A group of twenty patients will require twenty different theories to explain how they each got there and what they need in order to get better.

Diverse people have diverse etiologies and pathophysiologies and require diverse treatments in order to achieve diverse recoveries.

And if you really listen, you'll end up changing your way of thinking about addictions - if only because of the remarkable diversity of experiences people have had.

There is no one pathway. There is no one spiral. There is no one brain region or circuit or neurotransmitter.

You learn how it started, how it's been and how it's going. And if you listen long enough, you'll end up reconsidering your own theories and work in a deep way.

Often times, residential treatment means no TV, phones, news, outside world. There is only time to talk.

And people in treatment talk to one another in a way they do not talk to anyone else, including their clinician.

You learn the real truth about the life history of addictions in those moments.

In the future, I'll share how my lived experiences affect my thinking about the field.

In the meantime, bear with me as I navigate this space.

As you can see, I choose to remain anonymous for now. If you are trying to guess who I am, you're asking the wrong question.

I could be any one of us.

I learned a lot during this process, including changing the way I think about some of the theories, approaches and ideas that we have in the addiction neuroscience community.

But I also gained even more respect for what we - you included - are trying to do to change people's lives for the better.

While I feel distress, anger and sadness over what is happening to good, innocent people in the world - including, but certainly not limited to, the destruction of American science - I also know that I am not going to let some fascists deal me a setback.

How do I feel today? Hopeful about my long-term health and capacity to contribute. Eager to see what I can do without the alcohol monkey on my back.

When I felt I had done what I could do there, I raised the issue with my clinical team, and they agreed. Two days later, I packed my bags and went back home.

That was ~9 months ago.

When I was given homework, I had it done the next morning. When we were asked to do very uncomfortable things, I would raise my hand first.

For ~ 4 wks, I put my sense that I was in control to the side and just followed instructions. It was probably the hardest thing I have ever volunteered to do.

So, I decided to go big or go home. I found and signed up for a residential treatment program on a Wednesday, and I checked in that Saturday.

I committed 100% to it. I attended all the programming. I read. I participated. Even when being asked to talk or think in ways I didn't love.

These were now signs that I could not ignore, and I rapidly developed a profound motivation to change.

I tinkered with various easy-access medical options... Naltrexone. Brief therapy. But I didn't feel that they were having much impact. The longer I pursued them, the more frustrated I grew.

The emergence of mental and physical health consequences related to drinking happened really fast... in mere months. This included an episode of moderate withdrawal when I, at the recommendation of a nurse, tried on my own to cut back.

And professionally, I was on top of the world, so again, it just didn't feel like something to spend much time worrying about.

Until it was.

Because it happened so slowly and because I used every device in the textbook to convince myself that it wasn't really a problem, it kept on progressing. No major relationship / family problems. No legal problems. No big health problems I could see for many years.

But while my professional life was taking off, something else was happening behind the scenes.

Slowly - over the course of 25+ years - I went from never drinking to a happy-hour, social drinker to one a day to several a day to a heavy drinker to having a serious problem...