The typical person who attends a residential addiction treatment centre is in his or her 30s, 40s or 50s, with a job and a family, according to Maebh Mullany, chief executive of the Rutland addiction treatment centre in Dublin.
But while the age profile may be roughly the same as when the centre was first set up 40 years ago, the type of addictions people come in with have changed dramatically. “In the past, the addictions used to be alcohol or drugs but now, we see multiple additions – alcohol, drugs, prescription medicines, food disorders and/or gambling,” she says.
Psychotherapists and counsellors nowadays have to be alert to all kinds of cross-addictions, some of which only become apparent in treatment.
“When I first started working in the Rutland Centre in 2000, the majority of clients were alcoholics,” says psychotherapist Austin Prior. “We had some drug addicts from inner-city Dublin and some gamblers. “But over the 15 years I worked there, there has been a rise in poly-drug addictions – where people are addicted to alcohol, cocaine, cannabis, amphetamines and prescription medicines. There is also a growth in porn and sexual addiction. Eating disorders can sometimes be another hidden part of the addiction.
Childhood trauma, neglect, physical, sexual or psychological abuse can all be triggers for addictive behaviour
While the physical and psychological withdrawal symptoms may vary according to the addiction, the psychotherapeutic approach is the same. “The [person’s] behaviours – manipulation, dishonesty, preoccupation with the drug, obsession – are often the same across different addictions,” says Prior, who looks like he has witnessed the human condition at its most vulnerable.
Prior says that while recovery is about stopping using whatever the person has been addicted to, it is also about lifestyle change. “The addiction is a crutch for something, and if you take it out of the mix, the person has to make changes in his/her life,” he says.
Triggers for addiction
Childhood trauma, neglect, physical, sexual or psychological abuse can all be triggers for addictive behaviour, and the aim of treatment programmes is to help individuals face the emotional pain that has led to their particular addictions.
“We spend a lot of time identifying these underlying issues – whether it’s physical, sexual or emotional abuse, bullying – and their connection to addictive behaviour,” says Prior. “Sometimes, after a very tough day in group therapy, someone will want a drink or drugs, and only then do they make the personal connection [between the emotional pain they are feeling and their usual reaction to take drugs or drink]. This is very challenging for them, but we are very supportive. It can take the whole five weeks to learn some tools to cope with these feelings.”
Building up the person’s self-worth and self-esteem is a huge part of the therapeutic process. “When people say, ‘I’ll give up [alcohol or drugs or porn] for my wife, my children, my health, I say, ‘That’s not enough, you have to give it up for yourself. You have to believe you’re worth it because if you relapse, there will be nobody around to see you.’ Without self-worth, there is no foundation for recovery. It takes a lot of courage but it is empowering,” says Prior.
Family members
Addiction counsellor and psychotherapist Marion Rackard says it’s also crucial to help family members of those who are addicted. “Often, the individual with the addiction has lost touch with reality and what other family members are experiencing. If one family member can get help – to move from ignoring or enabling the addict – we find that the problem drinker/gambler will come forward for help,” she says. Rackard is also keen to point out that in Ireland, family members of those with an addiction need much more support to reduce the psychological symptoms they suffer as a result of their loved one’s alcohol or substance misuse.
Mullany adds that stigma remains one of the greatest barriers to people seeking help. “We know there are hundreds of women [and men] across Ireland affected by addiction who are not coming forward because of the stigma associated with drugs, alcohol or gambling,” she says.
For the past four years, the Rutland Centre has actively encouraged people to seek treatment through its Recovery Month in September. The theme for 2018 is "give recovery a voice". Starting on September 1st, a series of videos and blogs from people who have recovered from addictions will be available on www.rutlandcentre.ie/recovery-month
ROISIN SHERIDAN (70)
Roisin grew up near the Phoenix Park in Dublin and attended Muckross College in Donnybrook before going on to do a social studies degree at University College Dublin. “I met my husband-to-be at university and I had my first drink at university when I was 18. From the moment I took a drink, I knew it was self-medication. I didn’t like the taste of it at first, but after about three pints of beer, I suddenly felt better,” she says.
Sheridan, the second of two girls, says that on reflection, she believes she wasn’t allowed to express herself growing up. “My sister was very sickly and things circulated around her welfare. My role was to be quiet and invisible.”
When she finished college, she got a job travelling to factories around Ireland, giving free X-rays to test for tuberculosis. “When I got married to the man from Yorkshire I met in college, I had to give up my job. We moved to live in Sorrento Road, Dalkey.”
Roisin says that life became a bit of a blur for many years. “I drank at home to block out the reality, which I found boring. When I went out, I often made a show of myself, crying in a corner. I wasn’t aware of being an alcoholic. Her son, Ralph, was born in 1969. Her husband, who was an industrial chemist, got a job in Cyprus, and upon arrival there, Roisin got a job with a Cypriot wine company.
I was having panic attacks – I was so physically dependent on alcohol
“The fridge was always full of drink. I went from bad to worse. And with hindsight, I was already starting on my geographical escapes [from reality],” she says. Her marriage got into difficulty upon the family’s return to Ireland. “My husband was a very decent man who I cared for very much but the combination of our problems was too much for our marriage to survive.”
Her husband returned to England, and their son moved to live with Roisin’s parents as Roisin set about building a life of her own. “I got a job as a social worker in the Dublin Corporation Housing Welfare office. I was drinking a lot of the time but I was getting away with it. I knew sooner or later that something negative would happen.”
She changed jobs and started attending Alcoholic Anonymous meetings. “I finally signed myself into the Rutland Centre when I was 33 years old. “I was having panic attacks – I was so physically dependent on alcohol. It was awful. The Rutland Centre was very tough treatment, but I learned more about my own behaviour from hearing other people’s stories.”
After the residential treatment programme, Roisin she had one slip-up with alcohol. She felt at that point that she reached rock-bottom and had nowhere else to go. “I never had a drink after that. I went to AA meetings in Ranelagh every day for a year and kept going from that point onwards,” she says.
She used breathing techniques, cognitive behaviour therapy and exercise to help her deal with the raw emotional pain she experienced for about 10 years after treatment. “I preferred not to engage with identifying sources of the pain. I wanted to get through it and live life. There is no magic bullet to recovery from addiction; it’s a complex mix of awareness, courage, determination, endurance and surrender.”
For years after she had stopped drinking, people continued to view her as an “active alcoholic”. “I worked as a staff counsellor in the welfare section of Dublin Gas for four years and then I took redundancy and worked freelance in the arts. I wrote poetry and painted and did some arts administration. Then I worked and volunteered in humanitarian aid in places including Bosnia, Rwanda, Afghanistan and Tajikistan. I returned to Ireland, living in different parts of Dublin.
Looking back over her life, Roisin says that she sought refuge in travel. “Travel is still my salvation. I relate to the Songlines. I have favourite paths in many places all over the world. Now I tend to travel to Portugal, London and Majorca and I live in Portrane in north Dublin, where I enjoy reading and walking. I have become quite contemplative and I’m happy in my own company.”
PATRICK (61) *
Patrick grew up in Dundalk, Co Louth, the third-eldest in a family of six children. He started drinking when he was 11. “I was wild when I was young. I didn’t get on with my siblings. I couldn’t study. Maybe I had attention deficit hyperactivity disorder but no one said anything to me about that. When I did my Group and Intermediate Certificate [now the Junior Cert], my head went blank,” he says.
Patrick was physically and emotionally abused in secondary school. Not keen to go into the details, he says simply, “I ended up with a lot of resentment towards authority.” He left school at 16 and worked in various jobs while continuing to drink a lot at the weekends. “Money was scarce then, so you couldn’t afford to drink during the week.” He attended a residential treatment programme when he was 21.
“I didn’t think alcohol was a problem for me. I thought I had a mental problem. I was always getting in trouble at home,” he says. He found the treatment programme to be very tough. “I was an angry young man who had been drinking for 10 years. Within three weeks of the programme, I was drinking again.” Soon after, he found himself in a locked ward in a psychiatric hospital. He sums up that experience in a few words: “I told the doctor I was an alcoholic so I got out of there fast.”
Patrick still suffers from hallucinations and has been diagnosed with post-traumatic stress disorder
Throughout the 1980s Patrick moved between homelessness and prison, charged for various offences. “I felt safe when I was in prison. I read books and did workshops. I educated myself when I was there,” he says. “I used to drink just to go asleep but I didn’t drink when I was in prison, and although I was offered all kinds of drugs, I didn’t take any of them.”
In fact, it was when he was in prison that his life began to turn around. “I had a spiritual experience. I was sick of being sick. Once I accepted that I was an alcoholic, my life started to get better, but it took a long time.”
Patrick started attending Alcoholic Anonymous (AA) meetings and still goes regularly. “I went to two or three meetings a day for a long time. Now I go to two or three a week. All the resentment and compulsion to drink is gone. I now say a prayer for the Christian Brothers when I get angry. My sobriety is the most important thing in the world to me.”
Patrick still suffers from hallucinations and has been diagnosed with post-traumatic stress disorder. “I had to start from scratch when I came out of prison. I got a flat and got back in contact with my family.” He worked as a social care worker in various treatment centres and also as a mentor to ex-prisoners. He now works as a security guard. “I only got married two years ago to a Kenyan woman. I’ve peace of mind and freedom from fear now,” he says, visibly proud of the journey he’s made.
*Patrick is a pseudonym
TOM
“I came from a humble background in the midlands. I got a scholarship to school and university and spent a couple of summers on Long Island in New York in the 1960s. There was a very vibrant drinking culture there, but I never had a problem with alcohol.” It was the availability of cannabis, marijuana and later LSD that led to his addiction issues. “I became addicted to marijuana. When I gave it up, I couldn’t cope with life and it terrified me to take a job.”
Upon reflection, Tom says he had a very troubled family background. “I was diagnosed with a psychiatric condition and put on valium at the age of 22. I was also taking sleeping pills and [benzodiazepine].
Tom says the 12 steps of AA contain, for him, all the wisdom of the ages
He says that he was living in squalor and was in and out of psychiatric hospitals. “At that time, the only thing psychiatrists did was give you tablets. Through a series of fortuitous circumstances, I heard about the Rutland Centre.”
After medical detox in Jervis Street Hospital [which was required before attending the Rutland Centre], Tom signed in for the residential programme. “I thought it would be a geographical escape – somewhere to hide.” While suffering from severe withdrawal symptoms, Tom went to his first AA meeting, where he says he had a spiritual experience. Then aged 30, he says he was emotionally only about 19 or 20. “The Rutland Centre gave me a regular life of washing and eating. I was surprised to see younger men there who had wives and children.
“I was like a raw wound when I came out of the Rutland Centre. I’ve seen so many people die over the years. I wouldn’t have survived without attending AA meetings. I went to 90 meetings in 90 days, and I was at the first meeting of Narcotics Anonymous (NA) in Ireland in the late 1970s.
Tom says the 12 steps of AA contain, for him, all the wisdom of the ages. “I believe that most people with addictions don’t grow up properly. In the meetings, I became an adult and learned to deal with life’s turns, take responsibility for myself and develop a deep spirituality.
I also decided I had to get married, so I rushed into a marriage, which was a disaster. My wife was as damaged as I was, and the problem was that as she got worse, I got better. We’ve been separated now for 20 years.
“I became self-employed and continue to work now. In terms of helping other people with addictions, the only thing you can do is tell them to go to an AA or NA meeting.”
