Chapter two

The Rehab 

And then, to come to think of it, you may need a rehab, or at least a detox. If things are bad enough for you then maybe that’s the way to go. You may have noticed I said rehab or detox like there’s an alternative. Maybe there are some fancy medical terms for these but by rehab I mean something like a stay of several weeks, maybe a month, in a hospital or other facility whereas a detox is merely a temporary expedient just to get the alcohol out of your system so that at least temporarily (and I use that term advisedly) you are feeling a little better again. 

Each has its advantages and disadvantages. A rehab, by far the safest and wisest choice, tends to be expensive  and may not be covered by insurance. It takes time and during that time you have to be absent from work. This means explaining the situation to your employer. If it’s your first time around, federal and perhaps state law prevents your
being fired but still it’s quite a step to take. The good side of this is that leveling with your employer may be an all important step on your road to recovery, for by doing that you are, perhaps for the first time, being honest not only with your employer but also with yourself. This is the way out of what they call denial, the prison in which you have been confined for so many years. When you put all your cards on the table and admit that there really is a problem, a very big problem, it will of course be a very scary thing to do but , when you do that, you may experience for once a great sense of relief. It may feel as if you had put everything you owned on one roll of the dice, one spin of the wheel, betting it all on the red instead of the black, and when the ball stopped it did indeed come to rest on the red. So you can now take your winnings and start your life over again.

But if you don’t wish to go that route you may at least need a detox. As I’ve already said, this is merely a temporary expedient to clean all the alcohol out of your system. Unless there is a very strict and careful
outpatient followup it rarely has any lasting effect. A nurse once told me that for that reason it is sometimes referred to in the “trade” as a “spin dry” (i.e. just drying you out until the “ next” time and then the “next” time and so on until something more serious happens). 

Or then again, sometimes a person may choose to go “cold turkey”, a self detox as it were. This can be not only uncomfortable but highly dangerous. Delirium tremens, featured in many of the old films, is always a medical possibility. Not only is it horrendous in its effects but it can be fatal. In addition
there are other potential dangers, such as an alcoholic convulsion. I once saw one. I was in a rehab and we were just returning from an AA meeting. Suddenly the man next to me,, with whom I had been carrying on a pleasant conversation, suddenly started talking in gibberish, what the psychiatrists have sometimes called “word salad”. A meaningless collection of sounds. When we got him back upstairs he soon went into convulsions, lying on the floor while the staff worked on him. Fortunately they were able to save him but I suppose it could have gone the other way. Later he told me that, prior to entering the rehab, he had spent day after day alone in his apartment, alone that is except for his ever present companion, a gallon of vodka. He had been drinking so heavily that sudden withdrawal had resulted in a seizure. If this had happened when he was alone he might not have survived. 

 Another benefit of a detox is that various medications may be available to lessen the symptoms, often unpleasant, of sudden withdrawal (I have heard that, at least in times past, some detox facilities have employed gradual withdrawal, administering dosages of alcohol which are scaled down gradually over time, but such procedures, if proper at all, have largely been superseded by medications, generally of a tranquilizing nature). These medications may or may not be helpful, depending on the patient and the drinking history. Some persons, by drinking, may have built up such a tolerance to alcohol that their bodies may have but a muted response to other drugs (alcohol of course being a drug). 
Nonetheless tranquilizers may be better than nothing at all and having staff members available to assist in emergencies may be not only a benefit but, as we have seen with delirium tremens or convulsions, a necessity. This is particularly if an occasional patient has suicide in mind. 

Aside from rehab or detox, you may have one other option suggested to you, namely one to one counseling, such as by a psychiatrist or psychologist. All I can say is that I did this for thirty years and not only did it do little good but, in some ways it may have been counterproductive. Alcoholism after all is an addiction and by its very nature involves massive denial. An alcoholic may say that he or she wants to stop drinking or drugging, may even believe this subjectively but all too often this person may be lying not only to others but to himself or herself.  The body’s physical need for alcohol, a result of its radically altered chemical and possibly physical composition, is simply too strong and this is one instance in which the mind may be but the mirror of the body. Accordingly, a one to one series of “counseling” sessions with a professional may be little more than a cover for continuing the drinking, the alcoholic telling himself, his family and the doctor, “See I’m finally doing something about this problem! This shows I really want to stop”.

And the doctor, particularly if he or she were trained in a more traditional form of psychiatry, may focus on attempting to determine what causes the patient to drink. Is it something in her background? Some trauma, a hidden grievance or perhaps a loss or other grief? The assumption might be that, if only we could understand this, then the drinking might stop. The patient would gain “insight” and there would be no need to
drink any more. 

And so the sessions might continue, year after year. At least that was so with me. Occasionally I would manage to stop drinking for awhile, sometimes with the aid of antabuse, a prescription drug which reacts with alcohol to produce violent side effects. The episodic drinking eventually returned and went on year after year. 

But finally, all this came to a head, and, hopefully (for one never knows!) to an end. I entered a rehab for a thirty day period and there I participated not only in AA but in group therapy (there is a difference between the two which I shall go into later). 

If there is a more effective way than AA or group therapy to break through an alcoholic’s denial I have not become aware of it. Group therapy, where the group may be more judgmental than in AA, may be the more effective of the two. A group of recovering alcoholics can spot denial a mile off and can react like a sporting dog to a hidden grouse. Being professional liars, they recognize one of their own. Each evasion, each dodge on the alcoholic’s part is likely to be greeted with laughter albeit with some sympathy. For they’ve been there, done that! All of them! You can spend years lying to  yourself but lying to a group of liars is quite something else. You may think yourself secure hiding in your own little closet of denial only to realize that the walls are paper thin and there are faces peering over the top. Faces, some grinning
and others a little sad. And, if you are lucky you leave your hopeless little shelter and come out into the light of day. And there you meet your friends, those who understand, because they themselves have gone through just the same thing. And suddenly you may feel different, more at peace with yourself and with others. You may feel a growing  serenity because, you see, you have just taken the first step toward sobriety, the hardest and most important step of all. You have admitted to yourself and to others that you are helpless in the grip of this all powerful addiction, that you can’t do it alone and that there are others there to help you. There is, then, a way out for you, the beginning of a long journey back to your true home.

Ch. 4. Alcoholics Anonymous 

CH. 1. The First Meeting