Storyline continued, please read yesterdays blog first

This story is a continuation from yesterday. Please read yesterday's blog first. This story continues from two years after yesterday's blog.

Today, her mother had telephoned, Kathleen had been at a party and had fallen on a glass coffee table which had shattered and cut her arms and legs in various places. She had surgery last night and today was showing signs of delirium tremors. Her mother asked me to come to the hospital to see her. AsI headed towards the hospital I remembered the last time that I saw Kathleen Johnson, it was about two years ago, I had seen her twice when she had come for help to prepare for court because of a DUI. I remembered that Kathleen had been very reluctant to even acknowledge that she was drinking too much.  Although it was natural for Kathleen’s mother to be upset she seemed equally in need of my services as Kathleen was.

As I arrived on the surgical unit a small build woman with greying hair was sitting in the quest chair tying to compose herself and recover from an obvious crying session.  Mrs Johnson, I questioned and she answered, “Oh thank you so much for coming. I just don’t know what to do, I have been at my wits end with Kathleen for the last three months, well really for the last few years but the last three months have been so bad. I, we really need your help”.  What I really needed to know however, was Kathleen ready to be helped or was she still in denial.

I sat awhile with her mother and listened to what has been happening over the last two years, at certain critical spots; Mrs Johnson broke down in tears again, composed herself and then went on with the disastrous trail that Kathleen had created over the last two years.  Once she had finished and appeared calmer I had her remain in the waiting area and I walked down the hall to see Kathleen.

When I walked into the room I was shocked to see how the disease had ravaged Kathleen in such a short period. I was concerned that perhaps there was also another disease process going on. Kathleen had lost at least 20 lbs but on her small frame it looked like considerable more. She also was having a strong tremor so I rang for the nurse to come as I felt Kathleen was in need of some sedation, if she did not get something soon I felt that she might convulse.  The nurse came and left immediately to get a sedative to ease the central nervous system arousal that made withdrawal from alcohol so difficult and dangerous for an alcoholic. Once the sedative was given I gave it time to take effect, then I was able to help Kathleen focus on what Kathleen wanted to do help herself.  During the past year she had gone into a 28 day recovery program which the employee assistance program at the Bank had paid for. She had managed   very well for the first two weeks but then she slipped. She was unable to identify why she had slipped and then the slips became more frequent and the withdrawals became more difficult accompanied by tremors. The last time she had a convulsion her mother had to call 911.

I spent the rest of the afternoon talking with Kathleen and her mother and trying to arrange for Kathleen’s transfer to a withdrawal management center. I finally arranged for a bed at the center where Kathleen had previously been. That center however was only a 28 day center and I had become convinced that Kathleen needed longer term care. After all how could you expect that a disease that took years to develop was going to be cured in a month?  I had just never understood that rationale. I knew that once individuals started using alcohol as a coping mechanism that they stopped using other methods, at this point I still did not know how early Kathleen had started drinking but she was beginning to think that it had started at a very early age.

Kathleen was frighten and ashamed, how did she ever get herself in this position again, not exactly the same position, this time it was worse. Well, at least this time the medication was preventing her from having a seizure, at least for now.  Although no one here knew it she had been to the hospital another time, when she went to visit her friend in another city.  They had gone out partying and when she woke up in the morning her usual supply of alcohol that she kept in her gym bag was empty. How did she let that happen?  Her tremors were beginning, she had to make some excuse to get out and find some alcohol soon.  She told her friend that she was going out for a run, once outside she had tried to phone a liquor store to get directions on how to get there.  She thought she was running in the right direction and suddenly she felt weak and then she woke up in the hospital. Someone had phoned 911, the ambulance had taken her to the nearest hospital.  Only she and her friend knew about that time and although he might have suspected something, he did not push her for more information when she told him she had fainted because her blood sugar was low. God, she was really getting good at lying, lying and hiding. Maybe she really wasn’t that good after all, to be ending up back here. She hated this place! Not as much as she hated the hospital but she hated just enough. The biggest question in Kathleen mind, the one that she was almost afraid to ask herself,  did she hate it enough to do whatever she need to do not to come back here again.

Fortunately, she mustered up her courage and asked that question. She actually wrote it in large capital letters in the journal that she had been given on admission.  The last time she was here she spent little time writing in her journal, except for the times when she would repeatedly write, “I hate it here, I hate it here, I hate it here” like at school when she was made to write lines. However when she had done this in her journal on her last admission it was like a barrier, a defense against her hearing whatever the counsellor or the other women were trying to tell her.  What was it that she was so defended against?  Could she let herself be vulnerable this time? Oh, God, she thought, I so hope I can. Ever so carefully, in the best cursor form she could do she wrote, “Please, God, help me let what is ever so suppose to happen here, happen.” With that commitment to the process Kathleen settled into her bed and within a few minutes was asleep.  

In the morning since she was familiar with the routine of the recovery house, Kathleen felt an odd sense of comfort that increased even more when she found out that her primary worker would be Nancy. Nancy was about 15 years older than Kathleen with short curly brown hair, sparkling green eyes with an infectious laugh that lit up whatever room she was in. During her previous admission, Kathleen had admired her for her easy way with people, that laugh and because she just seemed to have so much joy bubbling out of her .  Normally, when she saw a person like this she would be afraid to approach her at least until after she had a few drinks, but this was not the case with Nancy as during her last admission Nancy had told her story, it was rough, but here she was 15 years later with all of this joy.  Kathleen had found it inspirational. She had also seen Nancy’s reaction to others stories and knew her compassion; she was assured it would be there for her. No wonder she felt at home. Wait, where was the hate from last night? That must be something to look at. Maybe, Nancy would have some ideas about that. Perhaps it would be a good place to start because Kathleen was beginning to think that it was her emotions that got her into at least some of her difficulties. She wrote this in her journal so she would not forget it when she and Nancy had their first one on one talk.  The rest of the day was spend meeting the other women in the house and in particular her roommate, Doris who was only seventeen and was sent here by her parents because twice she took a bunch of pills and alcohol and had to have her stomach pumped.  Doris said she never really wanted to kill herself, but Kathleen did not believe her. Besides meeting Doris and the other women clients and staff, they went to meetings to learn the rules of the center begin their group exercises and start their journals.  At the end of the day they had some inspiration reading then a yoga class. Tomorrow they would start their one to one work.

Kathleen woke early in the morning before the others were awake; she lay in bed thinking about where she was and what had brought her to this point in her life.  She thought of her parents and the pain and worry that she had caused them. How many times she had promised them in the last few months that she would never drink again. She had meant those promises, every word of them, but somehow she had not been able to keep that promise.  Was there something that she could do to ensure she could keep it this time? She so enjoyed waking up in the morning not hung-over and not worried if she was going to have a convulsion.  This was another question for Nancy. She reached for her journal and selected a new page and carefully woke the question, “How can I ensure I keep my promise not to drink again?”

After morning mediation and breakfast Kathleen had her first one to one time with Nancy. The first thing she did was to share what she had written in her journal. When she handed it to Nancy to read, she said, “this time I do not want to hide anything from anyone, I want this to work, I want you to know exactly where I am with everything”. Nancy thanked her for sharing and for her honestly and said that she would read parts of her journal anytime she wanted to share something specific with her, but the journal was for her to write her personal thoughts and then go back and reflect on them. Once she had reflected then she might decide to share them with others. Nancy was interested in her insights on her hating this place and recognizing that it was a defence mechanism and that fear was the emotion behind that, so they spent most of the rest of their time that morning talking about how frighten Kathleen was of almost any social interaction and what she might try to do to handle that fear. At the end of the session, Nancy asked her to leave the page with the question “How can I ensure I keep my promise not to drink again?” blank for now and they would fill it in over the next few weeks together.

The next few weeks in this protective nurturing environment flew by. Kathleen was working well with Nancy, I was checking in with both of them. Suddenly it was the Sunday where her family could come and visit. She was excited about seeing her parents but she also realized that she was also anxious, what was she to say, she could not bear making them another promise that she was not sure how she would keep, but she did not feel that she could not see them without talking about how much she felt that she had disappointed them.  With Nancy’s help she was able to work out reasonable expectations for both herself and her parents and with that and a little role playing before the visit she was able to have less anxiety going into the visit and a very successful outcome.

While she was basking in the glow of her parents visit Nancy asked her how things had gone to which she said, “ great I was able to tell them how sorry I was that I had hurt them and they were able to tell me how much they loved and cared for me and how worried they had been. Then we were able just to catch each other up on the happenings of the last two weeks”. Nancy then took the opportunity to broach the topic of longer term treatment. “You know if you are willing we can explore longer term treatment where you could learn many other skills that would help you with a number of your other anxieties. There are some choices near where you live, would you like to explore them?”. Kathleen responded, “If they can help me, I am open to find out about them”.

The local AA group came into the treatment center and held meetings on a regular basis. Up until now, Kathleen had not attended any of these meeting during this admission. But something about having such a good visit with her parents and thinking long term with Nancy made her want to attend. During the last admission she had hated the AA meeting as much as she hated the treatment meetings. Tonight, she relabelled that emotion as her fear and anxiety and wanted to go and see if it could be different this time around. Previously, she had seen these people as a group of losers that she did not want anything to do with. She thought she could not learn anything from them. Tonight was different. A young woman, close to her own age spoke. At first she talked about how bad her drinking was and people laughed. Not at her as Kathleen had previously thought but in recognizing themselves. The young woman then talked about her recovery, the steps she had to take, the changes she had to make and the challenges. She spoke about how they were there for her, always there for her, even calling her out, if she needed it. She said something that struck a chord with Kathleen. She said, ”we came to believe”,  maybe that could be her, Could she come to believe?  That phase was in Kathleen’s mind as she when to sleep that night. Could she come to believe that she could keep her promise?

As the next few weeks past Kathleen’s confidence and insight grew, she saw growth in the women that were in care with her but she also saw how anxious they were as they time came closer to the day they were going to be discharged. She was relieved that she had decided to go into longer term care. She liked the changes that were happening but she was not sure she could maintain those changes if she were to go home now.  Those feelings helped her go through the selection process to get into a long-term program.  Finally she settled on Firwood Hills which was near to her home and had an individualized program that progressed to home visits, outpatient and discharge as the person progressed. I thought it was perfect for her and promised that I would continue to have contact with her.

Discharge or graduation day as the women called it, came with its joy, its fears, its laughs and tears. The women had grown close by sharing and helping each other uncover their secrets, nurse their untended wounds,  heal they spirits and inspirit each other to change their lifeways. The closing ceremony was very emotional and afterwards the women exchanged email and telephone numbers with promises to keep in touch.  Family members arrived to drive the women home, Kathleen’s mother had come for her and to her surprise her father also came. He said so he could take his two favorite women out to dinner. Kathleen knew by the way he looked at her that he was proud of what she was doing.

Her bed in Firwood Hills would not be available for five more days, during dinner her parents tried to persuade her to come home with them in the meantime. Kathleen, gently but persistently, said “no thanks. I want to stay on my own; but I promise if I get lonely or I feel I need your support, I will come right over”.  With that, her parents reluctantly and somewhat apprehensively let her off at her apartment door.

Kathleen stood in the middle of the living room for a long time, looking around at her small apartment, seeing all the work that she wanted to do in the next few days. She looked down at her bugling luggage and remembered all the laundry that had to be done to get her clothes ready for Firwood. Last night she had looked up the schedule of AA meetings near her house. There was a meeting starting at 8pm just a few blocks from her apartment, she looked at her watch, it was 7:45 pm. She might be able to make it just in time if she left now, but then again she might be late. She looked again at her dusty apartment, the packing and laundry to be done. She then looked at her watch again, could she make it?  She might be late. She decided she did not mind being a few minutes late. With that thought she headed out the door. As she drove along the street looking for the community center where the meeting was being held, she was happy with her decision, she had put her sobriety above other things. Above her household activities and even above her fear of walking into a room full of people she did not know, and her normal necessity of being on time. As she approached the door, she was fully aware but more comfortable with her anxiety, she was proud of herself. Years later she would look back at this time as a critical decision time for her. She saw it as the first time where she made and kept a commitment to herself.  When she got home from the meeting, she wrote in her journal under the heading, “How can I ensure I keep my promise not to drink again? "the statement,  “Keeping your promises to yourself”.

Five days later Kathleen entered Firwood Hills,  in the years to come she would view her time at Firwood Hills and her first few years in the AA program as her Masters in Living,  although at first she called it her Masters in Healing. She named it that because that was what she did for the first few months was to review and heal traumas she had hided all her life, trauma that she even hide from herself that were the source of her anxiety and insecurities. Those trauma and insecurities had made her more susceptible to the effect of alcohol and to become addicted. This understanding helped Kathleen so much. She saw this understanding as changing the way she felt about herself, changing her self-image and her internal dialogue. She had just started thinking about Firwood as her Masters in Living when I told her that I thought she was ready for outpatient status.

Once Kathleen moved to outpatients she went back to work at the bank, she started part-time first but very quickly worked her way up to full time. Full time work and her AA group kept her busy because a small group of young people from the AA group went out for coffee after the meeting or to a movie or the beach on the weekend. She was just writing in her journal about what a wonderful day she had at the beach when the phone rang. It was Doris, her roommate at the recovery center. Doris was having a difficult day, her parents were getting a divorce and she was feeling very emotional and confused. Kathleen calmly asked her where she was and then said; "stay right there I will be there in ten minutes. Just play your favorite songs on your guitar and I will be right over”. When Kathleen arrived they talked for about a half an hour, then went to a meeting and then out for coffee. Doris was feeling better and she and Kathleen had put together a schedule for the next few weeks that include lots of meetings and time with each other.

As Kathleen drove home she felt happy and content, the last time Doris had phoned her she had been drinking. This was a big step forward. Before she crawled into bed, Kathleen picked up her journal and on the “promise page”, she underlined, “Helping Others”.