Judson Brewer M.D. teaches stone nicotine addicts how to quit by teaching them how to meditate. He’s a psychiatrist at Yale School of Medicine who, by some apparent miracle, trained in mindfulness meditation while studying medicine at Wash U in St. Louis.
He’d been studying stress in mice but after meditation training evidently decided that it might be more useful to study stress in humans. So he switched his research focus to the connections between stress, mindfulness and “the addictive process,” as he calls it.
Brewer’s Yale lab has found that mindfulness (i.e., meditation, i.e., Step 11) is twice as effective as leading treatments (read: drugs) developed for smoking cessation. His studies show …
A quick post—I am hard at work and have only a few minutes, but I needed to write this for my beloved friend P, who is still in Holland.
P has been going back and forth to Holland for almost a year, tending to her mother, whose health in her mid-80s has been in decline. She bought a ticket three weeks ago when she was told her mother had suffered another setback. Her mother had asked the nursing-home staff to email her daughter a photograph of herself in her nursing-home bed for Mother’s Day:
P’s mom in Holland on Mother’s Day, 2013.
Een dikke kus van Ma!—A big fat kiss from Mom.
Gosh. It has been 14 years since I had a kiss from my mom, who died June 3, 1999.
It’s hard for P to be so far away from her mom. “She’s just worried about ME having a good day,” P said to me during our morning walk and her eyes spilled over. “She’s only thinking of me.”
That’s the kind of mom I want to be. I want to let my kid go and do his life, even if it’s in another country, on another continent, or in the same house. My first real exercise will come this summer. He’s 15 and can go wherever he wants in our city.
P and I have talked a great deal about how we can’t know when life’s great changes will happen, when the shit will finally come down. Useless to walk around holding an umbrella over my head. I have to live and practice enough flexibility, spontaneity and ingenuity to respond to life’s surprises. I meditate to discipline my mind, prying its rigid fingers off the stories it writes before the shit happens. Trying, always, to dictate the story arc (I usually have several running at once).
P booked the ticket. Then, once she got there, she worried: that something would happen.
That, this time, nothing would happen.
I was talking with some women in recovery this morning. We meet up early Thursdays and this morning I was talking about some changes in my life, telling them I’m responding with as much flexibility, spontaneity and ingenuity as I can but that I’m still procrastinating on some tasks, that it feels as though I’m letting myself down, Letting God Down, and that when all is said and done, I can’t control everything—Shit Happens.
“But shit is unknown,” one of my friends said. “We can’t know what shit’s going to happen. That’s what makes change so unnerving.”
To get out of my head, to stop compulsively controlling The Story, I’ve been walking P’s dog, Ginger, three or four times a week, along with my dog, Flo. I’ve been doing this since P started going away. I herd Flo into the back seat and drive to P’s house at around 8, by which time everyone else in P’s family is at school or work. Ginny jumps on me (I can hear P telling her to get down) and, even though I shouldn’t when she jumps like that, I give her treats and kisses because she smells like P’s perfume and because she loves me, because I miss P and I want to make her dog happy even if I can’t make her happy—even if I can’t see the smile on her face, even if I can’t feel her arm threaded through my elbow as we walk.
Walking Ginger and Flo takes me two hours. They’re big dogs (Flo is only 45 lbs. but she has a big-dog attitude), and I sometimes walk five or six miles to do it. In the summer P and I will spend three or four (sometimes five) mornings each week walking the dogs together.
P taught me that dogs actually smile. Especially Labradors.
Ginger and Flo.
Saturday I walked Flo, and P’s husband, whose name is also P, walked Ginger. The off-leash park is around the corner from their Loft/House and we walked up the hill in chilly, damp air. I’m training wiry Flo to obey and stocky Ginger to jump:
G with Flo, Ginger, and Tyson.
Sunday and Monday I didn’t sleep well. In the small hours Tuesday I woke and checked my phone: an email from P titled “Sad”:
My mom passed away this morning 7:10 Dutch time.
Two hours before I woke.
That morning I walked Ginger and Flo and on my way up the hill passed a sign hanging from an electrical box:
So I took a “motivator” for P. It was a handwritten poem, maybe put there as a project by neo-hip-hop-folk-rapper students at the school across the street. It’s about Unknown Shit About To Happen.
Running like the wind
Fast, faster, fast as can be
Running to wondrous things
To a life full of possibilities
No more lying around
Sitting and lazing on the ground
Nothing will come to me if I don’t go and get it
So I’ll run towards the things I want to get
And I don’t care anymore if I have to sweat
And as I run I see all new things
Different lands with all kinds of shapes and beings
I feel different airs
Smell different scents
And I can suddenly handle the idea of rent
For as I run I can see what can be
All sorts of fun is waiting for me
So I run and I run, until I can’t anymore
And then I decide to run some more
And although I’ve seen so much more now
I know that there’s so much more to make me go “wow”
And since you worry because I’ve never worked so hard
I’ll send you a letter saying “I’ve found my inner bard”
This bard tells me my journey’s just begun
And I know life’s about to get much more fun
And all because I decided to run
“When I come home,” P told me before she left, “I’m not leaving again for a long time.”
But who knows? We can’t know. She might fly off to Barcelona again, or to Siena, or run off to stay in the loft in New York City. I might drive to Boston or fly to Rome, book a train to Ancona and take a ferry to Zadar.
The fact is, when shit happens, my life usually gets a lot bigger. If I allow it. And I don’t think God cares whether I sail to Zadar, but I think God wants my life to be big.
I know there is no magic bullet or simple answer, but I thought you may have a suggestion for me. I’ve been taking perc or ox for five years, for the first 3 it was only 30-50mg/day but now it’s between 150 and 180.
Suboxone scares the shit out of me, but at the same time, every time I try to taper, I fail and I’m starting to go broke. I lost my health insurance.
I go to meetings 4 or 5 times a week, all helpful, but the physical part keeps me hooked.
I heard suboxone may be ok if used very briefly (like a month or less), as when taken for longer, the withdrawal is way worse than the oxy itself. I wish I could go to a 7-day detox or something, but I just don’t have the money and I don’t have insurance. I also freelance so I need to be able to work and I can’t lose more than a few days.
Anyway, I started trying to find low-income or sliding scale suboxone programs in NYC, but it’s slow going and I don’t want to just get hooked on something else. I have read long term effects of suboxone are bad too.
I guess my Qs are:
if I were to do suboxone briefly, a few weeks, would I just then have the same withdrawal as I would going cold-turkey from the oxy anyway?
is there something else in my area (or anywhere) where someone could go for opiate detox that costs nothing or very little?
I want to be clean so bad, but every time I try to taper I just fail.
Any thoughts/suggestions appreciated – I know you’re not a doctor or professional, you just seem to have a lot of info and I know how we like to help each other.
Thanks in advance.
There is no magic bullet, but in my experience there are simple answers.
The first was to know that I wanted to get clean. (Which you say you do.) First problem solved: I was telling myself the truth. The truth was, I was willing to do what it takes. And It Takes What It Takes.
The second was to ask for help. (Which you have. Keep doing it.) Nobody, but nobody, does this on his own. Even the people I know who don’t go to meetings have put together communities of other people trying to stay sober.
The third was to use my willingness and my growing community to decide on a path, and walk the walk.
For some people, Suboxone is the solution. They’ll tell you they don’t mind eating an opioid for the rest of their lives—it’s “like a diabetic taking insulin.”
In my opinion the diabetes analogy is worn out. I wanted my solution to be real freedom. When I reached out for help I met people who had shot heroin and who had gone bankrupt buying drugs over the Internet and who had drunk themselves into blackouts—people who drank and used to the excess I had, or worse—who were clean and sober. I wanted to break ties with all drugs that cause physical and psychological dependence. For me taking drugs is signing on for slavery. Just my reality.
I really wanted to go to rehab but I knew I couldn’t leave my kid for that long.
Here’s how I decided on a Suboxone taper.
I knew I couldn’t detox off full-agonists like oxy. Too alluring. (More truth-telling.) I needed to change all my habits. So I asked for help—I found a detox doctor who was willing to oversee a Suboxone taper for me.
I told him at the outset that I wanted to taper. When my resolve flagged, he reminded me that the project was to get free.
I put the taper in his control. I never had more than one week’s worth of drugs in my possession. He wrote out the taper, I wrote out the check, we shook hands. I waved the white flag and gave up.
I did what he and a bunch of other people—Dani, Allgood, Sluggo, Bonita, all online friends; and my new real-life sponsor and community—told me to do. I put my faith in the people who were sober and who told me I could be, too. I burned a script for more drugs. I went to meetings and opened my mouth and let myself cry on people. I kept collecting sober people around me.
Several weeks later I was drug-free for the first time in years.
And yeah, I ain’t a doctor, but I’ll offer this anecdotal caveat: if you’re taking 180mg Oxy, they’ll try to start you out at 8-12mg Suboxone (or maybe even more). But that would be increasing your tolerance. If you really want to get clean, you’ll start at 4mg and taper to 3mg within two days. You could do a 2-week taper, cutting to 1/4mg—the equivalent of 1 Percocet—at the end and have a relatively smooth landing.
I ain’t gonna kid you: staying clean was a slog. Tapering off suboxone was not nearly as bad as detoxing cold-turkey from fentanyl or oxy, but it wasn’t painless—I shivered, I kicked in my sleep, I sneezed 20 times in a row. Keep in mind, my tolerance was more than twice yours, and I’m probably a little smaller than you. I spent each day telling myself if I made it to bed without having stolen drugs (because yes: I used to steal drugs) or used anything, including alcohol, I was a success.
The best treatment for drug-cravings was vigorous exercise. It helps the body produce its private supply of morphine and dopamine. Dr. Steve Scanlan told me research shows people who exercise cut their recovery time in half. I made playlists that helped me drag my body around the neighborhood. Walk, run, cycle. Do pushups. Lift weights. Start small and grow bigger. I exercised, and my body and mind recovered.
A 180mg oxy habit is totally beatable. With a stick, my friend. Dude, if I can get clean, you can. I was on more than twice that and I’m free today. And I did not use insurance to get clean. But I paid what it took—the first of several critical investments I’ve made in myself over the past few years. Paying that doctor made me realize that, for a long time, maybe all my life, I’d withdrawn a great deal without putting very much back.
The most important information here: Get to a meeting. Tell them you want to get clean. Ask them to help you.
If you feel you need inpatient or other professional help, try Phoenix House, a large NYC-based treatment system with detox facilities in Long Island City. Or try the “free and affordable” resources listed on this website.
I had a piece all planned out and half-drafted about David Foster Wallace’s addiction and the reasons he could not escape his depression; also another piece about a new magazine about recovery called Renew, whose editor has asked me to be the book and media reviewer; and I still plan to write those pieces, but I’ve wandered into a bad neighborhood this week. You know you’ve wandered into a bad neighborhood when it’s 9 in the morning and you’ve just dropped the kids off for camp and you’ve cranked up Lyle Lovett singing Townes Van Zandt, and you’re crying in the car.
Townes Van Zandt
Driving home and leaking a few scalding tears of self-pity, I was thinking how sick I am of being in early sobriety: that I’d like very much, thank you, to be one of those people you see at meetings who has 30 or 40 years (will I ever have 30 or 40 years?—I cleaned up pretty late, I might be dead before then) and who can stay sober seemingly without trying. One of those people who says they no longer need to go to meetings—that they just come to “give the message to the newcomer” (me). You ever run into those people?
Me, I have to try real hard sometimes. And then I try too hard. I can’t get the balance right. I can go a long time doing tricks on the bar, then I fall off, and it hurts.
I’ve been restless, irritable and discontent. My behavior yesterday pointed this out to me. Went to the library to pick up some books that were being held for me, and the hold on one of them had been cancelled because I was a day too late. One day. The book was sitting right there in front of her. I said, “Can’t I still take it out?” I take books out of the library to save money. If I were rich as Croesus, I would be buying all these books and supporting their authors, but I can’t afford to do that (poor me), so I support the public library instead. And the librarian checked the screen and said, “No, there’s another hold on this book.”
I said: “Isn’t there another copy in the system?”
She checked the screen and said: “No—this is the ONLY COPY in the entire system.” The entire frigging system, I thought, has only one copy of this title, and I can’t have it because I was 12 hours too late.If I’d been in the right frame of mind (i.e., sober) I would have thanked the librarian for her help, but as it was, I snatched the two books she allowed me to take and slammed the door on my way out.
On the curb, I thought, What the hell are you doing, slamming doors? You don’t behave like this anymore.
But yes, it turns out, I do behave like this. When I resent my own failings, I blame other people for it and slam doors.
Went home, opened my computer and saw that my battery had drained to 20 percent. Checked the cable and found the transformer had burned out on me. Looked for the spare and couldn’t find it anywhere. Called my husband, who is overseas, taking care of his family—but yesterday, he was by himself in the countryside, staying at a pub, having a sweet little holiday in the mild Yorkshire sunshine. And there I was, I thought, in this infernal heat, dealing with his inability to leave the spare charger where I could see it.
And in the back of my mind was the thought that, the last time I had a little tiny holiday by myself—exactly 72 hours away from home—I caught hell about it for a week. Resentment.
“I gave the spare to my sister,” he said. So he’d secretly taken it with him, and there was no spare in the house, and my computer was ready to die.
I let him hear about it, for 30 seconds, then told him to “have fun” in the country and hung up on him. Total bitch.
I mean yeah, it would have been nice if he’d told me he was giving away our spare charger. But would it have changed things in the least?—no. The reality is, I have money enough to buy a charger. Thank goodness.
Gratitude, man. It’s a choice.
Yesterday’s meeting wound up being about gratitude. Trudged through the 96-degree heat to the meeting and nobody had a topic, and my friend Benedick who was chairing said he wanted to talk about Step 4 and character defects—whether they actually get “removed,” whether we can truly change and become better people, or whether the defects stick around and we remain big bad addicts and have to struggle against them forever. He opened it up and a woman said, “What I really wanted to talk about is gratitude,” and this little moan went around the room—the way it quite often does, I notice, outside of Thanksgiving-Time Gratitude Meetings. Even at Thanksgiving you sometimes hear people mumble, “I fucking HATE gratitude meetings.” I’ve said it myself.
I hate gratitude meetings. Because they have a way of pointing out my weaknesses.
I want life to be easy. When it’s easy I think I’m safe.
Gratitude is the antidote to all this… even active drunks and addicts can understand this. Townes wrote:
You will miss sunrise if you close your eyes That would break my heart in two
He wrote this while he was killing himself drinking. Beautiful things can come out of suffering and devastation.
At the meeting yesterday I confessed that during these 96-degree days I sometimes wish I could have a cold beer. Drugs, I said, were for serious medication of suffering and pain; beer was for kicking back and having fun, cooling off, and having a laugh like everybody else. I remember the taste: a bit sweet at the front and bitter at the back, with the bubbles prickling my tongue and making my mouth water. And then the hit, first in my belly, which is also where the drugs always hit, but in a different way. I liked pale ale, or bitter. Fuller’s is (was) nice. … There is beer in the house, and a distributor up the block, a specialty pub two blocks away, and I am the only adult here, no one would know, but I haven’t had a drink.
My friend Benedick, a 30-year-alcoholic who just passed a year, talked at the meeting yesterday about how he’d been outside the day before from noon to 11 at night, and he’d gone through three shirts and after he knocked off work at 11, his colleagues all said, “Let’s go get a beer!”
“This sounded like the best idea that anyone had ever proposed in the history of civilization,” he said. “It didn’t sound like temptation. It sounded like a reasonable and intelligent response to a long day in the heat. I would pound the beer and I would go to Heaven, and Jesus would be there to meet me at the bar.”
If that ain’t temptation, I thought. “I will turn these desert stones into bread… all you have to do is Ask.”
“Except after the beer, I would have a shot, and then another few shots and a beer, and then a shot and a beer and a shot,” he said, and then he would be wasted and wake up with a hangover.
He told his friends this. He said it helped him to be honest. Thinking it through, surrendering to the reality of his alcoholism, helped him to stay sober that night.
So I tell you, my friends, today: I am in a bad neighborhood. I’m not obsessed with drinking or using but I am obsessed with worry—getting everything done, perfectly; proving I’m a Good Girl so I can be Safe Forever. Called Benedick last night and told him that I believe what my friend Sluggo has told me a lot of times: that addiction and character defects just cover up the divine beauty that is inside us; that it’s not up to us to Fix Ourselves but to allow that beauty to be revealed. God doesn’t come in, God comes out. Steps 6 and 7.
So, rest easy. I used to sing this song to my son to lull him to sleep.
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Leo DiCaprio as the obsession-driven Howard Hughes.
So here’s an interesting story about the work of Jeffrey Schwartz, M.D., a psychiatrist who studies neuroplasticity and mindfulness, and who specializes in treating obsessive-compulsive disorder (OCD) with cognitive-behavioral techniques. Schwartz was apparently a consultant to Leonardo DiCaprio when Leo was studying to play Howard Hughes in Martin Scorsese’s 2004 film, The Aviator. Hughes was notoriously debilitated by severe OCD, which eventually rendered him a recluse in later life. And to play the part, DiCaprio made the choice to “let his own mild OCD get worse,” Schwartz has said.
By playing Hughes and giving into his own compulsions, Leo induced a more severe form of OCD in himself. There is strong experimental evidence this kind of switch can happen to actors who concentrate so hard on playing OCD sufferers.
It apparently took DiCaprio three or four months to recover from his self-induced OCD.
When actors play a role, Schwartz has said, they can alter the functioning of their brain-chemistry—it’s been documented in the lab. Schwartz has taken that idea and turned it on its head: if people can successfully choose to induce illness in themselves, then people should also be able to induce healing.
Which is really good news for addicts. Because we adopted a bunch of behaviors and choices that led us into our illness; and it would seem Schwartz is saying we can get back out the same way we came—by making a bunch of different choices.
Schwartz’s new book, written with his colleague, Rebecca Gladding, M.D., isYou Are Not Your Brain: The 4-Step Solution for Changing Bad Habits. It’s a kind of sequel to Brain Lock, his popular manual for controlling OCD. In You Are Not Your Brain he aims to show how people with any kind of debilitating compulsion or habit can change their neurochemistry by changing their actions and thoughts—thoughts being a kind of action, according to the practices of mindfulness which Schwartz espouses.
I LOVE the idea of neuroplasticity—which is essentially says the body’s neurology is not set in stone. When I was a kid, I was taught that we were born with a certain number of brain cells, and that if they somehow got damaged or broken, we’d be shit-out-of-luck—those cells would never grow back, and those electrical connections would be forever severed. Scientists like Schwartz are proving that, in fact, the human neurological system is smarter and more resilient than we thought it was, and that it can not only carve out new pathways but that we exert a certain amount of control over our own neurology through the “force of will” or, as I prefer to understand it, through “mind.”
Schwartz makes the critical distinction that “mind” and “brain” are not one and the same:
The brain receives inputs and generates the passive side of experience, whereas the mind is active, focusing attention, and making decisions. … In other words, the brain does not incorporate your true self or Wise Advocate into its processes, but merely reacts to its environment in habitual, automatic ways.
Schwartz introduces the idea of the “Wise Advocate” (another way of thinking of higher power) very early in the book. He talks about “sculpting” the brain you want to have by using your will, but it becomes clear that in practice he advocates tapping into the wisdom of a power greater (wiser, smarter, more dependable, less selfish, however you want to say it) than self-will. So following his program becomes a process more of self-discovery than self-creation. I guess the latter would be more selfish and self-serving, unless healing and service are the primary motivations.
How can this book help people with addiction?
I’m a relative newcomer to sobriety, but I’ve experienced recovery as a process of finding out who I really am after a lifetime (or half a lifetime) of spending much of my time and energy pretending to be someone in order to make other people happy, which never worked anyway. Schwartz writes,
Deceptive brain messages get stronger the more you ignore, deny, and neglect your true self.
This is just another way of saying that the more I persist in insane behavior (which does not always have to include drinking, using drugs, gambling, overeating, or starving ourselves—it can include, for example, compulsively taking responsibility for other people’s feelings, otherwise known as “people-pleasing”), the more I lose any chance of finding out who I really am—and the more disconnected from my higher power I become. The more I foster spiritual weakness. The sicker I remain.
Schwartz and Gladding say recovery is all about taking “contrary action,” including changing our thoughts about ourselves. It’s not rocket-science, and it seems to me that, having been in and out of therapy since my mid-20s, I’ve heard his four steps before (Relabel, Reframe, Refocus, and Revalue). Which is just to say that his book offers commonsensical and reliable stuff. It’s also to say that it harmonizes with the ways I’ve seen countless people recover from addictions just as debilitating as Howard Hughes’s OCD, perhaps more so. We take action—“contrary action,” as they say in the rooms. Action that counters what we’d feeeel like doing, but that we believe (based upon the experience of trusted others) will benefit us.
"Already an award-winning blog, Guinevere Gets Sober is as good as it gets. As a professional with two degrees and a track record of success, Guinevere’s viewpoint reflects the reality that not all addicts fit the stereotypes. She has the guts to take a public stand for addiction advocacy and rehab success. She fights to reduce the stigma that prevents people from seeking treatment, and with a blog like this, she is surely succeeding."
When in 2008 I decided to recover from addiction, I started writing under the pseudonym "Guinevere." An ancient name meaning "white" or "fair," Guinevere is Welsh for my given name, Jennifer. And Queen Guinevere—though lovely, powerful, and rich—still lied and cheated to satisfy her desires.
A writer by habit and profession, I started this blog to examine issues of addiction in the culture. I'm especially interested in reducing social stigma that prevents people from getting timely help, and in supporting the many people who write to me looking for help in reducing their chemical load in life.
I love books, film, and art, and I review all of these here, along with the ongoing appearance of addiction and recovery in the news ... and of course I tell great stories.
Please share your comments here, or email me at guinevere (at) guineveregetssober.com.