As Tim found out, having a medical degree offers no protection against addiction, nor from the hard work that is required to change oneself as a key part of the recovery journey. (7,135 words)
‘I began to see that a key part of my own recovery was supporting others in the recovery process, of helping them to move on as I had been helped myself. This practice in recovery communities (recognised by mutual aid groups through the phrase ‘you only keep what you have by giving it away’) means that recovery is self-generating and constantly spreading.’ Tim
Having a medical degree is no protection against addiction. The annals of medical history are littered with the evidence of this simple fact. Nevertheless, for a long time I fancied that a bit of knowledge gleaned at medical school would act as a shield. I got this wrong at two levels, really. Until I suffered from it, I actually knew next to nothing about alcoholism and the little I thought I did know tended to enable my drinking rather than slow it down.
Geneticists reckon that about half the vulnerability to addiction is built into us. There’s certainly some anecdotal evidence of this in our family. I found myself to be a third generation problem drinker. My grandfather blazed the trail and my dad and I followed. We were all high functioning alcoholics, which is a very effective way to avoid being labelled an addict. It is also an effective barrier to seeking help. If you can hold down a job, then you can’t really be an alcoholic—right?
1. Early days
Growing up in an alcoholic home is a challenge for every child. The focus tends to be on the alcoholism, the behaviour of the alcoholic. All sorts of things that should be noticed get neglected. It’s like sleight of hand in a magic trick. Things like love and attention are palmed into hiding. There is a tension around that percolates into every nook and cranny, into every pore. There’s the uncertainty of what’s going to happen next. Inconsistencies abound. All of this creates heightened alertness and odd, reactive ways of behaving. Even small children can pick this up.
Anxiety became a very familiar companion and I remember vividly my first panic attack at age 11. I didn’t know what it was then, but I thought I would die. I had no practical way of expressing what was going on inside. I felt ashamed for having let everyone down and tried harder to be strong.
Of course, tension must out, and panic attacks were only one of signs that things were not going well. Somatisation describes the situation where psychological stress that’s not attended to creates physical symptoms. My teenage years were peppered with such complaints. Looking back, I think much of this was due to craving affection and support. These were scarce qualities at times in our home. I always had the sense that something was missing, that I needed something more. I also felt out of my depth a lot of the time. It always seemed to me that other people were familiar with the rules of life. Such rules seemed to be missing from my reference section.
Nevertheless, it didn’t seem initially that alcohol was going to meet the needs I had. My first drink at fourteen was a few mouthfuls of wine, with permission, at the family table. I didn’t like the feeling it gave me—slowed up and dulled. I went for a lie down afterwards and had no desire to repeat the experience.
I had a fleeting encounter with the world of recovery at this stage. I was a member of a youth club, which met in one of the halls of our local church. On the same evening we met, there was an Alcoholics Anonymous (AA) meeting going on. When they paused for a break, twenty or thirty men would burst out from the room chatting and laughing. I remember thinking, ‘They don’t look like alcoholics to me.’ My difficulty in ‘spotting’ the alcoholic was to hold me back later too.
I found school a haven from the unpredictability of home life. The order and rules meant safety and knowing where you were. Unlike many of my contemporaries, I looked forward to going into school every day. Unsurprisingly, I flourished where there was attention and reward for doing well. I took on responsibility wherever it was offered. I was a milk monitor, a librarian, a prefect. I had an affinity for science and studied hard, getting enough qualifications to enter medical school.
2. Medical times
I think in many ways I was unprepared emotionally for the demands of an intensive five years at university. The terms were long and expectations high. Competitiveness was endemic and unlike at school where I shone, here I was a small fish in a big pond. I was torn up with self-doubt and anxiety, but was an expert at hiding it.
When things got overwhelming, I would take to the gym and work out obsessively or get lost in books. It never struck me once that it might be a good idea to look for help or support. I didn’t think to reveal how lost I felt a lot of the time, as that would have been shameful. I found life to be hard work and quite frightening. However, in my early twenties, I didn’t see alcohol as any help for the fear or tension.
I think the first time I misused alcohol was in my first house job. This is the period immediately after qualifying when doctors start in hospital on the lowest rung in the ladder. There was an exhilarating sense of achievement at having qualified and in possessing the ability to help people in a very real way, but there were challenges too. Back in those days, we worked long and onerous shifts. In one job, I had to work a split shift where I came off duty late in the afternoon and had to go back on at midnight.
Most of the time I was not at all sure of what I was doing—I don’t think many of us were—and I used to worry about what I might have to face with new patient admissions when I came back on shift. I found that a couple of glasses of wine would help me get some sleep. I began to use alcohol primarily for a particular effect in the same way I might prescribe sleeping tablets or tranquillisers to a patient. Although I didn’t formulate it in this fashion at the time in my head, nevertheless a line was crossed. It was okay to use alcohol to change me in some way.
When I worked in A&E, I noticed that some colleagues held prejudicial attitudes to people with alcohol and drug problems. The associated accidents, overdoses and self-harm were often seen as a waste of time for some busy healthcare professionals and their patients would receive poor care. Distressed relatives would be further upset by the approach of some colleagues to their kin. I remember my registrar shouting at an intoxicated patient who’d collapsed that he was too busy to deal with this kind of shit. His family watched on in horror. Nobody (including me) challenged him on his behaviour.
I struggled with the large number of deaths with which I had to deal. I worked for a time in cancer care and had to give toxic chemotherapy regimes to people. This was essentially doctor-facilitated poisoning in an attempt not so much to cure, but to prolong life. In due course, many patients would die, but younger people’s deaths really got to me. It seemed to my (albeit inexperienced) eye that some consultants didn’t know when to stop treatment, essentially prolonging the process of dying. My overblown sense of responsibility and the need to try to make everything all right made me poorly equipped to work in that environment. I felt a sense of failure, as if it were somehow all my fault.
When my house jobs were complete, I trained in General Practice. I realised that I wasn’t cut out for shift work, nor the hierarchical hospital structure, and I enjoyed the variety of presentations that GPs get to see. The three year training was stimulating and although I was beginning to drink more than before, I don’t think that the amount I drank was much different from most people.
In retrospect, what was different was why I would drink. I drank for confidence, for relaxation, for reward, to drown sorrows and to celebrate. So do others, but I think alcohol did something a little bit more for me than it did for most people, though admittedly I had to work quite hard over a period of time to develop a problem—not everyone does.
3. Drinking
One way to deal with the friends-drink-too-slowly problem is to seek out new friends who drink the same as you. This was not a conscious decision, but it happened effectively anyway. More and more of my activities would be centred around alcohol. Boozy dinner parties, nights out, nights in: alcohol had to be around. My other activities became quite restricted or were adapted to involve alcohol. I joined a gym with a bar attached and my workouts became shorter and shorter. Eventually, I would arrange to go with friends to the gym; they would go and do a workout and I would go straight to the bar. I didn’t see anything too unusual in that.
The adverse consequences of my drinking tended on the surface to be limited to hangovers, but my life was changing in subtle ways. Hobbies and interests were taking second place. My zing was beginning to be eroded, although I couldn’t see it.
The first major consequence of my drinking took place about ten years before I stopped drinking. I was at a dinner party with friends. The booze was flowing. My partner and I got into an argument and had a public falling out. Enraged, I stormed out. I had intended to get a taxi home, but had taken the car to get there. I jumped into it. One or two friends tried to get me to stop, but I drove off.
On the way home, I took a corner too fast and crashed the car. The police attended, I was over the limit and lost my license. I was humiliated and deeply ashamed, but there was also a practical fall-out. The ban had a big impact on my job as a GP. I had to have a driver for a year.
This did make me sit up and think, but my thinking was along the lines of, ‘I need to leave the car behind so that doesn’t happen again.’ I don’t think there was any real exploration of whether the key problem here was not the decision to take the car, but due to the lack of judgement and loss of sense of proportion that alcohol had created. In any case, although it hurt, I rationalised the whole thing away. It turns out I had a penchant for that.
In a busy inner-city GP practice the demand is high, but so are the rewards. I developed strong relationships with patients and enjoyed much of the job. I had significant difficulties though with knowing where to stop. The bloated sense of responsibility issue continued to plague me. I found it hard to say ‘no’ and ended up with too many roles. As I began to drink more and more, I found it hard to make the work fit into the day. I began to take work home in the evenings and at weekends. My work/life boundaries began to blur.
I felt so tense when I got home after a long hard day in the surgery that it made sense to reward myself with a drink. That first drink of the evening became very important to me. I began to think of it earlier and earlier in the day and on getting home I would find myself dashing eagerly through the front door to the kitchen with my coat still on and medical bag in my hand. I would pour myself a whisky into a tall wide glass. The anticipation was electric.
As my tolerance increased, so did the volume of alcohol I needed to get the same effect. I needed to buy whisky on my way home most nights and would develop a network of local shops to rotate around—in case anyone thought I might have a problem. What’s odd about this is that I didn’t admit to myself that I might have had a problem. I was ashamed and a bit of me was working hard to keep that shame under wraps.
4. Consequences
Other consequences began to show themselves. The weekend had a tendency to gatecrash the beginning of the week and I found myself too ill to get to work. Observers would note that I was very unlucky with flu on a Monday. My car had a tendency to break down. Relatives got sick. Domestic disasters were ten a penny. My skills with rationalisation extended to telling lies to cover my tracks. In fact, many of my own values began to slip. I was not naturally dishonest, but lying began to come easily.
I remember years into recovery listening to Michael Parkinson interviewing Robin Williams, the late American comedian and actor, who happens to be in recovery. He described a relapse to cocaine addiction and the behaviours that followed by saying, ‘I was violating my standards faster than I could lower them.’ I strongly identify with this now, but when it happens gradually, it’s harder to see.
My descent into the chaos of addiction was like a soap bubble moving towards the bath plughole. A gradual and gentle course speeds up once the vortex is reached, but even here it rotates relatively lazily in wide arc, gradually accelerating in a tighter spiral until at breakneck speed it disappears down the abyss. What was quite odd was that although things were clearly terribly wrong in my life, and any observer would need to be blindfolded not to see that, nobody challenged me at work. Denial works in all sorts of directions.
Like most alcoholics, I wore a robust chain mail of denial about me, but at times it thinned to make me vulnerable to insight. One of these times was related to care of a patient. To keep my denial in check, I had to develop the skill of compartmentalising various aspects of life. It was important that the patients with addiction problems that I looked after were in a very different box from my own drinking. Quite how I managed to keep the two things separate seems a bit of a mystery now, but I would comfortably give patients advice on safe drinking while my own intake was close to 40 units per day.
5. Moments of insight
One day, a woman I did not know came to see me in the surgery. She wanted to talk about her brother who was a patient with the practice. I didn’t know him, but she told me he was an alcoholic. He’d turned into a recluse and was living in squalor. She was worried for his life. I offered to go and see him, but he was too ashamed for me to go to the house. She would try to get him cleaned up and bring him in the following week.
I made a long appointment slot and sure enough, they attended the following week. He was not well and my heart went out to him. We sorted out a plan for treatment and for his getting the help he needed. I think I did a good job and I was rather pleased with how I’d handled things. Although he and I were drinking the same amount of whisky daily, I chose not to connect the issues in my mind.
That evening, after work, I stopped off at one of my gaggle of obscure and anonymous corner shops to buy my whisky. As I was waiting in the queue with the bottle sitting enticingly in the wire basket and my anticipation growing, I became aware of a figure standing behind me in the queue. Some instinct made me want to sneak a glance. It turned out that it was the sister of the chap I’d seen earlier.
Now there was no way she could know that the bottle in the basket would be drunk that evening, but I knew, and shame of my knowing was crippling. That shame felt as if it would core me out, then suffocate the shell that was left. This was deep, incisive, pervasive pain. My answer to that pain? Assuage it with drink and put the experience that drew these two worlds together into the black hole situated deep in my unconscious.
Not long after, I went off work. I had a fight with my partners—again, I got things totally out of proportion—and I stormed out of a meeting. I went to my doctor and got a medical certificate and some antidepressants. Clearly I was depressed, and that’s what was making me drink. Work was stressing me out. I would take some time off to get myself sorted out and it would all be okay.
What actually happened was that I started drinking in the morning, partly because there was no reason not to now that work was out of the picture and partly because my dependence was so high that I was withdrawing badly in the mornings. I was bewildered by this development, but bewilderment settles quickly with whisky. The depression did not respond so well. The mornings got blacker and blacker and life seemed utterly bleak and pointless. Emotionally, it felt as if I was trapped in a permanent state of winter, with no hope of spring.
They say that addiction is a family illness and that indeed is my experience. My long-term relationship suffered terribly. There was co-dependency and shared depression. My wider family became more and more estranged. Friends faded into the distance. If anyone came too close they might see, they might discover what was really happening. That would be a catastrophe.
One night, I woke from sleep choking. I couldn’t breathe and I really thought I would die. A few hours later, I spiked a fever and began to shake uncontrollably. The doctor was called. I had vomited in my alcohol-induced sleep and inhaled some of the vomit. An x-ray confirmed infection in one of my lungs. It felt like if anything would stop me drinking then this was it. It wasn’t.
The epiphany which did eventually provoke some help-seeking was relatively simple. I came down to the kitchen one morning feeling wretched and defeated. I opened the cupboard and reached up. With one hand I brought down the cornflakes and with the other the whisky bottle. I flexed my elbows to bring the two closer to me and weighing them up in my hands I thought, ‘There’s something not right about this… there’s something very wrong with this picture.’ The bit of me that wanted to drink finally began to yield to the bit that didn’t. Shortly after, I went so see my GP.
6. First go
A couple of weeks later I attended the Alcohol Problems Clinic at the local psychiatric hospital. I filled in diaries with the details of my drinking (how much, when, where and why?), completed some worksheets aimed at behavioural change, and ended up getting an outpatient detox at the local hospital.
The consultant psychiatrist was kind. He put time aside for me, but his approach was pharmacological. After detox, treatment involved commencing disulfiram (Antabuse), which gives an unpleasant and potentially dangerous reaction if you drink on it, and acamprosate, which is supposed to reduce craving. Add in some anti-depressants and a ton of vitamins and I was rattling in more ways than one. I had to travel to the hospital ever day to have my medication dispensed.
Mutual aid, in the form of AA, was mentioned, but only really to dismiss it. I’m still not entirely sure why, but I suspect that the psychiatrist saw me as a professional man and did not associate AA with helping professionals. The other support group, the British Doctors and Dentist’s Group, was not mentioned at all, despite there being a large meeting very close to the hospital.
Those post-detox days were black days. I was riven with anxiety and dread and the desperate desire, no it felt like a need, to drink. If alcohol had occupied my life pretty fully in the few years before this treatment, there was not much difference now. I thought about a drink every minute, dozens of times an hour and hundreds of times a day. There was no sleep and no peace. My solution to living—drinking—had been removed and I had no replacement save some pills.
Over time, the anxiety and low mood showed some signs of settling, but the bleakness and thinness of life did not. It felt like a reverse process to the Wizard of Oz; life had suddenly gone from Technicolor to black and white. Or at least that’s how it seemed. I felt empty inside, as if someone had taken out the living heart of me with a kitchen utensil and then discarded it thoughtlessly.
7. Relapse
Eventually, I got back to work, although I decided to give up my job in my practice. I reckoned that if I did locums then I could still enjoy general practice without the stress of management and responsibility that partners in practice have.
I was still plagued with cravings. It was at this point I made a discovery. I found that codeine or dihyrocodeine from my medical bag were great solutions for craving. It was as if a switch were turned off. When I tested this a few times, I actually believed I’d made a new scientific discovery. And what’s more, opiates seemed to lend me the qualities of patience and peace too. Now, opiates can be addictive, but I rationalised that as a doctor I wouldn’t run into any such problems. I was too wise now for that, so I just needed to practise better living through a little bit of chemistry.
It seemed to work for a while. While it seems ludicrous looking back, I made no connection between my burgeoning dependence on opiates and my alcoholism. I thought, ‘It’s not alcohol.’ In the same way that my alcoholism progressed, so did my opiate addiction. My tolerance increased and I had to be smarter at how to get hold of prescription drugs. I began to cross lines again, rewriting my moral code when it needed a revision.
Where there was anguish it had to be dealt with. Uncomfortable feelings could be medicated away with pills. This phase of my addiction was the bleakest of my life. It felt like a finger was on the ‘fast forward’ button of my own personal disaster movie. As my addiction grew, my morals withered and I really did not like myself much.
People in recovery often talk about the experience of ‘hitting bottom’. Although there was a precipitant to my nadir, by far the most alarming aspect of this black chasm was the effect on my mood, spirit and personality. It was as if the last flicker of life was being strangled out of hope and spirit. I did not see how any sort of meaningful life could ever be regained. My relationship was in tatters and neither my partner nor I could see a way out. I did not actively plan suicide, but not being here was looking more and more attractive.
8. Getting the right help
During this whole episode, it never struck me that it might be a good idea to get some help. The shame that characterised my alcoholism continued to cripple me. Nevertheless, the possibility that I might be forced to ask for help was not too distant in my mind. I had seen an advert in the British Medical Journal for the Sick Doctors Trust, an organisation offering support to addicted doctors, and one morning when I got a telephone call from a recent employer to say that my addiction was uncovered and that ‘steps were being taken’, I knew where to turn.
I phoned the Sick Doctors Trust helpline and spoke with another doctor in recovery. Although I had attended the local NHS addiction clinic (and was still attending), I never really felt connected to it in an emotional sense. With the Sick Doctors Trust there was an instant emotional connection. The doctor volunteering on the helpline seemed to understand what was wrong with me and much more than that, he knew what I needed to do about it. He knew because he had been in a similar place to me and he knew how I could get out of it. He was in recovery.
He talked about going in to treatment. I said I already was in treatment. He laughed. He was talking about residential treatment. Two days later, I was admitted to residential rehab unit where I stayed for four months.
Although I’d had one or two patients who’d gone to rehab before, I really didn’t know much about it. I thought it might be like the version seen in the movies, but when I arrived nobody took my bags to my room, a room that I had to share with five other men. If there was a pool to lounge beside, I never found it. Food reminded me of school dinners and there was almost no privacy.
In fact, it turned out not to be the rest I thought I deserved, but bloody hard work.
The treatment centre ran a therapeutic community, a set up where there is a sense of community, a hierarchy and an atmosphere in which peers are expected to challenge each other on behaviours not compatible with getting well from addiction. At the core of treatment is group psychotherapy, daily meetings of a dozen of so patients who brought their issues to their peers for feedback, challenge and support.
This is not an environment where an isolated, middle-class doctor might find himself instantly comfortable. It wasn’t comfortable and I spent the first few days writing a list of all the things wrong with the place. Therapists call this externalisation: a device to avoid looking at what’s going on internally.
There were difficulties. I had to give up being a doctor and become a patient: something that was very challenging to me. The idea that I knew better had to be jettisoned. Achieving a degree of humility was painful. My peers in treatment told me to get off my pedestal and join the rest of the human race. In one particularly challenging group, I was confronted by almost every peer and encouraged to look at my attitude. They reckoned I saw myself as different and above the rest of the human race. I was affronted to hear this. Me, stuck up? But the truth is, I needed to hear that and I needed to change.
Today, I still have my list of the faults I detected in the treatment centre all those years ago. I keep it to remind myself of my lack of insight at that time and of my arrogance.
One thing that helped me though was the fact that many of the staff in the treatment centre were in recovery. Sure, they were qualified in various disciplines, but they had lived experience of addiction and how to get better from it. I could see they were people who lived what they believed and they certainly knew more than me about the process of recovery.
I learned more about addiction and recovery than I thought it possible to know… and more besides. The most valuable stuff I learned from my peers and other recovering people. Mutual aid meetings were an important component of the treatment programme. I remember sitting in my first meeting of Narcotics Anonymous (NA), with perhaps twenty other people in recovery from addiction—I’d never seen this number of recovering addicts in my life!—and wondering, ‘Why is this a secret? Why did I not know about this before?’
I found the group therapy and the peer-to-peer support hugely more valuable than the medication I’d previously been taking. Understanding what I do now about recovery, it seems naive to have thought that medication can ever be anything more than an adjunct to a more comprehensive approach.
I started to feel different, but struggled at times to identify emotions. Some of the time I was angry, but other people had to tell me that’s what was going on. At other times, there was sadness. To me it was, ‘I don’t feel right’. Often, my emotional state was clearer to my peers than it was to me. About five or six weeks after being admitted to residential treatment, I remember lying on my bed wondering what the hell it was I was experiencing. It felt amazing, but new. I was frightened it would leave me. After a while, I was able to put a name to this feeling. It was peace.
I discovered I had trouble being honest with myself, preferring to see things in a certain way. Group therapy is very helpful at giving you a new pair of spectacles through which to see the world, and very quickly I gained insight into the repetitive and self-destructive patterns of thinking and acting that had tripped me up so many times in the past.
One of the first lessons I learned was that I was responsible for my own feelings. Although now that sounds very self-evident, for much of my life I had believed that what was happening around me would determine the way I felt; as if I was passive and had no choice in how to respond to circumstances. There was a scared little kid in me who was still dictating the way I would deal with difficult life circumstances and difficult people.
Discovering that how I responded was actually down to me, and not to the circumstances I found myself in, was an eye-opener and very empowering. Treatment helped me to move away from being a perpetual victim to life’s challenges, and develop a bit more self-assurance and confidence.
I was also able to start the process of letting go. Throughout my life, I had been anxious when I did not feel in control. I realised through treatment that it was not possible to always make things turn out according to my plans, that in fact it was okay for things to turn out the way that they were going to turn out without any help from me. When I practised the art of doing my best and letting go of the responsibility for the outcome, I felt a sense of relief.
As time went by, I began to recognise in others coming into treatment the very traits that had been holding me back and I was able to start to share my experience of identifying and changing these traits. I began to see that a key part of my own recovery was supporting others in the recovery process, of helping them to move on as I had been helped myself. This practice in recovery communities (recognised by mutual aid groups through the phrase ‘you only keep what you have by giving it away’) means that recovery is self-generating and constantly spreading.
Framing recovery as a concept—a journey and a state of mind—was helpful to me.
I began to realise that getting better was going to require two things—time and hard work. One thing that proved hugely helpful was getting connected to other recovering doctors. The British Doctors and Dentists Group (BDDG) is a mutual aid organisation for medical and dental professionals with addictions. I was taken to a local meeting from the treatment centre and have continued to be active as a member ever since.
I remember the relief of hearing my own story, or something very close, at a meeting and realising that I wasn’t necessarily a bad person, just a sick person. I realised that even someone like me could recover. The power of peer support and positive role modelling is astonishing.
My two experiences of treatment could not be further apart. The first, medicalised version was good as far as it went, but I needed much more. I needed the instillation of hope and that cannot happen through prescriptions. It happened when I started to meet with other recovering people. Even today, addiction treatment professionals generally don’t get this. There are a lot of odd beliefs held about mutual aid. Few view connecting their clients to peers in recovery as important. I know that I hadn’t done previously, yet when addiction happened to me, finding mutual aid groups was something that completely changed my life.
9. Living recovery
When I came home from treatment, there had been a quantum shift in my approach to life. I had hope and although I was in a lot of trouble with no job, and a journey to go through with the General Medical Council, I had a conviction deep inside that everything was going to be okay.
I had an aftercare plan that included elements that would keep me safe. Primary amongst these was keeping connected to other recovering people. I did this by going to AA, NA and Cocaine Anonymous (CA) meetings locally. I also kept up BDDG meetings.
I put as much effort into my recovery as I had put into my addiction and it began to pay off. Self-esteem rose and my spirit, which I had thought extinguished, sparked into flame again. That first year was incredibly challenging and so many difficult things happened, but I had hope and enthusiasm and passion once more and crucially, I had an enormous amount of support.
Shame and guilt can be crippling in early recovery. In active addiction, they dissolved (albeit temporarily) in a cocktail of drink and drugs. In recovery, they needed to be addressed. The 12-Step programme encourages us to make amends to those we have harmed, where this won’t make matters worse. I had plenty of amends to make in different ways, to my partner, to my friends and colleagues and to my employer. My experience of doing this over time has proved to be a healing experience. As amends have been made, shame and guilt have melted away.
I eventually got back to work in General Practice through the kindness of colleagues. The GMC saw me as a sick doctor, rather than as a bad doctor. I decided quite early on that my own experience, and what I’d learned through it, might be of use to others. I was also uncomfortable that my patients who had addictions did not have the same opportunities in treatment that I had. Certainly for opiate addicts it was my experience that all of them, or almost all of them, got treatment based on medication and not much else.
This was good as far as it went. I’d seen many lives improved on methadone, but given the experiences I’d had, surely there ought to be more choices. The fact that a middle-class doctor could relatively easily access high intensity treatment of adequate duration and quality, but his patients could not, was something that could not be ignored. There was an anomaly that had to be addressed and I admit to some fired-up, evangelical zeal around this.
These days, I work in addictions and have a much better understanding of the impact of addiction in individuals and families. I know what works effectively to help people into recovery both professionally and at a personal level. I’ve done a lot of study on addictions, but the key lessons about recovery I learned from other recovering people, not from books, studies or professionals.
It’s important to me to try to put something back into the system by helping others, the way that I was helped. I maintain my recovery through regular AA meetings, stay connected to others in recovery, including my AA sponsor, and I continue to attend the BDDG group locally.
These days, I don’t have a struggle about whether I will drink or use or not, but like all human beings I do sometimes struggle emotionally. My recovery programme keeps me grounded and connected and helps my spirit burn more brightly. Besides, I get much more from being an AA member than just not drinking. I have meaning and a depth to life that I missed before.
One of the great things for me in recent years has been the discovery that you can regularly turn negative experiences into useful learning or opportunities. I always saw difficult times as just that, difficult times. Adopting a new way of thinking is not about going all Pollyanna, more about a different attitude.
Addiction recovery is a prime example of positives growing out of difficulty. For those of us who get the opportunity to be introduced to recovery communities and experience the birth of hope, the rising of a bright warm sun after a bleak black night, recovery is not just an experience that changes, it is an experience that transforms.
This transformation, in individuals, in recovery communities and in neighbourhoods, is being seen in towns and cities the length and breadth of the UK. Because of the infectious nature of recovery, it will continue to grow and to spread and as it does, more and more of us will find a way out of the dark winter that is addiction into the healing sunshine of recovery.
June 2020 (Seven Years On)
As I reflect on what’s changed and what’s been learned in this recovery journey, I’ve had to accept that we professionals are only a small part in a bigger equation that leads to recovery. I’m in no doubt that going through residential rehab in our service has changed the lives of hundreds of people and their families. I am equally sure that many more have found recovery without rehab. At the heart of the process is connection.
Addiction is about disconnection and loss. Disconnection from loved ones and from self. Loss of values and self-worth.
Recovery is about the opposite. Those connections are found most readily through others making the same journey. Sometimes the connections happen suddenly in epiphanies, but mostly they happen gradually—like a slow dawn. While we professionals can catalyse the process through treatment, I believe the most important thing we can do is to actively connect recovering people into recovery communities.
That’s where the magic happens. As someone trained in science, I would have been reluctant to use such woolly terminology in the past, but the truth is you need a bit of magic, some faith, some hope. Essential as they are, these qualities are not measurable and get little mention in policy or treatment. You find them in abundance in recovery communities though.
The service I work in is full of recovering people—staff and peer supporters alike who model recovery to others. When we create an environment where recovery is the foundation of our work, where the language of recovery is freely spoken, when we hold the highest aspirations for patients, a special environment is created. It’s an environment where transformation regularly occurs. Transformation is relatively rare in medical practice, but I see it regularly now. It’s been a huge privilege to work in such a place.
Years ago, my addiction psychiatrist, kind as he was, decided to direct me away from a group of recovering people meeting in the hospital at the same time as I was seeing him. Looking back, albeit with the benefit of hindsight, I can see it was a bad choice.
Knowledge of the science of addiction and recovery is not complete if the power of connection is discounted. While I needed my own drivers and motivation, I needed others—other recovering people—to help me on my way. The recovery phrase ‘I alone can do it, but I can’t do it alone’ is spot on. The sense of relief when I finally spoke to another doctor in recovery was amazing. It was inspiring and it was healing. It was connection.
I have seen patients with the most distressing histories of trauma, with major mental health problems, with no family, no home and no possessions, find a little bit of courage and hope and begin to experience transformation in treatment. They are supported by the recovery community, like I was, to start to get better, to build self-esteem and to heal. It is connection. There is something both humbling and exhilarating about that. Such stories of recovery are told by recovering people to others who need hope. It’s infectious—recovery leads to recovery.
As patients have been connected up to local mutual aid groups and other recovery groups, those groups have grown. People we have treated have become active participants, holding positions of responsibility in meetings and organisations. The recovery community has mushroomed. Recovery has become more visible. People seeking treatment now generally know others in recovery—something that was rare in my early days.
Because of the power of recovery to help others, I’ve been open about my own journey. I don’t know how many times I have told my recovery story. I’ve told it at mutual aid meetings scores of times, but I’ve also told it to medical students and to professionals at international conferences. I do a lot of public speaking and teaching, but I never feel so exposed as I do when sharing my own story. Without doubt, the talks I get the most positive feedback from are my recovery talks. People connect to recovery experiences.
So, some years on, what are my core lessons?
They are simple. I need help in life. Asking is a strength, not a weakness. I need connection—to others, to myself, to things greater than me. Treatment is helpful for some, but meeting recovering people is helpful for many. Working in a team with other recovering people, doing what makes your heart sing, is fulfilling and inspiring. Difficult things can lead to freedom and better places. Staying grateful is the key to contentedness. Giving recovery experiences and hope away to others is what helps me value and keep them.
I wouldn’t want to go through the misery of addiction again, but paradoxically, I wouldn’t wish for it not to have happened. The rewards of recovery are much too great.
> Tim’s Recovery Story (pdf document)
