Checklists

Rehab was on my radar screen by time I arrived at college. Not for me, of course, but because boys that I knew from high school had been sent to “treatment” by their parents. I had no real knowledge as to why and the hubris of youth resulted in my making summary statements like "their parents just wanted someone else to do the parenting". At 16 and 17 years old I didn’t have in mind the clinical signs of substance use disorder such as these presented by the Cleveland Clinic:

• Drinking more than you intended, or for longer than you intended

• Continuing to use these beverages even though your drinking affects your relationships

• Spending lots time obtaining and drinking these beverages or recovering from hangovers

• Using alcohol in physically hazardous situations

Rather, I was thinking "How could anyone this age have a drinking problem?”, “Might there be something else actually going on instead?” (teenage rebellion), and “I can't imagine being 16, 17, or 18 and being told I can't drink ever again". Of course, naivete played a role as well. Unbeknownest to me, some of these boys weren’t just drinking; they were using other drugs too and in some cases lots of them. I also had a misconception of what an alcholic* or drug addict* looks like. Regardless, if I didn’t think rehab/treatment applied to those boys, I definitely didn’t think it applied to me.

So, imagine my suprise, when making use of university mental health counseling services a few years later, I was told “well, if you had come to see me outside of this setting, I’d put you in rehab”. “What? Really? Me?” “Yes, you”. I imagine that the counselor must have been mentally running through a diagnostic checklist, contextualizing my answers in such a way as to minimize a potential problem:

• Q: Drinking affecting relationships? A: Not more than any other student her age in this evironment….

• Q: Failing to meet school obligations? A: Nope, good grades, high GPA

• Q: Spending lots of time recovering from hangovers? A: Aren’t all college students hungover from time to time?

• Q: Having a high tolerance for alcohol? A: Is tolerance even a thing for 20 somethings….

• Q: Drinking more than intended? A: Well, she’s here and talking about it so, YES

• Q: Repeatedly trying to reduce how much she drinks? A: Well, let’s see if she can ………

So instead of going to rehab, I left the counselor’s office with the suggestion that I test my ability to moderate. On my next visit to the bar, I was to pre-determine a reasonable drink limit and see if I could stick to it. I set a 3-beer limit and I stuck to it. But I did not like it. I was annoyed by the imposed rule, disappointed I could only have 3 beers even before the 3rd arrived, and left the bar quickly believing there was no other point to being there and keeping temptation at bay.

It didn’t occur to me to be curious as to why I was so annoyed with the limit, why two or three beers wasn’t enough. Or to wonder whether drinking was the only way to have fun. The campus culture simply was alcohol—fraternity keg parties for the underage, the neighborhood college bar when you’d aged up (or had a fake ID). About the most I took away from my moderation experiment was this : I could moderate when I had to so I must not have a problem. My conclusion fit an erroneous narrative perfectly.

The narrative was something like this: People with drinking issues don’t do well in school. People with drinking issues can’t hold down jobs. People with drinking issues come from broken homes. People with drinking issues can’t control themselves. Drinking issues happen to other people ………….. you get the point.

Years later, when both the false narrative and the ability to moderate were mostly gone, I completed my own checklist. Dissonance had fueled a growing sense of there being a problem—too many nights each week of drinking, too much emphasis on it when planning activities, not feeling well in the mornings, guilt over not being my best self, my brother’s life imploding due to alcoholism, etc. A second pregnancy had gifted me a period of abstinence. My daugther’s birth presented a choice: return to drinking as normal (my normal, which wasn’t normal) or continue abstaining. And when memory of that long ago encounter with the college counselor returned, the balance was tipped in favor of abstinence. I guess the words “What? Really? Me?” “Yes, you” were weighty words after all.

* Note: the phrase “someone with substance use disorder” is preferred today over “alcoholic” and “addict”, which are considered derogatory, stigma-perpetuating, and not reflective of the whole person. I use the older terms here as they more accurately reflect the language of the time.