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Free from Addiction
Facing Yourself and Embracing Recovery
By Morteza Khaleghi, Constance Loizos Palgrave Macmillan
Copyright © 2008 Morteza Khaleghi, Ph.D.
All rights reserved.
ISBN: 978-0-230-61542-7
CHAPTER 1
Introduction
Debunking the Addiction Myth
In my 25 years of experience in treating patients with chemical dependence on drugs and alcohol, I have come to two crystal-clear conclusions about addiction and its complexities. First is that every single addict can be helped, no matter how far gone they seem to be, no matter how seemingly determined they are to hurt or even to kill themselves. Second is that addiction does not happen in a vacuum, and it does not happen simply because someone has a genetic propensity to become an addict.
The spectrum of emotional issues to which I'm referring is as rich as any rainbow you might see. Some are biochemical, some are not. Some can be vanquished with a little attention; some require intensive psychotherapy and even medication. Think depression, bipolar disorder, anxiety. Think bulimia, anorexia. Think posttraumatic stress disorder (PTSD). Think child abuse. Think neglect. Think traumas, both big and small. Think of every addict you've ever known—in your family, or in your circle of friends, or in your office—ask yourself whether you believe those individuals have suffered from the "disease" of alcoholism or drug addiction alone.
I know that addiction and emotional issues go hand in hand because I see it in living color every day of my life. I know it to be true because I have treated hundreds of people whom traditional addiction treatment has failed, often repeatedly. I know it to be true because so many of my patients—dearly loved people whose families were on the painful brink of total despair—do the most surprising thing when treated for both their addictions and their underlying emotional issues: they turn their lives around. I have seen mothers who once locked themselves in their bedrooms for days and drunk themselves into a stupor return to their children. I have seen fathers, once too doped up to make school plays and birthday parties, make their way back home, and I have seen children in the throes of painful adolescence wrest themselves from the alternate universe of drug use and fill out college applications. I have seen people hell-bent on destroying themselves learn the gift of sobriety and health, and I have watched them get well.
I want to share why there is every reason to hope for better days and why I have a personal stake in what I am about to tell you.
THE EVOLUTION OF "DR. K"
Growing up, I didn't imagine that I'd become an expert in addiction. Looking back, though, I realize I've been on this path since I was a child in Tehran, Iran, five decades ago.
Mine wasn't an exceptional childhood. I was the youngest of eight children—which is notable today—but I was happy and close to my siblings and parents, thanks in part to a culture that greatly valued the family unit and its togetherness. It really allowed me to experience not only my own growing up but that of my immediate family.
I was a child who was in tune with those around him and aware of relationships between family and friends. Part of what I absorbed was how much my parents loved me, and I very much wanted to please them in turn: my mother because I adored her, and my father because I admired him. He was a self-educated entrepreneur who left school at a young age to make his own way in the world, and through hard work he provided every comfort for his family.
To make them proud, I worked very hard in school. Along the way, my dedication paid off; I always received high marks. As I grew older, I began to understand what my parents had long instilled in all of their children: that good grades could broaden one's options.
It was something my oldest brother, who is 25 years my senior, took to heart. He became an orthopedic surgeon in Iran, where he continues to practice today.
Two of my other brothers, Mustafa and Ahmad, were also ambitious, so they also studied hard, and after they graduated from high school, both went to the United States to pursue undergraduate and then advanced degrees. As the baby of the family, I absolutely worshipped the ground my brothers walked on, and as a young man who was forming ideas about how he would spend the rest of his life, I began to resolve that I, too, would go to college in the United States. I didn't know what I would find, but I knew that with my brothers close by, I could handle anything.
Then, before I left, something happened that changed the world for me: My mother died after a very short, painful battle with stomach cancer. I was 17 years old at the time the cancer was discovered, and I learned of it just two months before she died. My siblings didn't say anything sooner because they wanted to protect me as long as possible from her dreadful prognosis.
I was shocked to find out about her illness, and, left with little time to process this news, I was devastated when she succumbed to the cancer shortly thereafter. Her death left a gaping hole in my life. Being her youngest child my mother was particularly nurturing of me, and I reciprocated with my affections. She was my best friend, my biggest supporter, and her love of her children gave all of us a level of safety and comfort that I would later realize as a special gift that not nearly enough people enjoy.
I was intensely sad after her death. When I left for the States the next year, I knew that my life would be forever changed and that, with my mother no longer alive, it was unlikely that I would return to Iran. I was too young to know then that the sense of loss and abandonment that I experienced around her death would give me a greater understanding and compassion for those who have suffered their own profound losses.
When I arrived in this country, I joined my two older brothers in California. As is the case for many immigrants, the transition to a new country and culture wasn't easy. In fact, my brother Ahmad, who had begun struggling with seemingly inexplicable periods of depression, grew suicidal at one point and returned to Iran, feeling that it was not possible for him to live happily so far from family and the familiar surroundings of home.
For Gossem, the idea of returning home was very comforting. And I could certainly understand that. I, too, had periods of intense loneliness and self-doubt. I wondered if I was making the right decision, leaving everything I knew and nearly everyone I loved. But I felt too proud to return. And California was compelling: The weather was beautiful, the people were beautiful. And more important, the freedoms and liberties and opportunities that people seemed to enjoy all around me were beautiful. So I resolved to stay. After enrolling in English-as-a-second-language classes and getting a tentative handle on English—the mastery of which continues to be a pursuit of mine—I started classes at Glendale Community College in Southern California.
At first I didn't know what to study. But by my second term, I was completely turned on to psychology, in part thanks to a very encouraging professor. He made me realize that I'd always been fascinated by the field, an interest that really blossomed after I lost my mother—I had been drawn to people who demonstrated emotional difficulties.
What I was too confused at the time to recognize was that this attraction was a way for me unwittingly to work out my own issues, including a fear of abandonment. In fact, I was so blind to the help I needed that it was only when I was in graduate school, when my curriculum called for 50 hours of psychoanalysis over the course of one year, that I finally began to tackle some of my own ghosts.
The work was a revelation—so much so that I wound up seeing a psychoanalyst three times a week for the next 18 years. I was 28 at the time, and I wish I'd begun treatment earlier. I consider those 18 years the best investment in myself that I've ever made.
DISCOVERING A PATH
When I was a young man in Tehran I had no idea what addiction entailed. Many traditional cultures that base their value systems on honor and shame still don't acknowledge addiction. We knew people who drank and smoked hashish and opium but we weren't sensitive to the extent of their use nor how it governed their lives. In fact, I hadn't given the concept of addiction more than a passing thought, and then it was only when I heard of a friend in trouble or saw someone in the streets of Tehran or on the boardwalks of Los Angeles—someone who was obviously under the influence of something that made him bleary-eyed and mean-tempered and seemingly miserable in his own skin. Addiction? As far as I knew, no one in my family was addicted to anything. My father and my mother never drank. In fact, none of my siblings drank either, as it was culturally and religiously forbidden. It was not until my brothers and I went to the United States that we tasted alcohol for the first time.
I was completely mistaken to think we were immune, though. And I would learn just how wrong I was through my brother Mustafa.
I completed graduate school—where, incidentally, I met my wonderful wife, Karen, who is also a psychoanalyst—in the early 1980s and I decided to open my own practice with another doctor whom I knew and respected. There we treated hundreds of patients, all of whom had psychiatric issues, and a smaller percentage of whom also had problems with addiction. That smaller percentage of addicts concerned us, but in our determination to solve our patients' emotional problems, we didn't focus on their addictions. The reason? Like most other psychologists at the time, we didn't view addiction and emotional issues as two sides to the same coin. Our job was to treat our patients' emotional wounds. What pills they took or what drinks they snuck outside our offices—well, we hardly approved, but we reasoned that we could only do so much. We rationalized that for their addictions, groups like Alcoholics Anonymous could do much more than we were equipped to do.
We weren't alone in this thinking. It was how the world operated at the time. And it's how much of the world continues to operate, with addiction in one camp and emotional issues in another. Mental health professionals believe that drug and alcohol use can hamper the course of therapy, so it's customary for them to refuse to see patients unless they first stop using drugs and alcohol entirely. Even when doctors do treat addicts, many wrongly believe that if they tackle the issues underlying addiction, the habit will clear up all by itself, so they ignore it.
Exacerbating this divide is how our educational institutions work: Mental health professionals seldom have the necessary training to treat both issues. Most doctoral degrees in clinical psychology require only one course in treating addiction. Although many professionals have expertise in identifying, diagnosing, and treating psychiatric disorders, most lack detailed knowledge about the specific drugs that people abuse, the evolution of abuse and addiction, and how to handle addiction treatment, relapse, and recovery. Similarly, most addiction specialists have little training in psychology; they are much more focused on how to retrain the body away from addictive substances.
It pains me to think of the patients I might have helped back then, but I learned of my mistake soon enough, when Mustafa began to suffer from addiction and severe emotional problems— simultaneously. I'd like to say that a light went on in my mind as soon as this happened, that I suddenly realized that the two might be inextricably linked. Unfortunately, I didn't immediately understand that his becoming an alcoholic when he did was no coincidence. By the time I came to discover that addiction and emotional issues are as closely intertwined as the threads in a piece of fabric, it was too late. And the outcome was devastating.
My brother's journey into darkness began sometime in his early 30s, nearly a decade after he graduated from UCLA with a master's degree in engineering. Twelve years my senior, he had always been very popular. He seemed to have it all. Not only was he was very smart—growing up, I turned to him for tutoring on more occasions that I can remember—but he was also handsome and flamboyant, the star of our family. He was cherished by everyone even more than my eldest brother, the surgeon. I still marvel at how easily Mustafa could command love and attention from everyone, including me.
Things started to go wrong when Mustafa became captivated with acting shortly after receiving his master's degree. Once he became committed to any idea, he worked tirelessly toward realizing it. In this case, it meant giving up on engineering, moving to New York from California, and studying acting at the Lee Strasberg Theatre and Film Institute.
Mustafa may not have anticipated the intensity of his studies or the emotional toll it would take on him. Though he didn't discuss it much with anyone, it was clear that while studying acting, Mustafa occasionally sank into periods of depression, then flew into periods of mania. Maybe he wasn't as good as wanted to be. Maybe acting made him more vulnerable. I really don't know. But to deal with his emotional life, my brother, whom to my knowledge had never consumed much alcohol or used drugs, suddenly took up drinking heavily.
He was 33 at the time. At first, he drank only socially. Then, fairly quickly, he began drinking so much that his binges hampered his ability to perform. And that's if he even made it out of his apartment, which became one of the only places where he knew that he could drink himself into a stupor without calling attention to himself. For someone who had always been very self-possessed—or at least, that was the impression he gave, even to his family— his fall from grace was humiliating.
To hear Mustafa tell it, he was supposed to be Strasberg's next protégé. He was supposed to be the next Al Pacino. Still, he continued to sabotage himself, and on one very important occasion, when he was about to perform a role before Strasberg and some other luminaries in the theater community, something terrible happened: Mustafa froze. He forgot his lines. It was as if he were all alone. He just stared into the quiet darkness, sweating under the stage lights. When someone snapped him out of his paralysis by clearing his throat, Mustafa turned and left the stage.
Many people suffer public embarrassments, but this was unbearable for my brother. He knew immediately how disappointed Strasberg would be, and he felt completely devastated. He was so mortified, so disgraced. I think he concluded right then that he would never make it as an actor. He didn't tell me what had happened until weeks after the incident took place, and even then, he couldn't laugh about it or find the silver lining. It still filled him with shame.
Mustafa's state of mind worsened after he became involved with a married woman whose husband lived overseas. She was very young and newly immigrated, and the two lived happily—if wrongly—on her husband's resources for several years. When her husband eventually dissolved the marriage, the new couple was left penniless, and soon afterward, they, too, drifted apart.
Mustafa grew more and more isolated and continued to drink heavily. My family, like most, was unsure of what to do. My father essentially commissioned me to watch him—which proved difficult because I was in California while Mustafa was in New York—and he supported Mustafa financially in the hope that he would regain his footing. But Mustafa's severe depression, along with his sense of failure for not accomplishing what he'd set out to do—succeed in acting—consumed him.
And "consume" is not overstating things. On the contrary, at the age of just 35, my beautiful brother tried to kill himself by cutting his own throat. It was a dramatic cry for help—can you imagine anything more dramatic?—yet we still didn't appreciate the straits he was in; we couldn't figure out how to right the ship, so to speak.
I consulted with my dad, brothers, and a doctor who saw my brother. It was decided that a "tough love" approach would work best. For my part, I let Mustafa know that I loved him but he needed to get his life in order, and he shouldn't expect coddling from me or the rest of our family.
At the time, this tough love philosophy dominated addiction treatment. In fact, it still does, promising reform through confrontation, often in an isolated environment where an addict cannot escape the need to change his or her behavior.
Mustafa was too old to be sent to a military-style boot camp— which is what many tough love proponents advocate is necessary—but if we'd been able to ship him off, we might have done so, because it was commonly held then that ultimatums and constructive coercion were more helpful to addicts than lovingly delivered confrontations. And though I inherently questioned the very notion of making my suffering brother go through more suffering, I accepted that common wisdom, assuming that it was supported by data.
(Continues...)
Excerpted from Free from Addiction by Morteza Khaleghi, Constance Loizos. Copyright © 2008 Morteza Khaleghi, Ph.D.. Excerpted by permission of Palgrave Macmillan.
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