Blue Puzzle Pieces.

I was watching a pretty horrible rom-com movie the other night that had one redeeming moment. It was when the female told her heartbroken friend that he was ‘broken apart like a puzzle and needed to search for the blue pieces.’

Now this seemed like pretty bad advice. Putting together a puzzle involves seeking and creating distinct subject matter piles: the farm house, the feathers, the tractor. The blue ‘filler’ pieces, like the sky and the ocean, are chosen last.  (Why would you eschew the obvious for the nebulous?)  Clearly the puzzle comment was a metaphor; but was she actually advising her friend to find himself by looking outside himself?

I thought of my daughter. In recovery she has found success looking outside herself for stability. She has learned that arranging and re-arranging, ruminating and re-assessing the pieces of self is not always productive. Turning her attention to something bigger, something out there – like the sky – can be the best anchor there is.  It becomes an intangible you can neither wrangle with nor second guess.  You can rest in its remote vastness.

She often sends me pictures of the mountains she climbs. And the rivers she runs beside. And I download these photos to my iPhone. I look at them occasionally – they have become my blue pieces.  I feel this is both wrong, and right.

We spend a lot of time as mature adults concentrating on the subject matter of our lives; paying for and tidying the concrete spaces we have built. When we find time to consider the blue pieces – how often do we notice if they are truly our own?

 

Time is Not Golden.

 

Broken things can be mended. Like my coffee mug with the reattached handle. And my old cashmere sweater with the stitched moth holes. Broken things can also just be broken. Like my refrigerator which is currently leaking all over the kitchen floor.

You probably know where this is going. This is a blog about recovery after all.

I like to remind myself that broken things can be fixed. I am sitting at a round oak table that I found in the bowels of an antique store. The owner practically gave it to me when I said I liked the shape of it. I brought it home and stripped it, sanded it, stained and polyurethaned it. It is heavy and beautiful and has the most glorious curled feet. For so many years it sat in the basement of that shop covered in green paint. You couldn’t even see those strong, lovely feet.

But recognizing an objects worth and fixing it are sometimes not enough. The motherboard on my refrigerator has been replaced yet the temperature continues to rise. I defrosted a frozen drain hole and the ice block returned.  I superglued the fraying rubber gasket – it ripped some more.

People can be broken too. But unlike objects, people are not irreparably damaged.  Yes, some may have been born with “operating quirks.” Some continuously fall prey to their own bad choices. And some peoples broken-ness can be blamed on others.

The Japanese term for embracing imperfection is called “wabi sabi.”  I like this philosophy; I find delight in crooked teeth, aging faces, scarred body parts.  Who really wants airbrushed perfection?  But admittedly some things are not just worn, but broken.  The Japanese have a solution for that as well:  kintsugi.  Kintsugi is the practice of using gold joinery to reattach broken pottery. Gold joinery to illuminate imperfection!  The resulting pieces are a work of redemptive art.  Like my round table.  Like the people I have met in recovery.

But how come some people never make it to that redemptive place? I believe it is simply a matter of running out of time. The time needed to be pulled out of that “dark basement,” the time needed to have their broken-ness acknowledged, and the time needed to reassemble themselves.

Today I am thinking of all the lovely people who ran out of time.  When I was little my father would ask me “what kind of wings would you like when you become an angel?… gold, silver or copper?”  (Disclaimer:  my dad never believed in Christianity. He was most likely drawn to the Pre-Raphaelite imagery.)   I always answered copper. I preferred the warm shimmer.  

I know this is a silly wish – but if there is a heaven, I hope that when I arrive the golden wings are reserved for the broken people – the ones who either fixed themselves while on earth or were mercifully repaired when they ascended.  Kintsugi Angels.  

Amuse-Bouche

 

An amuse-bouche is a single, bite-sized hors d’œuvre. You do not order it. Instead it is chef chosen. A single earthy escargot. Tuna tartare wrapped in a crispy beet slice. An heirloom cherry tomato filled with lemon infused goat cheese. You get the idea: a tiny surprise that packs a big punch.

Amuse-bouche: it has a nice ring to it. It’s advantageous to have a fancy pants word in your back pocket for use at corporate back-slapping parties and such. But its use is kind of limited. And it’s a shame to have a good foodie word go stale. What if we applied it in a broader sense?

A successful amuse-bouche is more than a single yummy morsel. It’s a clue to the ‘taste direction’ of the rest of the meal. It’s basically the “divining rod” of the unfolding culinary experience.

What if we asked ourselves what small moment, or amuse-bouche, has predicted our life’s path thus far? It can’t be a moment we were responsible for; like choosing the late train home and inadvertently sitting next to our future spouse. Instead the moment has to have been presented to us. A tiny morsel that, if we were paying attention, forecasted the unfolding of future events.

If you had asked me a few weeks ago what my amuse-bouche had been I could have come up with a half dozen. It might have been how my youngest daughter did not like to be held close when she was an infant. Instead she liked the isolated confines of her car seat. In response I took to putting her in a snuggly every evening and walking up and down the streets of our small town with her firmly affixed to my chest. I figured it was a way to give her the best of both worlds. This small moment now appears a microcosm of our larger struggles; hers to uncomfortably retreat and mine to forcibly show maternal love.

I might also think back to how she wanted to fill her crib with large plastic toys – rocking horses and dump trucks. I would ably assist: You want this one? You want this one? She would grunt and nod and only lay down her head when she was nearly buried alive. For the next twenty years i would become a witness to her unconventional, and frightening, methods to self soothe.

Another “amuse-bouche” could have been her night time ritual. Instead of singing ‘twinkle, twinkle little star’ she would tick off a long list of potential disasters on her tiny little fingers. With her eyebrows stitched tightly together she would recite “house fire,” “tornado,” “molly-dog dying.” When I would ask her to please stop she would insist on continuing because “if she said them out loud they would not happen tomorrow.” It was like watching her conjure up the prop gun at the beginning of a movie. The prop gun that always portends disaster. As adults we know there is no wishing away the bad stuff.

But none of these were my true amuse-bouche moments.

I learned this after hearing a friend speak uncomfortably about her down syndrome sister and the family burden it had created: their father abandoned them and her mother became consumed with her care. This friend smiled recalling how she and her sister would play simple card games over and over and over. She didn’t recognize that her “amuse-bouche” had not been the birth of her sister. The card game was. The words “over and over and over” were the clue – they highlighted what was to become her signature strength: patience and empathy.

Her story was a reminder that our amuse-bouche moments are not the big things. They are not the burgeoning substance use disorders and the undeniable disabilities. They are much quieter, much more subtle. A chef would explain that it is not the oyster itself – but the taste of the brine.

I know now what my amuse-bouche has always been. It was the kindness shown to me by my eldest child when she was just a toddler. I had been lying in my bed, crying. It was nothing more than new parent exhaustion. But she got herself up from her nap and toddled her way down the hall to check on me and with her little hand on my back she gave me tiny pats. And then she offered her pacifier to me.  She was comforting me the only way she knew how.

How could I have nearly forgotten that one amazing moment?

An Augusten Burroughs Kind of Dream.

 

I had a strange dream last night.  In this dream I tried to help someone (a confident yoga teacher) find something in a dark basement. I ran after him to help because I knew it would be very dark and very dangerous down there. But he shut the door on me. And I was left behind in a room full of beautiful, happy, healthy people. It was then that I felt the arch of my foot throbbing. Refusing to acknowledge the pain only led to it increasing and traveling to the top of my foot, my ankle and my calf. When it became nearly unbearable I looked down to find swollen blackness had encased my lower leg like burnt elephant skin. I recall thinking, “This is okay. You can handle this by ignoring it some more.” Just then a partygoer with a handy pair of scissors grabbed my leg and started cutting the damaged encasing away. I was semi-terrified but decided to trust them and was surprised to feel no pain as the damaged skin fell away in sheets. I watched as my leg emerged – pale, healthy and pain free.

I think I know what this dream is about.
It’s about opening my eyes to the constant need to close them.
It’s about learning to let others fend for themselves.
It’s about cutting away the things that bring me pain (not to be confused with ignoring things that give me pain!)
It’s about trusting others to help me.
It’s about re-claiming space with the happy, healthy people.

This is the perfect sort of dream for a mom of a child in recovery to have.

It’s funny how our subconscious sends us freaky night time missives and our waking mind attempts to make sense of them. Of course I can read this dream many ways. Possibly I should be more humble – who do I think I am that I can help an athletic male yogi avoid danger? Or maybe I am simply being reminded to run a little less so my foot doesn’t throb in my sleep.

Or possibly my brain is sending me the naughty subliminal message to get in with the type of people who run with scissors.

🙂

Poetry. Addiction. Life.

Poetry. With just a few words it can make the most difficult feelings easily understood. Or it can transform the most mundane activity into a deeply humanistic ritual. I used to think poetry stripped things down to their basic essence but now I think it has the ability to alchemize life.

There is a belief that the creating artist suffers more than the rest of humanity. I do not believe this to be true. I had a Harvard professor (shout out to Vernon Howard!) who once said “one man’s opera is another man’s ball game.” He wasn’t merely being democratic – he was speaking the truth. Every day I am humbled by the breadth of artistic expression.

One artist I deeply admire is the Iranian born poet, Kaveh Akbar. I hesitate to explain what he means to me beyond revealing that he is in recovery and that his words seem to both inform, and include me. Miraculously he incorporates multitudes* in that his everyday language builds an opera of understanding around what it means to suffer, to dream, to survive.

 

RIMROCK – by Kaveh Akbar

Without the benefit of fantasy
I can’t promise I’ll be of any use.

Left to the real world I tend
to swell up like roots in the rain,

tend to get all lost in hymns
and astrology charts. Lately

I’ve been steaming away, thin
as cigarette paper, cleaning up

the squirrels that keep dying in my yard.
Each cascade of fur feels like a little tuft

of my own death. Am I being dramatic?
Mostly I want to be letters—not

their sounds, but their shapes
on a page. It must be exhilarating

to be a symbol for everything at once:
the bone caught in a child’s windpipe,

the venom hiding in a snake’s jaw.
I used to be so afraid of nature.

Peering up at a rush of rimrock
I imagined how unashamed it would be

to crush even me, a tiny stuttering boy
with glasses. I pictured myself

reduced to a warm globe of blood
and yearned to become sturdy in my end-

lessness, to grow heavy and terrible
as molten iron poured down a throat. Still,

I don’t know the rules. If I go looking
for grace and find it, what will grace

yield? Broken ribs, probably, flakes
of rust, an X marked in an atlas which itself

has been lost for ages. Oh, but I do
know what I am: moonstruck, stiff

as wet bamboo. I remember someone
once sang here, once strung together

a garland of near-holy moments.
It’s serious business, this living.

As long as the earth continues
its stony breathing, I will breathe.

When it stops I will shatter back
into gravity. Into quartz.

(*with another shout out to Walt Whitman’s Song of Myself.)

“ACE” made me do it.

There is a relatively new addiction model called Trauma Therapy. One of it’s chief proponents, Dr. Gabor Mate, explains that people are born perfect and adverse childhood experiences (ACEs) create trauma which leads to addiction. In an interview in The Fix Mate claims, “if children receive conditions of love and respect in their childhood, they’ll never be addicted, they’ll never get depressed and they’ll never be anxious.”

What qualifies as an ACE? Physical, sexual or verbal abuse, physical or emotional neglect, living with a parent who is abused or addicted, having an incarcerated or mentally ill caregiver, or suffering the loss of a parent through divorce, death or abandonment. The Centers for Disease Control developed these markers to identify people at high risk for obesity, depression and addiction.

According to Mate all IV drug users score positively on the ACE scale. Furthermore he insists if you do not recall childhood trauma then you are repressing it and in need of extensive “trauma therapy.” (If this is not a siren call for false memories then I don’t know what is.)

I shared my doubts with a follower of Dr. Mate. I explained that my child did not meet a single marker on the ACE scale. Stymied, they asked if her childbirth had been traumatic (which felt a bit like “mother blaming”). When I explained that she was the easiest of my childbirths I was told my daughter must be a victim of epigenetics. This was explained as “inheriting on a cellular level the trauma of previous generations.” I was then asked if something ugly could have happened to me as a child, something that I may not even recall. A subconscious molestation could be the reason I birthed an addicted child.

This does not sound like responsible science to me.

Epigenetics is the science of gene expression. It explains how the environment may turn on/off the expression of certain DNA coding. For example there is scientific evidence that extensive stress can cause permanent damage to the body’s production of cortisol. This makes sense since we are biological beings and our bodies interact with, and are affected by, our environment.

The proponents of an epigenetic basis for addiction cite work done by Rachel Yehuda Ph.D., at the Icahn School of Medicine. Dr. Yehuda hypothesized that genetic damage suffered by an individual could be passed down to future generations. She deduced this after finding an increased rate of anxiety, depression and obesity in the children of Holocaust survivors. She attributed their health problems to inherited faulty cortisol production and enzyme regulation; rather than asking if growing up with PTSD-affected parents could have produced an environment that fostered stress in the children.

It is important to note that Dr. Yehuda’s work has been debunked. The Chicago Tribune (citing various sources) reported “Yehuda’s study began with too small of a study size. Only 32 survivors and 22 of their offspring were studied. That’s a very small group on which to base this theory and a major study flaw.” The article further revealed a major flaw within Yehuda’s research: “While the team studied the children of women who lived through the Holocaust, they would have to study the great-grandchildren of survivors to prove actual epigenetic inheritance from mother to offspring. Why must four generations be studied? The eggs that made you were present inside your mother when she was a fetus inside your grandmother. Because a pregnant woman already possesses the DNA of her grandchildren and these genes can be affected by things during her pregnancy, the DNA of the great-grandchildren has to be studied to show that epigenetic changes were passed on across generations.”*

I also can’t help but think that if generational trauma was a prescription for drug abuse the species would be extinct by now. The circle of damage would have increasingly widened as generations multiplied exponentially through time.

Strict reliance on ACE is problematic on another level: it rigidly shuts the door on other causes of addiction. Purdue Pharma flooded the market with highly addictive pills that have been proven to change neuro-pathways in the brain. Are we really going to insist that those who got addicted did so because of early trauma (divorced parents possibly?) and not because they were the victims of corporate greed?

Interestingly Mate acknowledges that “not all of those who have ACEs become addicts, but all addicts have ACEs.” Why isn’t Mate questioning this discrepancy? Could the difference be attributed to the fact that some people are genetically predisposed? Or that they have less emotional resiliency because of a psychological disorder that is eased by substance use such as anxiety, bipolar, or depression?

Dr. Mate insistence that psychological disorders are created by early trauma is nonsensical. Babies are not born perfect! Every day children are born deaf, blind and lame. They have congenital heart defects, they have sickle cell anemia. To think that the newborn brain is inure to imperfection is ridiculous.

Imperfection is part of nature. I often ask my art students to go outside and find the perfect tear shaped petal, the perfect circular rock. They always come back empty handed and we marvel at the impossibility of it. It is only the foolish or megalomaniacal who dream of perfection.

My daughter is flawed – but not any more than me. She is stubborn, I am prideful. She is anxious, I have self doubt. She did not have a traumatic childhood; she had a fairytale one lived out in a house near the sea with a sister, a brother and a big fluffy dog. She tells me nothing untoward occurred during her formative years and I believe her. Can she benefit from trauma therapy? Of course. But it would be for trauma experienced while using.

Mate’s proposition is maddening because it is reductionist. And because it asks people who are already suffering to seek another layer of pain where none may exist. It also demands that science take a back seat to a condition that people are finally beginning to accept as a disease.

I feel traumatized by the possibility of it.

Stats… STAT!

Our children relapse. We are warned “relapse is part of recovery.” But I don’t think most of us believe it. By the time your child has a few years under their belt you get comfortable. You see a person emerge that you haven’t seen in years. Someone who is genuinely happy. Focused. Funny. Confident. Surely this person is here to stay.

But the fact remains. A mom I know confessed to returning to the days of sending canteen money to her son after his recent relapse landed him back in jail. She ended her dark missive with “why, why, why?”

It’s a rhetorical question I suppose. We know why. Giving up anything for a lifetime is a pretty monumental task. Giving up something you once loved more than life itself must be harder. Then throw in the added bonus of having an addictive personality or a mood disorder. Those are some pretty good whys. Sometimes I am amazed at the fortitude required to obtain 2-3-4 years of complete sobriety. It feels like a miracle. But I don’t want to think this way. I don’t want my daughter’s future to be dependent on a miracle.

Last week my daughter called me from detox. It was her third attempt in ten days. Her voice was hopeless as she numbly reported “only 1% of addicts ever make it mom.” I also have heard this number quoted. And I don’t like it.

We know statistics are manipulated to present a particular point of view. Is this one in existence because historically we haven’t cared enough to get the math right? Or has it been cultivated to justify poor spending on treatment?

This number was ringing in my head when I sat on an opioid forum last week. Beside me sat the head of a Massachusetts hospital emergency room department. He confidently stated that “involuntarily committing addicts to treatment is not recommended because we are setting them up for a higher rate of overdose death.” I am presuming his reasoning was based on the premise that this population is not interested in quitting drugs and therefore would return to using. I don’t question that deaths are higher among the involuntarily incarcerated vs. the voluntarily committed when treatment ends. It makes logical sense. But the data is flawed. The data is flawed because of “patient selection bias.” The doctor failed to include those who were NOT included in the data: those not forcibly committed to treatment. I venture to say that most of them are dead – or will be dead. Look at it this way: it’s like playing Russian Roulette with people who don’t want to quit the game. If you take away the gun some may eventually go back to playing with the gun. But if you DON’T take away the gun… well everyone is going to die. It’s that simple.

Are there better stats regarding relapse? Unfortunately there is a dearth of long term data. One of the few long term NIH funded studies followed 1,162 addicts for eight straight years. Published in the Journal of Alcohol and Drug Abuse it revealed that as the length of time in sobriety increases, so do the odds of continued sobriety. Those with less than a year have a 33% success rate. Those with over a year increase their odds to 50%. And those who achieve five years can expect an 85% future sobriety success rate. Data just doesn’t exist for those with 20 or 30 years of recovery time; but those who work in residential centers find their reappearance rare.

So we know clean time breeds more clean time. I remember joking a few years back with a local officer.  I asked him to handcuff my daughter to her bedroom radiator to prevent her from scoring. He smiled, but then seriously replied “yeah, I can’t do that…and neither can you.”

Since that day I have been searching for a legal means to success.  That searching even led to attendance at a spiritually based reading group (disclaimer: it is an act of desperation for me to turn toward faith for any sort of answer.)  What I found was that many of those in attendance were living a life of successful sobriety.  History, science, and society have not been kind to those suffering from the disease of addiction so we can not blame them for remaining in the shadows.  AA and NA use “anonymous” for a reason.  But by sharing their status this group become a living example of hope and, even better, a room full of positive odds!

It is still going to take a lot of unbiased research to get us solid numbers to stand upon.  Faulty statistical analysis, unfunded federal research, a lack of evidence-based treatment, and social stigma have led us to this unsettling place. To live within the world of addiction is to stand on shaky ground.

For now I will tell you what I can do. I can share a whole new set of facts with my daughter when I visit her at the hospital. I can tell her with confidence that the 1% success rate is inaccurate. And I will tell her with even more confidence that she matters 100% to me.

These are the only true numbers at my disposal and, for today, we are relying upon them.