On Addiction, Therapy, and Fentanyl: One Story
The life and death of a brilliant and complicated soul
It was Chris’s1 birthday last week. I found myself thinking of him as I stared at the date. I cannot honestly say how old he would have been anymore; it’s been so many years since he died. I’ve never shared his story before but seeing the date of his birth, and knowing about the recent decision in Portland to declare the sharp rise in fentanyl overdoses a state of emergency, it felt like the right time.
Fentanyl is a synthetic opioid that is far more potent than heroin and has been wreaking havoc on communities everywhere, with no end in sight. In just my community alone, overdoses from fentanyl are up 533% since 2018. Nationwide, deaths from synthetic opioids increased by 22% between 2021 and 2022.
Chris was my client.
I didn’t understand the significance at the time, but I dreamt of Chris the night that he died. It was a very short dream. I was seated in a simple chair in an otherwise empty room and could feel his presence. Standing behind me, he placed his hands gently on my shoulders and stayed there for a moment. The love he radiated was unmistakable. He would sometimes tell me in our work together, “I love you,” and I would, clinically, defer. But once or twice, in moments of his severe depths, his loneliness, I allowed the same: “I love you too, Chris.”
The curse of Sisyphus is the curse of the severe addict, an excruciating and endless toil with seemingly no way out and a heartbreaking descent at the very moment that relief and breakthrough seem possible. Chris lived with this curse day every day and I am pained to say that from the very beginning, I wasn’t sure that he would survive it. Neither was he.
I first heard Chris’s voice through a voicemail, a high-flying chatter declaring that he would like therapy and that I was to call him back. My first thought was that I wouldn’t want to work with him: as I later told him, his voice betrayed just how ungrounded he was. You were on another planet you were so high off the ground. I wasn’t sure it was something I could, without a team of clinicians, contain alone. But more than his mania, the power dynamics that were likely to unfold between us were evident in that initial message. I was to call him back: it was not a request but a demand. He was going to try to run the show and I would be expected to play along.
But I did decide to take him on as a client, and he decided to commit to regular sessions, and in the ensuing year that we worked together, twice a week, we walked a sometimes precarious path, through binges and detoxes and dangerous weekends, through grief and tears and anger and uncertainty.
Chris was 27 when he first called me, recently in town from Philadelphia by way of various other spots around the country, most of which he’d visited for rehab. Chris had been in seemingly every drug rehab or recovery program in the country (an unfortunate testament to how little any of them were working). He had been in religious detox, state-run detox, Scientology detox, and imposed detox in hospitals and jails. He had nearly died in alleyways and basements and warehouses in the middle of nowhere, nearly been shot in the back of the head at point-blank range, and overdosed to very near-death multiple times. He was manhandled by police and told, more times than he could count, that he was a piece of shit with a look of loathing he later would tell me cut him to his core.
“There is no reason,” he told me, “that a junkie of my caliber should still be alive.”
I pointed out his use of “caliber” like it was a badge of pride. He laughed and agreed that it probably way. Chris wrestled with the inflation that comes along with flirting with death as constantly as he did. Most of his friends or acquaintances from childhood or rehab were already dead. He was determined not to be one of them. “I’ve survived this far,” he told me after a particularly painful detox (always self-administered now) from a heroin binge. In those times, his grief was so profound and his self-hatred so deep I shuddered to witness it.
“I don’t want to die like this,” he would repeat in the voice of a terrified child. “I don’t want to die like this.”
When I saw the black void of suffering that Chris fell into in those times, so filled with horror in the morning that he struggled to open his eyes, I wondered too how he’d survive. In his vivid descriptions, those voids felt to me like Voldemort’s pull or the chilling specter of the Death Eaters. And he agreed. He pointed to the scar on his forehead and laughed. “They called me Harry Potter in jail,” he told me, for the scar, his youthful look, and his vast, nerdy intelligence that was always impressing his cellmates.
Chris identified with Jesus in those moments too, like he was only playing a role of one of the deeply suffering addicts, only in rehab to help uplift the other sufferers, always maintaining in his soul the awareness that he was also, somewhere, fully whole and awake.
Among all of Chris’s dangerous inflations, this Messiah complex also struck me as remarkably true. His recent conversion to Catholicism, devotion to the rituals, and critical reading of the texts made this 6’4”, skinny, pasty white boy, appear like Dorothy Day: living among the poorest and most forgotten people in our country and grieving with them and for them all day long. He lamented the incredible pain so many people were in, the fear of becoming homeless himself as winter was setting in, and vowed that he’d find a way to use his talented mind to make changes. He was going to find his way into academia to challenge how addiction is understood and treated, he frequently told me. He was like a journalist embedded in a war zone, this was all just preparation for the story he was going to tell someday, and the policy changes he hoped to make.
Chris never had it easy. He was born to a psychopathic father and a schizophrenic mother. As a part of his personal story, as we sorted it through together, his life was about healing the many layers of this trauma, but also the profound psychological polarity in his parentage. Chris almost certainly suffered from bipolar II disorder, which he acknowledged though ignored. I tried on multiple occasions to convince him to start medication, or at least consult a good psychiatrist for a second opinion. But, despite his frequent use of street drugs, he was reluctant.
“Don’t you think all this mania and depression is from the drugs I’m already on?” he asked me. “I want to stay clean long enough to see if all the highs and lows are just reactions.”
But self-medication rarely calms down long enough to create space for the preferred cocktail of psycho-pharmaceuticals. And Chris never got a long enough break to succeed.
Had he lived in another era, things may not have ended for him the way they did. Perhaps in an earlier era, a much earlier time, the availability of drugs wouldn’t have been so prevalent—and certainly not the horrific potency of fentanyl. In a later time, in an era still to come, perhaps his addictions and trauma would have had a chance of being cured with far more emphasis on embodied trauma release or attention to neurodivergence, and with greater support in funding. Unfortunately, Chris had emerged from rehab after rehab still in severe pain and still prone to use. He was like the Terminator, incorporating every new method thrown at him in treatment centers such that they seemed to only make him stronger and smarter: he could seamlessly dodge any similar method the next time it was tried. His isolation became greater and greater too. By the time he found me, he was really just looking for a doll to dance with on his journey through addiction and maybe help him explore his dreams and the Jungian notion of “the shadow” that had begun to grab his attention. But, of course, Chris’s desire to control therapy and intellectualize, was only cover for the profound anguish and loneliness that festered underneath. He wanted to be loved and to fall in love. He wanted to someday look out over a vista with his wife and see his large brood, children and grandchildren, gathered together. He spoke of that often.
Like many intelligent and angry people, Chris needed to know in his heart that I understood him, could see him, and could handle him. That when things got bad, when his defenses became angry and intense, I wouldn’t turn against him. He was as much trapped by his defenses as others were victim to them. He wouldn’t tolerate being “managed” or constrained by unnecessary rules. He was sensitive to anyone constrained by theory and defended with hierarchy, unwilling to allow some gives and takes. But he also had an incredible capacity for respect when it was earned.
Most theories of addiction see it as a disease, a disease a person has and then must live with and manage. Another camp sees addiction as undoubtedly rooted in trauma and the lingering residue of that trauma that can leave a person feeling like they’re carrying around an inner poison, or that their cells are coated with something foreign, or that they have a weight inside that they can’t release. Street drugs help to relieve this weight, temporarily. For Chris, these traumas were multiple, un-countable: the early trauma of his birth, the pain of being separated from his birth mother when he was adopted into the home of his grandparents in his first year, the pain of his father signing away parental rights for $50. The rest of the family relationships that he sketched in his stories read like the dark underbelly of a crime family: the uncle who tried to kill him by running him over, the birth father’s violent past and evasion of the law in every moment, the day he found his mother dead from an overdose of prescribed medications, she almost certainly having suffered his absence since the day he was taken.
From the Jungian perspective, Chris was a classic and tragic Puer, short for Puer Aeternus, the eternal boy, the high-flying Peter Pan who struggles to fully imagine himself grown-up, struggles to attend to grown-up things, and loves being high: high off the ground in moods, in drugs, in love. Chris was undone by women, desperately wanting their affection and company and yet often finding himself violently ejected from a period of sobriety by the unsuccessful bid for companionship with a woman or the heartache that followed.
In his unconscious realm, only rarely witnessed outside of a dangerous mood through Freudian slips or surprising uses of language, Chris was surprised to see how he hated women and looked down on them for all the weakness they represented to him. Not consciously, of course. Consciously, he felt love for women, the beautiful ones in particular, and profound compassion or pity for those women he knew on the street or in rehab who were so much worse off than he had ever been. He was very aware of the sexual abuse and powerlessness they endured. He saw how they were never safe. But he also knew he was a threat to them too.
The other classic story of the Puer is the Little Prince, the boy who lives on another planet and is always protecting a single rose under a glass jar: trapping his feminine side, his feeling side, his own “weakness” and receptivity behind a wall where he can see it but not feel it; where he can keep it forever as an object to be observed.
The feminine was dangerous for Chris. Profoundly dangerous. We talked about this at length and he was able to see that in reality, he viewed women as prey. It was so easy to manipulate them, he told me. And it was only after he realized fully that he and I weren’t “going to fuck” as he so delicately put it, that he settled into therapy in a new way. He saw his own abuses of power in the way he viewed women, he saw too that the women in his dreams rarely had faces. They were the personality-less women of his daily life upon whom he could project his weakness and then blame for any downfall he endured.
It was in accepting that his own feminine side was profoundly injured, that he was terrified of weakness, terrified of feeling and of emotion, that Chris began to heal. He had to acknowledge that his relationships with injured women were projections of his desire to save his own soul.
The sociopathic side of Chris had thrived on power over women. When this side was “up”, he looked dangerous to me, his eyes like a cobra seeking to hypnotize his prey. It was only through a combination of love and anger that I could wake him up to himself again and snap him out of that Voldemort quality, the hissing, slithering, poisonous snake whose energy I well feared would kill him or someone else. But as Chris began to attend to this, to witness the depth of his own inner injury, his relationships with women changed too. He noticed a significant difference in the way he was interacting with women, beginning to experience them as equals in a way he never had and beginning to experience the possibility that in this way he could have a loving partnership, without dangerous conflict or power struggles or abuse. He was learning that he could be loved and accept love, that he could feel, and that in feeling instead of thinking could finally start to attend to the grief inside of him.
When I went on vacation about a year into our work together, Chris was nervous. We wondered together where he could go where he wouldn’t be in danger. He needed a place where there wasn’t an overarching treatment model that would only bolster his defenses, nor the faux halfway house where he lived, always filled with power plays and covert drug use (largely by him). He had recently converted to Catholicism so I wondered about the possibility of a monastery. Could he find sanctuary somewhere inexpensive enough to be feasible, and beautiful enough to nourish him? Could he find safety there? And could he be safe for others?
I do not doubt that it was somewhat by the grace of God that we found him a place where he could go: a monastery nearby with inexpensive rooms for visitors needing respite from the world. I listened, anxiously, to the voicemail he left me just after he arrived and got settled.
Hey, listen: I just really wanted to thank you. You know. This was uh…I don’t know how… I mean I guess you do know… but you have no idea how perfect this is. Tomorrow morning, I’m going to try to follow their schedule, I mean it’s gonna be really hard, but like they get up at 6:30 in the morning for morning prayer, and then it’s mass at 7am. It’s like they don’t even eat until 8. It’s actually pretty cool. I know it seems a lot cooler now that it will at 6:30 in the morning. I’ve kind of got this feverish mania thing that I always get in a new environment, I think until I feel safe. Like anytime I enter a rehab, a detox, a jail, anything. I usually never sleep the first night. But there’s enough silence here for me to be able to distinguish mania from whatever’s real. But yeah, I’d like to talk to you once, please, before you go. But… thank you.
I breathed a sigh of relief and smiled. I was glad that he was safe.
We did speak before I left. I told him that the night after receiving his message, I’d had a dream of him as an old man. I shared this with Chris to give him the hope I felt. That with all the devoted work he was doing, he might just live to old age. He told me that image filled him with hope too.
“I’m going to be okay here,” he told me.
When I returned to work a few weeks later, Chris chose to stay at the monastery a little while longer. He’d fallen into a comforting schedule of living and working and, by the time I saw him again, was over one month sober. He’d even cut out the cigarettes he’d once relied on. He was suddenly thriving. The rituals and structure and separation from most of society had been healing for him.
When I saw him next, he’d arrived at my office to tell me that he was heading back home. His father was dying, he explained, and he needed to be there. He gave me a poem he had written and a letter of gratitude. I felt like screaming at him to stay. Writing this now, I still feel like screaming at him to stay.
But I held back. I didn’t say what I felt as strongly as I wanted because I knew he wouldn’t be swayed. He was going back to the place where all of his demons thrived and pulled him in; where all of his old connections would entice him and where his unhealthy patterns were certain to return. But I got him to agree, at least, to have something to anchor him to the ground back home. I helped him to find a new therapist in Philadelphia, and he found a recovery group that he could attend regularly. I spoke with his new therapist at least twice to transfer care. Soon, Chris was gone and only in touch intermittently.
It was about a week after I felt his presence so strongly in my dream that I received a voicemail from his new therapist. I was heading out the door, rushing to catch the bus and get to my office when I pressed play on a new message and heard the halting, uncertain tone. “I’m so sorry to have to make this phone call…” it began, “but I’ve just learned… Chris died last week.” I remember collapsing in the dining chair I was closest to, putting my forehead on the table, the phone still in my hand. I felt suddenly like an exhausted, grief-stricken surgeon crumbling into a seat after a long, arduous surgery when, after everything, the patient couldn’t be saved. The sadness and disappointment were overwhelming. I’d wanted so deeply to believe that he would make it, that we were out of the woods.
I learned later that fentanyl was present in Chris’s bloodstream when he died. Even a junkie of his caliber wasn’t able to account for the potency of this drug, it seemed, or to anticipate its presence mixed in with the heroin he’d used so frequently, at doses he knew how to manage.
He’d died at home, at least. I felt some relief learning a bit more about the circumstances of his ending, knowing that it hadn’t been in an alleyway somewhere, surrounded by people he feared. We’d talked so much about that possibility. It was an ending that I’m grateful he avoided.
In the last voicemail I received from him, Chris told me in a serious tone that I was going to see him again. I remember he repeated it twice. He’d said this to reassure me, of course. To tell me that, though he was back home and though we could both feel the return of that dangerous, inky void, he would somehow survive. I think he believed it. I tried to as well. And although he was no longer flesh and blood, I do think Chris told me the truth. He’d visited briefly to let me know that, despite everything, he was at peace. I think he would joke now that he’d converted to Catholicism just in time.
His name and other identifying details have been changed.
So much to learn about this thing we call addiction. This story has a lot to unpack about the struggles of this young man. I am curious Satya, if you’ve ever read The War of the Gods in Addiction by David Shoen. He’s a Jungian analyst that specializes in addiction. Anyway, his concept was that as addiction progresses a ‘network’ is established between the Shadow and Persona. This explains the Dr. Jekle Mr. Hyde behaviors while on the substance. Then, a more menacing threat takes over that network; the Collective Shadow. As Jungians know, anything collective or archetypal is powerful!! I’m simplifying, of course, but this explains the intense phsycological power driving the behaviors. It’s well beyond anything the ego or waking consciousness can deal with. That’s why, for some, the spiritual Higher Power or Self in Jungian terms may be the only way out of the Archetypal Evil/Shadow network. As I framed the story of Chris in this way, boy it all made sense. He was even aware of the God Self inside himself and sought it out in the Catholic monestary. But that trip back home to his Dad was just what that already established network needed to re-fire. His relationship to the Self wasn’t strong enough yet. Harry Potter is a perfect analogy to this. I’m very sorry for him as well as your pain and loss. Thanks for sharing his story. 🙏
Thank you for this heartrending story. I am so glad he came to you and touched you after his death. It does confirm that even though he died, he did feel a loving connection and wanted to let you know.