‘Physician Heal Thyself’

I’ve long realised that I’m as messed up as a lot of my patients. I’m not one of those psychiatrists who has an ‘us and them’ mentality – more one that recognises fellow humans’ struggles as things I struggle with too at times; and I’m often in awe at how resilient people can be in the face of so much adversity. I see my job as trying to help them feel better about themselves; to recognise their strengths as well as trying to lessen their suffering. When I feel better about myself, I’m generally a lot nicer to be around and much more able to sort stuff out. I figure that’s true for most of us. What it has taken me a long time to recognise is that I have a substance misuse problem. Strange that I couldn’t see it; doing the job I do? I come from a family full of alcoholics; I was getting books out the library about alcoholism when I was 13 and I originally wanted to specialise in addiction. I saw the switch to Child Psychiatry as moving on from rescuing my mother to rescuing myself, but maybe it was more about avoiding my own demons? I like to think I’m quite an open reflective person, but where drugs and alcohol are concerned, I’ve had one hell of a blind spot!

I think it’s particularly difficult for those of us in the caring professions to acknowledge our own struggles; and we’re more likely than others to have addictions. There’s not a lot of research out there but compared to about 10% of the general population, 10 – 12% of doctors have addiction problems, and 20% of nurses. I think the nurses are probably being more honest than the doctors. Much has been made of increased access as a factor, but alcohol is the most frequently misused drug, the one that’s most available for everyone. It’s also on the increase, with underfunding, impossible expectations and a name and blame culture identified as causes by a support service for doctors (www.independent.co.uk 24.06.17).

Whilst those things are undoubtedly making everything worse for professionals on the frontline, I think we’ve probably always been more vulnerable. Caring for others, dealing with pain and suffering day in day out will deplete anybody. We likely chose these jobs because we’re good at meeting others’ needs; not so good at meeting our own. Our identity and self-esteem become tied up with our job; one which society respects and rewards; but couples that with high expectations. Having problems of our own is shameful, we’re supposed to be sorting out everyone else’s. Shame corrodes our self-esteem, the ‘what if they knew the real me?’ thinking; pushing us further into addiction. Our substance of choice suppresses our emotions, including our shame. The traumas of the day are literally washed away, and our minds are anaesthetised to the pain of not being the superhuman perfect being that society and ourselves expect us to be. We can’t say anything because if we do, we will be referred to our regulatory body, and could lose everything. Most of us will be functioning addicts and really good at hiding it from everyone else. Once you admit it to yourself, the ongoing secrecy and isolation compounds the shame. ‘You should know better, you should be able to handle it, you’re a doctor for God’s sake – sort yourself out!’ – the kind of things my mind would tell me when I woke up dry mouthed with a headache in the small hours. There are multiple things that have led me down the path of addiction. My chosen profession is one of them.

The first time I stopped drinking was December 14^th, 2017. It was my eldest daughter’s birthday and I got upset in the restaurant as my food wasn’t good. I didn’t completely ruin the evening, but my younger daughter later commented ‘I don’t think it helps being pissed out your head most of the time mum either’. It was the reality check I needed. I’d been secretly obsessing about my drinking, occasionally openly saying ‘I must cut down’ with a tiny part of me hoping that someone would say ‘Yes you should – you really do drink too much’. As an outwardly functional person, a professional whom others ask for advice about all kinds of things; a fun happy drunk on the outside this was unlikely to happen. It was very easy to ignore my worries by literally drowning them in Sauvignon Blanc most nights. My daughter named the elephant in the room and I will be eternally grateful to her for that.

I stopped for 100 days, and then decided I could go back to moderate drinking. I went to a few AA meetings, but they weren’t for me. I’d done Xmas, New Year and my birthday sober. It hadn’t been much fun if I’m honest. I felt I’d failed at drinking and I felt deprived without it but after a 3 month break surely I could keep it to the odd one socially?

Fast forward another year and I was breaking every rule I set for myself around moderation and I was consumed with thinking about alcohol except for when I was drinking it! I’d learnt some things during my break so rather than let things get worse – (wondering what my own personal rock bottom might look like) – I stopped. The difference this time is I didn’t go it alone. I signed up for Kate Bee’s online Sober School and I’m now almost 11 weeks AF. The course really helped me change my thinking and I wholeheartedly recommend it for anyone considering embarking on this journey. It’s a lonely path on your own. Now the course is over I’ve moved from the pink cloud feeling I’ve read about to the wall of depression though. I don’t want to drink but I don’t want to do much else either. I think I’m grieving my old self whilst not knowing who the new me will be. I’ve drank a lot for over 30 years so it’s bound to be a bit strange. I’m not used to reaching out to others for support – it’s usually the other way around. Writing this blog is to help me keep on keeping on through this difficult bit on the way to what I hope will be a content sober life. I’ll be exploring how I got here; the ups and downs of recovery and anything else that comes up. If it reaches other health professionals battling their demons secretly and helps them feel less alone that will also help me.