The day after my father died in February 2001, I was at my parents’ place, doing the things you do when someone has died. Making lists and cups of tea, buzzing on the energy of shock and the many tasks involved with organising funeral arrangements.
I happened to answer the telephone. It was my father’s GP calling, who said, among other things: ‘I told him that if he didn’t stop drinking he would die.’ It struck me as rather an odd way to offer condolences.
And yet, at its simplest, it was true. If Dad had managed to stop drinking for good, he would not have died from liver failure, caused by alcoholic liver disease. Stop drinking and you stop the damage.
Two recurring questions coloured my relationship with my father. Why didn’t he stop drinking? And what more could we have done to help him stop? Since his death and my questioning of his life, I have occasionally wondered if that kind of chronic, long-term drinking was a form of suicide – a death by a thousand cuts.
With this query in mind, I recently set about doing a bit of research. I visited the State Library of Victoria and found an overwhelming amount of related literature. Consider the richness to be found in titles such as: A Study of Hospitalized Male Alcoholics, Family Identity and Intergenerational Recurrence of Alcoholism, Ascetic Protestantism and Alcoholism, and Outposts of the Forgotten: Socially Terminal People in Slum Hotels and Single Room Occupancy Tenements. This reading provided a range of information, from the purely statistical through to deeply personal stories of tragedy.
I worked at a drug and alcohol counselling agency, in an administrative capacity, for some years. I learned many interesting things, including the fact that there was such a person as an ‘Adult Child of an Alcoholic’, and that these people shared certain characteristics, such as taking themselves very seriously, lying for no particular reason, having trouble seeing projects through from beginning to end, and being either extremely responsible or irresponsible. I recognised many of them in myself. I went along to a few Al-Anon meetings (for family members and friends of alcoholics). While I can appreciate the value in the 12-step philosophy, it wasn’t all that useful in my investigation.
I made some good friends while working at the agency, a few of whom are still in the field. In order to get a professional perspective on my musings, I contacted a couple of them. I thought that their direct and daily experience with clients might cast some light on addiction, particularly the impacts and effects of alcoholism.
My friend Jo and I met over dinner to talk about addiction, addicts and death. Jo is a social worker who has worked for many years in drug and alcohol treatment agencies. In her experience, I asked, was long-term alcohol abuse a kind of death wish? Jo gave me this somewhat elliptical answer: because addiction is about existence, it is to a certain extent indeed about death. But it’s not so simple as a desire to die.
One thing that all the evidence and opinions I gathered confirmed is that addiction is both a confused and a confusing state. Both health-care professionals I interviewed described addiction in terms of a relationship. ‘It’s their friend and it’s their enemy at the same time. It helps them but it doesn’t’; and: ‘It’s like a disappointing relationship where one feels misled or disillusioned or even betrayed. It starts off as a nice thing, then it becomes a problem.’
In short, people don’t commence an addiction with the goal of death in mind. In fact, it’s usually the opposite. Drinking alcohol brings pleasure, good feelings. Many of my early memories of my father’s drinking are connected with socialising. He and my mother having a glass of wine with dinner. Stories of ‘long lunches’ (Dad was a merchant banker in the 1980s). Dinner parties with friends. All pretty normal – and certainly socially acceptable – alcohol-related activities.
There are reward pathways in the brain that are activated by sensory activities such as eating and sex. Recent clinical research has found that the biochemistry of addiction works on these same reward pathways. Therefore, in a non-cerebral and ‘instinctive’ way, it is linked to both sensory stimulation and survival. Drinking and drug use is also commonly associated with active avoidance of bad feelings. This can be a few beers to de-stress at the end of the working week, or ‘self-medicating’ to quell painful feelings or thoughts. Many of us use alcohol and drugs in this way, but it is usually a short-term solution. Alcoholics have difficulty limiting their drinking – even when there is ample evidence that it is impacting their lives (job-loss, family breakdown, poor physical health, financial troubles).
Sometimes a major crisis in one of these areas will prompt an alcoholic to seek treatment – voluntarily or at the behest of the justice system. Jo made the point that they don’t often see drinkers like my father in treatment agencies – chronic, long-term drinkers who have enough support at home. Our family fractured due to Dad’s drinking, but it didn’t completely break.
Whatever the trajectory, one question regarding addictive behaviour remains compelling. Why continue to engage in an activity that is doing you so much harm?
There are no easy answers to this question. One theory in drug and alcohol-treatment research is the disease model. In the case of alcoholism, this model suggests that alcoholics have an ‘allergy’ to alcohol. Dust mites make some people itch, so they scratch and then the itch increases. Similarly, alcoholics drink and then crave another drink, so they have another one, and the cycle gets worse.
There is also the suggestion that addiction should be viewed and treated like any other disease, such as arthritis, asthma or diabetes. This takes away the moral element of addiction. Alcoholics aren’t bad or weak – they suffer from a disease that is beyond their control. It’s involuntary.
One correlation which did make sense to me is that made between brain disease and addiction. Excessive drinking changes structures in the brain, causing a form of brain damage – alcohol-related brain injury. Even if excessive drinking starts as a voluntary behaviour (not a disease), the impact of it affects the brain so much that it becomes, like a disease, a compulsive, involuntary behaviour.
While these explanations don’t account for the emotional impact of alcoholism on a family, they contextualise it. Like many families in this situation, none of us ever used the word ‘alcoholic’. I can barely say it now without feeling like a drama queen. Towards the end of things, Mum would refer to Dad ‘not being well’. That was how she came to frame his condition. Perhaps a counsellor or the minister at her church gave her that line of logic and it helped. Dad was sick, like someone with cancer or multiple sclerosis. It affected who he was and how he lived, and it was part of her commitment to care for him.
That said, I don’t recall times when concerned friends or neighbours popped in to enquire after Hugh’s alcoholism. Nor did it ever seem like something I could take to school for a biology project (‘Here’s how excessive drinking has affected my Dad’s neurological, cognitive, physical and behavioural functioning…’). No matter what spin you put on it, addiction has a stigma and few people – outside of clinicians and self-help groups – are very comfortable talking about it.
As a teenager my scepticism about the disease model came down to crude logic. A person with MS could not ‘choose’ whether or not MS affected their life. A person with alcoholism, however, could always choose. Choose not to go to the shops, not to open the bottle, not to pour the drink. I did what all the literature, advice and counselling says not to do: I associated Dad’s drinking with some kind of character weakness, and I blamed him for being unable to overcome it.
During my research I was particularly drawn to a book titled Alcohol, Addiction and Christian Ethics, by Christopher Cook. My father was a religious man – he even trained for a year to become a Lutheran minister before giving it up for accounting. I had a feeling he would appreciate this line of enquiry.
The book delves deeply into theology. One of the more useful concepts it explores is that of inner conflict: why addicts behave in a way that so clearly causes pain and harm to themselves and others. Thankfully, rather than any kind of simplistic moralising, Cook posits the notion that this kind of struggle is common to us all, and that addiction can be seen as ‘one example of the many and varied ways in which different human beings struggle with a sense of wishing to be something other (or better) than that which they actually find themselves to be.’
This rang true; I liked its existential slant. I could identify with it. It made my dad seem less like a hopeless guy and more like a person expressing a difficult aspect of humanity.
As for literature that made a specific link between death by addiction and suicide, there was not a lot to be found. I did some reading about the psychological precursors to suicide. Substance abuse features in suicide research and statistics. However it is seen as a contributing risk factor – along with many other things, including mental disorder, family conf lict, unemployment, social isolation, past suicide attempts and a sense of hopelessness – not a form of suicide in itself.
Over the years, my mother has given me many of Dad’s personal effects. These include school reports, love letters, work documents and medical reports. A number of these cite Dad’s depression, erratic behaviour, impaired judgement and thoughts of suicide. So while he never went through with it, I know that he contemplated it.
Dad had drunk in a way that gradually brought about the end of this life. And yet I couldn’t pinpoint a direct and conscious link between these two things. His drinking appeared to be more about escaping reality than confronting – let alone chasing – mortality.
While some alcoholics may, in moments of lucidity, think that drinking might eventually kill them, rare would be the conscious and articulated thought: ‘Today is the day I will drink myself to death.’ You can’t count on when you might die if you leave it up to alcoholism.
A month or so before Dad died I arranged for an ACAT (Aged Care Assessment Team) assessment. The aim was to see if we could get him into respite so Mum could go on a short holiday. The assessor asked him a number of questions about drinking, all of which he seemed embarrassed to answer. Mum kept assuring him that the lady was just trying to help.
In the end it wasn’t possible to arrange for him to go anywhere for respite. He would have had to detox first. And even at this late stage of his life, he was not willing to admit that he needed to do anything like that.
Hugh was an unusual personality. He smoked and drank but was far from ‘blokey’, hating most sports and only ever listening to classical music. He had eccentric tendencies. The telephone he had installed in the bathroom so he would never miss a call. His inviting a stranger (a man he had just met) to my sister’s engagement dinner. As an adult I can see it was a poetic, if rather strange, gesture. At the time I just thought it was crazy. His experimental cooking that involved unlikely and often disastrous combinations included, but was not limited to, tinned apricots, prunes and offal. The years he spent trying to crack a code for predicting Tattslotto results.
Dad stopped working when I was 14. Having had a successful career in the finance world, he took on a business venture in the mid 1980s. When this failed, he had difficulty recovering and sank into a deep depression. He died when I was 27. In those 13 years he went through various stages of alcohol consumption.
He stopped a few times – no easy task, as withdrawing from alcohol is particularly traumatic on the body. I can remember him slipping and falling once in the kitchen, shaking with the ‘DTs’, my mother helping him up and gently admonishing him for scaring me. After these valiant efforts he would always, eventually, slip back off the wagon. My anxiety would escalate as bottles started to pop up in hiding places: under the kitchen sink, in filing cabinet drawers and tucked into the gaps of bookshelves.
He worked for a while at the local newsagency, getting up early (he was by nature an insomniac) to go and pack the newspapers. A humble job. He ruminated about people who had done him wrong. He was terrible with money, causing untold financial stress to my mother.
Over time his attempts to stop drinking reduced and his consumption increased. He lost the ability to take care of himself. He started having falls and going to hospital, and getting discharged with no diagnosis except that he was ‘an alcoholic’. Eventually, he stopped eating.
Hugh died after one last fall, one more admission to hospital. He was bleeding from the rectum; his liver had failed. My mother went with him to the hospital. He died when she went home the next morning to have a short break and call me and my siblings. The nurse reported that he was a little restless, but generally comfortable. At the time, his death was a shock. He had lived like that for so long, we all thought he would go on forever. But in retrospect it was pretty clear that he had been dying for some time.
In Barry Dickins’s autobiographical book, Unparalleled Sorrow, he makes several references to drinking and probably being an alcoholic. He says that it was relatively easy for him to stop once he knew he had to – because of his son.
As the child of an alcoholic who did not stop drinking, this is the thorn that embeds most deeply. I was not enough of a reason. We were not enough of a reason. Accurate or not, this was the assessment I drew. What more could we have done? What did we do that we shouldn’t have? Did he want to die? Why wasn’t he able to live?
Of course, the truth is uncertain. There is much I don’t know about my father and my vision is skewed. I believe he was terribly, painfully disappointed in life, and most likely in himself. I think he yearned for something different, but not necessarily death. The most frustrating thing for anybody trying to understand addiction is that it makes no sense and while there may be studies and research and data, there are no real answers.
My mother has said she saw closeness between my father and me. We had some similarities and I feel a certain understanding for him. We fought terribly. He liked that I stood up to him. Our relationship was clouded by disappointment and anger.
Today, I am more filled with sadness. I wanted so desperately for him to be happy. It has taken me a long time to accept that he was who he was and that nothing I could have done had the power to change that. It is sad for any of us to know that someone we love (however complicated the love may be) did not live the life they wanted.
There is also a great sense of loss at having never really known Hugh, only Dad – and then Dad the alcoholic. I wonder what he would have made of my writing, what it might have been like to sit down together and talk about ideas and life and death.
Glimpses of his passion and creativity remain: his often obnoxious opinions, his sense of humour, his great appetite for life and his generosity of spirit. One of my last memories of Dad is of a conversation we had, not long before he died. He asked me if I could arrange a Walkman as a gift for Mum’s birthday. He thought that she would like that when she went on her walks.