Now that it’s Thanksgiving holiday weekend, I finally got a chance to see the Robert Zemeckis movie “Flight,” starring Denzel Washington, Don Cheadle and Kelly Reilly.  In my view, this movie “nailed it,” with a poignant and moving portrayal of the struggle of a person with an addiction illness. So I’ve decided that now is as good a time as any for me to post my first entry on my new blog,  “Paging Dr. Steve: Mental Illness, Addiction and Wellness Info You Can Use.”  As a psychiatrist specializing in drug and alcohol addiction treatment for adults and teens, I’ve wanted to see this movie ever since it was released, and I knew it would touch me in a special way – and it did.  “Flight” captures beautifully the pain that is inherent in addiction illness, and it is accurate about many aspects of this tragic, debilitating disease.  In this, my initial blog post, I’m just going to highlight a few powerful “Eye-Openers” depicted in this powerful movie.

“Eye-Opener” #1:  The person with an addiction illness is literally the “walking enslaved.”  The addicted person thinks he’s “choosing” to drink or get high.  Probably all of us have heard someone with an addiction to alcohol or drugs say, “I can stop anytime I want.”  But he doesn’t realize that he is in the grips of a terrible disease – a brain disease.  And when the disease of addiction controls your brain, it controls the way you think, the emotions you have, the way you see the world, and the way you interact with the people in your world.  It controls your ability to order your priorities; it controls your choices; and it definitely controls your behavior.  Basically, any function your brain normally controls is now under the control of the addiction that controls your brain.  So everything the person’s brain would normally do is now controlled by an unrelenting drive to get the drug, use the drug, feels its effects, and do whatever it takes to prevent anyone or anything from stopping him from using the drug in the future.  So sure, if you’re addicted to alcohol or drugs, you “choose” to drink or get high, but only because the addiction controls what you “choose” to do.  You can “stop anytime you want,” but the alcohol or drug addiction is controlling what you want.  And as long as you’re in the throes of the illness of addiction, you’re inevitably going to “want” to keep drinking and drugging – even as it leads you to destroy everything else in your life that you used to “want” – like your career, your relationships, even your own life and health.

And that’s just what we saw in the movie: even when the chips were down, with the proverbial “gun to his head” – when he absolutely, positively needed to remain sober for just one more night – “Whip” simply couldn’t stop himself.  He couldn’t avoid drinking.  And once he started, it’s like the old Alcoholics Anonymous saying, “One is too many, and 1000 is not enough.”  There was no way he was going to have a “measured amount” or drink “in moderation”  – no, he was inevitably going to go to the extreme.  Because that’s what people with alcoholism and drug addictions do – they go to extremes.  They’re not able to moderate or limit their use, because that requires being in control of it; and they are not in control. The alcohol or the drug is in control.  The addiction is in control.

“Eye-Opener” #2:  It is possible to be addicted to alcohol or drugs and be incredibly talented and accomplished at the same time.  In fact, in some ways, “genius talents” like “Whip” are uniquely vulnerable.  We see it over and over again: when a person has jaw-dropping talent and accomplishments – especially when they are at the “one-in-a-million” level, as we see in this movie with “Whip”(or as we’ve seen in real people like Whitney Houston or Amy Winehouse, or Michael Jackson) – it can be much harder for them to recognize that addiction is destroying their lives and their relationships, and that it eventually will undermine or even eliminate all of their amazing talents and accomplishments.  It’s really unfair for the superstar suffering with an addiction.  Because it’s almost impossible to understand that even if you are the THE BEST at what you do – literally, light years better than anyone else, with no one who can even be compared to you – addiction will ultimately render all of that meaningless.  It will tear apart your life.  Even if it doesn’t kill you (and it often does), it will tear you down to a level far lower than you ever thought possible – ironically, far below people with infinitely less talent, ability and accomplishments than you have.

“Eye-Opener” #3: The person with an addiction is literally living a lie.  He lies to himself and to anyone and everyone he encounters.  He is so thoroughly entrapped in his world of lies that he hates the truth, regardless of the form it takes when it confronts him. It doesn’t matter if it is in the form of someone telling the truth to him in a loving way (like “Whip’s” girlfriend). Or in the form of someone he has hurt yelling the truth at him to try to get through to him (or to simply stop him from hurting them anymore – like “Whip’s” ex-wife and son). Or in the form of a professional who is trying to help him by asking him to confront the truth (like “Whip’s” attorney). Or even in the form of going to an AA meeting and hearing the truth described in vivid detail by a perfect stranger and knowing deep down that this truth applies to him as well.  No matter what form the truth takes, or how often or in what setting he comes in contact with the truth, the addicted person rejects it, runs from it, shouts it down, or violently fights it off.  Why? Because honesty and truthfulness – to oneself and to others – is the mortal enemy of addiction.  The two simply can’t coexist.  If you’re embracing one, you’re going to reject the other.  It’s that simple.

But then… it’s also a little more complicated. Consider this: The addicted person is not intentionally, consciously “choosing” to avoid the truth.  In some ways, he’s simply unable to grasp it.  Remember, his brain is being controlled by the addiction to alcohol or drugs, so his ability to see the truth, to recognize it for what it is, to understand the events of his life and how they are unfolding – all of that is impaired.  The addicted person isn’t just consciously trying to lie and manipulate. In a very real way, he just doesn’t get it.  His brain is being controlled by a syndrome of addiction to a toxic drug.  And on some level he simply isn’t able to process the truth and understand it the way the rest of us do.  That, in its purest form, is what is meant by the term “denial.”  It goes way beyond just consciously or intentionally “denying” the truth.  It is literally an inability to recognize, process and understand the reality of his drinking and drug use and what it’s doing to his life.  So we see in the movie, “Whip” can proudly shout at his girlfriend, “I choose to drink…I have an ex-wife and a son that won’t speak to me anymore because I choose to drink…” And we watch him and we think, “Dude, you must be out of your mind!”  And we’re right.  He is.  That’s denial.  It’s a hallmark – a core symptom, if you will – of the brain disease called addiction.

There’s an easy-to-recognize, easy-to-remember, user-friendly “definition” of addiction that this movie depicts powerfully and graphically – a definition I’ve been teaching to people for years. You know you are addicted to alcohol or a drug if you have:

1)   lost control over your drinking or drug use or your ability to stop;

2)   continued to drink or use even though you’ve had bad things happen to you as a result of your drinking and drugging;

3)   developed an obsessive desire for the drug – thinking about it constantly and always looking for an opportunity to use it  – and a pattern of compulsively finding the drug and using it, so that you simply are not able to leave it alone when the opportunity to drink or get high it presents itself.

If you haven’t yet seen “Flight,” by all means, see it and think about it in the context of this user-friendly definition and the thoughts I’ve shared here about addiction and the “Eye-Openers” this movie highlights.  If you have seen it, watch it again, but this time with this definition and this blog post in mind.  If you know someone who has an addiction illness, I hope this will help you to understand a little better, and possibly be better equipped to help that person. If you’re the one with the addiction, I hope this will encourage you to get help.  You can’t do this by yourself – but you can do it with the right help.  Recovery from addiction is possible and it is real.  Continuing to drink or drug without consequences is not.  “Flight” was accurate in that regard, too.  “Whip” didn’t escape the consequences of his addiction.  Without relentless pursuit of recovery, most people don’t.  Whitney, Amy and Michael didn’t.  If you don’t get help, you probably won’t either.

I welcome your thoughts, your comments, your questions.  Let’s discuss this.  This is important stuff!

Dr. Steve (General, Child/Adolescent and Addiction Psychiatrist)