It’s about the midpoint of my first semester of internship. Finally, I’m settling into a routine – I’m getting used to my clients and the clients and staff are getting used to me. One thing I’ve already noticed is how much relief I feel to have ended up where I’m at.
I’m going to be honest. Substance use was never really a field I wanted to be in. Or even near. Any person who has known me in the last few years knows that I want to work with individuals who are overcoming trauma – domestic violence, rape, abuse, neglect. I’ve considered work in prisons, the Veterans Administration, and I’ve volunteered in domestic violence shelters and with high-risk youth from abusive homes. When it came time to apply to internship sites, I desperately avoided this place unless it was my last option.
And anyone who knows anything about trauma is probably laughing at me right now.
Why? Because, as many laypeople and mental health workers know, trauma and substance use are intimately, intimately entwined. If you’ve ever heard of ACEs (Adverse Childhood Events – basically harmful events ranging from the divorce of one’s parents to physical and sexual abuse), you might know that the more ACEs you experience, the more at risk you are of becoming addicted to alcohol or drugs. You’re also more likely to get a range of other diseases (and addiction is a disease) like cancer, diabetes, and heart problems.
I’ve known about ACEs for a long time, and I’m familiar with different models of substance use disorders, especially the disease model of addiction. This model explains how individuals who become addicted tend to have different brain and other physiological and environmental factors that make them inherently more vulnerable to substance use from birth. So, if I supposedly knew so much why was I thinking I could work with a population who have experienced trauma without having to treat other issues like substance use?
Well, perhaps a little stupidity, perhaps a little naivete. But what might have affected me more than a little is society’s view of people who struggle with addiction. The common view is that – well, that they’re not very good people. They are seen as lazy, combative, etc., etc. There’s this false idea that individuals with addiction disorders can really just stop whenever they want – if only they’d stop being so weak or immoral. With all my education around this I’m extremely disappointed in myself that some part of me might have bought into this. After all, I am someone who struggles with depression, which is often seen in a similar light. (People with depression are also blamed for being lazy, slow, dependent, combative, immoral, uncaring, and / or weak).
And I have to say that after months of working with the people at my internship, I see a whole lot more than what society is telling me to see in these people. I see histories of terrible, terrible trauma – things that might break someone else yet these guys keep on fighting. I see perseverance. Every time a client of mine is knocked down they find the strength within themselves to get up, dust themselves off and keep moving forward. Even in recovery, when relapse is sometimes expected before someone reaches long-term sobriety. In my short time so far I’ve seen individuals relapse, pick themselves up, admit their mistake and get right back to work.
Not only that, but I’ve seen a great deal of compassion and empathy for other peoples’ struggles. The clients that I work with have been there. When they see someone else struggling the way they once struggled, they often fall over themselves to offer advice, reassurance, and comradery. These are all traits that I think any one of us could cultivate.
And while I definitely see individuals who push others away through anger, violence, harsh language, threats, isolation, manipulation, and crime, it’s still easy for me to see how they got there, at the very least. They’re little ripples in a larger ocean of heartlessness, poverty, crime, and trauma, and many days I think I can hardly blame them for acting the only way that allowed them to survive this long.
Still, many of them know that something’s got to change. They get tired of hurting themselves and their loved ones. They want to change and they push forward into recovery knowing it’s going to be a lifelong journey, that it may feel at times like they’re walking through hell itself. (For example, withdrawal from some drugs can make you horrendously sick. Withdrawal from heavy alcohol use in particular can be deadly if you’re not monitored in a hospital). And they push forward for the ones that they love – daughters, sons, wives, girlfriends, parents, aunts, uncles, and friends (alive or dead).
I guess what I’m learning so far from the clients I see struggling with the beast of substance addiction is this: Human strength and hope is a force to be reckoned with. Even when it seems like not a soul is there to help, these people push forward in hopes of a better life for themselves and their families. I’m learning that baby steps matter. I’m learning that sometimes in life, all you can really do is grit your teeth and walk away, no matter how much it hurts. I’ve never seen such a lesson in patience, and I wish for every single one of them that, sooner or later, they all achieve the better lives they are looking for in their recovery.