A colleague sent me a recent David Brooks’ op-ed from the New York Times about Alcoholics Anonymous (AA) and its founder, Bill Wilson. And like a good op-ed does, it got me thinking; specifically, it got me thinking about two things: 1) how challenging it can be to overcome an addiction, bipolar disorder, borderline personality disorder or any other mental illness, and 2) how grateful I am that Brooks used his column to highlight AA’s profound impact while acknowledging the complexities of treating addiction, despite considerable advances in brain research and the mental health field.
In the piece, Brooks says “in a culture that generally celebrates empowerment and self-esteem, A.A. begins with disempowerment.” True enough. And it’s my guess that is partly because mental illness, including addiction, is disempowering. It robs individuals of sound judgment, energy (unless, of course, you’re someone who experiences mania), direction, focus, hope, etc.
I’d even go so far as to say that this disempowerment is the definition of “rock bottom,” a common-enough phrase these days, which in my mind can only be a place of abysmal, unadulterated loneliness. It’s no place for a loved one, or even, dare I say it, an enemy.
Once in, there’s only one way out and that’s up. And the only way up is through the good strong grip–maybe physically, definitely symbolically–of another person’s hand. In all likelihood, that hand will belong to a stranger, perhaps even to one of the 1.2 million members of AA, each of whom could probably teach the rest of us a thing or two about “rock bottom.”
Which leads me to another powerful statement of Brooks: “Individual repair is a social effort.” When AA proves successful for one of its members, that success is predicated on the idea of social effort.
This makes sense to me, just as its opposite does: individual disrepair is a social effort, too.
Between nurture and nature we’re each shaped by things beyond our control–not always entirely, of course, but often enough. These things (childhood abuse, death of a loved one, extreme poverty, family genetics, etc.) have a great affect on us as we mature and become independent adults (or at least try to).
Sometimes the convergence of these things makes us vulnerable as adults to addiction and mental illness. No one ends up dealing with alcoholism or mental illness because they’ve been living in a vacuum; so we shouldn’t expect people to overcome these problems on their own either. And when you get right down to it, the mental health profession has always been a social endeavor between patient and clinician. I mean, Freud wasn’t analyzing imaginary patients on his couch all those years ago….
At Menninger, you hear a lot of talk about milieu therapy, which is, according to the Oxford Pocket Dictionary of Current English 2009, psychotherapy in which the patient’s social environment is controlled or manipulated with a view to preventing self-destructive behavior. It may sound like a fancy term for group therapy, but it’s far more than that.
Patients here live for weeks with one another and often see each other at their worst. Because they spend so much time together, they reap the benefit of becoming, as Brooks describes AA members, “deeply intertwined with one another–learning, sharing, suffering and mentoring one another.” They see–and feel–the importance every single member of the group has on the rest of the group. It’s pretty potent, healing stuff, and it’s the social effort of the group members that makes it possible.
I’m really glad that someone as prominent as Brooks shared some of the history of AA. He’s got a big following, and it’s not everyday that addiction finds its way into such valuable real estate as this prestigious op-ed column. It’s clear that the stigma surrounding people with addiction, particularly alcohol addiction, has decreased dramatically since AA was founded, and I think Brooks has, whether he intended to or not, whether he knows it or not, has further destigmatized addiction by devoting a column to the topic.
Now if borderline personality disorder, bipolar disorder, PTSD, schizophrenia and all the rest of diagnoses in the world of mental illness can find their versions of Bill Wilson soon, there’ll be more and more of us who will find ourselves just saying “no” to stigma. Plus, Brooks will have more great stories to tell in future columns, and I, for one, am looking forward to reading them.