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August 2005One Attorney’s Story: The Long Journey from Substance Abuse to Recoveryby Ellen A. Begley, Ph.D. This article is the second in a series of two on attorneys making the transition from active substance abuse to abstinence and recovery. Attorneys in the United States struggle with substance abuse more than the general population.1 For attorneys, substance abuse is suspected, along with mental health issues, to be involved in approximately 50 percent of the disciplinary problems brought before state bar associations.2 Formal statistical findings are difficult to ascertain, because attorneys do not always reveal the role of substances in their misbehavior. However, the Illinois Bar Association offered some objective data when it found 36.7 percent of the attorneys who underwent formal disciplinary proceedings between July 1, 1988, and June 30, 1993, either admitted to, or were found to have, substance abuse problems.3 In this article, I will offer one illustration of an attorney’s transition from active substance abuse to recovery. I will tell the story of one attorney whose particular experiences related to alcohol demonstrate two factors common to the recovery of many people who have struggled with alcohol problems: the role of relapsing back to active alcohol use, and the grass-roots organization Alcoholics Anonymous (AA). The American Heritage dictionary’s definition of relapse is: 1. To fall back or revert to a former state. 2. To regress after partial recovery from illness. 3. To slip back into bad ways; backslide. For individuals who have decided to cease their use of mind-altering substances, relapse back into active substance abuse is a common problem. Prevalence rates for relapse vary considerably, depending on one’s definition; nevertheless, they are generally high. For example, as discussed by Conners, Donovan, and Diclemente (2001), when relapse rates are defined as a return to pre-treatment levels of substance use, 50 percent of individuals were found to have relapsed during the 12 months after treatment.4 Alternatively, when a single drink of an alcoholic beverage post-treatment was used as criteria, 90 percent were found to have relapsed.5 Whether one accepts the more conservative or liberal estimate, relapse is a startlingly common occurrence among individuals who have gone to considerable effort to deal with their addiction by going through substance-abuse treatment. While relapse is a challenging and potentially deadly event, it can also be an indispensable opportunity to better understand what skills or resources are needed to live life more completely without drugs or alcohol. If individual attorneys are going to face this problem and make the decision to change their substance-using behavior, a significant number of them are also going to struggle with relapse. Therefore, it is important for attorneys to know that they can survive the difficult learning experience and get back on track to meaningful and productive lives. About nine percent of the adults in the United States have participated in an AA meeting at some point in their lives, and about one-third of those admit that it was for their own problem with substance use. Additionally, 12-step groups appear to be the most frequently attended form of support group for the adult American population.6 A survey of individuals with a history of alcohol problems who achieved approximately five or more years of sobriety indicated that 44 percent did so with the help of AA, revealing AA to be the single most commonly relied-upon method of achieving and maintaining abstinence from alcohol.7 For attorneys considering ceasing problematic substance use in our cultural climate, AA and related 12-step groups are options almost impossible not to consider. Often individuals have preconceptions about this diverse organization that do not always hold true in the light of real experience. It is important for attorneys to get accurate information about AA before making the decision about whether it could be helpful. For the sake of this article, I will call the attorney I interviewed Doug. Doug has practiced law for about 27 years. He lives and works in a small town. He is in his mid-50s and began his recovery approximately 20 years ago. Of his initial consideration that there might be a problem, Doug stated: “I thought I might have a problem in law school. Other people stopped [drinking] and I would continue.” He did not attempt to do anything about this disparity. Later, as a prosecutor, he and his colleagues went to the local watering hole. He would often think, “I’ll just get a couple of beers.” Sometimes he did have only a few and other times he would have a lot more, coming home at 2 a.m. extremely drunk. “I couldn’t predict when these episodes would happen.” One incident stands out as particularly alarming. He described it as a clear wake-up call for him. He passed out on his living-room floor after an intense bout of drinking. He woke up after missing a flight out of town and knew he would be late for an important bar association meeting. He got a later flight that morning, during which he had a bloody mary in order to feel better. Upon arrival, the alcohol on his breath was undetected by the other attorneys, because a cocktail social hour was in progress. To him, it was a miracle that he wasn’t discovered, and he thought to himself, “I definitely have a problem.” Soon after that, Doug had a deposition with a psychiatrist who has expertise in addictions treatment. He pulled the physician aside and expressed his concern about his own alcohol use. They agreed to meet at a later date, and the doctor advised him not to drink until that appointment, one month away. He was able to abstain for only one week. Along with a diagnostic interview, the physician gave him the Michigan Alcohol Screening Test (MAST) and concluded: “You’re an alcoholic.” Initially, Doug was resistant to the idea of abstaining from alcohol altogether and believed he could not control his alcohol use. So the physician set up a test: “You can drink all you want for a period of 90 days but you can never get drunk.” Doug succeeded in this for about 60 days and then got drunk. Upon returning to the psychiatrist, Doug said: “Maybe I am an alcoholic.” The doctor recommended that he make the commitment to stop drinking altogether. Doug agreed with one condition — only if his abstinence could start after football season. The doctor insisted that he should stop on that day. Reluctantly, Doug agreed. Doug’s abstinence began that day. However, he did not want to go to AA because he felt it was humiliating and was afraid of being seen by others he knew in this small town. He anticipated that AA would be “dour” and “full of derelicts.” He was also concerned about clients on either side of the cases he handled seeing him at meetings. “People would look down on me. It would be seen as a weakness.” Nevertheless, the doctor recommended a meeting in which he knew there were a few other attorneys in attendance. Doug agreed to give it a try. He was “petrified” walking into the local meeting. However, when another member began to speak his story, he suddenly felt at home. He met other attorneys at the meeting, and this also eased his discomfort. He and the other two attorneys founded another sober-support group for professionals in his town. He continued to attend both meetings, and his fears dissipated. Initially, he had no knowledge of its structure or philosophy but found upon experiencing it that he “loved it.” The tradition and ritual made him feel at home, as it reminded him of the religious practices with which he was raised. He valued the spiritual aspects and focus on developing a relationship with a power greater than himself. However, he stopped going to meetings after 10 years. His initial goal for entering AA was to simply stop drinking. After 10 years, he had achieved that goal and no longer felt the desire for alcohol. So, gradually “AA just disappeared” from his life. Over time, however, cravings for alcohol and the feeling of fighting those cravings returned, especially in response to external cues. As Doug described it when he heard someone open a can of soda, “my stomach went nuts,” because it viscerally reminded him of opening a beer. Nevertheless, Doug remained abstinent from alcohol for the next five years. After more than 15 years of sobriety, there was a death in Doug’s immediate family. Afterwards, he drank quietly for a brief period. In his pain and loss he turned to alcohol. He remembers thinking, “It will be OK for me to drink today. I can stop tomorrow.” Even though these fleeting thoughts and justifications flew in the face of his past experience of not being able to drink moderately for any sustained period of time, they served the immediate purpose of giving him the excuse to drink again. After resuming drinking, he could immediately see that his life would “go downhill quickly” if he continued. Specifically, he could imagine missing work, his law practice suffering, and being in danger of getting a DUI. Additionally, he “instantly experienced the progressive aspects of alcoholism in a physical sense,” including intensified cravings and needing to drink more and more alcohol to get the effect he wanted. He went to an AA meeting and talked about his relapse. He discontinued his alcohol use for the next three years, while irregularly attending AA. His level of participation was sporatic because he felt “inferior” as a “relapsed alcoholic.” About two years ago, while experiencing a family crisis, Doug experienced a brief relapse that resulted in legal involvement. For the first time, his alcohol related behavior created problems that were obvious to him and everyone around him. His behavior was more out-of-control than before. He returned to the physician who had treated him previously and asked if inpatient treatment was advisable. His psychiatrist recommended he increase his involvement in AA instead. This was effective, as Doug has not had a drink since. Doug learned from these relapses that the support of AA and a strong relationship with God are important to his recovery and life. The particular stressors that led up to his relapses do not really matter. Before each relapse, he did not have the tools to deal with life and wasn’t “spiritually grounded.” Doug says that he was “not connected to God and my place in the order of the universe.” When he discloses to others in AA about these relapses occurring after such a long period of abstenance, he sees fear in their eyes, that he reads as meaning: “You just took away my hope.” However, to Doug the relapses were “a good thing.” They forced him to examine how “miserable” and “spiritually disconnected” he was. That state of mind combined with virtually any significant stressor would have resulted in a crisis and likely relapse. Doug’s insight that his feeling spiritually disconnected led him to relapse is consistent with research that shows a modest but consistent relationship between religiousness/spiritual activities and decreased substance abuse and dependence. Carl Jung, who corresponded with the founders of AA, stated of alcoholism and spirituality: “One drives out the other.” For some individuals. Most of Doug’s negative expectations regarding how others would view his sobriety, participation in AA, and later struggle with relapse were dramatically invalidated. Of AA, he stated: “AA wasn’t what I thought it was.” He was surprised by the broad cross-section of people participating. In contrast to his idea of AA as serious and unpleasant, he found it to be “full of laughter” and “uplifting.” In the important relationships he formed in AA, he found that he grew as a person. He was surprised by the strength he found in people with dramatically different backgrounds and experiences from his own. For instance, his first AA sponsor was an ex-convict recovering from heroin addiction. He respected, and learned a lot from, this man. He found it “freeing” to admire people “not for what they did for a living, but for their sobriety.” Generally, Doug has “not had a problem” with clients or other counsel viewing him negatively because of his sobriety or involvement in AA. In one instance, an opposing party made a snide remark about his participation in AA. He found that this did not bother him. In contrast, there have been many times people have gone out of their way to express respect for him. When he has seen individuals involved in his legal cases at AA meetings, such as when someone comes up to him to shake his hand, he has simply set boundaries by saying that they can’t talk about the case. They have always understood and seemed to perceive the fact of his participating in AA as a strength. Other attorneys have had “nothing but positive” reactions to his recovery. Following his more recent relapse and legal trouble, Doug thought his career might be over. So he was startled when lawyers, judges, and clients went out of their way to express support for him. This was even true of attorneys who often oppose him in court. Additionally, to his great surprise, business went up after he clearly got back on his feet again. “People want a human lawyer” is his interpretation of this unexpected boom in business. In the end, rather than ruin his career, this experience has reaffirmed his commitment to his career and helped him realize how much he loves law. Having thought that his career was over and then to receive so much support has led him to look more deeply at his work. Currently Doug goes to two meetings a week, sometimes more. He believes working to help others helps him stay sober. When he travels, he attends other AA meetings and learns a lot, because it gives him further experiences with the wide range of recovering individuals. Doug wants other attorneys to know that “AA and being an attorney go together well,” because working as an attorney is very stressful and “AA is a great antidote to stress.” Additionally, he stated: “The law attracts people who are helper personalities, but with both strong egos as well as insecurities. Practicing the steps of AA helps produce a balance in that regard, which yields both inner peace and professional creativity.” Doug also speaks of how substance-abusing attorneys share “an inability to comfort ourselves,” and AA helps provide tools to do this. The fellowship and the safety of AA allow a “lack of masks.” This is especially helpful to individuals who work in an adversarial mode most of the time. If anyone is wondering if they have a problem, he hopes they won’t fear talking about it. Talk to another attorney in recovery, and the conversation will be both “confidential and nonjudgmental.” Ellen A. Begley, Ph.D., is a clinical psychologist currently working as the addictions specialist for the WSBA Lawyers’ Assistance Program. Support Resources for Attorneys in Washington State The WSBA Lawyers’ Assistance Program (LAP) offers individual therapy and referral services for addiction problems and other mental health issues. LAP office: 206-727-8268. Addiction specialist Ellen A. Begley, Ph.D.: 206-733-5988. Abstinence-Based Sober-Support Resources The following are some abstinence-based, nonprofit organizations that offer support to those struggling with addictions. They each offer a unique philosophy for achieving a sober, healthy life. This list is intended to give a sampling of the range of options available to individuals. Alcoholics Anonymous (AA): 509-758-2821, www.alcoholics-anonymous.org. AA is the most established, accessible, and prevalent sober-support organization in the world, and originated the 12-step method more than 60 years ago. In addition to the many meetings officially listed, there are many unofficial meetings for particular sub-groups such as attorneys, doctors, professionals, gay/lesbian/transgendered individuals, specific race/cultural groups, and others. Narcotics Anonymous (NA): www.na.org. NA applies a 12-step program and AA structure to help those attempting to stop the use of drugs of any kind. Derivatives of NA include Cocaine Anonymous, Marijuana Anonymous, and others. Women For Sobriety (WFS): www.womenforsobriety.org. WFS is the first national self-help program for women alcoholics. Started in 1976, it is well-established and has a spiritual component. LifeRing Secular Recovery: 510-763-0779, service@lifering.org. Started in 1985 (formerly known as Secular Organization for Sobriety), LifeRing encourages the use of reason and the scientific method to understand alcoholism. It focuses on prioritizing sobriety above everything else. SMART Recovery: 440-951-5357, www.smartrecovery.org. Facilitated support groups that offer cognitive behavioral tools to abstain from alcohol and other drugs. Religious/Spiritual Sober-Support Resources Jewish Alcoholics, Chemically Dependant Persons and Significant Others (JACS): 212-397-4197, www.jacsweb.org. White Bison/Wellbriety Movement: 719-548-1000, www.whitebison.org (Native American spiritual focus). NOTES |
