A letter to my higher power

This is part of my Step two / three homework. It feels very important so I thought I would write it as a blog post, that way it stays here for me to look back on.

As I have written before,  have struggled with the concept of a higher power – an internal struggle of ‘wanting to believe’ ; envying those who do ; but lacking the trust needed to make that leap … By some miracle (and I use that word deliberately because that is how I experience it) I have made that leap of faith and I now find myself embracing the faith I have searched for …

Dear God,

I have been aware of you all of my life. At times I have felt Your presence pushing at the edges of my consciousness and trying to make me see You , but in my arrogance and wilfulness I ignored the obvious signals You sent to me. I carried on alone, struggling to cope with the unmanageability and chaos of my life, trying to control every facet. I continued down my self destructive path for so many years ignoring the lifelines you threw in my path …

I feels so lucky that despite my stupidity, despite my arrogance, self will and stubborn refusal to listen eventually an enormous proverbial slap across the face woke me up to the blindingly obvious fact of Your reality. After so long agonising over something I could not control, it came right in the end, by Your Grace, You showed me that my will and planning  is irrelevant, that Your greater plan will prevail, and we will all be ok. We will all suffer, because that is a part of life, but with trust and faith we will be ok.

To turn my will and life to You, enables me to LIVE the serenity prayer. It allows me to stop fretting about what I can neither alter nor influence. Instead by trust and faith and prayer I can come to accept the futility of my attempts to manipulate the future, and learn instead to trust in You.

This may be the greatest gift my recovery has yet brought me. I have learned patience, self control, calmness, have practiced setting boundaries, learned to manage the shame that previously engulfed me, and started on the path of self love. All these are great gifts that have come to me in sobriety and the lived experience of a calmer, happier home, and greater honesty with those I love is a wonderful result.

All this however has not removed my worries about the future that have tormented me. This nascent faith, trust and deep feeling of serenity provides me with the key to a wholehearted, joyful, spiritually healthy future.

For this I am deeply grateful.

I know there are many incidents in my life that You threw into my path, trying to help me accept Your reality. Of course now I cannot remember a single one to acknowledge in this letter. But I now there were many that I ignored. This last, this amazing last, I could not ignore. Sent to me right at this time in my recovery when my mind is open and my willingness to hear Your call is at last developed.

The last barrier to my acceptance of You was ‘trust’ – and you showed me in the most obvious way possible that I could, and should, trust in You.

I humbly ask for Your help in embedding this faith deep in my soul. I understand that faith is an action, it needs nurturing and it needs time. I commit to regular practice of prayer and gratitude to build my relationship with You. I commit to honesty in my relationship with my God and to seeking help from those who have greater spiritual wisdom than I. Please strengthen and confirm my faith in my daily life.

Amen

Good enough …

My patient X has relapsed.

12 completed days of sobriety, intensive effort by a variety of people, proper supervised alcohol detox to obviate any physical withdrawal, a proper plan made with the drugs and alcohol team but she relapsed anyway. First chance she got really.

Interestingly I feel neither angry, resentful or that I need to fix it. I feel a little sad, but I’m able to shrug my shoulders, accept that this is her decision and  that she’s probably not ready yet. She may never be, and may be one of the sad statistics – young people who die from alcohol addiction. I have done what I could, I can do no more.

That realisation, that I can’t fix someone else, comes easier these days both in the recognition and in the acceptance of this as a simple truth. Reviewing the way I managed this, both medically and personally, I’m content that I acted appropriately (except in the moment that I told her I too have had alcohol problems – and I have learned from that and will not do it again)  Right now I’m more concerned about the fall out for others who tried very hard to help, and for the future welfare of her child. For the latter,  I will do what is professionally right. And that’s it, no judgement, no expectation, no emotional response, just respond professionally to whatever questions I am asked and do my job.

And it’s got me thinking about how I respond to my patients, how my personality impacts on the way that I do my job, and how my well-being is affected (as well as that of my family)

I’m trying to approach this with an open mind; in the past I have judged myself very, very harshly if my personal responses were anything less than 100% perfect, and been super critical of (almost) any emotional response I have had. I think this stems from a  belief that a good doctor should “care” about his /her patients but not allow that caring to be seen, not allow it to disrupt their emotional stability and never be affected by it. And I am a very emotional person. I care deeply about a lot of things, and a lot of people. In my personal life I am someone who has a small number of close friends rather than a large number of acquaintance, and these friends matter to me a LOT. If I can help, I want to, and I will try hard to do whatever I can.

Similarly in my professional life there have always been patients who really ‘got to’ me; the 26 year old Polish woman who arrived in A&E desperately unwell with sepsis and died 8 days later on ITU; the young woman with dreadful Crohn’s disease who I nurtured through her dangerous pregnancy; the man I diagnosed with HIV on his admission with PCP pneumonia; the astonishing 36 year old woman who was admitted to a hospice to die from her untreatable leukaemia. I have responded to these, and many more, by giving everything I have – in knowledge, emotional support, passionate attention to detail and hours of painstaking care. Early in my career I was warned, in a kind way, that my compassion could interfere with my judgement, and conversely I was often asked to ‘act up’ by Consultants who recognised that my dedication meant I would always give my best.

It’s taken almost my whole career to truly recognise the tension and balance in this characteristic. That it can be a force for good, and also result in problems.

In X there was another opportunity to go ‘above and beyond’, and to some extent I did. Few other GP’s would have taken on the risky ongoing detox of an unstable alcoholic. But I feel I have learned where to draw the line more appropriately to protect myself, not just emotionally but from the risk of practicing outside my sphere of expertise; the hazards of prioritising one persons needs over the many others, and the loss of judgement that can accompany a personal medical crusade.

I can view myself with compassion now, be thankful that I can still care about the outcome, and yet approach each case with a greater humility and recognition that I alone cannot provide the answers. And not only that I can’t, but that in trying I put myself at risk, (of intense disappointment and self blame; of not listening to others, of exhausting myself) and of disrupting the balance of my work /life.

I feel more kindly and benevolent toward my passionate intense involvement with some patients, more supportive and accepting than blaming critical and judgemental. I recognise that caring and involvement has made many patients feel listened to and as though a doctor is truly trying hard for them, and that this is a good thing. Its not wrong how I feel, it just needs soothing and containing in a kind way.

I think that’s a bit of a gift from this period of therapy and the programme I’m working now. The gift is self awareness and self compassion.

Long may it last.

 

Spirituality

My friend J died on June 8th.

I’m not going to write about that as its not my story, but I am just going to write this.

All through his illness, and K and J are like family to me, I have been very scared about the ‘end’. Not because I am afraid of death itself, but I am afraid of the process and the manifold ways in which death can be truly horrible. Afraid for J , but also for K and their son that something horrible would be their last memory, and after all the struggles there would be more traumatic experiences.

I knew this was weighing on me, and that it was largely a personal thing. I did talk to a few people about it, but it feels both ridiculous and a bit presumptive to try and explain why it was so important to me (and after all I am not family, just a close friend) . I also knew it was yet another example of me trying to control something that I really could not , and agonising about something that might not happen (not exactly keeping it in the day !)

Until he died, and it was a perfect death, insofar as such a sad, sad thing can be ‘perfect’, I had not understood the concept of ‘handing it over’, I had never seriously thought about ‘trusting’ in a ‘higher power’ as a realistic option. As I have been exploring, my trust in ‘God’ to help me, has been non existent.

In the last 48 hours this has completely changed. I want to capture it here because I hope so much that this will stick.

It seems to me that a) I was granted the strength, time and opportunity to have the conversations I wanted to b) that amongst the myriad of terrible potential scenarios in my head, something, somewhere, led J to a peaceful, dignified, pain free death with his beloved wife by his side.

And if that’s not a higher power working so that all things ‘intermingle for good’ I really don’t know what is.

I can see how I have tortured myself needlessly, made myself ill with anxiety over something I had no control over (although of course part of the issue is that I did potentially have just a little control in that I know how to administer medication) . By ‘handing it over’ and trusting that it will be ok, I could have saved myself a lot of angst.

Much more significantly I feel that I have been granted an insight. That ‘it’ WILL BE Ok … ‘all shall be well, and all manner of things shall be well’ in the words of the 14th century Christian mystic Julian of Norwich. That meddling fretting and agonising is not helpful, not productive and is unnecessary ….

That is the point of this post. I believe I have been given help, help to see a way forward to a calmer, more trusting future.

The picture is a beautiful fountain at the place J died.

May he Rest in Peace.

Sick

Yesterday I met some sick people. Spiritually sick.

And it scared me.

On the positive side I recognised them, almost straight away, and they looked deeply unhealthy and terrifying to me. despite their energy and charisma I could see right past that to something egotistical, selfish and potentially cruel.

On the negative side I felt incredibly vulnerable, like a newly hatched chick with only the nest to protect me from a whole host of predators who would gobble me up and spit out my bones without a second thought.

All the emotional energy I have put into my recovery this week, all the thinking and reading and reflecting has left me drained – I have made progress but I feel drained.

So I’m going to take this day to ask others for what I need, look for some peace and self care, and try not to overstretch myself.

I went to a quiet but powerful church service at 8am. A nice lady introduced herself and that simple, normal Interaction helped me to feel safe again.

But I’m rattled nevertheless

Step Two

“Came to believe that a Power greater than ourselves could restore us to sanity.”

Now this is a new challenge!

A “power greater than ourselves” hmmmmmm.

Traditionally of course this refers to God, and indeed the AA “Big Book’ published in 1939 has a significant emphasis on spirituality which at the time, meant belief in God. Over the years the book has been ‘updated’ and the twelve steps, the readings and traditions now refer to ‘God as we understand him’ or just “your / a higher power”

I have heard several times that all of the words of the 12 steps are very specifically chosen, and the second step doesn’t say “We came to believe in a power ….” it says “We came to believe that a power ” and the writings and reflections I have perused in the last week have suggested that this wording is important because it shifts the emphasis from what that Power is, to what that power might be able to do for us…

It seems that the key lesson /point that this step is making is that we can’t recover alone and that we need some kind of help,  The principles that are the foundation of this step are open mindedness, humility, trust, and a willingness to have faith.  Reading around  this step suggests that it doesn’t matter if we don’t know HOW this ‘power’ can help us,  just that we believe it is possible.

I wrote This in June 2016 when I had been sober just over 100 days; and when I read it back I marvel at how naive I was, and how wobbly …  I was vaguely aware that I wasn’t ready to do the ‘steps’ (although I phrased it as ‘I don’t want to’) If I’m honest today, I would rather it wasn’t necessary, but the difference is now I recognise that it IS necessary (for me) if I want a sustained and sincere recovery

I have read some inventories/ questionnaires pertaining to step two;  about coming to a place of belief; the definition of “a power greater than ourselves”; current experiences of God; questions about insanity; what a “restoration to sanity” might look like  and examining our own as well as general spiritual principles. Some of those questions that I found most illuminating, are reproduced below

  • What does “we came to believe” mean to you?

This is quite hard. Basically I would LOVE to have a true faith because I can see the comfort this can bring to people who have it. Comfort and peace. Not always, but a basic belief that God (and I’m going with God because whilst I respect other peoples different religious beliefs and indeed other peoples ‘higher power, for me, it makes sense to call that God) works for good, to redeem suffering and that ‘it will be ok’. I don’t have that, and I wish I did. I also find theology intellectually interesting, and truly spiritual people profoundly impressive. Not the tub thumping evangelical zealots, but the calm, loving, accepting, non judgemental people who radiate inner peace.

  • Do you have a problem accepting that there is a power/powers greater than yourself?

Simply put, No. I cannot believe that we are ‘just’ cells and biochemical reactions and that we do not have a soul. That this soul is much more than the scientifically rational. In fact its harder for me to believe this is NOT the case than that it is. I have seen many people die, and I have seen, with my own eyes the alteration in the body at the moment of death. As though the soul leaves at that moment, is released from the mortal body, and goes ? Somewhere … So if we have souls, there is something other than science involved …

  • What evidence have you experienced that a “higher power” is working in your life?

There is lots of evidence. Actually LOTS of evidence. Once you accept that Fate is in-fact “the will of God” . From small things, to the big things that include my miraculous and unlikely acceptance to medical school.

  • Do you have any fears about coming to believe in something greater than yourself?
  • I have a very deep fear that I won’t be able to do it ‘properly’, that I will always have a shaky faith because of my logical rational, scientific brain. The leap into ‘believing’ seems like a giant step into the unknown … and a leap away from the control I have tried to exercise over my life and it’s progress.
  • Did you make insane decisions as a result of your addictions?

Yes. Lots of them. The very definition of insanity, doing the same thing over and over again and being surprised when I got the same outcome …

  • What changes in your thinking and behaviour are necessary for your restoration to sanity?

I don’t know right now and this is a really really scary one for me, because clearly just not drinking, whilst an essential start, isn’t enough. There is a whole heap of stuff in here which is fundamentally related to the self critical and harshly self judgemental way in which I have critiqued myself all my adult life. I’m working through this with Angela, and I can feel the progress.. but it’s painfully, frustratingly slow. I used to think I would get “better” and then consider what changes I might make in my life – I’m becoming afraid that I might have to make changes in order to live a fulfilled, contented and happy life. But this would mean taking a huge risk, and challenging some of my deepest, most profound insecurities. It would mean giving up some of the drivers that have shaped my whole life ..basically, as I alluded to in my last post it would mean creating Time for myself …. which would mean changing / reducing my hours at work.

  • What fears do you have that are getting in the way of your trust /faith

One big issue is the “Why does God allow all the suffering in the world” conundrum. I struggle with this one, as to many people of all faiths. In the process of my reading around this (google really is amazing) I came across this text, and then an explaination for it which I paraphrase here.

And we know that all things work together for good for them that love God” Romans 8. 

The explanation I read about this text went along the lines that if you allow for the translation from Arameic, the phrase could be read as “all things intermingle for good” and that from this we can take that God does not will suffering, but instead the suffering of humanity whilst individually tragic, is part of a greater plan that we mortals cannot perceive or understand, but through faith can believe that God has control, or a ‘master plan’ for the world, that we cannot hope to know but which can can make personal suffering bearable.

I found this both feasible and comforting.

The other irrational fear I have goes like this. I have always sort of believed that God does not send suffering that a person cannot cope with. And I know I could not cope, as I am, with the death of one of my children. I could not. Deep inside I’m afraid that if I had faith, God might think I could cope, and visit such suffering upon me. This is totally irrational and contradictory on so many levels … I don’t need to deconstruct it; but it’s there. And it’s a barrier.

  • What do you need to do to help let go of the fears?

I don’t know. But building on the concept of neuroplasticity, and my accepted belief that repeated actions become habits and that from habits come new neural pathways I have committed to trying to pray every day and attending Church once a week when I can. Quietly. No big song and dance, no declarations of faith or expectation of spiritual awakenings, no discussions or high drama confessions. Just deliberately cultivating and nurturing my nascent spirituality in a way that seems manageable.

  • What results have you personally seen from demonstrating open mindedness in your own AA journey?

Just GOINGtoAA was a huge step in open mindedness for me, as those who have followed this blog for a while will recollect my deep aversion to doing so. And the decision has been rewarded a thousand fold with the friendship and support I have received. Attending AA gave me the courage to be open with old friends as well as new, and my life has been immeasurably enriched by the connections I have made through attending meetings, working with my sponsor and reflecting on my experiences.

It seems important to remember that step two, like all of them, is a process, not an event, and that perhaps for now, at this stage, all I need to achieve is the belief that a) there is a higher power / God and b) I was behaving in an insane way as a result of all my addictions and c) it is possible not to behave in an insane way.

Having it all

This is one of those posts that has been lingering at the back of my mind for months; every now and then I pull it up in the drafts box add a couple of lines and know its not fully ‘cooked’, and that my thoughts and feelings need more development before I can capture them accurately on “paper”.

Today I’ve rewritten most of it,  but the essence, that elusive “having it all” dream, is still the central theme thats been occupying me, and still the thing that needs examining.

Like many women brought up in the 70’s by mothers’ who had often had to settle for ‘jobs’ rather than careers, I believed the mantra of the time, that women no longer had to choose between being ‘wives and mothers’ or ‘career women’ but could instead “have it all”. 

“ALL” was a successful, lucrative career AND a husband, children and a happy family life.

This utopia was sold to my generation of young women by the feminist movement of the 1970’s and early 80’s and by the generation of women who had struggled so hard for any kind of equality in the workplace.

The equal pay act only came into force in 1970 in the UK, when I was already 5 years old. That is utterly shocking to me. But its the truth and it is the environment that those women who were influential on my adolescence had striven to be recognised within.

No wonder they were angry. And no wonder they wanted to pass their hard won “equality” on to their ‘daughters’.

However, this quixotic dream – that the career and family that every woman could have would each function perfectly well and that no sacrifices had to be made, quickly turned into a dystopian nightmare for many women. I do not propose to develop this theme further by looking at why that might be, nor to espouse on the (far too) slow evolution of the masculine brotherhood toward true equality. That might get me started on a feminist soapbox (and whilst I am proud to identify as a feminist, thats hardly the point of this post)

When I studied medicine, I always intended to work, and when I opted for a career in general practice after five years in hospital medicine, it was with the idea that I would be able to manage a family easier without night shifts to negotiate. I swallowed all the ‘research’ about how its not the quantity of time that mothers spend with their children but the quality of that time which is important… what I quite forgot in all this planning was that somewhere, somehow one also needs time for oneself.

So for the last 27 years, apart from three brief maternity leaves (no option for a year off at that time) I have always worked full time. And I have a career. I’m a joint owner of a medium sized business, and I have done quite well for myself.  Ok our primary responsibility is to deliver health care to patients registered with us, and this I am qualified and trained to do. Running a business however, means employment, governance, financial decision making, implementing guidance across practices, strategy planning and implementation, managing staff etc etc etc. And I am neither trained nor qualified to do any of these things. I’ve picked it up along the way and make a reasonable fist of most of it, most of the time, but the fact remains I’m operating way outside my comfort zone for about 1/2 my working week.

When you work 40 hours + a week, have to do all the ‘thinking’ in the house – who needs new shoes, who has to get to an appointment, what’s in the fridge, practically manage the bills, post, stuff, cooking, some of the cleaning and washing … try to spend time with the children you work so hard to provide, for I sometimes think I drank to escape from the pure stress of the merry go round. The busy brain, the inability to just switch off and do nothing, at least partly because there was NO-ONE else to rely on, no one else who would step up and take the slack and no-one else who cared.

But behind all that, the driver (one of them) was this frankly ridiculous belief that you can ‘have it all’ and nothing will suffer, and worse: if you don’t ‘have it all’, its because you are “not trying hard enough,” and are incompetent, lazy or selfish. (or all three).

And that is JUST NOT TRUE. This idea; this construct; this theory; that deep down has been one of my core beliefs is simply and intrinsically wrong.

Now I’m not saying it cannot work out. Clearly it can. In my own experience I see many relationships and families where it works out quite nicely: but in ALL of these situations there are TWO adults in the family and both take an equal and active role in the business of “the family”. For some, one partner works and the other stays home to manage the house/children etc. For others both partners work part time and during their home days, actively participate in ALL the house ‘work’ (not just cleaning the loo, but remembering to book tickets or get a birthday present) In still others both work full time but buy in help to outsource the cleaning / gardening / ironing etc and BOTH actively parent the child(ren) at weekends and holidays.

None of these scenarios was mine.

Im not playing the pity card here, but over the last 19 years I have always been the wage earner and the parent and the thinker/ organiser/planner.

WHY did I not realise sooner that what I have expected of myself was simply not possible. That NO-ONE could have done all this perfectly, that its just not feasible for one woman (or man) to manage all that with NO casualties.

The casualty has been my children’s upbringing

Too late the realisation that young children do not thrive without positive examples of how to live, being shown and taught how to do stuff, talked to, encouraged and nurtured. And that that takes time. Proper time. Quality time. That feeding, bathing and cuddling is ‘good enough’ parenting but its not fantastic, and it will have consequences. No-one can know, because life is not an experiment, what would have happened if I had realised this sooner, cut my work hours whenI got divorced and spent more time at home and less time building my business (in a world where I am respected, I know what to expect and there is much more certainly and less drudgery than being at home with 3 children under 11)

I’m getting to the point I promise. And its not about beating myself up for the past.

I wasn’t working full time because I wanted lots of money, I wasn’t working full time because I felt more comfortable in the adult world of work than in the drudgery and chaos of home life, I was working full time because I believed I should be able to do it all and have it all,  and if I did not I was a failure.

For many years now when asked for career advice by younger women, I have encouraged them to continue working once they have a family (because its extremely hard to get back to practice now after even as little as 2 years off) but to work less than full time. I have known in the deepest places of my soul that my choices were unsustainable, and I have been much kinder to others than to myself.

I have never before been able to accept that I struggle with my life, that it feels unmanageable, in part because it IS unmanageable. That all my addictions and strategies to control and manage the feelings I have so desperately tried to bury have grown in part because I have been fighting a losing battle and setting myself impossibly and ridiculously high standards.

No wonder I feel like a failure.

having t all

Reflections on Step One

This is a piece of Homework I was set by S. Its something I wanted to do, because the three weeks or so I have been looking at the Step One inventories & questions have been interesting, revealing and have, I feel, helped me toward a greater understanding of my addiction(s).

As I wrote before, I really wasn’t expecting  a lot from this step. When I deconstructed the wording, ‘We’ in respect to the admission of powerlessness seemed vaguely inclusive and comforting,  BUT I wasn’t about to give up my thought that, whilst I’m happy to admit to being powerless over alcohol after the first drink, I retain my power to decide whether or not to take that first drink. So far so good.

I’ve done some reading around the whole twelve step philosophy, about the meaning and purpose of the twelve steps  themselves, and about the science and research behind addiction. This has all been to the good, I’ve learned a lot that fits with my ‘lived reality’, and supports the total abstinence path. I have gained comfort from the stories of others in meetings, and several new friends met via AA who’s support I value so much.

BUT, In some ways I am in a worse mess (mentally) than I was before I decided to start the steps. I WAS in (quite) a good place; I have put my ex-partner out of my mind, and genuinely don’t think of him much now. I had started sharing and communicating with all the people around me, I felt quite secure in my sobriety (but definitely not complacent) , and life was looking up.

Now I have had to face a few unpleasant truths, and a few things I just don’t know how to change. Because whilst my life is significantly less chaotic and unmanageable since I stopped drinking, it’s still more tumultuous and disordered and unmanageable than I would like.

Or is it ? I have lived in chaos all my adult life with one drama after another – some good (marriage, births of my children, moving house) some not so (divorce, toxic relationship, financial stresses) and some just ongoing ‘normal’ stresses which I perhaps feel more acutely than others? I really don’t know but I’m beginning to agree with Angela’s assessment that I am ‘a highly sensitive’ person.

Since I completely accept responsibility for the way my life has been, is now and will be in the future, I’m forced to look at why – what is it about me that creates these situations and have I learned only to “thrive” in high stress environments ?

And what IS IT that I want from my life if its NOT this?

I’ve looked at the other two major ‘addictions’ in my life and I can SEE that often a huge food binge and a shopping spree is /are triggered by stress. In one way or another I have learned these responses to feeling anxious / afraid/ overwhelmed/ angry/ frustrated/ pretty much ANY emotion.

I’m holding these thoughts and connections tenuously in my brain right now, and Im writing this very early in the morning – because I feel If i don’t catch it, the connection will be washed away in the stress of the day.

The ‘problem’ is this … my life is just too busy.

For me.

Other people might be able to manage with this amount of pressure, but I cannot thrive and build the life I (THINK I )want with the current set up.

Currently I work full time, on average 40 hours a week, in a very stressful job with a lot of responsibility. Not just for my own actions, but for the running of a medium sized business (turn over about 4 million pounds a year) and the decisions of the  30 other clinical staff. I am a single parent three teenaged children who have a father who loves them but is not able to be an effective co-parent. I have a dog. I have an elderly mother who I love but with whom I have a fairly dysfunctional relationship. That’s the practical side.

I’m beginning to recognise that I find this all just overwhelming, I’m in a state of constant anxiety and tension,  and i find it virtually impossible to relax (unless I’m actually AWAY on holiday) The result of this constant background tension – say the emotional ‘tank’ is running at only about 20% availability (because 80% is taken up with stress about permanent fixtures)  , is that there is not much left for the inevitable day to day stuff – son 2 and his GCSE’s, etc.

As I look at my new yellow handbag, bought on-line earlier this week (it’s a copy of an extremely lovely Burberry tote bag – which was too expensive even for my fevered spending spree) I’m wondering how I can better manage my whole life.

boden

If I accept the twelve step theory for all my addictive type behaviour (and my logical brain tells me I must if I accept for my alcohol addiction) then the ‘answer’ is abstinence. And key  to peace, tranquility and ultimately abstinence (given that I cannot stop eating) in ALL the ‘stuff’ I have been reading, from Brene Brown to Stephanie Covington and Kristin Neff and the AA big book , is “spirituality”.

And to develop spirituality (and Im sure I don’t need to add that this is not confined to organised religious belief) you need TIME.

Time to practice meditation or prayer or reflection. Time to develop the creativity that lives in all of us. Time to nurture friendships, time to give back to the Community, time to just BE.

And I have NO TIME.

Yesterday I went to church. I was raised in the Church of England, not in an evangelical way, but church going was part of my childhood and many of my mothers friends in the local Community were also families with children who attended the local Church. Although I have considered both Catholicism and Buddhism (for very different reasons) I realise now that I feel most at home in the comforting familiarity of the English Church.  I know the words for want of a better explanation.

I was in Cambridge, and I attended the choral evensong at Kings College chapel, and I realised that although I spend a large part of that service on my knees trying to meditate, my head is just too full of ‘stuff’. One of those things was a realisation that I cannot take Communion any longer – because of the Communion wine  so I went to the alter for a blessing.

I have no answers to this. Perhaps my reflections on Step One are not exactly what I or S was expecting. But there it is.

If Im going to do this. If Im going to get there, to serenity and peace, something pretty massive is going to have to change. And only I can do that, only I can make these decisions.

And I will have to live with the consequences. Good or Bad.

And THAT is SCARY.

So for now, I will mutter the serenity prayer several times a day, try hard to keep it ‘in the day’, and try to trust that it will be ok.

 

 

Emotions

OK…. I have realised what a huge mass of seething “stuff” is going on under the surface. As they say in AA (listen to me I sound like an old timer! ) The best thing about sobriety is that you get your feelings back, the worst thing about sobriety is that you get your feelings back.

Indeed.

And I really have

In the past I have been SO shut down from my own emotions that I have struggled to call them or realise what they actually ARE Even the easy ones, such as anger, happiness, sadness, are not so easy for me to identify … and fear ? thats actually something I can now recognise a lot, but still it often takes conscious processing to evaluate what that ‘vague’ distress is all about. The less common ones , honestly I  still, ofetn really struggle to know what it is that I’m feeling. I sometimes use this mood chart to help me…

feelings-clipart-emotional-health-2

There is an even better ’emotions descriptor’ here I like this one because it allows you to think about how strongly you feel ‘something’ and roughly what category it falls into, to narrow down the correct descriptor.

I used to automatically think I was angry if I shouted (or wanted to) but the more I think about this I realise that default ‘anger’ covers so many underlying emotions for me.. fear, shame, vulnerability, embarrassment, anxiety, sadness. I’m  trying hard to look at whats underneath the ‘shouting’ urge, and have become much more honest with my kids – for example “Im sorry I seem angry, in fact I’m afraid when you do X, because of Y; can you understand”

It is sometimes quite painful for me looking at what I really feel; for example – I haven’t really given Son1’s biological father much of a thought for many years. But when I started talking about this to Angela (a long time ago) some real emotions started stirring in me and I realised I felt angry, disappointed, contemptuous, of him, and also, more difficult, sad, vulnerable, hurt and let down. Admitting this to myself was very uncomfortable. Although I don’t think any of these feelings are unreasonable given the circumstance, I find it hard to sit with that strength of feeling. (which is one reason i drank, binged or spent loads of money I didn’t have) I still do find it hard if I’m honest, and I notice a tendency to lose myself in the comforting world of work where I know what to do, how to do it, and who I am …… (Thats the subject of another blog post I am sure)

The first place I got the courage to be truly totally honest (about everything) was in the safe space of Angela’s therapy room, and I reckon it took me a year. I WAS honest with my brother, with K, with my sober sister, but not about EVERYTHING all together. I think, on reflection, thats how therapy is supposed to work –  providing a safe, non judgemental, space to practice thinking / behaving in a new way.  Since  I have felt very safe there, and since I have read Brene Browns work, I have started opening up a LOT more. The women I have met in AA have been fantastic for this. Pretty much nothing is going to shock them (well nothing I have done anyway) and the openness with which others have shared their stories and struggles with me, makes it easy to be open back.

Im not alone in this difficulty in recognising and identifying my true emotions, It seems almost universal in the addiction community (whilst actually using) some studies show that only 1 in 3 of us has the ability to correctly assess our feelings. Its important because because our emotions usually point towards deep and ingrained truths about our beliefs needs and wants. Our feelings come from our deepest desires, hopes, needs, and goals. If we don’t know what we’re feeling and why, or we deliberately drink it away (or do anyone of a number of unhealthy addict like behaviours designed to prevent us from listening to what we really feel) we will inevitably leave critical needs unmet. Then as surely as night follows day, if we can’t communicate what we need, it cannot be provided setting up a cycle of resentment, anger and unhappiness.

For me, ignoring what my soul was screaming at me that I needed, lead me to a breakdown, suicidal feelings and deeper into unhealthy addictions.

In the end, it seems to me that listening to how you really FEEL is just the first step. Being able to understand why you feel like that (sad, vulnerable, irritated) and  communicate that, in a way which someone else can hear and understand, Thats how healthy relationships (with anyone) should operate. Im practicing, baby steps, trying stuff out now. I know Im doing better than I was before, because the quality of the conversations with two out of 3 children is so much improved, and the exchange of information is clearer and less ambiguous.

I just have to keep going, keep practicing and keep communicating.

Still frustratingly slow baby steps …

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Work in progress

I’m quite enjoying this process. Not to be mistaken with “its easy.” Its definitely not easy, but after months and months of lassitude and ennui, the feeling that I’m moving forward, and doing something positive for myself is quite enervating and encouraging.

S (for sponsor) contacted me after she read my blog post. Its interesting that I hadn’t contacted her first, and I realised that, although I talked the situation through with Angela my therapist (because I knew I needed to talk my decision making through and reflect on both my boundaries and my motivations) , I haven’t yet added S to my list of ‘supporters’ that I could call for something like this. Of course she is exactly who I SHOULD call ! Anyway, she talked it through with me and we considered the situation as it impacts on me. It was interesting and very useful to hear the thoughts of a more sober alcoholic, and her words of caution. She was also able to recognise the things that I KNOW intellectually, but don’t ‘feel’ yet.

We also talked about the stuff I have been doing for Step One. I have heard several times the adage that a ‘solid step one’ is the key to a solid sustainable recovery, and as that is what I desperately want, I’m willing to put my heart and soul into anything that will help.

As part of the “homework” I’ve been making an inventory of

  • the consequences of my drinking,
  • times when I was powerless over alcohol
  • ways in which my life became unmanageable because of alcohol.

OUCH.

Indeed ouch. The more and longer I think about the stuff, the longer the list gets, If I needed reminding why I dont drink any longer a quick whizz through this list would remind me, I think thats sort of the point.

As well as highlighting the unmanageability of my life as a result of drinking, these questions and inventories have also thrown up the other ‘addictions’ in my life – spending and eating (and ye complete unmanageability of either of these) and also the huge spectre of my codependency and /or ‘love and relationship” addiction. These last two have actually made my life a fuck of a lot more unmanageable than alcohol, spending or eating and have caused much more pain to others.I  have felt more powerless to fix the rot in my life caused by toxic relationships that I have ever felt over alcohol.

This was all quite depressing and rather overwhelming until I realised that the chaos was there whether I faced up to it or not, that acknowledging it does not make it ‘worse’ and that only by facing it, and maybe taking a kind of 12 step programme approach to all these other issues, do I have any hope of sorting myself out.

Still looks bloody daunting. And tiring. But I WANT peace, serenity and inner strength, and I will just do what I have to do to get it.

Whatever comes next, I remain certain that stopping drinking was the first step down the path, and that this journey could not have begun until I stopped drinking and got some decent sobriety under my belt. So for now, I’ll settle for being a rather fragile work in progress, keep the faith and just keep going.

 

 

PS for anyone who is interested, X is doing ok. Early days, but I took over the detox when she was discharged from hospital (because she agreed to my stringent supervision terms) and so far, she’s doing ok.

 

 

Rock Bottom

Not me. (Today)

Though this episode and the step work I am doing have helped me reflect on the ‘bottom’ parts of my drinking and my life.

This is another of those work posts, that I just have to write, because I have to get it out. It has moved me and stirred my deepest emotions, both positive and negative, and I think this kind of situation brings out both the best in me as a doctor and potentially the worst. Living on this knife edge between going the extra mile that could (literally) save someones life and falling in to the crevice which is over involvement, control and micromanagement is both stressful and requires reflection, communication and support.

So. On Monday I was the duty doctor at my surgery. This role involves talking to all the people who call up saying that they need to see the doctor that day, when we have no more appointments. Essentially I see the ones that need seeing, and others I offer advice, medication , signposting to another provider or booking an appointment later in the week.  The number varies from 6 to 60 calls a morning.

Monday was busy.

Half way down my list I saw a call from a woman who I know is an alcoholic in denial. She has a small child and social services and the local alcohol team have been involved with her over the last six months. I will call her X, although that is not her initial. X has managed to shake off social services and the alcohol support team by insisting she was abstinent, but we (and I particularly) were quite sure this was not the case. But you cant help anyone until they ask for help …I saw her name on my list, got a prickle at the back of my neck, and picked up the phone.

Not good. She was drunk and desperate. I told her to come straight in, that I didn’t care if she had been drinking that morning, but come in, and tell me the truth. I sensed an opportunity and was keen to grab it. She did. I have not seen someone in such a bad state of alcohol withdrawal since I worked in hospital (more than 20 years ago) She was hallucinating, scratching till her arms bled, tearful, incoherent and falling over. She told me everything, and then more. Her rock bottom had arrived because her partner had left with their child and she was alone at home.

Now the rant. Like I said, she was in an appalling state and acute alcohol withdrawal is a medical emergency, the risks to life are very real from fitting, aspirating your own vomit and accidents to name a few. If she had MONEY I could have got an IP alcohol detox follows by 4 weeks residential rehab (which is the least she needs) on that same day. Because she has no money there is NOTHING. The advice from the ‘drugs and alcohol team’ was to go home and drink (really !!! ) at 80% of what you were drinking and withdraw slowly. FFS this person is an alcoholic, by definition she cannot control her drinking. This made me very angry, and frustrated and scared and led to that feeling (which I hate) of total powerlessness. I have previously offered to supervise a home detox – but only if there is a responsible adult also living with the patient (to supervise the medication and call an ambulance if necessary) I gave her 20mg of valium which barely touched her symptoms and eventually by a combination of begging and medical jargon slinging managed to get an acute hospital bed to at least start the detox. A friend of hers from that amazing fellowship collected her from the surgery and took her to hospital.

48 hours later, they are going to discharge her. FFS. Some muppet again suggested that she go back to ‘controlled drinking’ (really these people need some education) but in the end one of her friends from AA has agreed that X can stay with her, she will bring her in every day, and I will supervise a home detox (to complete the process safely) Will she agree to this? I have no idea. Her parents are at their wits end, her partner has left, this is, must be, rock bottom for X – but I am also wise enough to know it may not be…

So where am I in all this? Going the extra mile, that’s for sure. Taking a chance, yes. Over involved – probably. Not bonkers – shes not staying with me, I haven’t offered to fund her rehab (!) and I won’t detox her unless she is with another adult. But I’m examining my own boundaries, and considering my own emotional response to a fellow addict in deep deep trouble. The part of me that has always always cared too much for my patients is in the driving seat of my decision making (my first choice of career was Oncology but, in a rare flash of emotional clarity years ago, I knew I was not emotionally detached enough to work solely with people who are likely to die)

However, and I think this is important, I do recognise that I can only do so much. In the end the responsibility for her recovery is with her, I can help, (I can help a LOT) but I cannot do it for her. In her desperation, humiliation and shame on Monday I told her I too was an alcoholic (and I sort of regret that now – although I am quite sure she will not remember) and by great good fortune the AA friend who came to her rescue, and has offered a place of safety is my friend D. She and I have spoken about this and I’m confident that we can support each other and talk though our feelings about this to (and this is the most important thing) keep ourselves sober and not get sucked too far into it.

Is this over-involvement with a patient a good excuse to run away from my OWN stuff ? Am I using X’s disaster to avoid facing stuff that’s very painful for me ? Possibly – I have certainly recognised that this is a tendency I have. And there is certainly a LOT of painful stuff swilling around at the moment. Completing an inventory of  incidents when my alcoholism made me behave badly, and another set where my addiction caused my life to become unmanageable … that’s hard, shaming and embarrassing. Even with 802 days sobriety (as an aside I cannot imagine doing this in the very beginning of recovery, the  intense self- loathing that comes along would have been just overwhelming for me before now). The nice feeling of being useful, important and having people think (very) well of me for helping and supporting X – is that a distraction from the other stuff where I feel so very inadequate and that I have failed in so many ways?

I will discuss this with Angela later. And I will reflect reflect reflect – I hope this will help me avoid the trap of overstepping boundaries in a destructive way.

Because boundaries are there to keep the patient safe as well as the doctor. And I need to remember that.

This morning, talking to my AA friends at coffee I confided that I often mutter the serenity prayer when I’m feeling overwhelmed… so here it is

serenity prayer