The news of Philip Seymour Hoffman's death is heartbreaking and the outpouring of attention and emotion speaks to the impact his talent had on all of us. The world just lost a compelling human being and gifted artist.
As psychologists, when we hear about a well-known person dying of probable drug overdose, we are reluctant to comment because we have great respect for their family members and friends who are consumed by the loss. Yet as psychologists who work with people struggling with substance abuse problems, we know that his family and friends are not alone. Over a quarter-million people die of substance-related deaths each year in this country. A truly devastating quantity, especially when you consider that each death leaves a family and circle of friends with profound wounds that seldom fully repair.
In our culture, stigma and judgment continue to persist when it comes to substance problems. The shame that substance users feel is devastating despite striking advances in what science has taught us about what contributes to a substance use problem's development and the effective therapies and medications that are now available. This lack of awareness about options and shame associated with having a substance problem contributes to a needless loss of life.
Mr. Hoffman faced that stigma and was gracious and open about his recovery. In doing so, he acted as a role model to others. His reported return to use is a tragic reflection of how difficult it is to maintain sobriety over the long haul. Most people with serious problems have periods of stability and periods of setbacks. Learning to live a life without substances takes practice, trial and error and a significant amount of support. And still, unspeakable loss can be the outcome, in spite of best efforts and intentions.
The heartbreak, complicated feelings (oftentimes anger, confusion, despair), and deep shame that a family is often left with is just as profound as they wonder what they could have done differently, wonder why their loved one would not stop, and wonder what people think about their family given how their loved one died. In our country we do not have a track record of treating people with substance problems or their families with the kindness they deserve.
Science has given us motivational interviewing, family and individually-based cognitive behavior therapy (CBT), Community Reinforcement and Family Training (CRAFT), and certain medications, all of which have clear rates of success in both getting people into treatment and achieving successful outcomes. There is, however, a significant gap between what we know works and what is practiced in the field and is understood by most consumers.
We believe this gap in knowledge and practice is due to a persistent moralistic view of substance abuse problems in our country. The assumption that people who develop problems with substances are different, weak willed, self-centered, less-than, and essentially to blame for their own problems. This view is promulgated in subtle and blatant ways throughout our society in both pop culture and many health care providers who use derogatory vocabulary (entitled, selfish, lazy), moral notions of willpower, and character flaws, to describe a person with a substance use problem. How can we expect people who struggle to step forward and ask for help when they expect to feel misunderstood at best and possibly even denigrated and shamed? Families resist seeking help for the same reasons as they get told to detach, distance and use tough love, all of which are counter intuitive to the concern and hopefulness they feel for their loved one. In the end, the shame substance users and their families feel results in isolation, with people hiding truths from themselves and others, and in the process being effectively shielded from seeing pathways of hope and possibility with treatment.
Philip Seymour Hoffman was open about his recovery, and we are grateful to him for it. And we are grateful that in his period of stability he shared his art and his soul. We are humbled by the difficulties associated with staying stable over the long haul and hope that we continue to change the conversation about this problem from that of stigma to growth, from deficits to strengths and from shame to pride. We are so sad to see you go, and so sad for your family and loved ones suffering now from your absence. And we can only hope that someday soon the shame and stigmatism about what may have killed you decrease, along with the number of related deaths.
Need help with substance abuse or mental health issues? In the U.S., call 800-662-HELP (4357) for the SAMHSA National Helpline.
Jeff Foote, Ph.D. Dr. Foote is a Clinical Psychologist and Co-Founder of The Center For Motivation and Change in Manhattan, as well as CMC:Berkshires, an inpatient substance abuse treatment center in the Berkshires of western Massachusetts. He has been a federally-funded researcher on substance abuse treatment and a lifelong clinician in the addiction field, focusing on implementation of evidence-based treatments. Dr. Foote was also Psychologist for the NY Mets the last 11 years, as well as an independent performance consultant to athletes. He is co-author of the soon to be released Beyond Addiction: How Science and Kindness Help People Change, a Scribner books publication.