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As with any other type of person, some alcoholics are in themselves kind and thoughtful people; some are just narcissistic bastards anyway. Similarly some are solvent/lucky/educated/employed, with independent-minded and healthy partners, well-equipped to be strong; others live with all the burdens of poverty and dependence. Alcoholism apart, Robert and I lived in a pretty nice world. But addiction doesn’t give a toss about background. It feeds off whatever weakness there is. A solvent alcoholic can just afford more booze, more easily. Money and a safe home can themselves be enablers.
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He was writing music for the TV series The Inspector Lynley Mysteries. As usual his music was much better than it needed to be, but he took the piss out of the entire enterprise, undermining both himself and the show. Film and TV composers are often divided into two types, the brilliant talents who write brilliant music which the filmmakers work with and are inspired by, and the box-ticking ‘paint-by-numbers’ type whose every predictable note or snatch of melody is pre-assigned to a mood or a character. Robert, predictably, could be either and both. He was very reliable, from the point of view both of quality and of deadlines, to such a degree that he gained early on a reputation as someone you could call on when the score you commissioned turned out not to serve, and you needed a new one in two weeks. He had considerable respect for his own talent, and got in a fury about the socio-professional aspects of that world – the requirement to get on with people, be civil, and produce what you are asked to produce. He saw lesser talents overtake him, ‘operators and retro-heroes who camouflage their small talent with charm and mere technical competence’, as he put it – but he admitted he was a massive self-plagiariser, and declaimed on the pointlessness of writing modern classical music for its own sake, because you slog for a year, it gets played once if you’re lucky, in a tiny studio behind an opera house where they do Mozart all the time, they can’t afford an actual orchestra anyway, and nobody would come.
Lola (now ten) and I had been writing a novel together: Lionboy, about Charlie Ashanti, who can talk cat and runs away with a floating circus. Robert amused himself and us by writing a suite of piano pieces based on the book for Lola, who was learning – and hating – the piano: a pretty waltz for zebras; a stalking habanera for Pirouette, the Girl on the Flying Trapeze, a tragic eerie melody for the tight-rope-walking violinist. The Lionboy books took off, and suddenly we were being hailed as The New J. K. Rowling, doorstepped by the Evening Standard, published in thirty-six languages and proud purveyors of the film rights to Stephen Spielberg. We went to New York, Buenos Aires, Amsterdam, Bangkok and LA. Robert recorded the tunes he had written, and they became the soundtrack of the audiobook.
Robert was seeing his son every other week, for pizzas, trips to the park, lunch at my house. This involved not just the delight of seeing him but also the torture of having to say goodbye. I cheerfully thought that seeing Jim would be a simple good thing, but Robert suffered monumental shame and self-punishment in this area – for the pain he must be giving Jim; for having allowed this situation to arise; for not handling it better – as well as the visceral pain he felt at the end of the visits. He’d say, ‘I need to be alone after I see him, calm myself down.’ At times he sabotaged these meetings, made himself ill to put them off because he feared he would be unable to resist the urge to drink afterwards.
‘I want a new flat,’ he said. ‘I’m fed up with these basements. Fresh air will be good for me. First floor, south facing. Nice big windows. I love a first-floor sitting room.’
I helped him move in. Some furniture came out of post-marriage storage. There were some boxes that he had never unpacked: books and old stuff from before he was married. Concert posters, piles and piles of music, photos.
‘Didn’t you sort out your things?’ I asked.
‘Nope,’ he said. ‘I just said to her to put in whatever she didn’t want. I’ll unpack them,’ he said. ‘That’d be good. Let’s go for lunch.’
I hung his pictures and drew a heart on his mirror in lipstick, and we went and ate sushi.
‘That’ll build me up,’ he said. ‘Fish oils. I talked to Ingrid. She’s a nutritionist. She says to eat fish, apparently.’
His ignorance was still touching: the way he brought up basics of common knowledge as if they were jewels of important new information.
He wore clean clothes, and was careful about Lola’s feelings. He bought me a painting. I bought him shoes. He lent me £1,000 when my tax bill was alarming. We talked of moving to the country. I celebrated when he got to the doctor to see about pain in his legs, and his terrible insomnia, both of which kept both of us awake at night (along with horrific post-apocalyptic nightmares that made him shout aloud, in which he was watching through the window of a fast-moving sealed train as awful things were being done outside to those he loved. As a metaphor for addiction it’s unfaultable.)
I had already lost contact with the fact that these things I was celebrating should be normal (tricky words, should and normal) and that celebrating them suggested a low standard of expectations. He said ‘I’m fine, I’ll be fine’, because he wanted to be; I believed him, because believing was my default. I was ignorant, but not naive. He apologised for not being at his best, but I wanted him to do, not say; to be, not to promise to be. How could I show him how to do things – to get the doctor to pay attention, for example? He didn’t even know what kind of specialist it was he had seen, or what he’d been tested for. Timing became an issue: when does patience become indulgence; support become enabling? When does ‘being taken for a ride’ begin? Not by him. By the addiction which had already taken him.
I assumed he was both serious in his intention not to drink and capable of delivering on it. A counsellor was in the pipeline. He did a second detox: librium, to ease the potential side-effects. I didn’t know what the side-effects might be. I didn’t know how long ‘coming off’ went on for. I thought he had already come off. He told me he was tempted, and needed help. I didn’t know if he was taking the pills. I didn’t know what the specialist actually said. I didn’t know anything. He wasn’t going to AA meetings. He just went to the doctor and got some pills. That was his idea of medicine – a cure, some tablets provided by a third party, rather than any kind of prevention that involved him doing anything. I was leaving him to it because they have to do it themselves, right? After hitting rock bottom? I knew that much. And being divorced, that’s quite rock-bottomy, isn’t it? The bitter end of your rope, as someone once said.
I feared that my loving care would make him happier and healthier and more attractive, and by then I would be properly in love with him, and then he’d go and fall in love with somebody else. I feared that my loving care wouldn’t make him happier and healthier and he’d get ill and I’d have to push his wheelchair while he vented his frustrations on me. Though he was trying hard to limit himself, and though I didn’t know it, he was drinking.
Truth was, I didn’t know detox from rehab, rehab from recovery, alcoholism from a hole in the head. He and I had been using the word alcoholic for years, but we knew sweet nothing, and never bothered to find out because we were young, and still immortal. Now that I do know, I want more people to know; to say whatever I can say to improve the chances of nobody ever having to go through what he and I went through. I want to make clear that alcoholism – addiction – is not a racy lifestyle choice, not a decision, but an insidious and baffling condition which kills people. I’m not telling anybody what to do. I’m just telling how it was, for him, and for me.
So: detox is a set of pills to take in order to safely come off alcohol after an extended period of heavy drinking. Rehab is an extended set of therapies dealing with the physical, mental and emotional results of long-term heavy drinking, and the obstacles to giving up. Recovery is where you want to end up: a long-term state of carefully nurtured sobriety.
And alcoholism? The simplest and most useful account I ever heard is this: It’s not what you drink or how much you drink, it�
��s why you drink and what it does to you. You might drink every day and not be alcoholic; you might have been sober for twenty years and still be alcoholic.
Technically, it’s a primary chronic disease of unknown cause and a slow onset, with genetic, psychosocial, cultural and environmental factors influencing its development and manifestations. (It’s worth mentioning here that genes work in complex relation to each other, and concern risk and possibility, not destiny. Research shows that genes are responsible for about half of the risk for alcoholism. Epigenetics – how different factors can alter the expression of our genes – also affect the risk for developing alcoholism.) It is the compulsive consumption of and psychophysiological dependence on alcohol. It’s associated with a cumulative pattern of deviant behaviours, impairments of social and behavioural function that interfere with the person’s health, relationships, and/or means of livelihood. It is progressive and pathological, mainly affecting the nervous and digestive systems, including the brain, pancreas and liver. It may occur at any age. Families of alcoholics have a higher incidence of the disease. It is characterised by distortions in thinking, most notably denial. It’s often fatal.
It isn’t a moral failing; an act of aggression; lack of willpower; personal. Nobody fills in a form saying ‘I’d like to be an alcoholic please so I can destroy myself and ruin the lives of everyone who loves me.’
Here is an explanation I was given by a specialist, which makes most sense to me. If a person has (1): the genetic predisposition to physical addiction, and also (2): the psychological predisposition to using chemicals to change the mood when they are suffering mental or emotional pain, and also (3): things happening in their life which cause them that mental and emotional pain, then it is likely that enough of that pain will provoke them to use enough of those chemicals for the physical addiction to kick in.
And then they are in trouble. Two out of three, one out of three, won’t do it.
Perhaps because it is not a straightforward physical condition, and perhaps because it makes its sufferers behave so badly, people say that they don’t think addiction is an illness – although illness is the usual term for something that gives a person life-threatening physical and/or mental symptoms which need medical attention. Illnesses have been ascribed moral character ever since the gods first threw plagues on misbehaving Ancient Greeks: poetic tuberculosis, for those too sensitive to bear the vulgar everyday world; mad syphilis for the uncontrolled and lustful; dirty leprosy, attention-seeking anorexia. (A good guideline to an illness’s moral status is the use of a noun to describe its sufferers – a leper, an alcoholic, an anorexic – rather than using the illness as a qualifier, which allows the inclusion of other qualifiers and thus preserves the patients’ humanity: a child with flu, a woman with gastro-enteritis, a man with cancer. The use of a noun also re-iterates the illnesses’ chronic nature. These are conditions which must be managed but cannot be cured.) This approach lingers, including among alcoholics themselves, who often see themselves as bad people who should be ashamed of themselves, rather than sick people who are having trouble getting their head around this complex and murky condition. This maintains the illusion that they personally are in control, which leads them either to forced periods of ‘dry-drunkenness’ – white-knuckle trying to stay sober without help – or to further drinking, further shame at their failure to stop, and a feeling that they deserve the problems drinking brings precisely because they have been weak in failing to give up. The moral reality I recognise is this: addicts are not to blame for the genes/circumstances which contribute to their illness. But they are responsible for what they do about it. They have choices. Only when they recognise this can they start to deal with their condition. And recognition takes time.
When your boyfriend is sick with alcoholism, there can be a tightening of the lips, a small raising of a judgemental eyebrow, a ‘Well what do you expect/God, not again’; and for you, his companion, a low-lying murmur of ‘poor fool’. This is a natural impatience, for your and/or his own good. Courtesy, embarrassment and shyness keep it just far enough out of range that one cannot quite respond to it. But it is there. How could it not be? People get fed up. God knows I got fed up, and by the end he was beyond fed up – even without Christian morality and the ‘just fuckin’ sort it out’ post-Victorian Northern working-class ethics he was born into, and to which he half subscribed himself. Clearly it’s hard to live with an addict. Imagine how it feels when the addict lives in your head.
I wonder whether as a society we will make a leap of understanding about addiction that will cause people to look back and be ashamed for describing (as I heard all yesterday on the news) a murder victim as ‘an alcoholic’ rather than ‘a woman’; for pursuing Amy Winehouse to her death; for all the mockery and ignorance. In a documentary I hear the blotchy, sick, swollen, desperate alcoholics, dying of this physical and mental disease which though it is their responsibility is not their fault, saying: ‘I must just be strong’; ‘I’ve been naughty all my life but I’ll be good now’, ‘You get what you deserve’. Nobody deserves it.
I know a doctor – an alcoholic doctor, as it happens – who doesn’t think alcoholism is an illness, displaying with wonderful irony the first easily identifiable symptom of alcoholism in everyday life: denial. That’s the thing about denial: you don’t know you’re doing it. Because – as Robert told me later – and I didn’t hear – your own self is the first person you deny everything to. It shows up not just in individuals, but also in a mass of institutionalised semi-alcoholic social habits and terms (Happy Hour, pre-loading, prinking, lady-petrol); in jokes: ‘I don’t have a drink problem; I drink, no problem!’ ‘Giving up drink doesn’t make you live longer, it just makes it seem that way!’ ‘I’d rather live a shorter life to the full and go out on a high … ’ as if liver disease and cancer were some kind of easy way out, Thelma and Louise flying glamorously over the cliff.
Those who fail to laugh along are, like the girl who doesn’t fancy the bloke who fancies her, humourless, frigid, spoilsports, prudes. Nobody likes the Cassandra of Wine O’Clock. Nobody wants to be her. But all this jollity denies the unwelcome chemical truth that alcohol is a depressant. Used sparingly, it is an effective anti-anxiety drug (and yes it’s wonderful to stop feeling anxious); used too much it both loses its effect and gets its claws into the genetically available. Booze is not actually fun, it just seems it, for a while – which for those of us lucky enough to stay in that ‘while’ is great. But on the strength of that seeming is built a massive industry and a wide and glorious culture with a hideous underbelly which we find easier to, yes, deny.
Half of the alcohol sold in the UK is not accounted for in the amount people report using. One and a half million UK adults1 are alcoholic; many more drink every day. People who drink at risky or harmful levels (10.8 million in the UK)2 account for 60 per cent of alcohol sales.3 Alcohol costs UK society £21 billion per annum4; and in 2013–14 it cost the NHS £3.5 billion. Hospital admissions wholly or partly attributed to alcohol – including harmful use, alcohol addiction, acute intoxication, high blood pressure, cardiac arrhythmia, injuries, falls, self-harm and assaults – have gone up 115 per cent in ten years.5 Then there is liver disease, diabetes, stroke and cancer. Alcohol is implicated in 10 per cent of the burden of disease and death in the UK. Alcohol-related deaths almost doubled between 1994 and 2013. Drinkers are paying their own way, though; indeed the government profits from drink sales: 67 per cent of the price of spirits is tax. In 2011 six UK alcohol and health organisations, led by the British Medical Association, very publicly walked out on a UK government policy initiative, the Responsibility Deal for Alcohol (RDA), saying it was a diversion from the evidence-based alcohol policies likely to achieve a real reduction in alcohol harm, such as policies on pricing and availability of alcohol. Even parts of the alcohol industry agreed that the deal would be almost wholly ineffective. There’s a word for not listening to your doctor when it comes to your drinking. Yes, denial –
but enough. This is a love story, not a treatise.
Here are a few things I wish someone had told me straight out about loving an alcoholic, right at the start.
You need to understand the difference between fault and responsibility. As in, if your dog craps on your neighbour’s step, it is not your fault. However it is your responsibility, and you must clean it up.
Cleaning up after your alcoholic when s/he craps on your neighbour’s doorstep infantilises them, denies them access to their own responsibility, makes them a naughty puppy. Which they are not: they are a human being. The correct response from you, oh competent perfecter, putter-of-things-to-rights, know-all, must be to step back and let them have their own relationship with their own crap, for however long it takes. It’s their life.
Nobody imagines we can cure cancer, or Parkinson’s, with love. Why should we imagine we can cure addiction with love? Because that is what we’re thinking. We don’t say, Oh, you wouldn’t have muscular dystrophy if you really loved me. Oh, you have Crohn’s disease; here, let me love you enough and you will be better, oh, my love is not curing it, I am a bad person, I must love you more.
But at least, with any disease other than addiction, you’re allowed to look after them. With addiction, we are required to turn around the natural instinct which says to us: he’s ill? Look after him. She crashed the car? Call the garage. He puked? Clear it up. She insulted someone? Apologise on her behalf. He’s drunk all the time? Hide the booze, yell at him, weep, complain to others, blame yourself. This instinct is wrong, all wrong. Turn it round. The trouble is theirs. Their responsibility. Theirs to clear up, theirs to apologise, theirs to call the garage, theirs to work it out. You are wasting time by confusing these issues. They alone can heal themselves.