What he said, but what he did...

Two weeks ago I was sitting with Paul, who was forty-five years-old and had been a binge drinker since he was eighteen. His drinking had cost him several jobs, a marriage, and his driver’s license for a while. He had been totally sober for almost two months. He is now taking an SSRI for depression and Naltraxone to help diminish his craving for alcohol. No doctor would prescribe an anti-anxiety for him because he had such strong addictive tendencies that he was a very high risk to abuse it.

Paul told me at that session that he had been running from anxiety his whole life. He had always felt that he couldn’t handle things. This was partly because his father had always put him down and he had been picked on at school. Alcohol had always driven the anxiety away. But now alcohol was only causing problems. The new medications, and psychotherapy, were supposed to help him live with and overcome anxiety and his feelings of failure. He should be able to do this. he was intelligent, caring and, when he was sober, a very reasonable person.

“Anxiety” Paul said, “is a part of life. Learning to handle it means your growing up. I am, forty-five; it’s time to grow up. There are no drugs or chemicals that can do that for you. The good thing,” he added, "is that the more you handle it, the better you feel about yourself, and the less anxious you are.”

That insight was very true, and could have come out of almost any “self-help book. The problem is that insight, fortitude, medication and psychotherapy don’t have direct access to actually changing someone’s mind. Two days later, in an impulsive moment of frustration, Paul took a whole bottle of benzos that he had kept hidden and ended up in the hospital.

That’s the way the human mind really works. So far, none of us, psychologist, psychiatrists, neurologists, geneticists, priests, probation officers, self-help gurus, nutritionists, philosophers, or third-base coaches, really know how to get in there and change it.