A Common Struggle: A Personal Journey Through the Past and Future of Mental Illness and Addiction

by Patrick J. Kennedy

  —

  FRIDAY MORNING, I arranged to read a brief prepared statement to the press before leaving for Minnesota to be treated at the Mayo Clinic. In the statement, I revealed much more than I needed to and much more than my advisers advised me to. I explained that I had been struggling with the challenges of addiction and depression my entire adult life—as did the millions of Americans to whom I had dedicated my public service. I admitted for the first time that I had been treated for addiction to prescription pain medication and that I had spent the recent holiday recess at Mayo trying to address that problem.

  I expressed my genuine confusion about what had happened on Wednesday night. I admitted I had no memory of getting out of bed, driving to the Capitol, being pulled over by police, or being cited for driving infractions.

  But I was not trying to use that as an excuse. “That’s not how I want to live my life,” I said, “and it’s not how I want to represent the people of Rhode Island. . . . I am deeply concerned about my reaction to the medication, and my lack of knowledge of the accident that evening. But I do know enough that I know that I need help.”

  The statement ended, “I hope that my openness today and in the past, and my acknowledgment that I need help, will give others the courage to get help if they need it. I am blessed to have a loving family who is in my corner every step of the way. And I’m grateful to my friends, both here and in Rhode Island, for reaching out to me at this time.”

  But while it took every ounce of restraint I had to stick to the prepared statement—which my staff had never, ever seen me do before—I did finally deviate on the last line.

  I was supposed to say, “Thank you for your prayers and your support.”

  Instead, I looked right into the cameras and said, “And I’d like to call, once again, for passage of mental health parity. Thank you.”

  —

  ON THE WAY TO NATIONAL AIRPORT, I had the driver bring me by my dad’s house for a minute. We sat on the back porch—me, my father, Vicki, their dogs—and there wasn’t a whole lot anyone could say. By then there was no more talk of “fendah bendahs” and damage containment. I had escalated everything myself, answered questions the press hadn’t even thought to ask yet. There was no turning back.

  I remember my father saying, “You did a good job today. You’re doing the right thing.” And then I had to get going so I could make my plane.

  As I left town, the two people who meant the most to my political future stood up for me in strong public statements.

  From my dad:

  I love Patrick very much and am very proud of him. All of us in the family admire his courage in speaking publicly about very personal issues and fully support his decision to seek treatment. He has taken full responsibility for events that occurred Wednesday evening, and he will continue to cooperate fully in any investigation.

  I have the rare and special honor of being able to serve with my son in the Congress, and I have enormous respect for the work Patrick has done. The people of the 1st District of Rhode Island have a tireless champion for the issues they care about, and today I hope they join me in feeling pride and respect for a courageous man who has admitted to a problem and taken bold action to correct it.

  And from Nancy Pelosi:

  Congressman Patrick Kennedy’s statement today was one of honesty and courage. I hope it will serve as inspiration and encouragement to all the families in America who are facing the challenges of addiction and depression.

  No one in the country has been a better advocate than Patrick Kennedy for the parity of mental health services—to end the discrimination by insurance companies against people struggling with mental illness.

  I have told Patrick I am so proud of his brave statement today and for his leadership and service to his country every day. I pray for him and his family during this difficult time, and look forward to his return to Washington.

  —

  I ARRIVED at Mayo late Friday afternoon. This time, I wasn’t going to make the mistake of doing the “just visiting” version of rehab in fear of being found out. I checked into the Intensive Addiction Program in the Generose Building as an inpatient, making sure I had nowhere to hide. The single rooms were plain but comfortable, with a hospital bed, a private bathroom, and a nice big window overlooking a yard and woods.

  The very next day, I had my first visitor. It was Representative Jim Ramstad, who had driven an hour and a half from his home on the other side of Minneapolis to come see me. He showed up before my siblings, before my lawyer, before everyone.

  I walked down the hallway from the treatment wing and he was standing there. He had tears in his eyes just like I did, but he said they were tears of joy that I was where I needed to be getting treatment. We sat down in a private visitors’ area and just talked.

  Jim wanted me to know that I did not have to be alone in this, that he was my friend and, perhaps more important, my brother in recovery. He let me know that he was there for me, 24/7, no matter what. He said I had to take this one day at a time, but he believed in me. He said . . . well, he basically said almost everything that was on all those pillows on my mom’s couch that we used to snicker about when she joined AA. But hearing them now, from this guy I didn’t know well but who said he was committed to my recovery, was a powerful experience. I’m not sure I had ever heard a man closer to my dad’s age than mine speak so openly.

  We talked for about an hour and a half. And then he left me to my therapy and said he’d be back in a week. In fact, he said he’d be back every Saturday during my twenty-eight-day stay. And he was.

  —

  I WORKED REALLY HARD in individual sessions and the unbelievably confrontational “process group” run by Mayo’s legendary therapist John Holland. I heard from lots of family and friends. One of the most powerful outreaches I had was from my cousin Tim Shriver, with whom I had been getting closer over the past few years. Tim was eight years older than me and was married with five kids, so he had a much different life from mine. But since he had moved to DC in the midnineties to oversee the operations of Special Olympics—while keeping his hand in education and his social-emotional learning project—we came to realize we were operating in closely linked worlds. The science of developmental disability and the science of mental illness were starting to overlap more and more as they both became part of the growth of neuroscience and genetics. So the politics of our work was starting to overlap as well. And we were the members of the family most actively involved in the modern iteration of what his mother and our Uncle Jack had tried to accomplish with the 1963 Community Mental Health Act.

  Tim’s brother, my cousin Anthony Shriver, had co-founded an ambitious spin-off of Special Olympics, the Best Buddies program, which helped arrange one-on-one relationships and employment opportunities for people with developmental disabilities. My cousin Maria was also involved with those groups, but increasingly, as their father, my uncle Sargent Shriver, became more affected by Alzheimer’s, she was devoting more of her efforts to the growing need to support the caregivers who were on the front lines of this epidemic (along with her work on empowering women).

  But Tim and I were the ones working in the political trenches of developmental disability and brain disease every day. We lived in the same small town and often exchanged affectionate notes when we saw each other on TV or in the Post. So I was really touched by this note he sent to me at Mayo, in a card with the famous painting by Van Gogh of his solitary chair.

  Dear Patrick,

  Over the last few days I have thought often of you and what must have been the maelstrom of emotions and thoughts surrounding last week’s accident. While I cannot imagine how difficult it must have been, I can send you my thoughts and prayers for greater peace in the days ahead.

  Surely, despite all the pressure from all sides, somewhere in a place of quiet you will find the still small voice of goodness and love
that will remind you how nothing can take away all the goodness and wonder that is you. In the larger family, there are so many messages—to perform, to achieve, to be great, to be humble, to be funny, to be smart, to be more than any one person can be. Sometimes I think that each of us in our many different ways have struggled with the same realization that no matter what we do, we cannot achieve the greatness we are expected to attain. And then we’ve got two choices—frustration or acceptance.

  For me, the athletes of Special Olympics have been great teachers of how to face such moments—great role models of self-acceptance who I can aspire to emulate. You too are a role model of this great gift—not in your achievements though they are enormous—but in your humility and honesty—in your openness not only to admit struggle but to face it directly. If each of us could muster that courage, we’d have a new family story to tell and one which could again change the world, even if only for one person at a time. . . .

  All my love,

  Tim

  —

  DURING MY FIRST WEEK at Mayo, the lawyer we had hired for my criminal case flew out to see me to discuss a possible plea agreement on my charges of driving under the influence of a drug and reckless driving. He also wanted to talk to my doctors about writing a letter to explain the drug interaction I had experienced. Over the weekend, Jim Ramstad came back. I told him I had never had an AA sponsor; while I had attended some twelve-step meetings over the years, I had never done it long enough or consistently enough to develop that kind of relationship.

  I asked him if he would consider being my sponsor, and he graciously agreed, which gave me a rush of relief and hope that I still often think about. It was all new to me, but he had a lot of experience. Since committing to his own recovery in the early 1980s, he had been a sponsor to dozens of people in Minnesota and DC. While he didn’t tell me this at the time, some of my staff and political friends apparently had been reaching out to him even before my accident to see if he would consider talking to me.

  After agreeing to be my sponsor, he told me that besides daily twelve-step meetings he wanted to invite me to a special private weekly meeting he had been attending for years. It was at the home of Dr. Ronald Smith, who was director of psychiatry at the National Naval Medical Center and had helped in the creation of the Betty Ford Center, and included several people I already knew in the government but didn’t know were in recovery. It was a powerful and generous offer, and after he left he arranged for my physician at Mayo to reach out to Ron Smith, who not only encouraged me to join his group but offered to help support me through my legal issues as a medical expert.

  By agreeing to become my sponsor, Jim was taking a risk. Unlike others he had helped, I was going to have to be very public about my recovery—in a way that would run up against a lot of privacy and anonymity rules associated with traditional twelve-step programs. There was, actually, a growing group within the recovery movement, represented by the organization Faces & Voices of Recovery, which for a number of years had been trying to change that and allow those who did not want complete anonymity to feel comfortable being more open. But a lot of people in AA would find my acknowledging the identity of my sponsor—which was bound to happen—to be shocking.

  We decided, however, that the shock would be worth it—because it might help the cause of parity, which desperately needed a huge boost to get it to the next level of political reality. And the story of an older Republican sponsoring a young Democrat was one that just might bring all the work we had been doing to the next level. Two weeks into recovery may have been a little soon to make such an unconventional decision. But to really make an impact against something as intractable as medical discrimination and stigma, sometimes you have to risk being a little dramatic, no matter how symptomatic you might be.

  Chapter 19

  As I spent more time in the small Mayo process group, where I was called out on things in a way I had never before experienced in my life, I was confronted with all kinds of ideas that had never before occurred to me. Some were profound and healing. A couple less so.

  I was, of course, getting a lot of grief for being from a world of privilege and growing up in a family that had “gotten away with” things that other people with drug and alcohol and mood disorder issues did not. That was fair criticism, and honestly, nobody said anything about me that I hadn’t already said, much more cruelly, to myself in my darkest hours.

  But during my last weeks of treatment at Mayo, I got it into my head that there was actually a solution to this.

  I needed to go to prison.

  In my plea agreement negotiations, nobody on either side was suggesting I needed to be in prison. It was all my idea. I decided that I should spend a short time in jail. And since I didn’t want my prison sentence to cost the taxpayers of the District of Columbia one penny, I wanted part of my plea agreement to be that I would personally pay back any and all costs of incarcerating me. That way, nobody could ever accuse me of “getting away with” anything.

  My lawyer was, of course, dead set against this. He made it clear that not only wasn’t I getting any preferential treatment—any Congressman would have been (and had been) treated the same way in similar circumstances—he also thought, as a practical matter, what I was suggesting would completely backfire and not only hurt my plea agreement but further hurt my reputation.

  When I wouldn’t let this idea go, he wrote me a long, powerful e-mail that not only challenged my strategy but, as a counterpoint to some of the hard, deeply psychological opinions I’d been hearing in group, offered one of his own. He wrote, “I suspect that in your group sessions at the Mayo Clinic, people who themselves are facing issues regarding acceptance of responsibility have challenged you or suggested, based upon their own stereotypical thinking, that you are ‘getting off ’ in a manner that others would not. . . . I am convinced that [this] is playing directly into very deep-seated feelings you have regarding your relationships with, and the past conduct of, your mother and father. It is almost as if you subconsciously feel that by accepting responsibility for your parents’ past conduct you can expiate your own problems and transgressions, simply by acting [out] what you believe will be a very public act of contrition.”

  He was right, of course, but I wasn’t listening. On my BlackBerry, I messaged him back that I knew I was being an “obstinate SOB” but this was what I wanted. When he wouldn’t do it, I actually got the number for the DC Attorney General’s office and called him myself—a call that, thank goodness, went to voice mail. But the AG was informed I had called and reached out to my attorney. Ironically, they had pretty much finalized my deal earlier in the day, and when my lawyer heard I had called the AG myself from rehab, he threatened to resign. So did my chief of staff. Finally I calmed down and dropped that idea. Because of what I had done, however, I was offered a slightly less appealing plea deal, which we took.

  —

  THIS WAS ALL BEING DONE in a mad rush because my standard twenty-eight days of rehab were almost up. I could have paid to stay longer than what insurance generally covered, but politically I didn’t think I could afford a longer stay without resigning from office. In retrospect, I was nowhere near ready to actually leave treatment and return to the real world—especially my real world.

  Someday, I hope in the not-so-distant future, the amount of time people in my situation spend in intensive treatment will be decided not on the we’ll-pay-for-twenty-eight-days standard, but with evidence-based tools informed by ways of measuring severity and information about how long a typical patient needs intensive treatment to minimize the chance of relapse. There was, honestly, no way I was ready to be released that soon. But I made that decision myself.

  I also decided that rather than easing back into work, I would hit the ground running.

  For the past couple years, I had been organizing a big annual conference at Brown University—which was in my congressional district—call
ed Frontiers of Health Care. It was held in the early summer and attempted to bring together cutting-edge science and public policy in a high-profile way. It kicked off in 2004 with former Speaker of the House Newt Gingrich and I discussing one of our shared concerns: transforming healthcare using new information technology.

  It just so happened that, many months before my car crash, we had scheduled the third of these Frontiers of Health Care conferences, “Imagining the Future of Behavioral Health,” which was going to feature two of the nation’s most powerful scientists on this subject, Dr. Thomas Insel, director of the National Institute of Mental Health, and Dr. Nora Volkow, the director of the National Institute on Drug Abuse. They were going to discuss their own neuroscience research and the future of their fields—which were starting to overlap more than ever as new advances in neural imaging showed the similarities between how the processes of mental illness and addiction appeared in the brain.

  This was breakthrough research and they certainly could have held this event without me if I canceled, which everyone involved expected me to do. Instead I decided to double down. I would not only speak to the group of over three hundred coming to Brown but would make this my first public appearance since going to rehab, and then hold my first press conference afterward.

  So, I got out of rehab on the first Friday in June and went to the Cape to be with my family for the weekend.

  And then I appeared at Brown on Monday, June 5, 2006, where I was love-bombed by the mental health and addiction communities with a full-page ad in the Providence Journal, followed by incredibly kind personal statements of support during the conference from Tom Insel and Nora Volkow.

  After I finished my own talk at Brown’s Salomon Center, I walked across College Green to meet reporters at Faunce House. I announced that I planned to have “the most transparent recovery that anyone’s ever seen” and if my constituents expected me to come out and assure them there would be no more slipups or embarrassing incidents—well, that was a promise I was not able to make. Recovery was one day at a time.