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But I’d hate to be a grown-up
And have to try to bear my life in pain
— Phoebe Snow, “Harpo’s Blues”

For several years during my early childhood, my mother administered an aspirin to me every day.  This was not because I was sickly, nor because I was in pain.  This was, she told me, preventive, in case I might fall ill.

She must have read about this somewhere.  I’m sure it sounded like an excellent plan.  She had spent over a year of her own childhood bedridden with an illness that was never satisfactorily diagnosed.  What better than to inoculate her daughter against disease and hurt?

She couldn’t have known about the harsh effects of aspirin on the liver, how the toxicity built up in that organ from this daily dosing would create in me excruciating headaches and menstrual cramps that would begin in adolescence and recur into early adulthood.

And undoubtedly she did not share the view that pain is a teacher, that it arises to direct our attention to potential or actual damage to the body or psyche and teaches us to not repeat the behaviors that induced that pain.

It is by experiencing pain that we learn to prevent it in the future.


Self-medication is the use of drugs and other substances or rituals to treat pain or malady, whether real or perceived, physical or psychological.  Its practice may arise from the wish to feel control over the degree of one’s suffering.  Or from a refusal to learn the lessons pain would teach.  Or from a determination to continue the pain-inducing behavior without suffering the consequences; for example, if I take Pill Curing, a Chinese herbal remedy, when I eat hot chilis, it will diminish the diarrhea that always occurs when I eat hot chilis, a signal that hot food is in fact bad for my digestive system.  What would happen if instead I listened to the pain and learned what my body really wants?

Self-medication may lead to dependence or addiction, but is not synonymous with these.


I was taught the art of self-medication.

I was a lonely child of a too-young mother who felt suddenly trapped by the bonds of maternity, wrecked by the devastation of first one and then a second marriage.  I was taught to dull my longing for her love, to soothe myself instead with whatever substance was at hand.


Sugar was the first drug.

Cinnamon buns.  Hot fudge sundaes.  Chocolate almond bark.  Caramel turtles.  Pecan Sandies.  Red licorice.  Sweet Tarts.  Grape popsicles.  Cherry Kool-Aid.  Bun Bars in maple cream and vanilla cream.  Chocolate milkshakes.  Jujyfruits.  Lorna Doones.  Eskimo Pies.  Butterscotch Lifesavers.  Hershey Kisses.  M&Ms.  KitKats.  Milk Duds.  Malted Milk Balls.  Jawbreakers.  Rock candy on a stick.  Bazooka bubble gum.  Doughnuts coated in powdered sugar.  Butter pecan ice cream.  German chocolate cake.  Apple pie a la mode. 

There were rituals.  French crullers when I went with my grandma to get her hair done.  Homemade fudge when we played Flinch or Muggins.  Butterscotch sundae after the dentist.

Holed up in my room with a big bag of M&Ms, I liked to sort the entire bag by color; first into complete sets—red, orange, green, yellow, tan, and brown—then incomplete sets after one color ran out, usually orange or green; sorting into progressively smaller sets—five colors, four, three, two, then sets of one, usually a few extra browns.  I’d eat the smallest sets first; saving until the very end the complete sets with all six colors, consuming last the rarest colors—orange, red, green.   This ritual was part of the soothing.

Pop Tarts in the morning.  Red Hots at lunch.  Hot Apple Pie from McDonald’s on the way home from school.  Cookies in my bedroom in the evening, once I was home and more likely to feel upset.  Cake frosting from a can on a bad night.  By these means did I survive the day.

The negative consequences of eating too much sugar are numerous; one article lists “76 Ways that Sugar Can Ruin Your Health.”  For me, those consequences included being overweight, being depressed, having eczema and headaches, a suppressed immune system, near-sightedness, anxiety, food allergies, PMS and, later, a predisposition to alcoholism.  Additionally, sugar alters one’s metabolic pathways, so the more you eat, the more efficient the body becomes at absorbing it; the more you absorb, the more damage it does.

But of course, I didn’t connect the long term consequences with the short term burst of comfort and numbness sugar reliably provided.


But did sugar come before reading?

Before I could read, my grandmother read to me, built me a boat on which to sail through the dark nights while my mother was out.  Hour after hour we’d travel across those moon-scorned waters, words lapping at the hull until her voice gave out.

Then I learned my letters; then I no longer lived with my grandmother, but my own eyes could oar me to another world, any world but the one where voices raged and glass shattered.

Alice in Wonderland.  Winnie the Pooh.  Peter Pan.  Little Women.  Jane Eyre.  A Tree Grows in Brooklyn.  To Kill a Mockingbird.  I Never Promised You a Rose Garden.  Flowers for Algernon.  The Effect of Gamma Rays on Man-in-the-Moon Marigolds.  A Raisin in the Sun.

It was twelve blocks to the library and I would have walked ten times farther to bring home an armload of escape, places to go without ever leaving my room, illumined by lamplight deep into the night.

There is, of course, nothing wrong with reading.  Except perhaps that it can be a way to not engage with the world. To retreat into solitude and the imagination.  To shun the risks of human companionship.  To cultivate loneliness to a fine art.


I didn’t start cutting until I was eleven or so.  The hallowed razor blade drawn down the inner arm, scratching across the wrists, the bright red beads popping like new flowers.  With a little more force one might produce a small stream, but it stung.

Bloodletting was a medical practice among the Mesopotamians, the Egyptians, the Greeks, the Mayans and the Aztecs, among others.  In Europe it was practiced by barbers, signaled by their swirling red and white striped poles.

Although I often had the wish to die, this slicing was for me less about death than about release.  How else to let out the howling demons?


My mother and stepfather were eager to share with me their own coping strategies.  From the time I was six or so, my mother would offer me sips of her cocktails from Bar Thom’s, where we often took late night supper.  These were after dinner drinks with names like Grasshopper and Stinger, tasting of chocolate and mint; they slipped down easily and left a pleasant sort of drift in my head.

My stepfather taught me to mix their martinis, their gin and Squirts; he taught me the proper ratios, the careful treatment of ice, the olives or the lemon twist.

It was easy enough to help myself when they were gone or passed out.  It was easy enough to get fake ID, a girl who seemed years older than my age, to buy bottles of sweet cheap wine from the falling-down liquor store around the corner from my high school, Boone’s Farm and Ripple consumed in the school basement, in the orchestra pit underneath the stage in the auditorium.  Or I’d skip class, walk to Greektown to drink Retsina in a café.

Once I turned eighteen, my stepfather began to give fifths of Scotch and tequila in my Christmas stocking.  As if drinking were a family tradition he was passing on.

The first drink I ever ordered in a bar was a whiskey sour.

The summer I was dieting, I drank rum and Tab with a slice of lime in the sun in the middle of the day before my waitressing shift at night.

Bloody Mary’s with V8 juice for brunch.  Bass Ale while I played air hockey.  My friend Marilyn made me a copper necklace that read “Tequila Queen.”  Scotch on the rocks on an airplane.  Campari and soda on a train.  Pernod.  Ouzo.  Kahlua and cream at the Three Sons, the gay bar in Grand Rapids, Michigan, where my friend Jere took one look at my drink and asked, “Why don’t you put a nipple on it?”

The morning I woke with vomit in my hair.


Pot was even better.  Despite the fact it was illegal—an injustice, yes, but rarely worse than inconvenient—pot coaxed the worry, that constant rhythm in my brain, to drift away in wreaths of smoke that dispelled in air, but left me free to function, something not always guaranteed with alcohol.

Homegrown.  Domestic.  Mexican.  Red bud.  Columbian.  Columbian Gold.  Thai stick.  Hash.  Opium.

It’s true, it led to other drugs.  Altered reality was definitely habit-forming.  Acid—blotter and windowpane, Purple Haze.  Mescaline.  Psilocybin mushrooms.

Once I’d taken psychedelics, I understood that the way I’d been taught to perceive the world was but one of many possibilities.  Worlds upon worlds, so many doorways.

Smoking opium with my childhood friends on a plastic inflatable raft off Sanibel Island in the Gulf of Mexico, unconcerned at that moment about the fact I do not swim.

Tripping in a field at night, late autumn in Michigan, and every plant was radiating energy from its spindly branches.  Staring at their vibrating colors, I saw in my own cells the luminosity of all living things.

Clutching the railing of a freeway overpass on New Year’s Eve, watching traffic stream beneath me, the streak of taillights burning red into my brain, streaks that went on forever.

Walking far out onto the frozen shelf of Lake Michigan in January, the ice under my feet creaking, snow swirling all around me like neurons pulsing.

Standing atop a sand dune overlooking that same lake, some summers later, watching the red sun sink into the water, watching a woman I loved and her daughter bob in a yellow inflatable boat as the sun went out like a dying spark.

I wanted to feel better, and in this way I did: the worlds outside me were vaster than I’d ever seen, and so too the worlds inside.  So much more was possible than I’d been taught to believe.

There were other substances as well: quaaludes, valium, speed, cocaine, angel dust—really, whatever you had.  It was the alteration itself that mattered, whether it made me feel good or made me feel nothing at all, whether it gave me a headache that lasted for days or paralyzed my body and speech, making me fear I’d be locked inside my mind for the rest of my life.


In my twenties, attractions were my medication of choice.  It wasn’t so much the sex that soothed me as the act of looking into a woman’s eyes and feeling wanted and desired.  That adrenaline rush at the start of a new relationship.  Relief, however temporary, from the ache of feeling unloved.  Anything to not be alone.

Apparently attraction’s all chemical.  Brain research shows that those feelings of romantic love light up a part of the brain stem region called the ventral tegmental area, known as the “reward” part of the brain.  Cells in this region flood the caudate with dopamine, a neuro- hormone associated with pleasure.  And it’s addictive; when the caudate receives dopamine, it signals for more dopamine.

And, like any addiction, not without risk.

If one approaches relationship as a means of soothing the terror of one’s own company, it’s not so different than the rat who keeps pressing the lever to get a pellet of food.  It becomes about pressing the lever; one can’t even savor the pellet.

In my case it led to manipulation, deception, and lots of crying on the phone at work, to the chagrin of my assistant who shared the office and thus had to listen to it.  It led to my causing suffering to women whom I loved.  It led to not being able to treat those women in caring ways because of my need to alleviate the pain of existing.


In my thirties, I discovered the potency of meaningful work.  Then I worked all the time— writing, performing, running a nonprofit, operating my own business, teaching.  Constant activity, though depleting, was at the same time soothing.  Unlike my romantic partners, work never got upset with me.  I could feel productive, heroic, competent, useful and appreciated.

The consequences—exhaustion, over-seriousness, stress headaches, a distinct lack of play—seemed minor when compared to the rewards.


In my forties, my longtime partner left me for someone else.  When I moved out of the house we’d shared, a friend gave me a TV—something I’d managed to live without for years.  She said, “It will keep you company,” and despite my disdain for the faux companionship of sitcom characters, their fake problems and witty banter did provide a way to staunch my loneliness.

I only watched TV at night, once I was done working late, re-runs of Friends and Mad About You and Cheers—shows I’d never watched in their original runs.  Repeated nightly, the sound of their theme songs cut through the nervous quiet of my house and produced a little sigh of familiarity and comfort that bypassed my intellectual judgments.  It was a way to pass the hours before it was time to get dressed and go out to work again.


“What’s the matter with working?” protests one friend who reads a draft of this.  “What’s the harm in watching a little TV to unwind?”  She feels defensive, as if I’ve threatened to deprive her of something she holds dear.

“And why are you telling me I can’t eat chocolate?” someone else argues.  “Haven’t you heard that the anti-oxidants in dark chocolate are good for the heart?”

“What could be wrong with reading?” another asks.  “You meditate every day; you make art.  Isn’t that self-medicating too?”

It’s a different set of friends that defends the right to alcohol and drug use, but they too speak up.  “It’s bacchanal.  It’s revelry.  It’s ceremonial,” they proclaim.

One even speaks in defense of cutting.

And thus I see the need to clarify that it is not a matter of specific substances or practices but a matter of their application.  To what degree do they serve to open consciousness or enhance pleasure?  At what point do they begin to numb?

The philosopher Epicurus said, “By pleasure we mean the absence of pain in the body and of trouble in the soul.”  Certainly some of my strategies for self-medication did eventually create pain and trouble.  But also, as my student Nina points out that, when a substance or practice is used for self-medication, can one derive any pleasure from it at all?


For me, the practices were at one time or another used as strategies to reduce or eliminate pain. To mask it.  Dull it.  Distract me from it.  Help me pretend it was something else I was feeling.

Not the physical pain of arthritis or migraine or cancer or having spent the day doing manual labor where every muscle throbs.  I’m not suggesting that anyone should eschew treatment, self-care, or relief from trauma or illness.

But what should be done about the emotional pain of trauma, sorrow, disappointment?  Of seeing too great a gap between what one expected and what one has gotten.  Of feeling alien in one’s own skin, or inside one’s own mind.  Of suffering the inability to connect to another living being.

It appears to me that in earlier periods of history, people simply endured their pain, suffered it stoically, silently, and went about their business.  Perhaps expectations were lower then, before capitalism started constantly seducing people with images of the carefree existence surely to be had upon purchase of this latest product.  Has our pain increased now that there appear to be more remedies with which to subdue it?

It also appears that people in more dire physical circumstances—people undergoing bombardment; people who lose their homes, land, family members to war or natural catastrophe; people who suffer famine or other extreme privations; people whose struggle to meet their basic needs would be unimaginable to most of us reading this—are less prone to this emotional pain.  Is this because they simply don’t have time to focus on it, or does privilege actually come with a psychic cost?  Or does economic advantage simply raise the expectation that the bumps in life are supposed to be smoothed over?


Considering self-medication, on the one hand, I think: why not?  Why not escape, avoid, elude or numb the pain?  If I am able to keep myself going from one day to the next, who cares by what means I do it?  To whom would I be trying to prove myself by toughing it out?

Then I think again of the way that pain is a teacher, how it forces us to pay attention to what we’ve been doing, how it provides the opportunity for us to make different choices in behavior.  My student, Mary, says that when pain is present, “something is trying to be known; it requires patience, sitting with it.”

What lessons do I refuse to learn when I reach for a bag of cookies, stay at work another hour or two, or spend the evening on the couch with the remote clutched in my hand?  By self-medicating, do I in fact prolong or even deepen the circumstances that gave rise to my suffering in the first place?

By choosing to self-medicate, do I settle for enduring my life instead of changing it in ways that will help me thrive?