Silence about addiction and mental illness is still rampant in our society and stigmatized, even though one in four families will experience either or both. I should know. My family is one of the four.
As a recovering alcoholic whose family history is one of mostly untreated alcoholism and mental instability, I wanted a front row seat when Representative Patrick J. Kennedy came to town to discuss his book, A Common Struggle, at the WHYY Speaker Series. Some came to hear the salacious details about his family — how his father, Ted, self-medicated away his mental desperation and trauma and his mother, Joan’s, years of drinking were unsettling to the entire family.
But many there, like me, came because their families — “frozen by the shame and hostage to the silence” — are rife with these dual conditions. Others are concerned with the policy issues and advocacy proposals he presents.
Deny, deny, deny
Both sides of my family tree carry genetic predispositions to addiction and mental health issues. My Scandinavian father’s father, brother, and sister were all alcoholics, a fact that was denied, even on their deathbeds, by two of his sisters. Yet those sisters both acknowledged that their father frequently beat his sons, my father and my godfather, Carl; spent weeks away on benders; and died with a death certificate diagnosis of cirrhosis of the liver. What, if not alcoholism?
My mother, Gaelic and Catholic, was born into a family where her father and seven of her eight brothers were alcoholics, and pockets of mental instability and outright psychosis sat on branches of her tree as well. Her family caused deep shame and potential disgrace as she was trying desperately to climb out of the Irish backwater. Her father, a stately dapper man when sober — walking stick in hand and mustard-colored sport jacket donned for his daily constitutional around our neighborhood in Chestnut Hill — would periodically drink so much that he would slide down the stairs late at night. I, the eldest of the children, would try, when my parents were out, to get the old man back to his bedroom. Once, when I couldn’t and my younger siblings were terrified seeing their grandfather slobbering, slipping, and sliding, I went to our neighbor for help. When my mother found out, she was furious, chastising me for “hanging dirty laundry out for neighbors to see.” She is also the one who, when her brothers came home on a bender, singing, yelling, fighting, would close the windows and pull down the blinds so the neighbors would not know what was going on.
Our home was the family detox center. One after the other, they would come. Drunk, dirty, penniless. “Peg, Peg, take care of me,” they lamented. And she would do so. More than once I helped her hose them down in the back yard, strip them, burn their clothes, provide them with clean pajamas, feed them soup, put them to bed. She then gave them money a week later, after they “dried out.” Off they went back to Chicago, Fort Lauderdale, Buffalo, or wherever, only to return six months later. Those dear boys died horrible alcoholic deaths: wet brain, gastritis, cirrhosis, ulcers.
Breaking the code of silence
Kennedy, looking boyish and fit despite his own problems, spoke passionately about the need to break the code of silence on mental disorders and addiction. Although he is the leading political voice on mental illness, addiction, and other brain diseases — and his family’s addiction and mental health issues have been in the tabloids for years — his family is incensed over the disclosures in this book. His father, Kennedy says, had posttraumatic stress disorder and used alcohol instead of psychiatry. His alcoholic mother has been a chronic relapser whose own mother died of the disease. Still, both his mother and brother, Ted Jr., a state senator in Connecticut, are angry about the book, about Kennedy breaking the injunction not to talk about these kinds of problems outside the family.
The Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 was Kennedy’s signature achievement of his 16 years in Congress. His book is essentially a follow-up to that bill. The bill and the book are meant to reduce discrimination and improve access to care for people with mental illness and substance use disorders and help to remove the stigma associated with these conditions. Unfortunately, according to Kennedy, familial silence is still the name of the game. There is still little parity between mental and physical disease, even though the Substance Abuse and Mental Health Services Administration reports that by 2020 mental and substance use disorders will surpass all physical diseases as a major cause of disability worldwide. Frequently overlooked by physicians, these diseases are even today seen as manifestations of moral turpitude by society and personal failure by families.
An open secret
By speaking out and speaking up about mental illness and alcoholism in families, Kennedy is helping those of us who still feel shame, yet live with the fear of what these conditions will do to future generations if we keep silent. We must speak up, too, if only in our own families. Even though I still feel the shame about my history, I speak to my children and grandchildren about my addiction and recovery. That might not save them, but at least they will be forewarned. They will not succumb to these conditions on my watch because I refused to break the code. Being prepared is really the only way to combat these conditions: Addiction and associated mental disorders are a family disease, not a death sentence or a mark of evil.
Kennedy says these are medical issues, not moral issues or character flaws. He wants alcoholism and mental illness treated with the same urgency we treat cancer and heart disease. "Silence,” he has said, “is almost as bad as the disease.” I agree — it’s the silence that will kill you, not the alcohol or the psychosis.