanttoreportthetruththatIwasabad,damagedperson(whichIsometimesbelieved)IthinkIwas
afraidofbeingthrownintothe''loonybin.''
Lessthanthreemonthsafterstartinglithium,Iwashavingfinehandtremors,Icouldn'tcontrolmybladder,Ihadgainedfifteenpounds,andItastedmetalinmymouth
allthetime.Icomplainedtothedoctor,andhesentmetohavemylithiumlevelchecked.Ithoughthewasn'tlisteningto

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me,soIstoppedtakingthelithiumandstoppedseeingthedoctorandthepsychologist.IseveredmyconnectionwithAAandgotinvolvedinanewrelationship.
Evencomparedtomyusualrelationships,itwasanincrediblyintenseandstormyone.Duringthattime,Ispenttherestofmyinheritance,onehundredeightythousand
dollars.Lookingback,IcanseethatIwashavingthemoodswingsbutthatIwasn'tawareofmydisorderatthattime.
ThemanIwasinvolvedwithcouldn'tmakeacommitmenttome.Whenhetriedtotellmewhy,Iwasdeeplyoffended.Isawmyselfascapableofanything,intouch
withthespiritualinaspecialway,beautifulandhighlyintelligent.Icouldn'tunderstandwhathewassaying,howhecoulddothis,orhowhecouldleaveme.
Beingunabletoletgo,Idecidedtoleavealastditchploytobringhimback.Whenitdidn'twork,IcalledmyexhusbandandaskedhimifIcouldcomeandlive
withhim.IfeltIcouldn'tsurvivealone.Iwasstilldrinking,buthehelpedmeanyway.Imovedintohisplace,whereweoccupiedseparaterooms.WhileItriedtoput
ourrelationshipbacktogether,Iwasstillpiningover,hearingfrom,andseeingtheboyfriendI'djustleftinCalifornia.Theemotionalgnashingofteeth,thecussand
discusswithbothmyexhusbandandboyfriend,weretortureforme.Iescaped,generally,intothescotchbottleIescapedfromthehousebyattendingschool.
Attheendofthesemester,inDecember,IattendedapartysetupatalocalbarbyawomanIhadstudiedwith.Imetamanthere,andbytheendoftheevening,
we'dgottenclose.ByFebruaryofthefollowingyear,weweremarried,andIhadmovedfrommyexhusband'shousetomynewhusband'shousebythetimeofthe
wedding.

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Overthenextseveralmonths,Ibecamedepressedandsoughthelp.IthoughtIwasstillgrievingfortherelationshipinCalifornia.Iwasputonanantidepressant.I
continuedtodrink.Afterawhile,Ifeltbetter,soIstoppedtakingtheantidepressantandseeingthepsychologist.
Lifewenton.Igotagoodjobworkingasalegalsecretary.Withintwomonths,Ihadquitinangerandirritationandhaddecidedtotrysobrietyagain.Iremembered
thatmylifehadbeenbetterandthatIhadkeptajobwhenI'dbeensoberbefore.Ihadtolookforthatbetterlifeagain.IwentbacktoAA,andintheprocessfound
AdultChildrenofAlcoholics(ACOA).
IwenttoACOAaswellasAAforaboutsixmonths,andIfoundanACOAtherapist.Afterseveralmoremonths,IdecidedIwasn'tanalcoholic,Iwasjustan
ACOA,andsoIdrankagain.IwastoldnottocometotherapyanymoreunlessIstayedsoberforsixmonths,soIdidn'tgoback.Ijustgotdrunkerandsicker,until
IknewIwasdrinkingmorethanI'deverdrunkbeforeandgotscared.Ivoluntarilywentintotreatmentatawomen'streatmentcenter.Iremainedsoberforabout
elevenmonths,thenIstarteddrinkingagain.Iwasstillmarried,andbythistime,myhusbandhadlearnedalittleaboutrecognizingalcoholism,soIspentmoreand
moretime,includingnights,awayfromthehousewithsomeonewhowoulddrinkalongwithme.
EventuallyIquitmylatestjobinangerandagitation.Myfriend'sdrinkingincreased,andsodidmine.Webothgotangrierandstartedarguingandhavingterrible
fights.Iwenthomeandangrily,defiantly,drankthere.IworkedparttimetemporaryjobsnowandagainasIcould.Idon'trememberwhatmymoodwasbecauseI
spentmostofmytimedrunk.
IthendiscoveredIwaspregnant.Thenextday,mydoctortoldmeIneededemergencysurgery,thatmypregnancywas

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tubal.ThusbeganadepressionunlikeanythingIhadeverknown.TherewasnothingIwantedinthislifemorethantohaveanotherchild.Aftersurgery,therewould
benohopeleftformetobecomepregnant.Iwasthirtynineyearsold,andIwouldneverhavethebabyIsolongedfor.IstoppedcaringifIlivedordied.
Ihadbeendepressedbefore,butthiswasdifferent.Ihadalwaysworkedontalkingmyselfoutofdepression,believingitwaspunishmentformybadbehavior.This
timetherewasnorelief,andIdidn'tcare.IfIstayedinbedforweeks,itdidn'tmatter,becauseIwantedtodie.Iwoulddrinkmyselftosleep,withthehelpofthepain
pillsIgotaftersurgery.Dayandnight,thedepressioncontinued.I'dcrywhenIwokeup,becauseIwasstillaliveandwouldratherhavediedinmysleep.Ididn't
wanttogoon.Idrankglassesfullofstraightwhiskey,washingdownthepainpills.Withinfiveweeks,Iwashuddledonthefloorinacornerofmykitchen,screaming
outinpainandhorrormyhusbandwasonthephonearrangingtogetmeintoanothertreatmentcenter.
Itwasthere,inthealcoholtreatmentprogram,thatIwasdiagnosedasamanicdepressive.IwasputonTegretol,analternativetreatmentusedforthosewhocan't
takelithium.Theunitwasonthefourthfloor,anditslecturehalloverlookedthehospitalparkinglot.Patientswouldlookoutoverthelotwhenitwastimeforvisiting
hours,watchingforfamiliesandfriends.Ihadlookedonlyoncesincestartingtreatment.
ButonthedaythestaffgavememyfirstdosesofTegretol,somethingsubtleandpowerfulhappened.WhenIwenttothelecturehall,couldactuallyseeourcar
drivingintothelot,andcouldseemyhusbandgetoutandstarttowardthedoor,Ihadmyfirstrealizationinthirtynineyears

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aboutmymanicdepressionanditseffectsonmylife.Itstartledthehelloutofme.Untilthen,Ihadbeensweptalonginthestorm,bobbingupanddownlikeabuoy
loosedfromitsmooringinanendlesslyrestlesssea.Suddenly,itseemedsosimple,nowthatIcouldconcentratelongenough.NowIcoulddomorethanjustregister
thattherewerecarsandpeopleinaparkinglot.Icouldfeelthatitwasourcarandinitwasmyhusband,andIknewthathewascomingtoseeme.Thejoythat
feelinggavemesurpassedanythingIhadknownforalongtime.
Afteralmostayearofsobriety,Ibecamemanic.IhadbeentakingmyTegretolincorrectlyand,asIhaveahistoryofdoing,I'dstoppedtakingmyantidepressant
withouttellingmydoctor.Theresult?IdrovefromCaliforniathroughCanadatoAlaskainfourdays,foughtwiththegirlfriendIwastravelingwith,flewbackfrom
Ketchikan,andthentooktwoseparatedrivingtripstoandfromCaliforniatoseemychildrenandattendastrologicalworkshops.Ichargedclothesandhotelsand
mealsandwhateverIwanted,andIdidn'tthinktwiceabouthowwe'dpaythebills.Thethoughtthatshouldhavecomebetweentheimpulseandtheactionwasgone.
BeforeIdrovebackhomethelasttime,mymoodcrashed,andIbarelymadeithomebecauseofthedepression.WhenmytherapistanddoctorsuggestedthatI
neededtogotothehospital,Iagreed.
Ihavedonemuchbettersincethen,stayingsoberformorethansixteenmonths.Ithasn'tbeeneasy,becausenowIhavefeelingstodealwithrealones.Idon'tknow
howtodealwithfeelingsbefore,Ihadalwaysdonesomethingtoescapethem.ItwasespeciallyhardforawhileafteritfinallyhitmethatI'mmanicdepressiveand
thatmylifeisriddledwithlostdreams,holes,andtornplaces.WhenI

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fullyrealizedtheeffectsofmybipolardisorder,myalcoholism,andmyposttraumaticstressdisorder(fromgrowingupwithanalcoholicschizophrenic),Igrieved
deeplyformanymonths.ButIhavemadeprogressandremainedsober.
Now,insteadofactingcompletelyonimpulse,Icanthinkfirst,somethingI'veneverbeenabletodobefore.AndIcanlistentomyownthoughtstheynolongerrun
toofasttohear.SometimesIdon'tlikebeinglevelImissthehighs.ButIdon'tmisstheintenseirritabilityandragethatoftenaccompaniedthehighsandmademequit
jobsandleaverelationships.WhenIthinkI'dliketobemanicagain,Iremindmyselfofwhatitwasreallylike...whenthepartywasoverandIwasaloneand
depressed.TodayIdon'thavetospinoutofcontrol,Idon'tgetlostinthecar,Idon'tdreadthemorningafterbecauseofhangoversordepression,andIdon'tgoon
wildshoppingsprees.Idon'twakeupinstrangeplaces,withstrangepeople,orhavetoparkmycaronthesideoftheroaduntilI'mabletodriveagain.I'mfreefrom
manicdepressiondrivingmeintorelapseafterrelapse.
Rightnow,IthinkI'mbetweendreams.Thedelusionaldreamsofmyillnessarebehindmeinmostways,andmynewonesareverytentative.WhenIrememberhow
manyofmyolddreamsdied,IwonderifIcanmakethesenewonesintorealities.ButIhaveadifferentkindoffaithtosustainmenow.Before,Ihadtheglittering
faithofthemanictodaymyfaithisfirmer,groundedinreality.

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Scott'sStory
Icamefromawelltodofamilyandwastrainedfromearlychildhoodtogrowupandbecomeaprofessionalpersonofsomesort.EverythingseemedtoindicateI
wouldsucceedinthisendeavorastheyearspassed.Igotexcellentgradesinschoolandwasanexcellentathlete.Ididalltherightthings.
Somewherearoundtheageofseventeenoreighteen,InoticedthatIwasn'tfeelingquiterightmentally.Thingswereconfusing,notmakinganysense,andIstarted
losingmysenseofconnectedness.Todealwiththis,Istarteddrinkingalcoholmoreandmore.Iwasverylonelyandunhappy.Myparentsandotherstriedtohelpme
"snapoutofit,"buttonoavail.
TheyearIenteredcollege,Idevelopedaseriousdrinkingproblemand,asIlearnedlater,crossedoverthelinefromsocialdrinkingtoalcoholism.MaybeI'dcrossed
overearlierIdon'tknow.Letmetellyou,beingarrestedfordrunkdrivingseveraltimesandspendingtimeinjailwasnotfun.
SchizophrenicsAnonymous,c/oMentalHealthAssociationinMichigan.

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Anyway,IgotsoberbyenteringtreatmentandAlcoholicsAnonymousaboutayearlater.Iwasexhilarated,althoughthingsstilldidn'tseemtobequiteright.Ifeltlost.
Aboutfourteenmonthsintomynewlife,Idecidedto(onceagain)findsomemeaninginmyexistence.Whileonatripwithanacquaintance,Inoticedthingswere
reallyquitedifferent.Theleavesinthewindseemedtobetalkingtome.Cloudformationshadspecialmeanings.Televisionandradioshowsweretalkingaboutmy
life.IthoughtIcouldreadpeople'smindsandcommunicatewiththemwithoutspeaking.IthoughtIhadfoundthestatethatgreatspiritualleaderstermed"being
spiritual."ItrulybelievedIhadbeenblessedbyGodandthatIhadadirectpipelinetoHim.Ifelthappyandscaredatthesametime.Iwasinadifferentworld.
Aboutoneweeklater,IdecidedtotravelouttotheWestCoasttoreallyfindmyself,givenmynewfoundpower.Whiletraveling,itseemedasifGod'svoiceentered
intomythoughtsandtoldmethatifIwantedrealpeaceandpowerinmylife,IshouldrunmycarofftheroadandleavetheresttoHim.Ididthis,onlytofindno
peace,ratheratotaledcarandatriptothestatementalhospital.
Sincethattime,I'vebeendealingwithadiseasecalledschizophrenia.It'sbeenanuphillstruggle.Atthetimeofthiswriting,IbelieveI'vefoundawaytopullmyselfout
ofapsychosisandtofeelconnectedlikeIdidbeforethealcoholismandschizophrenia.TodayIfeelatpeace,ownathrivingbusiness,andhaveawonderful
relationshipwithmywife.We'reintheprocessofplanningafamily.
ThishasbeenaccomplishedthroughthephilosophyofSchizophrenicsAnonymous,AlcoholicsAnonymous,andafewspecialpeopleinmylife.

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Willie'sStory
Beingtheyoungestinmyfamilycausedproblemsforme.Iwasalwaysoverprotectedbymyparentsandolderbrothers.Iwasnevergiventheopportunitytodothings
formyselfeverythingwasdoneforme.Thatpamperedtreatmentwasnottomyliking,andIrebelledattheageoftwelve.Iwantedtobemyownman.
Aftergraduatingfromgrammarschooltojuniorhigh,twoofmyclosestfriendsandIdecidedthatweshouldeachgetabottleofalcohol.Igotextremelydrunkthat
nightonahalfpintofmintflavoredgin,andIhadtosneakintothehouse.Thatwasmyfirstdrunk.Shortlyafterthatexperience,Ihadmyfirststickofreefer,along
withsomecoughsyrup.SoonIgotcomfortablewithbeingundertheinfluence,andatthirteen,IlookedforwardtomyweekendallowancesoIcouldbuyalcoholand
drugs.Theymademefeelterrificand,mostofall,powerful.
IfeltpowerfulinthesensethatIwasaroundotherpeopleandtheycouldn'tdetectwhatmademetickorwhatgavemetheconfidenceIdisplayedatthisyoungage.
Thereweren'tmanykidsintoalcoholanddrugs,soIfeltspecial.Thefew

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kidsIregardedasfriendstriedtopersuademetostopusing.Itwasn'tlongbeforeIexperiencedachange:IabandonedallthepositivethingsIhadbeentaughtbymy
parents,andIdidn'tallowmyselftothinkaboutGodoranythingspiritual.
MypersonalitychangedsodrasticallythatIflunkedseventhgrade.IhadanIdon'tgiveadamnattitudebecauseIwasindulginginalcoholanddrugsregularly.My
parentswereveryupset.Mymotherknewsomethingwaswrongbutcouldn'tfigureoutwhatitwas.ShetookmetotheprincipalandaskedifIcouldbeplacedinmy
propergrade,becausesheknewIcoulddothework.Theprincipal,too,feltthataccordingtomygrammarschoolgrades,Ishouldn'thavefailed.Hegaveme
anotherchance,providedImadethehonorroleduringthefirstmarkingperiod.Imadethehonorroll,andtheprincipalkepthisword.Myparentswerenow
monitoringmyschoolwork,soIdidjustenoughtopass.Duringallthistime,Icontinuedtoabusealcoholanddrugs.Igraduatedfromjuniorhighschooltohigh
school,onlytobekickedoutinmyfreshmanyear.
Outofschool,Ihadalotoftimeonmyhands.Ispentitinthepoolhallandgamblingjoints,supportingmydrughabit.Iwasnowapolydruguserwhoconsumedany
andeverytypeofdrugavailable:reefer,microdots,blackmollies,THC,CIBAs,reddevils,airplaneglue,hashish,nutmegspice,Valium,cocaine,heroin,pollutants,
coughsyrupwithcodeine,and,ofcourse,alcohol.EventuallyIfoundadrugofchoice:heroin.
Atseventeen,Ibecameafatherandateighteen,ahusband.Nonetheless,Icontinuedtoabusedrugs.Atnineteen,Ibeganhearingvoices.Thisscaredthehelloutof
me,butIcontinuedtoabusedrugs.Thensuddenlyoneday,Isensedaninternationalconspiracyagainstme.Forthreeweeks,I

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refusedtoeatorleavemybedroomeventuallymywifegotmetoahospital.
Iwascommittedtothestatehospitalforthreemonths,whereIcontinuedtoabusedrugs,drinkalcohol,andsmokegrassuntilIwasdischarged.Beingdiagnosedasa
paranoidschizophrenicseemedtoimpelmetodrinkandtakedrugsmorethanever.Ididn'twanttothinkthatIhadproblems.Afterdischarge,Ifoundmyself
recallingsomeofmyexperiencesinthehospitalattemptedsuicide,nearlychokingtodeathwhenattendantsstrangledmewithbedsheets,andbeingknockedout
withdrugsthatwereputinmyfood.Becauseofthistreatment,theideaofconspiracyseemedallthemoreprobable.I'dnevertrustedanypsychiatristorcounselor.
Asamatteroffact,Iloathedprofessionalpeople,becausewheneverIdealtwiththemtheypretendedtobelikeGod.
Althoughmymentalhealthissuesneededtobeaddressed,Icontinuedtoabusealcoholanddrugs.Icompoundedtheproblembyusingstreetdrugsontopof
prescribedmedications.
Shortlyafterbeingdischargedfromthehospital,Igotamediocrejob.Ilostitafterfourmonthsforbeingintoxicated.
Overtheyears,Ihadafew,moreproductivejobs,buttheyneverlastedforanylengthoftime.Istillhadn'tseenthelightorrealizedwhatthosechemicalsweredoing
tome.Attheageoftwentyfour,Ifoundmyselfagainatthestatehospital:drinking,drugging,andbeingindenialaboutmymentalillness.Ispentthreemonthsinthe
hospital,andmuchofwhathadhappenedduringmyfirststayhappenedduringthesecond.
Afterdischarge,Iagainchosetoabusealcoholanddrugs.I'llomitlistingthewaysIsupportedmydrugaddictionover

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theyearsthethingsIdidaren'teasytothinkaboutorwriteabout.
BythegraceofGod,mywifeandourtwosonsanddaughterwerestillwithme.ForyearsIraisedhellwiththem.Iwasnothingbutaburdentoanyonewhodealt
withme.
Afterstayingoutofmentalhealthhospitalsforfifteenyears,Iwastoreturnoncemore.Beinghospitalizedandthinkingaboutdoingawaywithmywifeandkidsfinally
mademehitbottom:Itwastimetoleavealcoholanddrugsalone.ThishappenedinAugustsevenyearsago.IknewthatAlcoholicAnonymousmeetingswere
availableonFridaynights,soIaskedthedoctorifIcouldattend.IwasgivenoutsideprivilegesandwentthetwoFridaysofmyfourteendaystay.Upondischarge,
however,Iwentbacktothesamepatternofdrugging,butthistime,IknewIwasgettingtiredtiredofbeingtiredofeverything.Mywifeencouragedmetokeep
goingtoAA,andeverynowandthen,Ididattendameeting.YetIcontinuedtodrinkanddrugandcontinuedtobetiredofthewholerottenscene.
EventuallyIdecidedtoputmyselfinthehospitaltobedetoxed,butwhileinthehospital,Ihadfriendsbringmealcohol.Ialsohadaccesstodrugs,butsincedrugs
didn'tdoformewhattheyhadinthepast,Inolongerabusedthem.IcompletedthealcoholanddrugprogramandfeltverygoodaboutitIwasn'tusedto
completingwhatIstarted.Ialsofeltgoodabouttakingtheinitiativetogethelpformyself:Iknewtherehadtobemoretolifethanjustadrinkoradrug.
Butevenaftercompletingtheprogram,alcoholcontinuedtobeaproblem.Ayearlater,Iwenttoanoutpatientrehab.ForthefivemonthsIwasthere,thestaff
membersstressedgoingtoAlcoholicsAnonymousasanadjuncttreatment.

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Ilearnedalotaboutalcoholism,andalthoughIwasstilldrinking,AAbeganmakingsensetome.Istartedgoingtomeetingsthreeorfourtimesaweek.
IenrolledinadulteducationclassestogetmyGED.WhenIattendedtheclasses,Iwasstilldrinking.TheresultsfromtheGEDexamshowedthatIhadfailedbyone
point.IreasonedthathadIbeensoberduringclass,Iprobablywouldhavepassed.Twomonthslater,Iappliedtotaketheexamagain.IcontinuedtogotoAA
meetings,andIdidn'tdrinkuntilclasseswereover.
ThenonedaywhenIwasdrunkandhomebymyself,tearsstartedstreamingdownmyface.Itseemedasifmywholelifewerepassingthroughmymind.Idropped
tomykneesandbegantopraythatGodwoulddelivermefromtheobsessiontodrink.Aftertheprayer,Ipassedoutonthefloor.
Dayspassedbywithoutadrink.IcontinuedtogotoAAmeetingsandwasencouragedtogetanAAsponsor.I'llneverforgetaskinganAAmembertobemy
sponsor:hesaidhe'dbehonored,andIwaselated.Imadeprogressinovercomingmyalcoholismandwaseventuallygivenresponsibilityforopeningthefacilityfor
theAAmeeting,makingcoffee,arrangingchairs,andgreetingpeopleatthedoor.Thiswentonfortwoyears.
ThesecondtimeItooktheGEDexam,Ipassed,whichpavedthewayforenrollmentatthecommunitycollege.Atthattime,Ihadthreemonthsofsobriety.Inow
havesixyearsofnotusingalcoholorstreetdrugs.Mylifehaschangedfromdarknesstodaylight.Ingettingsober,Iexperiencedmanyobstacles,butIrecognized
themaspartoftherecoveryprocess.

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Throughouttheyears,I'vebeentakingmedicationformymentalhealthproblems,butIcomplicatedmyrecoverybyusingmoodalteringstreetdrugsalongwiththe
prescribedpsychotropicdrugs(Thorazine,Stelazine,andArtane).Thefirstgroupcanceledoutthesecond'sbeneficialresults.YetbythegraceofGod,todayI'm
healthyandsober.
IamverygratefulfortheopportunitytofacilitatetheSTEMSS(SupportThroughEmotionalandMentalSerenityandSobriety)groups.Theyhavegivenmeself
esteem,purposeinlife,andsupport.
Idon'tknowwherelifewillleadme,butIhopethatIwillneverreturntothedamnationofalcoholanddrugs.IamgratefultomyHigherPowerforguidingmetothe
doorsofAlcoholicsAnonymous.

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DUALRECOVERYANONYMOUS
AblueprintfordevelopingaTwelveStepprogramformenandwomenwhoexperiencebothchemicaldependencyandanemotionalorpsychiatricillness

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DualRecoveryAnonymous:
ABlueprint
TimothyH.
Introduction
Thissectionofferssuggestionsfordevelopingarecoveryprogramformenandwomenwhoexperiencebothchemicaldependencyandanemotionalorpsychiatric
illness.Theideas,basedontheTwelveStepsofAlcoholicsAnonymous,aretheresultofextensivediscussionswithmenandwomenindifferentstagesofrecovery
fromdualdisorders,indifferentpartsofthecountry,overthepastseveralyears.
DoPeopleWhoExperienceDualDisordersNeedaSeparateTwelveStepProgram?
Yes,thereareseveralreasonswhyaTwelveStepprogramisneededforrecoveryfromdualdisorders.
First,thoseofuswhoexperiencedualdisordersareaffectedbysocialprejudiceandbythestigmaofmentalillness.Prejudiceandstigmaarepartofalargersocial
issue,butwhennegativeattitudesandbeliefsshowupinaTwelveStepgroup,theresultscanbedisastrous.
Second,manymenandwomenwhohavebeendiagnosed

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withadualdisordersaythattheyhavereceivedmisguidedadviceabouttheirdiagnosisandtheuseofmedicationatTwelveStepmeetings.Somehavebeentoldthat
theydonothaveanemotionalorpsychiatricillness,andthattheyareexperiencingmerelyselfpityorsomeothercharacterdefect(Youdon'tneedthosepillsthey'll
causeyoumoreproblemsandIfyou'retakingpills,thenyou'reinrelapseandnotreallysober).Individualswhohavefollowedsuchadvicehaveexperienced
relapse:somehavebeenhospitalizedsomehavereturnedtoalcoholordrugusesomehaveattemptedorevencompletedsuicide.
Third,theexistingTwelveStepprogramswerenotdevelopedtoaddresstheproblemsofdualdisorders.Theyofferneitherdirectionnorguidancefordualrecovery
basedonthepersonalexperienceofothers.
Fourth,existingTwelveStepprogramsareunabletoofferthedegreeofemotionalacceptanceandsupportthatisneededanddeservedforpeopleindualrecovery.
Someindividualsarefortunate.TheyhavebeenabletofindaTwelveStepmeetingthathassomeappreciationofemotionalorpsychiatricillness,andtheycherishthe
supporttheygetfortheirsobriety.Nevertheless,theymayfeeluncomfortablesharingtheirdualrecoveryneedsopenlyandhonestly.Theymaystillfindthemselves
feelingtheneedforsecrecyinaprogramofhonesty.Unfortunately,theymaygraduallyminimize,deny,andignoretheotherhalfoftheirrecoveryneeds.
Fifth,theexistingprogramsaresinglepurposeorganizationsonedisease,onerecovery.Dualrecoverydoesnotfallwithintheirprimarygoals.Peoplewhohavea
dualillnessrecognizethatitcannotbedividedintosimpleandseparateparts.Theyacknowledgethatwhiletheydofindsupportfor

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aspectsoftheirillnessfromavailablegroups,theyalsoneedagroupinwhichtheycanlookattheirtotalillnessandrecoveryneeds.
Atpresentfewprogramshavebeendevelopedbypeopleindualrecovery.Prejudiceandstigmaaboutmentalillnesscontinuetocreateproblemsforindividualsin
dualrecovery,bothinsideandoutsideexistingfellowships.Itdoesnotappearthatdualrecoverygroupsarelikelytoformasspecialissuegroupsunderthe
organizationalstructureoftheexistingTwelveStepfellowships.Therefore,anindependentTwelveStepselfhelpprogramneedstobedeveloped.
Moreover,acomplementaryprogramneedstobedevelopedforthelovedonesofthosewhoexperiencedualdisorders.Parents,spousesandsignificantothersalso
needassistanceastheybegintostrugglewiththeirownrecoveries.
WhatWillaDRAProgramBeLike?
TheDRAprogramisbasedonthreesimpleideas,whicharesuggestedasafoundationfordualrecovery:
Today,Iwillbefreeofalcoholandotherintoxicatingdrugs.
Today,Iwillfollowahealthyplantomanagemyemotionalorpsychiatricillness.
Today,IwillpracticetheTwelveStepstothebestofmyability.
WillDRADifferfromOtherTwelveStepPrograms?
InorderforDRAtohelppeoplewhoareaffectedbydualdisorders,theconceptsoftheTwelveStepsneedtobeextendedinordertoincludetherecovery
needsofbothchemical

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dependencyandpsychiatricillness.Herearesomequotationsfrompeoplewhoarebeginningtoworkontheirdualrecovery.
Powerlessness
Theillnesshasdevelopedithasalreadyhappenedformeitissimplyafact.
Icannotalwayspredictwhentheurgetouseandsetbacksofpsychiatricillnessmayoccur,howlongtheywilllast,orhowintensetheywillbe.
Iampowerlessovertheeventsthathaveoccurredduringepisodesofmyillness.
IampowerlessoverthefactthatIneedtomakechangesinmylifetotreatmydualillnessifIwanttobehealthyandsafe.
Iampowerlessoverthefactthatsomeofmyabilities,skills,andefficiencyhavebeenaffectedbymyillness,somethatImaynotcompletelyregain.
Unmanageability
BecauseofmyillnessIhavenotbeenabletobetheparent,spouse,provider,friend,andspiritualpersonthatIhavewantedtobe.
Ihavenotmanagedtoavoidagrowinglistofproblemsandconsequences.
Icannotmanagetostoporcontrolmyillnessonmyown.
Ihavenotmanagedtohangontomyselfrespect,confidence,hope,security,innerfreedom,andvisionofthefuture.

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HigherPower
Ineedtimeformybrainandbodychemistrytorebalancetimetolearnandpracticethehowto'sofdualrecoverytimeformyrelationshipstoheal.
PracticingtheprogramofrecoverywithmyStepsandmedicationsisGoodOrderlyDirectionIknowthatevenifIamhavingseveresymptoms,whichmay
includelossofcontactwithrealityandmemoryloss,IknowthatmyHigherPowerwillcareforme.
Appropriatemedicationshelpreducemysymptoms.
IbelievethataHigherPowerhascreatedtheblueprintsforthemedicinesweneedandthatresearchersaregraduallyfindingthem.*Ihavesymptomsthat
comeandgo,butIamalwaysokayontheinside.It'sjustmybiologicalmachinerythathastheproblems.
IlookformyHigherPowertogivemewhatIneedinordertocopewithmyillness:hope,faith,courage,wisdom,strength,andpatience.WhatIlookforin
myHigherPoweriscare,notcure.
SometimesIamuncomfortablewhenIthinkofa''HigherPower.''Theconceptbringsupuncomfortableimages,feelings,andmemories,someofwhichare
relatedtopriorreligiousbeliefsthatarehardformetoseparatefrommyfamilyandearlylifeexperiences.Someoftheseconceptsaretiedtomyusingdays,when
Iwasintooccultbeliefs.Forme,itisjusttooearlyinrecoverytodealwiththisconceptitisoverwhelming.WhatworksformeinsteadistothinkofaHelping
Powerinotherwords,mydirection,thepathsIneedtofollow.HelpingPowersuggeststhetoolsthatIneedtouseandthetimethatIneedtopracticethem.

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Progression
Indualdisorders,asinaddiction,thereseemstobeaprogressionofcommonexperiences.Individualsindualrecoverybegintofindthattheyhavesharedmany
similarexperiences,eventhoughtheirparticularillnessesmaybedifferent.
First,a"nofault"illnessbegins.Itmayhaveasuddenonsetordevelopslowly.Sometimesitseemstotakeonapatternofitsown.
Second,theillnessproducessymptomsthatareexperiencedinavarietyofways.Theymayaffectone'sthoughts,emotions,sensations,andperceptions.
Third,thesymptomsbecomedisruptiveandbegintointerferewithone'sabilitytofunction,torelatetoothers,andeventorelatetooneself.
Fourth,theindividualbeginstoexperienceproblemsandconsequencesasaresultofhisorherimpairedskillsandabilities.
Fifth,thepersonattemptstoprotecthisorherfeelings,security,lovedones,andfreedom.However,sincetheperson'sabilitytocopeisaffectedbythe
illness,heorshemaybegintoactinselfdefeatingorselfdestructiveways.
Sixth,thepeoplewhoareclosetothepersonwithadualdisorderarealsoaffected.Theylackadequateinformationabouttheillnesstoclearlyrecognizethe
symptomsorknowhowtohelptheindividualfindappropriatehelp.Unfortunately,familiesthenlearntocopewiththeillnessinunhealthyways.
Personalinventory
Directlyandindirectly,apersonalinventoryispartofseveralTwelveStepprograms.Itisaprocessthathelpspeopleidentify,relateto,andaccepttheirillness.
Inventories

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canalsohelppeoplelearntomonitorandmanagetheirillnessandtocopemoreeffectivelywithsetbacksandrelapse.
Assetsandliabilitiesarefrequentlythefocusofanextensiveinventory.Thisflexiblecategoryincludesattitudes,behaviors,beliefs,copingmethods,and
memories:
IneedtohaveaclearpictureofwhatIhavethat'sworkingformeandworkingagainstmeifIhopetohaveachanceatrecovery.
Mygreatestliability,"stinkin'thinkin',"includesmynegativeattitudes,beliefs,expectations,andassumptions.Stinkin'thinkin'leadsmetostoppracticingthe
Stepsandgooffmymedications.This,inturn,allowsmypsychiatricsymptomstoreturnandperhapsleadstoarelapsetodrinkingorusingdrugs.
Someofmyliabilitieshavebeenwithmesincechildhood,andothershavedevelopedovertimeasaresultofmyillness.
Stresscancausemyillnesstobecomeworse.SomeofmystressliabilitiesaremyACOAandcodependencyissues,myangerandfeelingsoflossthatare
relatedtothegrievingprocessabouthavingdevelopedamentalillness.
IneedtoknowthepatternofmyillnessifIamgoingtolearntoliveandcopewithit.Whatarethewarningsigns?HowcanIrecognizewhenIam
becominglostinthesymptomsratherthancopingwiththem?
Assetsarethefoundationofadualrecovery:
Mygreatestassetisthatafteryearsofcrisesandillness,IlearnedtorecognizeandacceptthatIdohaveassets.
Followingasuicideattempt,Iregainedmywillingnesstosurviveandthrive.Iexperiencedachallengetoliveandcreate,andtobeapartofsomethingnew.

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Ibelievethatmyinterests,abilities,talents,andskillsareassets.
AmajorassetformeisthatIcareaboutmyself,myfamily,andmyfriends,andthatIcanusuallyshowit.
Iamstubborninapositiveway.IamdeterminedtogetthehelpthatIneedanddeserve.
Myfaith.ThetimeofsobrietythatIhadbeforemymentalillnesshappened.
Sanityandinsanity
TheTwelveStepsfordualrecoveryidentifytheneedtobe"restoredtosanity."Thisconceptappliestobothchemicaldependencyandthepsychiatricillness.Itis
lookedatfromtwopointsofview:biologicalinsanityandinsane"stinkingthinking."
Biological/physicalinsanityreferstochangesinperceptionofrealityaswellaschangesintheemotions,sensations,judgments,andbehaviorbecauseof
chemicalorbiologicalchanges.Thesechangescanoccurasaresultofpsychiatricillnessorfromtheuseofalcoholordrugs.
Insane"stinkingthinking"referstoattitudes,beliefs,expectations,andcopingbehaviorsthatareclearlyselfdefeatingandselfdestructive.Stinkingthinkingis
frequentlyrelatedtounhealthydefensemechanismsandtodenialofthechemicaldependencyorpsychiatricillness.
MysymptomsaffectthewayIthink,myattention,mymemory,myconcentration,thewaymybodyfeels,myappetiteandsleep,mybehavior,andtheway
Irelatetoothers.
WhenIbegantofeellikemyselfagaininthehospital,IfeltlikeIwascomingoutofaseriousblackout,butIhadnotbeendrinkingorgettinghigh.

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Iwenttoworkandsatatmydesk.Mymindsimplywouldnotwork.NothingmadesenseIcouldnotdothejobIhadbeendoingforalongtime.
Adualdisorderisastrangeillnessthatcausesmetwokindsofchemicalinsanity.Mypsychiatricillnesschangesmybodychemistry,whichcanmakeme
prettyinsane,andmychemicaldependencymaytriggeranurgetogethighagain,despitetheproblemsandconsequencesIhavealreadyexperienced.IfIrelapse
intoaddictiveillness,Igetintoxicatedandaltermythinking,feelings,andbehavior.Torecoverfromthisinsanity,Ineedtostoptakingintoxicatingchemicalsand
thenIneedtotakeappropriateprescriptionchemicalssoIwon'tactinsane.
Insaneattitudes,beliefs,andcoping
Formanythisisthesameconceptasstinkingthinking,andmanypeoplebelievethatstinkingthinkingisacentralpartoftherelapseprocessinchemical
dependency.Thesamemaybetrueofemotionalorpsychiatricillness.Hereareafewpointsofview:
Ihavehadsetbacksandrelapseswithmyillness.WhenIhavebeenworkingmyprogramtothebestofmyabilityandmysymptomsrecur,Iseethatasa
setback.Perhapsmymedicationsneedadjustingorchanging.Perhapsitwasastrongcycleoftheillness.ButifIthinkIamdoingsowellthatIdecidetogooff
mymedications,skipmydoctors'appointments,keepmyactionsasecret,andbelieveI'mdoingokay,that'sprettyinsane.Andthenwhenthesymptomsrecur,I
don'tseethatasasetback,that'sarelapse.
WhenIfeelsymptomsstartingandIgointodenialaboutit,that'sinsanethinking.

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WhenIstopchallengingthevoicesIhear.
WhenIthinkthatIcanusealcoholtotreatmysymptoms.
WhatProblemsCanOccurInaDRAGroup?
TwosituationscancreateseriousproblemsforaDRAgroupandcandamagethecredibilityofDRAasanewTwelveStepprogram.(Theseconcerns,however,are
bynomeansuniquetoDRAortotheproblemsofdualdisorders.)
Thefirstsituationariseswhenmembersofthegroupbegintoofferadviceonthediagnosisandtreatmentofemotional/psychiatricillnessorchemicaldependency.
DRAisanonprofessionalselfhelpprogrambasedontheTwelveSteps.Itdoesnotoffertreatmentservices(althoughsomemembersmayinfactbeprofessionalsin
thefieldsofmentalhealthorchemicaldependency).Everyindividualatameetingisthereforhisorherowndualrecovery.
ThesecondsituationoccurswhenmembersgetsidetrackedontoissuesotherthantheTwelveStepsandpersonaldualrecovery.Thisisunderstandable,because
manyhavenothadtheopportunitytospeakwithothersindualrecovery,withotherswhotakemedicationtotreatemotionalorpsychiatricillness,orwithotherswho
haveexperiencedfrustrationandresentmentinreceivingprofessionalservices.Theproblemoccurswhenthemeetingcomestodwellonproblemsalone."Problem
bashing"iscounterproductiveandcreatesbarrierstosolutions.Focusingonwaystocopewithresentments,losses,andfrustrationsrelatedtothoseissueswilltakethe
individual,andthegroup,furtherintorecovery.(DRA,ofcourse,hasnoopiniononoutsideissues.)

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Eachmemberindualrecoveryhasavaluablemessagetocarrytoothersfacedwithadualdisorder.WecarrythemessageoftheTwelveStepsandtheexperienceof
ourpersonaldualrecovery.Slowlywelearntoprotectouropportunitiesandourabilitytocarrythatmessage.Wecanbuildbridgesoftrustandmutualrespectonly
byearningandmaintainingtrustwithothers.Thisisinkeepingwiththepreceptofattractionratherthanpromotion.
ShouldDRAEngageInPublicEducation?
ThepurposeofDRAshouldremaintwofold:personalrecoveryandcarryingthemessagetootherswhoareafflicted.ThetaskforDRAistodevelopourService
CentertohelpotherswhowishtostarttheirowngroupsandtonetworkwithDRAasawhole.(SeeResourceslistingforaddress.)Toavoidanyconfusionofroles,
educationandadvocacyneedtobecarriedoutapartfromDRAbyanindependentorganization.ThereforetheDualRecoveryNetworkAssociationiscurrentlybeing
formedoutofconcernforpeopleaffectedbythosewithdualdisorders,theirfamilies,andtheirlovedones.(SeeResourceslistingforaddress.)

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DualRecoveryAnonymous:MeetingFormat
DualRecoveryAnonymousisaTwelveStepselfhelpprogramforindividualswhoexperiencebothchemicaldependencyandanemotionalorpsychiatricillness.Men
andwomenwhocurrentlyusepsychiatricmedicationsunderadoctor'scare,orwhohavedonesointhepast,arewelcometoparticipate.
Opening
Welcometothe__________meetingofDualRecoveryAnonymous.ThismeetingisopentoDRAmembersandtootherindividualswhoareconcerned
abouttheirpersonalrecovery.Mynameis__________,andIamindualrecovery.Willyoujoinmeforamomentofsilence,followedbytheSerenity
Prayer?
Godgrantmetheserenity
ToacceptthethingsIcannotchange,
ThecouragetochangethethingsIcan,
Andthewisdomtoknowthedifference.

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WouldanyoneliketoreadthePreamble?
Preamble
DRAisanindependent,nonprofit,selfhelporganization.Ourgoalistohelpmenandwomenwhoexperienceadualillness:Wearechemicallydependentandweare
alsoaffectedbyanemotionalorpsychiatricillness.Bothillnessesaffectusinallareasofourlives:physically,psychologically,socially,andspiritually.
TheprimarypurposeofDRAistohelponeanotherachievedualrecovery,topreventrelapse,andtocarrythemessageofrecoverytootherswhoexperiencedual
disorders.
DRAhastworequirementsformembership:adesiretostopusingalcoholandotherintoxicatingdrugs,andadesiretomanageouremotionalorpsychiatricillnessina
healthyandconstructiveway.
DRAisanonprofessionalselfhelpprogram.TheremustalwaysbeaclearboundaryseparatingtheworkofDRAfromtheworkofchemicaldependencyandmental
healthprofessionals.TheDRAfellowshiphasnoopiniononmattersofdiagnosis,treatment,medication,orotherissuesrelatedtothehealthcareprofessions.
TheDRAfellowshipisnotaffiliatedwithanyotherselfhelporganizationorTwelveStepprogram.DRAhasnoopiniononthewayothergroupsaddressthe
problemsofdualdisordersanddualrecovery.Wedonotcriticizetheeffortsofothers.
TheDRACentralServiceOfficewilloffersupporttootherswhowishtostartDRAmeetingsandwhowishtoworkwithothergroupstocarrythemessage.
Thankyou.

Page234

Announcements
Arethereanyannouncementsatthistime?
Introductions
Shallwetakethistimetointroduceourselves?Someofusarecomfortableusingthefollowingintroduction:Mynameis[firstname,lastinitial]andIamin
dualrecovery.Butthereisnoofficialintroduction.Feelfreetofindawayofintroducingyourselfthatyouarecomfortablewith.
Wouldanyoneliketoread"AcceptingDifferences"?
AcceptingDifferences
Newcomersandvisitorsmayask,CanaDRAprogramhelpmeevenwiththetypeofsymptomsthatIhave?Suchfeelingsarenotuncommon.Weneedto
helpnewcomersrecognizethatavarietyofsymptomsarepossiblewithadualillness.Thereisnosingletypeofdualdisorder.
Ourchemicalproblemsalsovary.Forexample:
Onemanusedalcohol,whileanotherusedmanydifferentdrugs.
Onewomangothighdaily,whileanothergothighonlyonceamonth.
Someofushavebeenintreatmentprogramsseveraltimesforourchemicaldependency,whileothershavereceivedoutpatientcarewhilelivingathome.
Someofushavebeencleanandsoberforalongtime,whileothershaveyettobecomeabstinent.
Wehavefoundthatthisisalsotruewhenweconsiderthesymptomsofourspecificpsychiatricillnessandworrythattheywillsetusapartfromothers.For
example:
Someofususeprescriptionmedicationstocontroloursymptoms,whileothershavesymptomsthatneednomedication.

Page235

Someofushavestruggledformanyyearswithourpsychiatricillness,whileothershavejustbeguntoexperiencetheonsetofsymptoms.
Someofushaveexperiencedchangesinourabilitytoperceiverealityclearlyandhaveexperiencedhallucinations,whethertheycomeintheformofhearing
voicesorseeingvisions.
Someofushavefeltincreasedenergyorhaveexperiencedchangesinourabilitytothinkandmakejudgments.Wemayhavealsofoundthatourthoughts
sometimesraceandseemtogooutofcontrol.
Someofushavefeltalossofenergy,alossofenjoymentoflife,andhaveperceivedlifefromanegativeperspective.Perhapsoursleepingpatternsand
appetitehavechangedaswell.Wemayhavebecomesuicidal.Wemayfindthatwehavedifficultieswithourthoughtsandconcentration.
Theselistsarefarfromcomplete,buttheypointtoacommonbond:bothmenandwomenareaffectedbydifferenttypesofnofaultillnesseswhosesymptomscan
disrupttheabilitytofunctionandrelatetootherseffectively.
Someofusfearedthatwewerebecominghopelesslyimpaired.Wecametobelievethatwewouldneverbe''normal''again.Manyofushaveexperiencedgreat
shameandguilt.Webelievedthatouremotionalorpsychiatricillnessandchemicaldependencywereourfault.Someofushavebecomesecretive.Wetriedtokeep
ourdrinkinganddruguseasecret,andlatersomeofusfeltaneedtokeepourrecoveryandStepsasecret.Wealsofeltourpsychiatricillnessmustbekeptsecret,
especiallyifourrecoveryprogramincludedprescriptionmedication.
Weseemedtorunoutofwaystoprotectourfeelingsandselfesteem,andtoprotectourselvesfromtheattitudesof

Page236

thosearoundus.Manyofusgraduallywentintoaclosetofdenial.Ifthereareanyamonguswhohavefeltasthoughtheywerelivinginthatcloset,wewelcomeyou.
Wewantyoutoknowthatthefear,isolation,andsecrecynolongerneedbeapartofyourlife.
Wouldsomeoneliketoread"GettingStartedinDualRecovery"?
GettingStartedinDualRecovery
TheDRAapproachtodualrecoveryisbasedonasimplesetofideasandSteps.Theyaresuggestionsforrecoveryratherthanasetofrules.Theyencourageus
tofindourownpersonalrecovery,theonethatismostmeaningful.Theyaremeanttosupportthoseofuswhowishtobringaspiritualdimensiontoourdual
recovery.
TheDRAprogramisworkedonadaybydaybasis.Herearethesuggestionsfordualrecovery:
Today,Iwillbefreeofalcoholandotherintoxicatingdrugs.
Today,Iwillfollowahealthyplantomanagemyemotionalorpsychiatricillness.
Today,IwillpracticetheTwelveSteps:
1Weadmittedwewerepowerlessoverourdualillnessofchemicaldependencyandemotionalorpsychiatricillnessthatourliveshadbecome
unmanageable.
2CametobelievethataHigherPowerofourunderstandingcouldrestoreustosanity.
3MadeadecisiontoturnourwillandourlivesovertothecareofourHigherPower,tohelpustorebuildourlivesinapositiveandcaringway.

Page237

4Madeasearchingandfearlesspersonalinventoryofourselves.
5AdmittedtoourHigherPower,toourselves,andtoanotherhumanbeing,theexactnatureofourliabilitiesandourassets.
6WereentirelyreadytohaveourHigherPowerremoveallourliabilities.
7HumblyaskedourHigherPowertoremovetheseliabilitiesandtohelpustostrengthenourassetsforrecovery.
8Madealistofallpersonswehadharmedandbecamewillingtomakeamendstothemall.
9Madedirectamendstosuchpeoplewhereverpossible,exceptwhentodosowouldinjurethemorothers.
10Continuedtotakepersonalinventoryandwhenwrongpromptlyadmittedit,whilecontinuingtorecognizeourprogressindualrecovery.
11SoughtthroughprayerandmeditationtoimproveourconsciouscontactwithourHigherPower,prayingonlyforknowledgeofourHigherPower'swillfor
usandthepowertocarrythatout.
12HavinghadaspiritualawakeningasaresultoftheseSteps,wetriedtocarrythismessagetootherswhoexperiencedualdisordersandtopracticethese
principlesinallouraffairs.*
RoundtableDiscussion
ThisisaclosedmeetingwherewecandiscusstheStepsandmattersofpersonalrecovery.Everyonewillhaveanopportunitytoshareaswegoaroundthe
table.Ifyoudonotwishtoshare,simplysay"Pass."
*AdaptedfromtheTwelveStepsofAlcoholicsAnonymous.TheTwelveStepsofAAappearonpage241.

Page238

Closing
TraditionSevenremindsusthateveryDRAgroupisfullyselfsupporting.Asweclose,abasketwillbepassed.Alldonationsareusedforourliteratureand
othergroupexpenses.
TraditionTwelveremindsusofourneedforanonymity.Weaskthatyoudonotrepeatthenamesofanyonewhohasattendedthismeetingortalkabout
whathasbeenshared.OnlybyexercisingthistraditioncanDRAprovideasettingwherewecanfeelsafetoshareinawaythatwillhelpourdualrecovery.
IfyouknowsomeonewhomightfindhelpfromtheDRAprogram,feelfreetobringthemtoaDRAmeeting.However,pleasebringthemonlyifthey
expressapersonalinterest.Recoveryisalwaysamatterofpersonalchoice.Wecandoourbestwhenwecarrythemessageandpracticetheprogram.
Wouldallwhocaretojoinmeinthe"SerenityPrayer"?
Godgrantmetheserenity
ToacceptthethingsIcannotchange,
ThecouragetochangethethingsIcan,
Andthewisdomtoknowthedifference.

Page239

RESOURCES
AlAnonFamilyGroupHeadquarters,Inc.
1600CorporateLandingParkway
VirginiaBeach,VA234545617
(757)5631600
AlcoholicsAnonymousWorldServices,Inc.
468ParkAvenueSouth
P.O.Box459
NewYork,NY10163
(212)8703400
TheAnxietyDisorderAssociationofAmerica(formerlyThePhobiaSocietyofAmerica)
6000ExecutiveBoulevard,Suite513
Rockville,MD208523801
(301)2319350
DepressiveandManicDepressiveAssociation(DMDA)
222SouthRiversidePlaza,Suite2812
Chicago,IL60606
(312)9930066
DualRecoveryAnonymous
CentralServiceOffice
P.O.Box8107
PrairieVillage,KS66208
(913)6767226
Aselfhelporganizationforthosewithdualdisorders(TwelveStepformat).
DualRecoveryAnonymousCanada
294St.VincentStreet
Barrie,OntarioL4M4A1
(705)7226443
DualRecoveryNetworkAssociation
P.O.Box8107
PrairieVillage,KS66208
(913)6767226
Anadvocacyandeducationserviceprogramforthosewithdualdisorders.
EmotionalHealthAnonymous
2420SanGabrielBoulevard
Rosemead,CA91770
(818)2403215
ATwelveStepprogramforpeoplewithpsychiatricproblems.

Page240

GamblersAnonymous
3255WilshireBoulevard,#610
LosAngeles,CA90010
(213)3863789
GROW,Inc.
2403WestSpringfield
Champaign,IL61821
(217)3526989
Aselfhelpprogramforpeoplewithpsychiatricproblems
NarcoticsAnonymousWorldServiceOffice
P.O.Box9999
VanNuys,CA91409
(818)7739999
NationalAlliancefortheMentallyIll
2101WilsonBoulevard,Suite302
Arlington,VA22201
(703)5247600
Supportgroupsforpersonswithmentalillnessandtheirfamilies.
NationalClearinghouseforAlcoholandDrugInformation
P.O.Box2345
Rockville,MD208572345
(301)4682600
(800)7296686(800)SAYNOTO
NationalInstituteofMentalHealth
95600FishersLane
Rockfille,MD20857
(301)4434513
NationalMentalHealthAssociation
1021PrinceStreet
Alexandria,VA22314
(703)6847722
NationalMentalHealthConsumer'sAssociation
311SouthJuniperStreet,Room902
Philadelphia,PA19107
(215)7352465
Supportgroupsforthementallyill.
ObsessiveCompulsiveFoundation
P.O.Box9573
NewHaven,CT06535
(203)7720565
Supportgroupsandnewslettersforpeoplewithobsessivecompulsivedisorderandtheirfamilies.
OvereatersAnonymous
6075ZenithCourt
RioRancho,NM87174
(505)8912664
SexAddictsAnonymous
P.O.Box70949
Houston,TX77270
(713)8694902
SexandLoveAddictsAnonymous
SLAAAugustineFellowship
P.O.Box119
NewTownBranch
Boston,MA02258
(617)3321845
TwelveStepgroupsforsexandloveaddicts.

Page241

THETWELVESTEPSOFALCOHOLICSANONYMOUS*
1.Weadmittedwewerepowerlessoveralcoholthatourliveshadbecomeunmanageable.
2.CametobelievethataPowergreaterthanourselvescouldrestoreustosanity.
3.MadeadecisiontoturnourwillandourlivesovertothecareofGodasweunderstoodHim.
4.Madeasearchingandfearlessmoralinventoryofourselves.
5.AdmittedtoGod,toourselves,andtoanotherhumanbeingtheexactnatureofourwrongs.
6.WereentirelyreadytohaveGodremoveallthesedefectsofcharacter.
7.HumblyaskedHimtoremoveourshortcomings.
8.Madealistofallpersonswehadharmed,andbecamewillingtomakeamendstothemall.
9.Madedirectamendstosuchpeoplewhereverpossible,exceptwhentodosowouldinjurethemorothers.
10.Continuedtotakepersonalinventoryandwhenwewerewrongpromptlyadmittedit.
11.SoughtthroughprayerandmeditationtoimproveourconsciouscontactwithGodasweunderstoodHim,prayingonlyforknowledgeofHiswillforusandthe
powertocarrythatout.
12.Havinghadaspiritualawakeningastheresultofthesesteps,wetriedtocarrythismessagetoalcoholicsandtopracticetheseprinciplesinallouraffairs.
*TheTwelveStepsofAAaretakenfromAlcoholicsAnonymous,3ded.,publishedbyAAWorldServices,Inc.,NewYork,N.Y.,5960.ReprintedwithpermissionofAAWorld
Services,Inc.(Seeeditor'snoteonthecopyrightpage.)

Page243

INDEX

A
Abstinence,6972
Acceptance,150
Addictivebehavior,8990
Admittingnatureofourwrongs,5354
AdultChildrenofAlcoholics(ACOA),181,207
Agnostics,5562
Agoraphobia,29,33,13134
AlcoholicsAnonymous(AA),44
foundersof,42,89
meetingsof,177,17980,188,198,201,2034
TwelveSteps,listof,241
Alcoholism,32
andbipolardisorder,12330,15269
andborderlinepersonalitydisorder,18389
anddrugs,21318
anddepression,17082,19098
andmultiplepersonalitydisorder,11822
andphobias,11117
andschizophrenia,199201,21112
AmericanMedicalAssociation,28
AmericanswithDisabilitiesAct,86
Anonymity,76
Anorexia,38,13543
Antidepressants,129,141,190
Antisocialpersonalitydisorder,36,14451
Anxietydisorders,3234
Assets,22728
Atheists,5562

B
Beingcalled"crazy,"9091
BigBookofAA,63,87,89,91,94,97,149
Bipolardisorder,3132,82,20210
andalcoholism,12330,15269
Borderlinepersonalitydisorder,36
andalcoholism,18389
Bromocriptine,42
Bulimia,3839,123
Bulimics/AnorexicsAnonymous,13942

C
Caffeine,39
Charactergrowth,49
Chemicaldependency,2729,41
Clinidine,42
Cocaine,39

Page244

Codependency,37
Compulsions,33
Confidence,1067
Crack,39
Crisis,41
Cyclothymia,12330,20210

D
Delusions,37
Dependentpersonalitydisorder,37
Depressantdrugs,34
Depression,3132,141
andalcoholism,17082,19098
Detoxification,4142
Diagnosis,27,4043
Dietpills,39
Discrimination,86
Dissociativedisorders,3436
Diuretics,39
Drinkingpersonality,35
Drugs,21318
Dualdisorders,2729
andTwelveSteps,4446
DualRecoveryAnonymous,22131
meetingformat,23238
problemsingroups,23031
andpubliceducation,231
Dysthymia,31

E
Eatingdisorders,3839
Emotionalproblems,2728
Employers,8688
Exercise,67

F
Familysupport,65,1027
Friends,65

G
Griefprocess,150

H
Hallucinations,37
HigherPower,4751,5562,7072,93,225

I
IncestSurvivorsAnonymous,121
Insanestinkingthinking,22830
Insanity,22830

J
Journal,68

L
Laxatives,39
Liabilities,227
Lithium,129,151,166,205,208

M
Mania,32
Manicdepressivedisorder.SeeBipolardisorder
Medicationproblems,66
Mentalillness,64
stigmaof,89101
Moodalteringdrugs,30
Mooddisorders,3132
Moodswings,3132,67,12330
Moralinventory,5153,22628
Multiplepersonalitydisorder(MPD),3536
andalcoholism,11822

N
NarcoticsAnonymous,44
NightLight:ABookofNighttimeMeditations,61

O
Obsessions,33
Obsessivecompulsivedisorder,3334
OvereatersAnonymous,12729

P
Panicdisorders,33,13234
Personalinventory,5153,22628
Personalitydisorders,3637
Personalrelationships,7376
Phobias,33
andalcoholism,11117
PhobicsAnonymous,11617,134

Page245

Posttraumaticstressdisorder(PTSD),34
Powerlessness,4647,224
Professionalrelationships,8285
Progression,226
Psychiatricdisorders
anxietydisorders,3234
dissociativedisorders,3436
eatingdisordersandsexualcompulsions,3839
mooddisorders,3132
personalitydisorders,3637
schizophrenia,3738

R
Recovery,3940,6368,9294
Relapse,6368
Resources,23940

S
Sanity,228
Schizophrenia,3738,41
andalcoholism,199201,21112
Selfblame,1056
Selfesteem,93
Selfmedication,30
SerenityPrayer,119
Sexualcompulsions,3839
Simplephobia,33
Smoking,123
Sobriety,6972
Socialphobia,33
Spirituality,48,62
STEMSS(SupportThroughEmotionalandMentalSerenityandSobriety),218
StepFive,5354
StepFour,5153
StepOne,4647
StepsOnetoTwelve.SeeTwelveSteps
StepSeven,148149
StepThree,5051,55,57
StepTwo,4750,55
"Stinkingthinking,"227,228230
Substanceabuserisksof,2931
Suicide,68
Supportgroups,81

T
Takinginventory,5153
Tegretol,208
Tellingothers
employers,8688
nottellingfamilyandfriends,7981
personalrelationships,7376
professionalrelationships,8285
supportgroup,81
trustingothers,7678
Therapist,6465
Treatment,4043
Trust,7678
TwelveSteps
advantagesof,4243
anddualdisorders,4446,22131
listof,241
philosophyof,28
StepFive,5354
StepFour,5153
StepOne,4647
StepSeven,14849
StepThree,5051
StepTwo,4750
TwelveStepsandTwelveTraditions,14849

U
Unmanageability,224

W
Willpower,57
Withdrawal,4142