Chapter 1: Rock BottomA Chapter by Philip MulsDown And OutI am Dr. Christine Lavorter, Head of Psychiatry at the Sankt-Alexius Hospital on the banks of Lake Geneva, Switzerland. We treat patients here with severe addiction and impulse control issues. Under my guidance, our facility and staff have gained a reputation for saving so-called hopeless cases from life-long institutionalization. I know all this sounds very cold and clinical. In reality, we deal with people and I consider myself an expert when it comes to helping my patients get to a better place, by treating them on the level of mind and body but also on their deeper self, their essential life force, also called, soul or spirit. From my office, overlooking the shores of the crescent-shaped Lac Léman, with its vista of exquisitely arranged vineyards, I wrote this book based on the recovery therapy conducted with my patient Peter Baer, whom I consider to be an extraordinary man. When Peter first contacted me, he had just completed his fourth attempt to deal with his severe alcohol addiction. He had gone, yet again, through extreme withdrawal in rehab and - to the outside world - seemed to have come out a sober man at the other end of twelve long weeks. Yet, he was exceedingly doubtful about his ability to stay sober and ever leading a normal life without drinking. But he would, in his own words, rather die trying than going back to hell. This book is about what happened next. It is fair to say that Peter was a man on a mission and his demons got unleashed during therapy before he could finally let them go. Recovery for him was like navigating a minefield of existential fears and old beliefs, each of which could explode and shatter his susceptible sense of self. I took it upon myself to take note of his difficult journey. May this exceptional story of personal transformation be an inspiration to anyone out there, battling his or her own demons. Peter agreed to co-write this book with me to give it a unique doctor-patient perspective. His contribution consists of a number of stories I encouraged him to write during his business trips in Asia. These travel vignettes in themselves are quite remarkable as the reader might soon discover. You could say, in a sense, that writing them showed Peter a path back home. I have been trained to take an objective, dispassionate view of the disease of addiction. This sometimes makes me seem detached and unemotional in my responses, while, as you will see, Peter is great at expressing his very personal sense of his condition and is not afraid to show his despair, at times. But he also shows great courage to turn his misery into insights which can greatly benefit the reader. Our conflicting styles might give the reader the impression that I do not care. But make no mistake, this case has moved me to my core. Together with Peter, I discovered that melancholy has its very own beauty and is not a disorder that needs to be cured. To live a good life is not to be immune to sadness. I first met Peter in the summer of 2013. He introduced himself to be a forty-seven-year-old business executive who was traveling the world extensively as the director of a global software company. His travels took him from Beijing to Moscow and from Bangalore to Singapore. A rainmaker for his company, the incessant wheeling and dealing across the globe was clearly taking its toll on the man. Peter's wife, Helen, runs her own consulting business and also travels a great deal. Together they have two grown-up children, a son Wolf and a daughter Winter. The Baer's live in a lovely mansion right here on the shores of Lake Geneva. Both Peter and Helen are accomplished professionals, yet they were unable to prevent the family unit from running completely off track. It is safe to say that Peter’s addiction to alcohol was a key driver for their difficulties, but definitely not the only source of trouble. A seasoned corporate warrior, Peter came across as sophisticated and worldly-wise, and yet unable to cope without alcohol. Fully identified with his mind, Peter was at the extreme end of the spectrum of true thinkers, people who are unaware they even exist beyond their thoughts and who are out of touch with their emotions. And in that very rational way of his, he was very conscious of the problematic function that alcohol played in his life which is to let him escape from his mind. To illustrate that his preoccupation with endless thinking was not something recent, Peter brought to our very first session a picture of himself as a twenty-two-year-old, sitting on a marine dock watching a stunning sunset on the coast of Amalfi, Italy. I must admit that I had never before seen a young face so troubled by thought in such a wonderful setting, where, of course, you would expect the exact opposite. The glorious light of dusk in Amalfi made for an amazing picture and yet the viewer is drawn to the distraught expression on the boyish face, which can only be read as a mix of despair and hope. Peter brought the photo because to him it captures his whole life in a single image. With a look of nostalgia on his face, he told me it had been taken on the legendary summer break he took in the Mediterranean together with three girls and one other boy, straight out of college. Five young people, hungry for life, roaming through wondrous Italy. Yet there he was, sitting in isolated rumination, regretting things from the past and worrying about things to come. At that young age, right after graduation, the world was open to him, yet he felt ambiguity about the sense of life and he considered his sharp mind to be a curse and a blessing at the same time. A mind that in the years to come, would go and create its own interpretation of the world, when reality turned out to be just too real to cope with. Early on, Peter realized that the key to his recovery was to find a natural way without alcohol to take a step back from his own psyche. He came to see that problems of the mind cannot be solved on the level of the mind. He felt he needed to go deeper, below his scattering thoughts and emotions. When he first spoke to me on the phone, he explained that he had been released from detox only two days earlier and was certain he would relapse in the next hours if not helped. He sounded anxious and sincere and because I had a cancellation in my schedule, I proposed to see him that same evening. He entered my office at 7 pm sharp and right from the start, he struck me as a man in pain. He looked young for his age with kind blue eyes but his facial expression was tense and his voice was slightly trembling as if he had been bottling up his emotions to the point of eruption. It was beyond doubt that he needed immediate support in order to stay sober over the next hours and days. I went ahead and asked him to recall his darkest hour, a recent moment of deep suffering that ultimately made him decide to stop drinking and go into rehab of his own volition. In my experience, a vivid reliving of the deep and utter despair that hitting rock bottom brings about can provide a strong defense against imminent relapse. I asked him to tell me about his recent nadir event in the present tense as if he was right there, back in the moment. The aim being to replay the tape and make him re-experience the horror with the same emotional intensity and hence also find back his resolve. Peter’s face visibly turned ashen as he worked at making his rock bottom moment resurface. As I would find out later, he was an excellent pupil when it came to taking instructions and doing exactly what was expected of him. No doubt this was also the reason for his professional success. His sharp intellect could rapidly find its way to any objective, like a guided missile. He started talking in a husky voice while looking straight at me: “It is 3 am on a Wednesday night, now twelve weeks ago. I wake up in a cold sweat, trembling violently from severe withdrawal. My heart is beating in my throat and I feel nauseous and dizzy. My bed linens are soaked with sweat. It’s been only five hours since my last drink but my body has woken me up from a booze-induced sleep because it needs alcohol and it needs it now.” I was somewhat taken aback by this forceful start. When I found my bearings, I said: “Peter, you've got the right tone, try to face the horror of the moment and describe it to me, however painful.” He duly complied: “I am scared shitless because it is clear I’ve lost all control. The addiction has taken full possession of me. It seems I’ve crossed an invisible line and alcohol is the new boss. I have been spiraling down for a while now, like a helicopter with a broken tail fin caught in a lethal spin. And it seems that tonight, it has come to a point where forces of nature will dictate what will happen next. I feel I have zero options.” “You accurately describe the overwhelming feeling of powerlessness that comes with the addictive state, Peter. What else is going on in your mind?” “Apart from the terrible craving for booze, there is also the fear to suffer a seizure if I do not get alcohol in me fast. This has happened before and it is not something I want to see repeated. My will power seems to be unplugged from its source, my body and mind are conspiring against all better judgment.” “Losing control like that can be extremely scary. What happens next?” Peter: “I struggle to sit up straight in bed, in the spare bedroom up in the attic of our house. I feel utterly alone. By then, I’ve been sleeping alone for more than a year because my wife Helen shut me out of the master bedroom after many reproachful discussions about my drinking. She has lost all respect for me after my recent lapses, and so have I. A familiar black desperation washes over me.” I could picture him up there, all alone in that dark attic room under the roof, craving for a drink. I really felt for him but it was my job, however, not to become emotionally involved. I encouraged him to continue: “What did you do then, Peter?” “Well, Doc, they say stopping is simple, just do not bring a drink up to your mouth. If only that was an option." He waited for a minute and said: "So I am sitting there, thinking I do not want to go downstairs to the kitchen, yet I am certain I will. It is 3 am for god’s sake, only an insane person would drink now. But my body screams for alcohol, just to make it through the night. The cold shivers, the trembling, the chest pains, nausea. All of that will go away immediately with the next intake of booze. Of that I am sure.” I tried to offer some sympathy: “I understand it was anything but simple, Peter. If it would have been, we would not be sitting here now. So did you do it? Did you go down to the kitchen to get that drink?” “I remember putting my bare feet down on the hardwood floor. I try to stand up but feel very shaky. I shuffle around in the dark until I find the light switch. I curse myself for being weak and I even say out loud: This might be your last chance, do not go down, sweat it out." He was shaking his head while he continued: "Yet my body responds by calling out for alcohol vehemently and the familiar voice in my head says: I am a victim and this is a disease. I cannot handle this on my own, the delirium and tremors will kill me. Just get that drink, just the one, to make it to the morning.” I want to ease his mind: “All of these considerations are rational, Peter, despite the state you were in. This tells me you did not act on impulse. You really felt there was nothing else you could do. So you went ahead to get that drink?” I could tell from Peter’s expression that the worst was still to come. He said: “Yes, I navigate the stairs all the way down, putting both feet on each staircase, as an old man would." "When I am finally down in the kitchen, I do not switch on the light. I open the fridge and in its divine light, I see the half empty bottle of white wine I knew would be there. The bottle sparkles like a sliver of heaven in my hell. I make a last futile attempt to resist, forcing myself to think the wine is poison. The voice in my head takes the cue and says: Yes, but it is your poison, your lifeline.” “Heaven and hell, those perfectly capture the duality of drinking, Peter. Please continue.” “Well, Doc, I can’t be bothered to locate a glass. I just raise the bottle to my lips and drink. The cold liquid eases down my throat and fills my stomach. It creates a burning sensation that radiates throughout my body. A wonderful feeling of deep relief rushes to my head and takes away all the pain. I get tears in my eyes from joy and self-hate, in equal measures. Deep emotions roll in like a tsunami that hits the shores of my sanity." "Emotions like guilt, Peter?" "While drinking, I know this is but a short truce. The more alcohol I take in now, the more brutal the withdrawal effects will be later on. There is no doubt in my mind that I will pay for this in hard cash. A feeling of complete aloneness and mortal dread overtakes me. Deep down I know that I am committing murder.” “Peter, I must admit, I get shivers all over when I hear you tell your story. My hair stands out on my arms. I can only imagine how powerless you must have felt that night, alone in your kitchen, realizing you’re caught in a lethal loop." I let this sink in and say: "You sound very authentic which tells me you have come a long way in understanding the disease that is alcoholism. You are certainly not in denial.” “But why is it, Peter, that you needed to see me urgently today? You told me you made it through rehab once again, is that not a solid basis to abstain? Surely you do not want to go back to the horror of what you just told me?” “Doc, I had myself committed four times in the last two years and in the first three rounds, each time I relapsed on the very first day out. This time around, I am out two days and I find myself in hell." "Describe what hell means to you, Peter." "Well, the bottle is so close, I can touch it, I can feel it on my lips. I keep thinking Why would, this time, be different. In the final analysis, I will drink again. The reality is that I still feel like a dry drunk, with my sobriety balancing on character effort only. White knuckle stuff, you know, as opposed to a bottom-up recovery. At this very minute doc, I have to tell you, I feel my inner resources depleting fast, I am afraid I will cave soon. I might go for a drink once I leave your office. Honest to god.” “I believe you underestimate the power in yourself to stay clean, Peter. You clearly have the will to recover. You will not drink today. You will not drink tomorrow. Think about your rock bottom moment when you need to. That will stop you from actually reaching for the bottle." He looked like a lost puppy. I said: "I will see you in two days’ time. Trust yourself, you are stronger than you think.” I felt I needed to send him off with a challenge: “There are no guarantees but I feel confident that together we can instill a lasting sobriety, that you can own fully. It is clear we need to dig deeper, give you a reason to want to live a sober and authentic life and enjoy it even. But this type of personal transformation can be a long journey. Are you up for it?” He took up the glove: "Doc, I see this as my last chance. Deep down I know that if I touch alcohol again, even one small sip, that will be it. All my resolve will be gone, forever. No way back. So yes, I am up for it. But still, I fear that I will relapse before I see you again. I have a bad track record, I lack the backbone to see it through.“ With a faint smile he said: “Clearly, you have more faith in me than I do.” “Peter, I need you to trust me in this. You will not drink. I will see you the day after next and you will tell me here in this office how you did it. This is your turnaround point, you get to decide to live.” When Peter left my office that day, I felt a heavy responsibility descend upon me. I believed him when he said it was his last chance. I was convinced that the tough love I had given today was the only cure. The decision to stop drinking needed to come from him and from him alone. No point in having him recommitted into rehab for yet another flying trapeze act with a safety net. It was now or never for Peter. I was very much aware I just took away his net.
© 2017 Philip MulsAuthor's Note
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Added on September 13, 2016Last Updated on April 3, 2017 Tags: zero options, alone, despair, bottle, rumination, relapse, rehab AuthorPhilip MulsGrimbergen, BelgiumAboutLiving in Europe, but travelling frequently in US and Asia. I love to combine what I experience during travel with observations and thoughts about the human condition. more..Writing
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