New York Times journalist Benoit Denizet-Lewis is a sex addict. That is a fact he openly discloses at the start of his excellent new book America Anonymous: Eight Addicts in Search of a Life. Now that I have your attention, I can also tell you that it was one of the best books I read in 2008 (I received a review copy; the official release date is January 6, 2009), and one of the most powerful I've encountered about addiction.
This owes in large part to Denizet-Lewis's keen observational eye and engaging style writing style; he spent two to three years following men and women ranging from 20 to 80 years old, with addictions that include crack, alcohol, crystal meth, sex, food and shoplifting. Whether the word "addict" is even applicable to all of these behaviors is something that he deals with in American Anonymous. Likely, readers will walk away with differing opinions as to the strength of both the addictions and the subjects facing them. I found them by turns sympathetic and infuriating.
Denizet-Lewis gets into the heart of their addictions and (often rocky) roads to recovery, detailing the heights of their substance abuse, including health problems, lost jobs and families, painting a stark portrait of the pain and physical/emotional/mental damage addiction can do. But this is not simply an account of the depths of addiction. It focuses on the recovery process, which for some involves living under supervision, for others support groups and counseling of various kinds. Interspersed with his visits with his subjects, Denizet-Lewis explores modern medical thinking about addiction and recovery, raising powerful questions and attempting to unlock why some succeed in defeating their demons and others don't.
Ultimately, though, Denizet-Lewis is not trying to offer up a cure-all or solution, but instead to show the various ways addiction can take hold. You can read more about the book and his blog on related topics at www.americaanonymous.com. This interview was conducted via email.
How did you come up with the idea for America Anonymous, and where did you find your sources? What criteria did you use in selecting them? If you know, what were their reasons for allowing you into their lives?
Clearly, there have been many books about addiction. Some would say too many. But when you look at what's been published (and I certainly did), they tend to fall into four categories. 1) Memoirs. 2) Books that focus on alcoholism or a specific drug. 3) Spiritual or self-help books. 4) Books that poke fun at the "recovery" movement and that are critical of the Twelve Steps. I didn't want to write any of those books. I wanted to write a book about what is our most misunderstood public health problem, one that triggers and exacerbates many of our costliest social problems--skyrocketing health care costs, poverty, crime, and our backlogged criminal justice system. But I wanted to do it in a narrative way that focused on real people.
I found them by walking up to complete strangers on the street and saying, "Hi! What are you addicted to?" Just kidding. I went the more conventional route, talking to addiction experts, counselors, and treatment centers. I also demanded that my friends confess their addictions and introduce me to all of their addicted friends. That's how I met Todd, the bisexual bodybuilder who used to abuse meth and was struggling to cut down on his steroid use during the time I followed him. (When he did try to cut down, he felt like he was shrinking and could barely leave the house.)
Many of the people I wrote about told me that they hoped to help other people by letting me tell their story.
You told Gawker, "My goal is also to get the subjects I'm writing about to forget that I'm a reporter." How did you go about that in this case? You seemed protective and concerned for your subjects; were there ever any ethical issues for you over how involved to get in their lives?
I don't think there is any way to follow people for as long as I did and not care about them. If I displayed an unusual amount of empathy toward them, it's probably because I am one of them.
What I thought was most interesting about America Anonymous is that you treat shoplifting and food addictions as you do crack and alcohol, though you note that there is even debate about sex addiction from within the medical community. Do you see them all being rooted in the same sources?
Addiction is very, very complicated, and as much progress as we've have made in understanding what's going on inside the addicted brain, we still don't really have the full picture. Some scientists, addiction "experts," or pharmaceutical companies may claim otherwise, but they are -- and I hope you'll forgive me for this -- on crack. We know even less about addictions to things like food and sex. But those kinds of addictions fascinate me.
I obviously have a bias in this area, because I'm a sex addict in recovery, and I have no doubt that my sex addiction is very real. Do we throw the word addiction around too much in this country when we say we're addicted to our cats or our iPods? Sure. There's also little doubt that addiction is a cultural construct. Cultures define addiction differently, and we've been maddeningly inconsistent in this country about how we understand addiction or what substances we consider the most dangerous and addictive. (Cocaine, for example, has been considered everything from an addiction cure to the most addictive substance ever.) But after spending three years traveling the country and talking to people about their addictions and recoveries, I have no doubt that behaviors like gambling, sex, and compulsive overeating can be just as addictive and destructive for some people as alcohol is to the alcoholic. We've pretty much accepted this idea when it comes to gambling, but we're reluctant to fully endorse the idea of food or sex addiction. I explore the reasons for that in my book, and I delve deep into the lives of Americans who are trying to recover from powerfully destructive addictions that much of this country isn't convinced should be called addictions.
The Southie (South Boston) resident you profile, Bobby, is one of the few whose location is specifically named and, in your telling, plays a major role in getting him high (the same goes for the Harlem crack addict you cover). How much of their addictions do you think is nature vs. nurture (in the form of being surrounded by those actively doing drugs)?
There is no doubt that stress in childhood (whether from poverty, physical or sexual abuse, or emotional neglect and abuse) makes one more likely to become an addict. Trauma is perhaps the greatest predictor of addiction. We also live in a country with a relentless appetite for distraction. As we obsessively search for new and innovative ways to escape the reality of whatever is actually happening and make ourselves feel "better," we've created a schizophrenic culture where nothing is ever enough, where stillness is equated with boredom, and where we need increasingly intense experiences just to feel alive. In essence, we've created a culture that supports and encourages addiction while at the same time shames, ridicules, and criminalizes those of us afflicted with it.
For Bobby, it would have been a miracle if he hadn't grown up to be an addict. Southie is an insular Irish-Catholic neighborhood (although it's gentrifying rapidly) that has been ravaged by drug use, and Bobby told me that only one of the friends he grew up with never got hooked. There is likely also a very strong genetic predisposition to alcoholism in many Southie families, but it's impossible to know for sure what's nature and what's nurture.
You wrote that you related the most to Sean's struggle since he's a fellow sex addict. Did that make covering his story harder or easier? Were you out about being a sex addict to all your subjects?
Sean was the only person I followed who I knew before I started writing the book. Because we're both sex addicts, we related strongly to each other's struggles. Sean is straight and I'm gay, but the insanity of our addictions is the same.
I was open about my sex addiction with the people I wrote about. And because I spent so much time with them, they often asked me how I was doing with my own recovery. Bobby was the only one who couldn't seem to wrap his head around the concept of sex addiction. He didn't understand how anyone would choose sex over the high of drugs. I told him I didn't know how anyone would choose drugs over sex.
The book is heavily focused on 12 step programs, with most of your interviewees actively taking part in various recovery groups and attending meetings. Why did you choose to emphasize 12 step programs?
There are many pathways to recovery from addiction. Many people use the Twelve Steps, but many others don't. Five of the eight people I followed used them, but I really tried to explore many different tools that people use to get and stay sober.
I was reading the book on the subway and struck up a conversation with the woman next to me about the topic of addiction, and she said it came down to "willpower," an idea you debunk in the book. Why do you think we cling to the idea that it's just a matter of willpower to overcome an addiction? What other stereotypes about addicts were you trying to debunk?
People say the darndest things on the subway! But, seriously, it's not only random women on the subway who cling to the idea that willpower is enough. Addicts do, too. That's why we spend years doing the same thing over and over again and ruining our lives in the process. What separates addiction from other illnesses is that denial is one of its primary symptoms. Either we deny that we have a problem, or we tell ourselves (disregarding years of evidence to the contrary) that today will be different, that willpower will finally be enough. I know that this is very difficult for people who aren't addicts to understand, but willpower is usually no match for addiction. But damn if we don't cling to the idea that is. I mean, who wants to admit powerlessness? It sounds almost un-American. The paradox, of course, is that admitting powerlessness over an addiction is often the first step toward finding the strength to heal.
Where are your subjects now and how are they doing in their recovery?
I'll let you know when I update their stories for the paperback edition. =) But if you're really interested, two of them (Janice and Jody) will be participating in my public event in New York City at 7 p.m. on Monday, January 5th, at the Barnes & Noble in Tribeca. Author Susan Cheever will be hosting the event.
You don't talk too much about your own battle with sex addiction, though you do mention it and reflect on it at the end, discussing your relapse. Looking back now, how did your own addiction shape the narrative of the book? Even with the relapse, do you think it was personally helpful to you to immerse yourself in addiction literature as well as the lives of your subjects?
I really don't know if it was good for my recovery to write this book. I've thought about that question a lot. Researching and writing on this topic certainly kept addiction in my head for four years, but it could sometimes be exhausting to think about addiction all day and then make time for my own recovery, too. That's the same challenge that addiction counselors (many of whom are in recovery) face.
Several times you talk about the politics of addiction and recovery, noting that if addicts were a lobbying group they would have major power in the political system. Do you think this is likely to happen? Does the focus on anonymity hinder any attempts at political organization around addiction?
The Twelve Step tradition of anonymity has been critical to the success of groups like AA, and nothing is more important to the sobriety of millions of recovering people than the continued strength of Twelve Step programs. With that said, the focus on anonymity has undoubtedly added to our cultural confusion and apathy surrounding addiction. As I write in my book, by keeping our recoveries private and anonymous at all costs (except for the addicted celebrity, who often enters and exits rehab with great fanfare), recovering people have unwittingly excluded addiction and recovery from the national conversation and cemented the belief that being hooked is something to be ashamed about. There are still way too many negative public attitudes about addicts in this country. But the very people who could change those attitudes (people who have been sober for decades and are leading rich, fulfilling lives) have been talking to each other for years in church basements.
Groups like Faces and Voices of Recovery are creating an advocacy moment among people in recovery to bring this issue into the light. (The organization urges people with longterm recovery to advocate with anonymity by not naming the Twelve Step group they belong to.) There's even some talk of a Million Addict March on Washington, although that's probably some years away.
What would you like to see from the Obama administration in terms of helping addicts recover?
We can start by conceding that the War on Drugs has been remarkably ineffective -- and staggeringly unjust. (Blacks and whites use drugs at about the same rate in this country, but blacks are ten times more likely to be jailed on drug charges.) Should we try to stop illegal drugs from coming into this country? Of course. But that can't be our entire strategy to combat addiction. We're making some progress on this, but we need to stop warehousing addicts in prison, where most receive little treatment. The majority of people behind bars in this country have a substance abuse problem (many were either high when they committed their crime, or they committed the crime to get money for drugs). In general, we need to make treatment more available and affordable. The rich can afford fancy treatment centers, and the poor can often access not-so-fancy treatment through city or state services. But the middle class really struggles to get help. Of the 23 million people in this country who needed treatment in 2006, for example, only 2.5 million received it.
We also need to shift our focus a bit to prescription drugs. While illicit drug use is declining (except among adults older than 50, where it's skyrocketing as the Boomers age), many addicts have simply switched to abusing prescription medications. According to the 2008 Monitoring the Future report released this week, seven out of the ten top drugs being abused by high-school seniors are legal prescription or over-the-counter medications.
Finally, if we really want to help people recover, we need to start talking about addiction and recovery in an intelligent, nuanced, compassionate way. We've never really done that before, but in the spirit of a new year and new president, I say, Yes We Can.