Twelve – Stepping into Narcotics Anonymous

So I joined Narcotics Anonymous. I was desperate and I knew that if I continued to use, I would lose my career and my relationship with my future husband. I had some knowledge of Alcoholics Anonymous. I remembered having to learn about the program for an exam I was sitting. I had envisaged crusty old men in a dusty church hall. NA was very different. For a start, most of the “members” were around the same age as me. Our backgrounds were very different though. They were mostly males and many had been addicted to heroin and been through the criminal justice system. A large proportion of them were smokers. I didn’t really know what to say to them.

When I get stressed and anxious, I tend to use long, intelligent sounding words to cover my insecurity. One guy, named Tony came to chat to me and told me all about his recent leg operation where he had ended up with septicaemia and post-thrombotic syndrome. Many years later, he told me he had seen straight through me and this was his way of breaking the ice and helping me to feel at home. I was very grateful to him.

I remember sitting down in the circle and trying to work out who the “leaders” of the group were. What were their credentials and qualifications? Perhaps I could be the leader? I probably had more letters after my name than most of them there. I was also very arrogant. Never mind. After my second meeting, I was given a job making tea for the meeting. This was in theory easy to do but there was one small problem. The amount of sugar used. This is not uncommon in twelve step groups where members will switch addictions from say, drugs to sugar and caffeine. I felt that from a health promotion point of view, I was not being true to my profession, if I didn’t ration the amount of sugar being consumed. I even bought sugar cubes and tongs to aid me in this quest. Needless to say, this was not well received by the group and I was forced to reign in my controlling tendencies. I was still very arrogant

Twelve step groups work on many levels and to be honest, when I first arrived I wasn’t expecting much. I went to meetings, I did what they told me to do, keeping it simple. I attended 90 meetings in 90 days and I found myself a sponsor. A sponsor is simply another member of the program who agrees to keep tabs on you and help you work through the steps. My sponsor was a pharmacist who had become addicted to dextroamphetamine. This suited me as I felt a greater connection to her because of my pharmaceutical addictions.

There is no doubt to my mind that 12 Step programs such as NA work. They are not perfect and they certainly don’t fix everything. They operate on many levels. Firstly, they provide a solution to the isolation and dishonesty and characterises active substance addiction. Suddenly, you are part of a community of people who have all done what you did and so there is nowhere left to hide. Rigorous honesty is called for (especially with your sponsor) and members work together to help the newcomer – who is the most important person at any meeting.

The Steps themselves are spiritual in their outlook. The concept of God is a very loose concept. Basically God can be anything as long as it isn’t related to the addictive process. Albert Einstein said that “No problem can be solved from the same level of thinking that created it”. Once you step outside of the problem, you have a better chance of finding the solution.

The 12 Steps of Narcotics Anonymous

Deep change can really only come from surrender and this is the basis of Step One. “We admitted that we were powerless over our addiction, that our lives had become unmanageable”. For me, this ties in with Leonard Cohen’s quote a blog or so back. When we finally STOP doing what we are doing, there is a metaphorical space for something new to come in. Then we have the concept of the “Higher Power/Higher Self” – whatever which can help and guide us into new choices. (Steps 2 and 3).

The motivational author Louise Hay once said that “In order to clean a house, you had to be able to see the dirt”. This is the basis of Step 4 and 5 where you identify your personal character defects and share them with your sponsor. I’m not a fan of the term “character defects”. In my experience, patterns of behaviour develop to help the person cope with the environment they are living in.

We are adaptive creatures and this serves as a helpful survival strategy. For me, my preferred character defects were perfectionism, people pleasing and self obsession. In many ways, I hadn’t matured or grown up and I was still trying to control and ensure care by controlling others. It was all about me. I was also frightened. Frightened about being alone, people leaving me and a horrendous feeling of being bad and defective. It kind of made sense but it was not helpful in 2019. Sharing this part of oneself with another is a very freeing act. One of the really healing aspects of 4 and 5 is the realisation that the sponsor has often struggled with the same issues and to a wider perspective, so do most of humanity. We are all in it together.

Steps 6 and 7 allow us to prepare and subsequently ask our higher power to remove these defects. Again for me, this allows one to step back and exercise new choices. To come out of that pattern of problem behaviour and allow new choices to come in. Depending on the belief system, some people have experienced miraculous healings which they have attributed to divine intervention . It doesn’t really matter why it happens, only that it does sometimes.

We then move onto Steps 8 and 9 which are the amends steps where we seek to make retribution for our wrongs. In my case, I had stolen drugs from various medical establishments when in active addiction and so it was not practical to to simply admit this as it would have set in chain a number of consequences. I decided that the way to rectify this was to donate the value of the drugs to charity and commit to mending my ways. I did this through extensive personal work and did what I could to become a more caring and effective health professional. Where possible I tried to show myself the compassion I would have shown to a patient who was unwell and this practice actually helped me to become more compassionate in general. I still have a long way to go.

The final three steps work in the present. They teach us to be awake and aware. Moment by moment . How do we conduct ourselves in the Now? Are there people that we may have offended and we need to apologise? This means, paying attention to one’s speech. Is what I am saying kind? I might think it is funny but does the other person see it that way? Free speech is all very well but are we mindful of others? Does this itch to share something have to do with my ego, my importance or is it helpful to the other person? Taking inventory at the end of the day is another part of the tail end of the steps. It’s like a reflection of what happened and what could change. Depending on the belief system, we can ask a higher power for help. Perhaps we tap into the sense of humanness, the Universe, the sense of “Us”

And finally Step 12, the giving back. The buzzword is “carrying the message”. We seek to connect with newcomers and help others to get clean. Working with others without strings attached is therapeutic. It integrates us back into society and the human race. We start to wake up and become useful to others and that builds our sense of esteem and helps to keep us clean.

The Steps work – If you are struggling with an addiction, perhaps there is something in a group for you?


Where I came from – background

I feel it is only right to provide some information about my background. I hinted at this at this in the previous post. My journey had started many years before – perhaps as a child. I was brought up in quite a privileged family. Both my parents were physicians and I was the eldest of three children. I don’t remember my childhood being particularly happy and it was very difficult to put a finger on exactly why this was. I was anxious as a young child and my parents took me to see a psychiatrist at around the age of 3. I had a real problem with going into shops or any enclosed spaces and would freak out and “do a runner”. On one occasion, my mum took me to the circus and I was so alarmed when they closed the doors that I managed to crawl out under the edge of the tent to escape. That was even before the clowns came out!

I worried constantly that my family didn’t love me. I used to spend a lot of time alone, in my head, making up stories about imaginary parents that would come and rescue me. It was sad looking back on it. I had friends at school but they were not felt to be as functional as my sister’s friends and I used to compare myself to her and usually come off worse. Teenage years were probably the worst. I developed quite extensive cystic acne and was bullied at school for it. I covered my face with make-up but I was so distressed by the acne, I used to put the foundation on without looking in the mirror. Cue the nickname “cake face”. I think that bullying can be really damaging to a child’s self esteem and now, as a practitioner working with college students, this is a story I hear repeatedly. Name calling and singling out can stick with people for a long time. We have a duty to call this sort of behaviour out in schools. It’s not acceptable.

In my early teens, my father died suddenly after a short illness. He had worked as surgeon and I was incredibly proud of him as he fixed people. He’d operated on the mother of a friend of ours with breast cancer and she’d outlived him. He wasn’t around very much when we were growing up as he was often called away to various emergencies up at the hospital. I found myself in a real conflict with this because I knew the patients needed him but so did we – his family. I found myself being angry with him for not being around, then feeling bad about being angry because of the importance of his job. My mother, very much had the attitude that that was the way it was and so we needed to accept it, but I found this hard. It wasn’t until I became a doctor myself that I understood what an effect the “pull of human need” can have on you. It can be really detrimental to family life and such was my dedication to my job, I made the decision not to have children because I didn’t think I’d be able to balance my life effectively.

After Dad died, I was very proud of myself for the degree of emotion I managed to suppress. I don’t remember feeling anything for many years. I suspect the lack of emotions and grief might have had something to do with the eating disorder (bulimia) that I developed a couple of years afterwards and also an episode of ulcerative colitis. It’s funny I do feel slightly angry writing this – perhaps that was the emotion I didn’t feel? Who knows?

I realised fairly early on that I was reasonably proficient academically and this was my saving grace. This kind of helped me buffer a very precarious sense of self esteem. I’d also been told that I had a good sense of humour. I channeled most of my efforts into these two factors. I got into medical school, qualified and started working. Then came the problem that would bring me to my knees – addiction .

I don’t believe anyone sets out to become addicted to substances. I initially started using prescription opiates to help me sleep when I was resident in the hospital. I found it took the edge off the anxiety I felt. The problem was that it wore off and I had to take more and more to have the same effect. After a while, I had to use just to feel normal. This went on for 8 years. By this time I was a qualified family physician and realised pretty quickly I couldn’t go on like this. I was in a horrible limbo of not wanting to live but also not having the guts to end my life. I was really stuck. I have counselled many patients who have said the same thing to me almost word for word so perhaps it is a very common human predicament. It’s not at all nice. The drugs are a false friend, on one level they provide a sense of relief but on the other they are what they are – an addiction. Finally in 2010, I surrendered, entered treatment and gave up. As Leonard Cohen says in Anthem – “There is a crack in everything (there is a crack in everything)
That’s how the light gets in”

This was the beginning of the next stage.

Photo credit

Image by Alexas_Fotos from Pixabay