Women and Alcohol (part one of three)

Sometimes I drank in the bathroom.

I have various theories about this.  First, because so many of my drinking binges ended with me passed out in a bathroom, I may have decided to start short cutting. I have had people drag me into bathrooms and leave me to myself more times than I can count.  Sometimes, they simply maneuvered me near the toilet.  Once, I came to in a full tub.  This didn’t strike me as being very intelligent, on the part of my saviors in waiting.  Girl could drown, you know.  But I was hardly in a place to criticize, and it seems I was very dirty.  People sometimes react with a desire to clean me, wash me off, or at least to wash their own hands.  I mean this metaphorically. I mean this literally.

Secondly, the loo was often the safest place for me to drink.  This was rarely premeditated.  It just was.  You have a husband, for example.  Or, no one else seems to be drinking at the brunch.  Or, say, you’re at the bar with everyone else.  What happens then is that you say ‘bathroom’ when what you mean is a shot – one on the way to the ladies room, one back.  Or, what you mean is, you are aware of how thin the ice is, and need to frequently check your face to see that it’s holding still.

Thirdly, bathrooms are small enclosed spaces with doors.  Bathrooms can hold you.  Doors are important.

Oddly, it appears I’m not the only girl who did this.

A severe theme of hiding

If I am honest in my self-awareness, I begin to see patterns.  The predominant one is alcohol.  But behind this, or perhaps a part of it, is the sister theme of hiding.  This is not and never has been limited to my alcohol use.  I do not know, it is entirely possible, that drinking alcoholically taught me to hide.  But it may be that my ability to hide enabled me to become alcoholic.  And it certainly seems to be that women, on the whole, know hiding as a lifestyle more than men ever have.  When I speak of it (and it is often laced to another shadow, another theme, that is sometimes alcoholic and sometimes not but is ubiquitous among women and goes by the name shame), men look perplexed.  Women, on the other hand, tend to blush with recognition, nod vigorously, or look at their laps while whispering I know exactly what you mean.

Women hide from the beginning.  We hide our period.  We hide our breasts or lack of them.  We whispered on our phone calls with boys.  We hide what we eat and what we spend.  We hide our emotions.  Oftentimes, we hide our smarts and our common sense.  We hide the fact that we smoke, that we’ve downed enormous amounts of junk food, or that we’ve stuck a finger down our throat.  We hide our sex.

And we hide, are hidden in, our drinking.

When women seek help or try to get sober, most of them hear from someone or other: really?  I didn’t realize you had a problem.  Not only do we hide.  Others do the hiding, for us.

The problem

At this point in time, alcoholism is recognized as a disease, there are treatment options, and a fairly standardized prognosis and approach to intervention.  This is a good thing.  It is a better thing than having nothing.

The problem is that women (and minorities) don’t often fit the picture that we have, becoming invisible.  The studies of alcoholism and treatment have largely been done with white men, even though we are learning that women’s patterns in addiction can be radically different.  We’re also learning that women’s prognosis and recovery patterns may be significantly different from those that work for white men.  In particular, the 12 step model and it’s theme of powerlessness may do more to re-victimize or alienate woman (and, again, minorities) than it does to help them.  The 12 steps are based on the theory of hitting bottom and losing control, admitting powerlessness in the face of addiction.  For many women, bottom is a relative term, control was never a thing they had, and powerlessness is everyday.

Many women have found recovery in the 12 step model.  It remains our best shot.

We know now that women’s ‘progression’ of alcoholism and addiction is usually faster – much faster – then men’s.  This is a biological reality.  The size and relative weight, fat, and water content have something to do with it.  So, too, do hormones.  So, too, does the fact that women lack a chemical in their stomach that men have.  This chemical begins the breakdown of alcohol in a ‘first pass’ before it goes on through the digestive tract.  This means that women have unprocessed alcohol in their bodies longer than a man does; her body doesn’t begin to ‘break down’ the alcohol until a later stage.

We also know that the ‘classic’ progression of alcoholism may not be a very helpful concept for women.  Our life patterns seem to be aberrations, unless we sit down with a bunch of other women.  While men seem to have a regular progression, starting sometime in early adulthood and progressing with age, women more frequently have periods of heavy use and periods of ‘regular’ drinking or abstinence.  Many women don’t have a problem with alcohol until middle age, when they become ‘full blown alcoholics’ in a matter of a year or two.  Others develop ‘full blown alcoholism’ in their sixties and even seventies.  And there are many girls who develop ‘alcoholism’ or ‘addiction’ while in their teens, seem to straighten out, and later have recurrence of problems.

The effects of ‘long term drinking’ or ‘heavy drinking’ on women’s livers, hearts, and brains has been shown to be more likely and more rapid than in men.  This echos the above: a woman can be severely physically impaired or ‘alcoholic’ in a very short period of time.  A woman drinking two or three years may have comparable alcoholic ‘effects’ as a man who has been drinking heavily for 20 or more years.

Alcoholics frequently deal with mental health issues, financial issues, and trauma.  However, studies show that most women have these issues prior to active addiction, while most men develop those issues in consequence to addiction.  Therefore, intervention for addiction with women only goes so far: of course, it is true that not much can be done for her depression or her job skills unless and until she gets clean.  But it is also true that unless those issues are dealt with, her chances are slim.  They aren’t dealt with.  Usually, they aren’t even considered.

A woman’s addiction often changes according to her life situation.  Motherhood, relationship status, social economic status play larger roles in the ‘addictions’ of women than they do of men.  This is not to say that the conditions cause the addiction, or that a man’s life circumstances don’t influence him; it simply means that women’s addiction is a complex of biology, social standing, familial roles, and economics different than that faced by a man.

Stigma

There are double standards across the board.  The first and most obvious is probably sex itself.  Men want you to sleep with them, but they don’t want to know about your sex with others.  This applies to booze, equally well.  I often had men who wanted to drink with me, some of them even admitted to finding it attractive.  But if they knew I drank like that at other times, they became uncomfortable.  Case in point.  I can take the cap off a bottle of beer with my teeth.  A guy told me this was the sexiest thing he’d ever seen.  A few hours later, when he realized I’d developed this skill through a life of hard happy hours, he was not only not impressed, he was intimidated.

The double standard is tough.  Most of us can acknowledge it and see how it’s real, generally speaking, but don’t want to talk about it in the concrete.  Most men, family, and peers are quickly able to see how ‘it’s different for women’, but are slow to talk about their own participation in the problem.

The double standard is tough also because we can’t win.  We can’t be both a good girl and a good time.  We can’t be a nurturing mother and a social goddess.  We are simultaneously sent conflicting messages: be sexy, be coy; be yourself, don’t do that; be independent, live for your family.   As soon as alcohol or drugs come into the picture, the double standards are amplified.

The fact is, a woman alone in a bar is looked at differently than a man alone in the same bar.  A woman who has sex under the influence is judged differently than a man who does the same thing.  As the stakes go up, so does the judgement.  A man may very well be able to drink at the family dinner, but eyebrows go up when a woman does it.  Issues of violence, crime, child rearing, sex, career and education are all judged differently the moment it’s known a woman drinks, and differently than if it were a man doing the same thing.

Treatment

Treatment centers have become increasingly aware of the need for gender specific alternatives.  But there remains a lag in practice.  Much of it has to do with the addictions field failing to realize the realities of a woman’s life.

30% of treatment admittance is female.  Retention and completion are severely lower than this.  There are a number of reasons.  First among these are socio-economic.

Women are more likely to be under-employed, un-employed, and un-insured than are men, even within the same socio-economic demographic.

Even for those women who are employed, economics often plays a serious role in treatment outcomes.  Women are more likely to lose wages or employment if they take time off.  Women, even married women with employed partners, often struggle to find childcare during treatment.  Very few treatment centers offer assistance or on-site childcare.  The threat of custody issues and the involvement of Child and Family services is a very real deterrent to seeking treatment for many women.

Treatment centers assume that addiction is the central issue in a woman’s problem.  Since they are a treatment center, this is to be expected.  But it is not usually the truth.  Women seeking treatment are more likely to be facing homelessness issues, sexual assault issues, domestic violence, and traumas resulting from childhood abuse, prostitution, and human trafficking then are men.  Women are not screened for rape or domestic violence upon admittance.  They are not asked if they are safe at home.  Without those screening tools, giving a woman a few weeks of sobriety is a fairly moot point.  When she returns to a violent home, her chances of relapse are high.  If she is involved in prostitution or human trafficking, her lifestyle is largely controlled for her.  Without addressing and offering resources for sexual assault, safety, housing, child care, and mental health, substance abuse treatment may do little more than serve as a layover in a woman’s chaotic life.

The ‘other hand’ is also true: when women seek help for other services, such as sexual assault crisis intervention, shelter from abusive relationships, or emergency assistance, drug and alcohol use or dependence makes her ineligible for services.

12 Steps

Alcoholics Anonymous was founded in 1935 by two upper middle class white males, a financial man and a doctor.  Since then, ‘the program’ has saved millions of lives and has proven to be the single most effective course of action in arresting alcoholism and returning the alcoholic to a healthy lifestyle.

From the beginning, there have been women in the rooms.  The big book includes their stories, and acknowledges (with it’s common sense wisdom that was decades before statistical validation and medical truth) that women’s alcoholism can occur more quickly than can a man’s.

However, there may be sexism and wrongheadedness in the language, perpetuated in the daily practice, that works against the female alcoholic.  As everywhere else in life, a woman who needs the service will usually have to take what she can and turn a blind eye to the rest, but it is fair to say that AA has alienated some women.

As mentioned above, the central concepts of ‘powerlessness’ and ‘acceptance’ may prove difficult for women who have always been powerless, and have had little choice in what they accept and what they are given.

Further, the program and it’s traditions have central tenets addressing ‘resentments’, making ‘amends’, and ‘live and let live’.  Anger is anathema.  Forgiveness and acceptance are pivotal.  Of course these are words, and words can and should mean different things in different contexts.  And of course the tenets of AA are based on universal ‘spiritual’ principals, addressing spiritual paths in language common to spiritual paths across millenia.  

The program, at face value, is a good thing.  However, the phenomena of ’13th stepping’ is real.  I’ve also worked with a number of half way houses and recovery homes for women that so focus on ‘humility’ that they constrict a woman’s life, when the last thing a woman’s life need is limitations.  Women with PH.D’s are sometimes told they should not work in their field, but in fast food industry.  Women are not given crisis intervention for things such as sexual assault and domestic violence, but are taught to be ‘humble’.  Women who have worked in prostitution, been involved in crime, or been in abusive situations (all highly likely) are told to accept, let go of resentments, and to ‘look at their own part’.  This denies the central fact that violence against women is wrong, never her fault, and a crime even if she is under the influence or addicted.

Women are more likely than men to seek alternative help, through mock off programs of the 12 steps like SMART or Women in Recovery.  However, those programs lack the strength of numbers found in AA.

The point is not to disparage AA: for being founded when it was, it did a remarkable job.  It has grown in inclusivity, and ultimately, it works.  As AA would say, the problem is not in the principles, but the personalities.  Unfortunately, the reality of needing to be aware still largely falls on the individual woman, often when she is at her most vulnerable.

Hope

Addictions and alcoholism are deadly, awful things, whenever and whoever they strike.  That women may face different barriers and social facts is not, in itself, the end of the world.

In fact, recovery from alcoholism and addiction is often the starting point for a woman’s larger sense of self-control, empowerment, and grace.  Women find, in recovery, the tools to challenge status quo and recover from trauma.  Women also find, often for the first time in their lives, positive relationships with other women.  Women can also find new strength, mutuality, and community with men in their process of recovery.  Recovery changes everything, beginning with us.

Three Girls in a Tub

Maybe I drank in the bathroom for other reasons.  Bathrooms evoke a kind of privacy and self relation that doesn’t happen anywhere else in the world.  Some things happen in bedrooms, some in kitchens.  Some in offices or public parks.

When I sobered up, I’d been saying that I ‘didn’t drink at home’.  I later found bottles stashed in odd places.  I found three in the bathroom.

The bath is haven of self-nuturance.  It is confessional.  And it’s sickroom.  Of course I drank in the bathroom.  I drank most anywhere.

Girlfriends and I used to do lines or shoot up in the bathroom.  I also had one girlfriend who knew where my whiskey bottle was in there: we shared it.  But my intimacy, my hiding, what I’ve got with other women isn’t only in the booze.

I’ve held girlfriend’s hands while they purged.  I had a girlfriend wash my back, shampoo my hair, when I was too depressed to do it myself.  I don’t know how many times I’ve been in the bathroom with another woman as we did our hair, leaned in to fix mascara, shunted in and out of outfits.  Meanwhile, we talked things mundane and relevatory.  Women have told me of their first pregnancies in there.  Hell I’ve sat in there with women watching the pee on a stick test, and had others do the same for me.  A girlfriend and I sat in her bathroom for hours the night she and her husband decided to separate.  When a friend lost her brother suddenly and violently in a mess of metal and sirens, we did our grieving on the bathroom floor.

Nothing is as intimate as the tiles, I mean.  But what I’ve come to learn is that my most shameful secrets, the most private parts of my body, the things I vowed to tell no one, ever, are things I have since learned other women know, too.  This doesn’t make them less intimate.  It makes them more so.

Once, I ended up drinking wine in a dry bathtub with two other women.  We were on our way somewhere, but fell into conversation, sat down, and didn’t move.  There was something silly to it, but also something very safe, very intelligent, very important.  It was more important that we stay there, together, than that we go out.  The bathroom door was closed, even though no one else was in the apartment.  Sometimes, doors are important.

Women and Alcohol, Part Two: Alcohol and Mothering

Coming, Women and Alcohol, Part Three: alcoholism and sex (relationships), alcoholism and violence, alcoholism and cash prizes (slavery, prostitution, industry) Alcohol as coping skill: Alcoholism and eating disorders, alcoholism and co-dependency, alcoholism and self injury, alcoholism and mental health

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