The End of My Addiction

he pressed me to play at them. Playing for a trusted friend in private, or in public at a recital or in a restaurant or hotel lobby, where people were free to come or go, respond to the music or not, wasn’t difficult for me. But playing in a social setting, where I would have to confront the reactions of fellow guests, triggered all my anxiety about being inadequate and an impostor.
    Just attending Murat’s parties made me feel tongue-tied and shy. I tried to put up a good front and chatter away like other guests, but inside I was a bundle of raw nerves. I discovered that one or two shots of Scotch—although I hated the taste and almost had to hold my nose to get it down—produced a remarkable relaxation effect. The alcohol calmed my anxiety as benzos had never done, and without any of the benzos’ unpleasant side effects. It also raised my sense of self-esteem. I felt calm, expansive, lucid, completely at ease. I could chat enjoyably with a perfect stranger.
    When much later I began attending Alcoholics Anonymous meetings, I discovered this was a standard refrain: “I never felt okay in myself,” “I never fit in,” or “I never really relaxed”—until they started drinking. With a couple of drinks I could play the piano with confidence in my ability to entertain. At Murat’s delighted behest I transformed his parties for an hour or more into a combination cabaret and concert hall, stimulating the other guests to dance, sing along, or listen raptly as I played their requests and my own favorites. As soon as I arrived at one of his parties, or before long at parties given by other friends, people began asking me to sit down at the piano and play.
    And so it was that I became an occasional moderate social drinker, and I remained one for many years.
    After I went into private practice, however, for the first time in my working life I did not have a guaranteed income, and I became increasingly concerned about my finances as my practice hovered above the break-even point for month after month. I worried about my age. I was now over forty, and I felt that time might be running out for me to marry and have children. I feared that I would never achieve a big enough income to support a family. Or to provide the kind of lifestyle that my father had provided thanks to his successful business career.
    Beyond that I feared I would lose everything and become completely impoverished and homeless.
    The logic of anxiety is that it can latch onto any idea, rational or irrational, and lock it into a feedback loop that keeps strengthening in intensity and irrationality. If this feedback loop is not broken soon enough, it becomes impossible to reason with the fear and dread that it generates. The fear and dread may take no specific form, but rather be an overwhelming sense that horrible things are going to happen.
    Until this period, my anxiety had been a background hum that I could turn down for days or even weeks, if never entirely switch off. It flared up from time to time, but then subsided thanks to a change in circumstances or a medication like Tranxene or Valium. But over the next two years, my anxiety became a more and more insistent distraction, and I ceased to be able to turn the volume down.
    I began to have paralyzing panic attacks that made me feel like I was losing my mind. The attacks began innocuously enough with a twitching in my calf muscles. This sort of twitching of bundles of muscle fibers, or fascicles, is called benign idiopathic fasciculation. A fluttering eyelid tic is a common example. The fasciculation is benign because it will cause no harm in and of itself, and idiopathic because it has no known origin. In my anxious moments, however, the fasciculations increased until they felt like worms under my skin. The next symptoms were tightness in my chest and internal trembling. I felt as if I couldn’t breathe and would suffocate. And then unstoppable panic took over my whole being.
    I was already seeing a shrink, and he referred me to a psychopharmacologist, who tried me on a vast range of medications at different doses. Nothing helped.
    Worn out by accumulating stress, I began increasing my intake of the one drug that brought relief: alcohol. Talk about a slippery slope. The more I drank to ease my anxiety, stave off panic, and counter draining insomnia, the more I had to drink for the same effect.
    At this point, alcohol ceased to be a means to relaxation and became an end in itself. I managed