Drink_The Intimate Relationship Between Women and Alcohol

by Ann Dowsett Johnston

  For some, new sobriety is a pink cloud. Not for me. Without a plan, cocktail hours were tough. Parties? Sometimes I had to breathe through them. It took a full two and a half years and a lot of hard work before I found my equilibrium. Once it was established, it was unshakable: I had a calm I had rarely experienced.

  But by that time, Jake was gone. Eighteen months into my sober journey, he called me on a Monday morning and broke up with me on the phone. Just like that. It came out of the blue—two weeks after a particularly romantic email exchange on May 1, the day we called our anniversary: I was in New York, visiting Nicholas, and I woke to an email itemizing the “Fifteen things I love about you.” It was a keeper, articulate and effusive. Among the things he loved: “The way you snuggle up against me when we sleep. Your scalpel intellect. Your inquiring, open mind. I love your courage in dealing with ideas. The smell of your hair, your neck, your sweaters. The way you hold my hand when we walk down the street.” It went on in loving detail, and ended with number sixteen: “How about our longstanding date at the National Magazine Awards?” The awards were only weeks away: we already had our tickets and were discussing what dress I would wear.

  Seventeen days later, the phone call came. “Surely you don’t mean forever?” I said. “Maybe we could try again after Labor Day,” he said. He paused. “No, I take that back.” I couldn’t make the news go into my head. “Let’s talk midweek,” he said. I called. He would not pick up the phone. I did not call again.

  Perhaps there’s no good way to break up with someone—but this was a parting that made no sense. Not to me. Not to many around us.

  Maybe this is the way it always transpires: one person leaves, and the other is shattered. Decades ago, I broke up my marriage to Will, and he spent weeks trying to talk me out of it. I would not budge.

  All I know is this: my breakup with Jake still makes no sense to me. His absence is a presence for me, one that informs my writing, my thinking, my way of looking at life. I’ve grown used to it, as you do a much beloved dog: it accompanies me wherever I go. The writer Edward Hoagland once called his marriage breakup “the rip in his life.” This was—and remains—the major rip in mine. I miss Jake each and every day. And yes, I still love him with my whole heart.

  Twenty-four hours after Jake’s call, numb with shock, I learned that I had won the prestigious Atkinson Fellowship in Public Policy, charged with delving into the subject of women and alcohol: a yearlong project that came with a generous travel budget. After three years of staying at home to heal, I was back in business.

  Still, I was bereft: that summer was the toughest of my life. Eight weeks into the breakup, Canada’s national newspaper ran a piece exposing the details of our relationship and what had happened. Written by a mutual friend, it posed this question: why had we spent fourteen years in two different cities, never resolving our living situation? Pseudonyms were used, but it was no mystery as to who the couple was. It called me smart and sexy, but this was cold comfort. As the husband of a friend observed, “Names were changed to protect the guilty.” My titanic heartbreak had a very public airing.

  Less than six months after Jake left, my beloved father was dead. When the doctor called to explain, he asked me if I was aware of Korsakoff’s syndrome. With a quiet voice, I said yes. When he asked me if I knew what a twelve-step group was, I said yes again. He suggested Al-Anon. I smiled. It was all too Gothic. My beautiful father—stoic, singular, brilliant—had fallen into the trap. I thanked the doctor for his kindness and hung up the phone. Later, my sister would find an Al-Anon card tucked away in my father’s filing cabinet. I found this unspeakably sad. It all is.

  14.

  Breaking the Trauma Cycle

  THE MOTHER-AND-CHILD REUNION

  The past is never dead. It’s not even past.

  —WILLIAM FAULKNER

  At two, she was taken from her mother by her father. She lived in a truck for a year, with his mother and his sister. At seven, she started sipping beer and was taken from her father—“just say it was sexual abuse.” She moved in with her aunt and uncle. At eight, she went into the first of many foster homes. At eleven, she moved to a group home. At twelve, she quit school and began “living on the street.” This, I learn, is a euphemism for prostitution. At thirteen, she was pregnant. At fourteen, she gave birth to the first of her four children.

  Now thirty-two, Annie Akavak can tell her story without reaching for Kleenex—a change from when I met her at a treatment center two years ago. “Alcohol was my first experience of getting high,” she says. “I remember wondering, ‘What can I forget? What else will numb the pain?’”

  From alcohol, Akavak moved on to marijuana, then ecstasy. Eventually she used crack. “Crack takes all the pain away. It numbs everything. The only thing I never did was shoot up—I’m afraid of needles.”

  Today Akavak is in the process of putting her life back together again. It has been a very long road. Four years ago, her newborn daughter was taken by Native Child and Family Services of Toronto. “They don’t mess around,” says Akavak. “I swore that I would fight to get her back.”

  She did, with the help of the Jean Tweed Centre in the west end of Toronto. Enter the doorway off Evans Avenue, under the humble striped awning, and you confront a world shaped by Nancy Bradley and her team. Treating substance use is the focus of the center, whether inpatient or outpatient. Clients include sex-trade workers and university students, women from the corporate world and those with a criminal past. Bradley, who has been at the helm of Jean Tweed for twenty-five years, has seen them all: “a microcosm of society.” “Twenty years ago, we made some mistakes,” she says. “We used to believe that you dealt with the addiction and told the woman to wait two years to deal with her other problems. Now trauma pervades everything we do. You can’t separate recovery and trauma. Women may not be drinking, but they will still be very, very troubled if you don’t address the underlying issues.”

  “Braiding” is the approach used at Jean Tweed: the ability to move back and forth between a woman’s addiction and her other challenges. It might be violence, it might be sexual abuse, extreme poverty, or a traumatic childhood. Rare is the woman without a troubling past or present. “Someone can’t go through substance abuse who isn’t anxious, depressed, having issues related to self-harm or perhaps food,” says Bradley. “We meet women where they are. We know that some behaviors may manifest themselves. Some may begin to have flashbacks—which can be extremely painful for both the clients and the staff. We try to help them see the links. We hear some of the most unbelievable stories—there is immense courage here.”

  How one deals with trauma is key. “Trauma shuts down the frontal lobe,” says Susan Raphael, a Toronto counselor who specializes in dealing with young clients. “If you don’t deal with the trauma, it recycles. But you have to move away from the narrative: make the connections to the past, but not have the client relive it.” Often, being addicted to substances means that the woman will be retraumatized by experiences that happen when they’re under the influence. “Young women still really objectify themselves,” says Raphael. “I would have thought things would have changed by now. But I see clients flirting with being escorts, having a sugar daddy—what I would call a watered-down sex trade.”

  “We miss the biggest part of the story if we don’t link the addiction to the rest of the woman’s life.” This is the voice of Nancy Poole, director of research and knowledge translation at the British Columbia Centre of Excellence for Women’s Health. With more than thirty years’ experience in the field of addictions, Poole is a dynamo, with her finger in dozens of projects. She is talking about the importance of what is known as trauma-informed care, which gives credence to the woman’s past or present, and the role it plays in her addiction. Co-editor of a new book called Becoming Trauma-Informed, Poole says: “We are neophytes when it comes to dealing with trauma. The term ‘trauma-informed care’ has some cachet, but people have very little experience in translating it
. The way we have been delivering care has been retraumatizing—crippling instead of empowering. It’s really about our collective denial about child abuse and violence against women. Trauma is quite common for people, and it can interfere deeply with a person’s ability to cope. Trauma-informed care is supportive, creating a safe place—the Jean Tweed Centre, for instance, is years ahead of others in Canada.”

  Head to one of the most renowned treatment facilities in the world—the Betty Ford Center in Rancho Mirage, California—and you will hear a similar story. Johanna O’Flaherty, vice president of treatment services, stresses the correlation between trauma and addiction. “A traumatic event is a dramatic event that is so extraordinary that it’s outside the individual’s coping abilities,” says O’Flaherty. “It does not toughen the child or the individual, but it toughens their defenses. Defenses serve you very well. Drugs and alcohol may actually be a wonderful anesthesia to keep the pain numbed. But once one stops the drugs and alcohol, the individual will reexperience the painful feelings. And there is now research that validates that if trauma is not addressed, there is a high propensity for relapse in the first six months. It’s all about moving from ‘victim’ to ‘survivor.’”

  O’Flaherty stresses that not everyone who ends up being an alcoholic has early childhood trauma, and not everyone who has trauma ends up being an addict. But she does underscore the importance of this work, which she has brought to the Betty Ford Center in the past six years. Beyond trauma, what is the largest issue she is confronting at Betty Ford? She doesn’t blink. Mixing other drugs with alcohol is the first thing she mentions—“benzodiazepines and liberal prescriptions of Ambien.” Says O’Flaherty, “There are enormous barriers for women accessing treatment. What’s really lacking in the field? Treatment centers that will accommodate babies.”

  At the Jean Tweed Centre, helping clients change their lives often includes assisting mothers with their parenting skills or custody problems. Twenty-four years ago, a young woman barged into Bradley’s office with her seven-year-old, desperate for help. She said, “I have to give my kid up to Children’s Aid—he is out of control.” The young woman had been through Jean Tweed and felt a part of the place. “I thought to myself: ‘We have an opportunity here,’” says Bradley.

  With that, Jean Tweed began offering child care so that parents could attend evening sessions. Twelve years ago, they started Pathways to Healthy Families, an outreach program aimed at helping women who are pregnant or parenting children up to the age of six. They placed staff outreach workers in shelters, in a maternity hospital, in the aboriginal community: looking for women who needed help finding housing, prenatal care, midwifery, counseling for substance abuse, and more. They built bridges with agencies that were historically adversaries: Children’s Aid Society of Toronto, the court system.

  As part of the Pathways program, they developed the Mom & Kids Too program, tailoring the essence of the classic twenty-one-day treatment program to a young mother’s schedule. Treatment is spread over seven weeks, three days a week, with child care in their licensed facility. Workshops on parenting, play routines, and attachment are incorporated, along with sessions on substance abuse. In the morning, mothers and their children can arrive and have breakfast together. With this program, retention of young mothers went from 26 percent to higher than 80 percent. Says Bradley, “Often, women haven’t been parented well themselves, so we’re role-modeling.”

  Akavak used both programs to help her get her life back in order. When her daughter was taken from her, she found Pathways and Jean Tweed, enrolling in Mom & Kids Too as well. “That’s when everything changed,” says Akavak. “I stopped relapsing, and started learning some coping skills.” Gradually, Native and Family Services allowed her to have her daughter with her for the day sessions. Her daughter was in foster care. “They were seeking adoption for her at the time,” says Akavak, “with no opportunities for visitation. I wanted her back—I didn’t want her to feel that she was being pushed away as I was as a child. I wanted to be there.”

  Over time, with Jean Tweed’s help, Akavak won her fight for custody. “They saved my family and they saved me,” she says. “To have someone acknowledge that you are willing to make a change is everything. Jean Tweed taught me how to be a better mother, and a healthy mother. I know I am going to be okay because I’m going to make it different for my kids. That’s what makes me strive to be strong.”

  Today, Akavak is back at school. Her two youngest children are in day care, she is doing two kinds of therapy, and she can see a path forward. I ask her if she is in a relationship, and she shakes her head. “I have to love myself before I can love anyone else,” she says. “It feels like it’s going slow, but there’s a lot of self-healing. Self-healing, self-love, self-forgiveness. That’s the biggest thing for me.”

  Jerry Moe, the founder and head of the Children’s Program at the Betty Ford Center, is a clone of William Macy: an open-faced, openhearted guy who gets right to the point about “his best teachers”—namely, kids. And since his clients are pint-sized, he spends a lot of his day on his knees, speaking at their level, helping children separate the person they love from the disease that’s consuming them.

  “The Children’s Program is about breaking the cycle,” says Moe. “Roughly seventy-five percent of the people in treatment come from families with addiction. My role is to teach kids self-care in a family that doesn’t practice self-care—this is a strength-based program. And sometimes the first person in the family to get help might be the seven-year-old.

  “So many of the kids are ‘looking good’ kids—most are suffering in silence. These kids are guarded: they don’t want anyone to know the family secrets. Remember, this is a disease of silence and secrecy. They may not know the family problem is drinking, but they know something is wrong.” How long does it take for a child to open up to him, to build trust? “Typically, about an hour,” says Moe. “No, actually, thirty minutes.”

  Moe works with children ages seven to twelve, doing “all sorts of experiential activities that help kids learn to thaw all those emotions that are kept in check. We’re with them for four days,” he says. “Kids can’t look good all day. When you’re with them all day, you really get to see how they deal with frustration, what they do when they’re sad. It’s a great opportunity to build relationship, to get a window into the way kids operate. At some point I will say, ‘All of us have someone we love who got trapped by addiction. Tell on the disease, on addiction. It loves when we are silent.’”

  One of the activities Moe relies on is drawing: “Kids can often draw what they can’t say.” Another centers around a backpack full of rocks: about forty-one pounds in all. “Each of the kids gets to carry it briefly,” he says. “We talk about what our lives would be like if we had to carry it all the time. ‘I’d be miserable,’ kids will say, or ‘I couldn’t ride my skateboard.’ They’d do anything not to carry it. We say: ‘Many of your moms and dads are carrying that backpack. Where do you think they carry it?’ To which one seven-year-old girl replied: ‘It’s somewhere in that space between your heart and spirit.’

  “How long do you suppose they’ve been carrying it?” asks Moe. “Since they were little kids,” he says. “So how can anything in that backpack relate to anything you’ve done?”

  “Whatever’s in that bag, why don’t they let it out?” asked one young girl. “They don’t know how,” Moe tells them. “If they do drugs or drink, it goes away. But when they pick it up again, it weighs more. It gets to the point when the bag hurts all the time. That’s when they go to treatment.”

  All the rocks are painted. One reads “secrets,” one says “fighting,” three are named “problems”; one says “addiction,” another says “abuse.” “There are four kinds of child abuse,” says Moe. “They typically talk about physical abuse, maybe verbal abuse, occasionally someone will talk about sexual abuse. Then there’s neglect.

  “While we’re doing this exercise, we’re still dev
eloping intimacy, informing them and helping them understand that people can get it out or keep it in. How do people get better? They talk about a secret. And by the third day of the four-day program, we teach the children that they have their own bag of rocks.”

  “Part of this is breaking the belief that it is scary to talk about,” says Peggy McGillicuddy, a counselor who has worked for years with Moe. “There’s not much denial with little kids. Once one kid talks, it’s amazing what the other ones will share. Parents are always so scared—and it’s always the opposite. They just love their parents.

  “On the second day, the kids write their own true story. ‘Who in your family got trapped by addiction?’ On the third day, the child reads the story. ‘Tell your mom what you were worried about,’ I say. A lot of them will say: ‘I was worried you were going to die.’ Kids are allowed to be angry at the disease and still love their parent. Kids get to talk about how awesome their parents are—even if they aren’t getting sober.”

  McGillicuddy herself is the child of a female alcoholic—Mary Gordon, who just happens to be head of the Family Program at Betty Ford. On the week that I visited the Betty Ford Center, there was a full complement of families attending the program, including one from the United Kingdom and one from Saudi Arabia. “This is the week when we disturb the comfortable and comfort the disturbed,” says Gordon. “These families may have been functioning, but they have been functioning in shame. We have a resiliency model—we try to avoid the word dysfunctional. Of course, we use the three C’s—you didn’t cause it, you can’t cure it, you can’t control it. But you can cope in new ways. Ideally, the women learn about the self-care piece, and the men learn how to let go of the fixer or problem-solver roles. They will learn not to react, rescue, caretake.”