Excerpt from "The Stranger You Love"

Chapter 2

The Stranger You Love

All addicts' stories are heartbreaking in their own unique ways. But if you hear enough of these stories, you begin to realize that they are also distressingly similar. They follow a predictable pattern of experimentation, addiction, and eventual loss of everything most of us hold dear, including family, home, job, and personal values. Addicts become estranged from the nonaddicted world and seem not to mind when they are reduced to circumstances that would be intolerable to almost anyone who is thinking clearly. My own daughter was a prime example.

A heroin addict at age twenty-three, my daughter and her boyfriend, a fellow addict, were evicted from their apartment for not paying their rent. In the four months they had lived there, their apartment had become almost uninhabitable. The filthy bathroom contained a phone book that they used for toilet paper. The living room was a chaotic jumble of dirty dishes and soiled clothing and bedding. The bedroom floor was covered with animal feces from their cats and ferret.

They eventually moved in with friends for a short time and then to the back of their car, a small station wagon. By that time they had lost or sold most of their possessions. Only a few items of clothing and some bedding remained. My daughter always wore the same long-sleeved shirt stained with sweat; the cuffs and sleeves were speckled with dots and streaks of blood. Her shoes smelled like rotten meat.

Yet when I confronted her about her situation, she insisted that nothing was wrong. "A lot of people live in their cars, Mom," she said, as if it were the most normal thing in the world. "We're going to get a new apartment next week. This is not a big deal." She denied the addiction outright.

As sickened as I was by her situation, I did not fully realize that I was dealing with someone who inhabited a different mental world than my own. Only later did I begin to see that we shared no common ground, that it was impossible for us to communicate because she had lost touch with everyday reality, and that my daughter had, in fact, become a stranger.

Most families of addicts experience similar feelings about their loved one. They say such things as "I don't even know who he is anymore" and "I look into her eyes and it's like there's no one there." One mother of an addict said to me with tears in her eyes, "What a terrible disease this is. It takes away our kids."

People sometimes claim that addicts have "lost their souls." What they mean is that the addicts no longer seem to care about anything but their drug of choice, that they have become untrustworthy, and that their value system seems bizarre or nonexistent.

Families experience a tremendous sense of loss as they see their loved one, who once possessed certain defining characteristics such as a good sense of humor or a strong work ethic or an affectionate nature, lose these positive traits. Indeed, individuality deteriorates as the addict takes on behaviors that are typical of other addicts, behaviors that are aimed at achieving one end: the next high.

Recognizable addictive behaviors, present to a greater or lesser degree in most addicts, emerge as addiction takes hold. They are the result of a subconscious process in which new thought patterns are adopted to facilitate addiction. Addicts do not consciously decide to change their behavior. Rather, the process of change occurs at a deeper level, a result of the marvelous human capacity to adapt to altered circumstances. The addicts, not realizing what is happening, begin to think and behave in ways that may have been foreign before the addiction took hold, but that now seem natural and even necessary. Their brains have been biologically and chemically altered.

Families generally sense the changes in their loved one but do not fully appreciate the depth of those changes. They may continue to treat the addict as they have in the past, only to find their interactions with the addict increasingly confusing. They cannot find any solid ground in the changed relationship as the addict begins to exhibit a disturbing repertoire of addictive behaviors.

Foremost among these addictive behaviors is denial.

Denial

It is not uncommon in our society to hear someone described as being "in denial." This condition is generally understood to mean that the person in question is unwilling or unable to face the truth about a particular circumstance. Who among us hasn't been in denial about something, whether it's our relationships, our diet, our spending habits, or some other troubling aspect of our lives? Many families of addicts, including myself, deny their loved one's addiction for a long time before circumstances force them to face it. Denial seems to be a natural human response to situations we are unready or unable to cope with.

When applied to addiction, however, denial is taken to the extreme. Denial permeates all of addicts' thinking, blotting out reality and replacing it with a twisted perception that everything is other than what it is. The denial is most obvious when addicts are challenged to evaluate their own situation. They immediately deny that they have a problem and insist that they can control or stop their use of alcohol or other drugs whenever they choose.

Denise, a secretary whose seventeen-year-old son was hooked on heroin, described talking to him about the problem: "At first he said I was crazy, that I was imagining things. He kept telling me to leave him alone. He was really angry. But a friend of his had told me he was addicted, so I kept after him. He finally admitted to snorting heroin 'a little bit' at parties and things like that. He acted like it was nothing. Then he started stealing money from my pocketbook. All that time I was confused because I felt things were bad, but he kept assuring me he had things under control. Then he sold his guitar, and I knew I couldn't go along with his denial anymore. I forced him to see a counselor. I found out he was shooting up four times a day. Even then, he still insisted he could stop anytime he wanted."

Peggy, married to a police officer hooked on cocaine, faced a similar experience. "He was spending every cent he made on cocaine," she said. "He stopped paying the bills, stopped buying groceries, so I had to take on all the household expenses. I kept threatening to walk out on him, and he kept saying I was crazy. He didn't have a problem. He was just fine. You know something? I honestly think he believed it. I don't think he had a clue about what was happening to him."

The pattern of denial that Peggy and Denise confronted is typical of most addicts. Denial is the mental mechanism that enables addicts to give up more and more of the things that are truly valuable in life in favor of an artificial and fleeting sense of well-being induced by a chemical. In other words, denial is the foundation of addiction, the fertile soil in which it grows and flourishes. Denial provides the comforting delusion that everything is all right, smoothing the way for addicts as they wind deeper into their downward spiral.

A truism about addicts is that they will always deny their addiction or, if forced to admit it, they will minimize its depth. They consistently say such things as "I can stop any time I want" and "I only use it occasionally" and "I don't need help-there's nothing wrong." Even when everyone around them knows that addiction is destroying their lives, addicts will deny that they have a problem.

The depth of their denial does not stop there. As addiction takes it inevitable toll, addicts will also deny the severity of the consequences. Even as their world crumbles around them, as everything of value is stripped away, they will claim that their losses are not of much consequence. Their entire belief system is altered by the power of denial.

Jerry and Teresa, who had recently celebrated their thirtieth wedding anniversary, described their horror as their only daughter endured one tragedy after another without apparent concern. Their daughter was a nurse, a single mother in a committed relationship with her child's father. She became addicted to prescription drugs and lost her job. Soon afterward, she was arrested for forging prescriptions, then for shoplifting, and finally for prostitution. Over the course of several years, she spent many months in jail and lost her car, her apartment, and most of her possessions. Her boyfriend left her, and ultimately she lost custody of her child.

"It wasn't until we were awarded custody of our grandchild that I finally realized just how sick her thinking had become," Teresa said. "As she was being led off to prison and we were raising her child, her only comment was 'Well, it's only for nine months. I don't see what you're making such a big deal about.' Nine months! Nine minutes would have been too long for me to endure a situation like that. But she didn't seem to get it."

The power and importance of denial cannot be overstated when it comes to understanding addiction. Even when addicts are facing life on the streets or incarceration, they will deny that addiction is the root cause of their troubles. Their perception becomes so distorted by denial that they may be truly unable to comprehend the disaster that has befallen them.

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Behaviors that are Symptomatic of Addiction

In my experience, denial, dishonesty, and manipulation are the behaviors most fundamental to addiction. They are the behaviors addicts call on time and again in the all-consuming effort to get drugs, use drugs, and conceal the addiction from others. These behaviors become like second nature, helping the addiction take root and blossom.

However, there are other behaviors associated with addiction that are often more readily apparent and that make the experience of dealing with addicts confusing, even bizarre. These behaviors result from the effects of the alcohol or other drugs themselves. They include withdrawal from family and friends, defensiveness, lack of responsibility, lack of personal hygiene, and irrational and inexplicable mood swings.

My daughter exhibited all of these behaviors over a two-year time span. I kept trying to convince myself that she was suffering from nothing more serious than mild depression. She was living with her boyfriend in an apartment about a fifteen-minute walk from my house, yet I rarely saw her. She avoided answering the phone or opening the door when I rang her bell. Once she was coming out of her building just as I was arriving, and she became hysterical. "Why can't you leave me alone? Why are you always bothering me?" she cried. I had never seen her so frantic and had no idea at the time that she was coming down from a cocaine high.

On another occasion, after her phone was disconnected and neither her friends nor I had heard from her in more than a week, I became so alarmed that I asked her landlord to let me into her apartment. I had been ringing her bell and knocking on her door off and on for most of the day with no response. As he inserted the key, he banged on the door, and I called out her name yet again. There was no response, so he pushed the door open. I was convinced that she had moved away or was dead. Instead, as the door opened, my daughter and her boyfriend jumped up from their futon, not more than three feet from the door, with a surprised exclamation of "What the fuck!" Anger and accusations followed. "You're psychotic, Mom," she screamed. "Why can't you accept that I'm grown up? I don't have to be hanging out with my mother anymore."

The refusal to answer the door became a common thread throughout her addiction to cocaine and then to heroin, as did her reluctance to participate in family gatherings or join me in activities she had once enjoyed, such as going to the movies or going out to eat. She became increasingly isolated and treated every overture of kindness from her friends, her siblings, and me as an invasion of her privacy. Her rare interactions with the family usually resulted in scenes of hysteria or tears. Amazingly, through it all, I persisted in my own denial of her drug problems, although they were the obvious explanation of the terrible changes I was seeing in her.

Another mother told me of a similar experience with her son, a thirty-two-year-old licensed electrician. "He used to be so responsible," she said. "He made good money and had some close friends, and I thought he was set for life. Oh, I knew he smoked pot, but I didn't consider it a problem. He had a good head on his shoulders. Then everything fell apart. He stopped paying his rent. He wrecked his truck and lost his job. His phone and electricity were shut off, and he stopped coming around to visit. We all saw him less and less. Looking back, there were plenty of red flags, but I didn't see them.

"Finally he admitted to his brother that he was hooked on heroin. When I learned the truth, I went over there and banged on his door for at least an hour. I was screaming his name at the top of my lungs. The neighbors must have thought I was a crazy woman. Finally, I said I was going to get the cops to break down the door because I really thought he must be dead in there. What else could I think? That's when he opened the door. He looked awful, thin and sickly. He let me in, but he turned his back to me. He kept saying he just wanted to be left alone. Why couldn't I just leave him alone? I started yelling at him. I couldn't help myself. I kept asking how he could he be so stupid, things like that. I was out of my mind. After a while, I don't know how long, he just broke down and sobbed. He was like a little boy."

Her anger at her son's "stupidity" was mingled with disbelief. "It was like a nightmare," she recalled. How could drug addiction change her son from the clear-headed, hard-working young man she had always known into the irresponsible, emotional wreck she saw before her? It seemed impossible that this weeping, fragile man was truly her son.

Yet the kind of transformation she witnessed in her son is one that is seen all too often by families who are struggling with addiction. Families try desperately to say the right word or do the right thing that will snap their addict out of the insane behavior. They try reasoning, threatening, or any tactic that may formerly have affected the addict's actions. But their efforts are usually futile-for the simple reason that the addict's brain has been dramatically altered by addiction.

Scientists are only recently exploring the ways that addiction physically alters the brain. What is becoming increasingly clear is that giving up alcohol or other drugs is not a simple matter of choice or willpower. The addicted brain itself functions differently from a nonaddicted brain, and addiction affects every aspect of the addict's physical and emotional existence.

This knowledge is terrifying for most families, driving home the point of just how appalling their loved one's condition is. But there is also strength in knowledge. No addiction is hopeless, and by understanding how addiction works, families can find effective strategies for coping with this terrible disease.