Guinevere Gets Sober

Recovery news, reviews and stories, by Jennifer Matesa.

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I Am Not “Clean.” You Are Not “Dirty.”

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On the screen—some of the ways we can use language to reconceive of what we’re doing in fighting addiction. With Michael Genovese, MD, JD, addictions psychiatrist, integrative healer, and CMO of Sierra Tucson.

I’ve been saying for years that language matters. I’ll line up some of these posts for you:

  • here, a post about my spiritual soul-brah Dr. David Servan-Schreiber, who wrote books teaching people how to look for the innate healing power (HP) inside themselves
  • here, about Christopher Hitchens’s death—”Poor Hitch,” who used language to deceive himself and others about his addiction-driven illnesses that killed him
  • here, after a NYC AlAnon meeting—the first time I wrote about sober sex (very cool ending!!)
  • here, about my discovery that most people in recovery do not have language to express the unspeakable sexual transgressions many of us endured in childhood. This also denies them access to language for the joy they experience, or imagine, in adulthood

There are many more. Go search “language” on Guinevere Gets Sober.

MA-Language-Cognition

I’ve been writing about language’s bearing on addiction and recovery for five years. Now, thank goodness,  people (especially the youngsters, like Holly and Laura) are finally paying attention to language and its implications for recovery success. I went to amazing meetings in NYC last week in which a clinician said, “We don’t call urine testing ‘dirty’ or ‘clean,” we call it ‘positive’ or ‘negative’ for presence of opioids.” Sigh. About time.

I have never called myself “clean.”

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Michael Botticelli, the new director for the federal Office of National Drug Control Policy, has said he is not an “addict” or “alcoholic” but “a person in long-term recovery.”

Yet!!!

I can hear old-timers say, “Yet.” The “yets” are the things that haven’t yet happened. “He shouldn’t be up there saying he’s in recovery because what if he relapses?” Michael Botticelli could drive his beemer or whatever to suburban Virginia and ask a bartender to line up some shots, or he could cop some heroin, where east of DC it’s said to be 65 percent pure (if it’s not spiked with fentanyl). He could crash his car.

But the fact is that by articulating that he is “a person in long-term recovery,” or when I say in a meeting, he is living in the present moment, and he gives hope for other people.

In meetings I now say, “I am sober and awake today,” and that declares what I am—what I want to be, what I’m working toward. Hell, it gives myself hope.

“I’m Joe and I’m a miserable lying cheating powerless alcoholic”

That ritual was born of early rehab culture, I was told, when residents (mostly men) were told they had to submit to “ego-deflation” (or “ego-puncturing” as it’s sometimes called in The Literature).

This term—”ego-puncturing”—came up in a women’s meeting yesterday. We were passing around the 12-and-12 and reading Chapter 7 together. Chapter 7 is awesome in that it promises—PROMISES, a big word in traditional recovery—that we will be able to use not only the strengths we’ve started to gain but also all our stumbles and past fuck-ups (with which we identify much more strongly) to actually help people.

The fuck-ups, in particular, are our key to recovery. I mentioned in that meeting (or Saturday’s, I can’t remember) that I had been arrested and stuck in jail with a pocket full of fentanyl that the cops never found. This story is always helpful for newcomers because they look at me, all put-together with mascara and shit, and talking calmly about jail, and it proves we may have some things in common.

What seem like sexual fuck-ups in particular can help other people, and ourselves, if only we can find the language for them.

Example:

One 40-something guy named Tom told me he’d started having sex with a woman whose grass he cut when he was 16. It sounds like something out of a Stephen King novel, right? And it was basically statutory rape. Because 30-something women are not supposed to fool around with 16-year-old boys. He was sixteen, right?

When I would have sex with someone all I cared about was making sure they had pleasure, because I wasn’t sure I could get pleasure from it, because I was too scared.

BOOM: into language, the feeling most 16-year-olds (and 40-year-olds, and 50-year-olds) are afraid to say.

Then he started rolling his mower over to her house. Drinking some lemonade in the kitchen led to her taking him to her bedroom.

She showed me how to please a woman. She showed me ways to manipulate her body, mostly with my hands, and taught me about breathing exercises to take your partner through so you could mutually breathe together. At certain points she would take my hand and place it on her solar plexus and she would reach out and touch mine when she was close to orgasm. She taught me certain areas within the vagina, about the nervous system—I mean, she was very extensive in her education. It was weird, but it was also kind of cool, because she was showing me things with which I literally had instantaneous results in my later life.

Educating Tom.

I laughed at this story. Tom looked at me askance. I said, “It’s not a prurient laugh at all.” He recognizes this because clearly he understands that an irony stands as one of the pillars of our recovery: within the strange, fucked-up illegal shit that happens to us and that we cause to happen to others are the nuggets of gold that we later mine and hammer into gifts for ourselves and for others.

If we can put language to it. It’s little good to us or to others without language. But language and labels are not the same. We need to ditch the labels.

 

with thanks to DM for the video.

Sex in Recovery: Advance Praise

Sex In Recovery revised 2c

The people who know their stuff are liking my new book.

Sex In Recovery is a work long overdue. In a frank, personal and highly personable way Jennifer Matesa opens a topic usually only whispered about: the essential role of sexual healing in sobriety. Many readers will be grateful to her.”—Gabor Maté M.D., author, In The Realm of Hungry Ghosts: Close Encounters With Addiction

“In this beautifully written work, Jennifer Matesa accomplishes a herculean task. For decades, clinicians have struggled to assist patients to integrate healthy sex lives into robust recovery programs. At the same time, traditional 12 Step programs have promulgated rules that shamed and denied their members’ sexuality. Sex in Recovery resolves this disconnect. Through compelling narrative descriptions, it gives its readers a map to navigate, resolve and embrace their sexuality in its most rewarding expression.”Dr. Paul Hokemeyer, Senior clinical fellow at Caron Treatment Centers

Release date: Oct. 4. Preorder here.

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Step Carefully Or You Could Be Eaten.

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I know a woman who is writing a book about various practices of “self-care.” From time to time, she posts requests on Facebook asking for people to reveal their practices. It makes for some interesting reading. Today she asked people to write about what they “do for spiritual self-care.” “How do you transcend the self, surpass the ego and face existential realities that we are all going to die?” she asked.

Wow.

“Meditation? Hiking? Going to church? Twirling like a Dervish? Analyzing dreams? AA meetings?”

People were writing about angels, crystals, goddesses; meditation and prayer; reading the Bible and listening to music; walking in the woods; watching birds, watching the moon.

They also talked about how they don’t do their chosen disciplines enough. “I need to find myself again,” one person wrote.

I thought about what I do. I don’t hike but I walk the dog. I don’t go to church. I don’t twirl like a dervish or analyze my dreams.

But I go to meetings.

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“Meetings won’t keep you clean and sober,” I was told when I started going to meetings, by an awesome spiritual seeker of a sponsor who a few weeks later started using drugs again.

I learned a lot from that woman. I think she’s right: meetings don’t keep me off drugs, and when people say “just don’t pick up, and go to meetings,” I cringe because I don’t buy it. If I could “just not pick up,” I wouldn’t even be sitting in that folding chair trying not to eat the cookies/doughnuts/other high-fructose garbage-food on the table next to the shitty Maxwell House coffee.

I go to meetings because it lets me spend time with people I love. And it forces me to spend some time taking the steps.

The steps are suggestions, all of them, so none are compulsory. But practiced with discipline, their result is not guaranteed happiness but spiritual enlargement.

Every day, I try to turn my will and my life over to the care of forces greater than I am. Most people focus on the word “greater,” but for me the operative word is “care.” I totally get that there are lots of forces greater than I am (time, light, gravity, Google, etc.). But having grown up with addiction and depression in the house, it has been an ongoing effort throughout my life to remember that there are great forces in the world that can and will CARE for me—without expecting anything in return—if I diligently practice surrender of my will.

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Harambe

My will is wild. Some news stories of late have reminded me how wild the will is: the kid who wiggled into the Cincinnati gorilla enclosure; the Nebraska toddler who was eaten by a Florida alligator on Disney property; the Oregon guy who went to Yellowstone, decided he’d step past the barrier and walk across the fragile mineral crust, and fell into the hot springs. The water in those springs is so acidic that nothing was found of his body.

Os desaparecidos.

I think perhaps books like Cheryl Strayed’s “Wild” and films like “Into the Wild” have “popularized” the idea of wilderness and made some people think that the wild is entertainment. Safe wildness. But there end up being holes in the zoo fences, gators in the peaceful tropical lagoons. (Disney’s will was to earn money, and not to spoil the fantasy with warning signs.)

And toddlers (and even adults) just seem to want to go wherever they want to.

The wild is certainly beautiful and strong and glorious, but it is also unpredictable and deadly if we do not abide by some rules and apply discipline.

The will is wild. My will can very well drag me underwater if I do not let go of it and follow some rules for safety.

  • Trust “The God Thing,” as my friend Em likes to call it.
  • Clean the dog hair out of my house.
  • Help other people.
  • Be grateful. Write those down.

Also eating good food and drinking clean water. Because I don’t Stop Drinking, I just don’t drink the stuff that hurts me.

It’s hard to practice every day, because I Just Don’t Feel Like It, you know what I’m saying?

And as every spiritual practitioner of every discipline has ever recorded in their meditations, there can be long spiritually dry spells. AND THAT’S NORMAL. But because our self-help culture has sold us the idea that we should always be happy, we think it’s abnormal to practice, and then be unhappy, and then to keep practicing.

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A Different Prince.

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Prince, pupils pinned v.01. (When you’re addicted to opioids, you can hide a lot, but you can’t hide your pinned pupils.)

When they said Prince had been saved by a shot of naloxone on the plane home from a show, I knew he’d been using something stronger than Percocet, and I was right.

I didn’t say this out loud, or write it here, because some people who loved Prince were screaming on social media that anyone “standing by to call him ‘addict'” were “haters.”

I don’t want to be a hater. I just want to tell the truth. I knew he was on something stronger than Percocet. He must have been, for a long time. Otherwise, the Tylenol in Percocet would have shut his liver down long ago.

“The decedent self-administered fentanyl,” the medical examiner wrote.

By all rights, I should have gone the way of Prince. For three and a half years I was prescribed fentanyl for migraine and fibromyalgia, and, as he did, I took too much (aka, “overdosed”). Many times.

Fentanyl is the strongest painkiller known. It comes in lollipops and in patches that you’re supposed to stick on your skin, but people who abuse the drug often suck on the adhesives. I did.

Mixed with heroin, fentanyl has killed dozens in the Northeast and Midwest United States.

Fentanyl is not as commonly prescribed for chronic pain as Vicodin, Percocet or OxyContin, for the simple reason that it’s much more lethal. Fentanyl is about 80 times stronger than morphine or heroin. From the variety of estimates given in the press and in professional literature, it’s clear that scientists have not even determined the precise bioequivalencies.

It’s just fucking STRONG.

Fentanyl’s particular pharmacologic qualities allow it to zip into the brain like a high-speed train, flooding receptors and stopping autonomic functions, including breathing.

Prince was apparently saved at least once by a shot of naloxone, or Narcan, a drug that kicks any painkiller off the receptors and reboots respiration. To help save lives in the opioid addiction epidemic, Narcan must be made more widely available.

But when dealing with fentanyl, the federal Drug Abuse Warning Network notes that EMS staff generally don’t have enough time to use Narcan “because this highly potent opioid can quickly cause death.”

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Prince, pupils pinned v.02.

I know how Prince would have felt when he was overdosing. He would have felt as if someone were stacking a pallet of bricks on his chest. Brick by brick, he would have exhaled, maybe closing his eyes, and it would have been a long time before his body wanted to inhale again. He might have wondered whether his body would remember to breathe.

He died alone on the floor of an elevator. Just sit and hold that image for a minute.

If he were in excruciating or intractable pain, which by many accounts he was, respiratory depression might, sadly, have come as a relief. For 30 years Prince performed acrobatic stunts in high-heeled boots, and the hip surgery he had about 10 years ago reportedly did not resolve his pain.

As a serious performer, Prince wanted above all to show up as the sequined spectacular of Paisley Park, The Purple One, The Artist. American society is competitive, and it values only what we’ve done lately, and those of us who grow up inside it—as children, being bullied by its bullies—learn to identify ourselves primarily with what we can DO. If we can’t perform, if we cannot work construction, sit for hours in front of a computer, carry our children—or sing the songs we ourselves have written and do splits with a hardwood guitar strung across our chest—without debilitating pain, we may begin to feel there’s little reason to live.

Often, our solution is to find a way to control or numb our feelings about the pain so we can do whatever the hell we want.

No: it’s up to scientists and physicians to find ways to control pain. We ought to surrender that job to them. When we play around with doctors’ tools, we risk our very lives.

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My detox from fentanyl in 2008 was a hard, year-long slog, and it taught me my job is to find ways to treat my body so I don’t hurt it in the first place. We all need to live inside our mortal bodies and learn to accept their earthly limitations.

Drugs—the doctors’ and pharma corporations’ solutions to problems—give us the ability to power through pain, but at what cost?

To be sure, no one really knows what crossed Prince’s mind when he put the extra patch on his skin, plastered it inside his cheek, or sucked the extra fentanyl lollipop.

Ostensibly being a devout Jehovah’s Witness, he may have wished he could quit the drugs. His staff apparently called in an addictions specialist shortly before he died—a California doctor who was sending his son to Minneapolis to conduct an addiction intervention—so it sounds as if Prince, and/or the people who surrounded him, might have known he had a serious drug problem.

Not many people have ever taken fentanyl. Having unfortunately been there, I can say it’s beyond hard to quit. Anyone using fentanyl to feed their addiction—or even to numb chronic pain—is in dire straits and will be slowly backed against a wall. Whether quitting the drug and getting sober or continuing to take the drug to control pain—either decision requires a transformation of one’s life, an acceptance of real limitations, physical and psychological. 

Prince might have been saved by Suboxone—the partial-agonist opioid drug used in detox and medication-assisted treatment, which the California doctor’s son was reportedly bringing to Prince the day he died. In fact, Suboxone helped me detox—but I’m glad I didn’t wind up taking it indefinitely.

Ironically, Suboxone or Subutex may also have controlled Prince’s pain. But never again would he have been able to leap off risers and cavort in high heels.

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Prince

Prince, pupils pinned, v.03.

I remember dancing with my hazel-eyed college boyfriend to “Little Red Corvette.” (Ahhh.) That song is like a scent that forever hangs in the hallways of my brain, preserving my personal history. Little Red Corvette.

Those memories get filed away, and we move on. Right?

In order to live, Prince would have had to file those memories of landing in splits and accept his body’s demand that he transform his idea of himself—that he find a different way to be Prince. And we still would have loved him.

The Prince is dead. Long live the Prince..

The Prince is dead. Long live the Prince..

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Prince.

Prince

I’ve been waiting to comment about Prince, because the tox screens aren’t yet in.

It’s not like it was with Philip Seymour Hoffman, who was found dead with the rig still in his arm and drugs all over the house.

But today the New York Times is running a front-page feature about Prince’s apparent addiction to painkillers. Associates have been saying since the day he died that he’d had hip surgery because of his acrobatic performances onstage, in high heels.

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Prince was a short guy—five-feet-two. He was slim and lithe, and he spent decades bounding onstage with guitars strapped around his torso. Guitars are basically pieces of solid hardwood. They’re heavy, man.

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And the high heels—they look awesome, but they hurt the whole body, not just the feet.

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In the years I’ve been running this blog, I’ve heard from so many people who became addicted to painkillers because they felt the need to push themselves past the limits of their bodies. Speaking for myself, I sought treatment for two painful neurological conditions in the early 2000s, when OxyContin was being jammed onto the medical market. I was assured by high-level pain experts that there was little risk of my becoming addicted because I had “legitimate pain,” but within a couple of years I was being prescribed massive doses of fentanyl, and I was abusing it.

Not many people make it off fentanyl alive.

I’m able to manage my pain without dependency producing drugs, because I have learned to work within my limitations. It has been a frustrating and humbling experience. My constant pain reminds me every day that I have to take care of myself in ways that are different from what I learned as a kid, and also ways that are different from what the culture would have me do—which is take drugs.

When the CDC last month issued new guidelines for opioid prescribing, Center for Disease Control Director Thomas Frieden M.D. noted in the New England Journal of Medicine, “Initiation of treatment with opioids is a momentous decision and should be undertaken only with full understanding by both the physician and the patient of the substantial risks involved.”

Drugs are not inherently evil, but they carry particular dangers. We live in a culture in which these very powerful chemicals are prescribed by doctors, many of whom do not understand their powers. And that ignorance is then passed to patients, who then learn not to respect the powers of the chemicals.

In Prince’s case we still do not know the autopsy findings, but reports from associates serve to remind the public of the importance of considering one’s penchant for using substances to drive oneself past one’s own limits. The artist formerly and belovedly known as Prince was a true original—as a friend of mine put it, “his own freak.” He was also a human being and a businessman, and he wanted to keep doing what he was doing despite the limits of age and physical injury. Unfortunately the human animal is not built to jump off stage risers in high heels for more than three decades without sustaining chronic injury. However artistically independent Prince was, a little humility is called for to accept the limitations of the human body and mind.

I’ve always found it pretty ironic that when Pink Floyd was writing their song “Comfortably Numb,” the working title was “The Doctor.”

Come on, now
I hear you’re feeling down
Well, I can ease your pain
And get you on your feet again …

Can you stand up?
I do believe it’s working good
That’ll keep you going through the show
Come on, it’s time to go

Prince-1

 

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