Dr. Patrick MacAfee and Jeff

With Dr. MacAfee’s death, I reviewed a few of my notes from our conversations. He said: In most family situations, we help and this is good. In addiction, help often becomes enabling which keeps the disease status quo. We don’t do this maliciously. We want to help, but without the right information we foster the sickness and get caught in the trap of manipulation. If the lies collapse and the fiction is eroded, breakthroughs usually occur, but they’re painful. That’s why we maintain the denial and don’t want to see the truth of what is happening. When we stop enabling, we give the addict a chance to shift. We need to get out of the way and stop intervening in the consequences. 

My reflection: I was the queen of enabling and denial. I didn’t want to see what was happening with my son, and I wanted to believe him when he told me that he wasn’t using drugs. At the end of fourteen years, I finally got out of the way. I told him that I loved him, but he had to fight for himself. All my efforts to save him only continued the devastating decline. 

Today’s Promise to consider: Dr. MacAfee taught me that we need to acknowledge the painful enormity of addiction, but we also need to get out of the way of its consequences. Today, I’ll continue to educate myself about this cunning disease. There’s only room for one in the addiction.






PATRICK MACAFEE, PH.D. 03/03/1940 – 08/09/2016

TM.Doc (1)An open letter to Doctor MacAfee

My dearest Doc,

You’ll never know how difficult it is to say goodbye to you. What would we have done without your steady presence? When Jeff was in his tenth rehab and in that delicate space of deciding whether to get clean or submit to yet another deadly run, you were the one who made the difference. You saw his sensitivity and gentleness, and you led him through his pain with grace. You helped him see his inner goodness and you never demeaned him for his addiction. You acknowledged his strengths and helped him to understand his weaknesses.

You taught me, too. You told me that it takes courage to fight addiction and that relapse isn’t failure. You showed me that my loving son was still alive under the drugs. You and I talked for ten years about addiction. When I felt confused or needed direction, you were there. When I reached out for advice for others, you were there. When I doubted my abilities to be a good mother, you were there.

You ended all of our conversations with the words stay close. I’ll stay close, Doc, and continue to spread all I’ve learned from you about taking addiction out of the shadows and into the light. I know you’ll stay close to us, especially to Jeff. He represents your best work.

You told me that addicts are saints in the making. You, Doc, are a saint to us. Pray for us.

With love and eternal respect,



Dr. MacAfee and Jeff

Dr. MacAfee and Jeff

Dr. MacAfee explains, The word saint used in the context of addicts is controversial, but there’s an important distinction to be made between recovering addicts and those who are abstaining from drugs. Abstinence is the beginning, the time when the addict puts down the drugs. Recovery is a transformative process when the addict moves, step by step, into living a life of truth. Recovery happens when the addict leaves the hell that he has been living and moves to a place of belonging, of contribution, of coming alive. His defensiveness goes down and he knows that honesty is his only way to health. With this transformation, his humanity starts to emerge.

My reflection: When Dr. MacAfee told me that addicts were saints in the making, Jeff was still sick and had been sick for 14 years. What I heard in Dr. MacAfee’s words was hope. Hope that Jeff would recover and grow to be the person he was meant to be.

Today’s Promise to consider: When our loved one is in active addiction, life is suffocating. But when he decides deep down to recover and takes the diligent steps healing requires, he comes back with a burning desire to be of service to others. He regains his humanity and chooses a life of truth and purpose. In this transformation, he is, to me, a saint in the making.


IMG_2927.TMDr. MacAfee told me, When addicts start to live a sober life, they recoup their lives. During their addiction, they looked death in the eye. This changes them. Through recovery, they break out of their isolation and learn to serve. 

My reflection: I’ve talked with many recovering addicts and they tell me that service is a key part of maintaining sobriety. They are well aware of the people they hurt and the damage they caused. In recovery, they have a strong desire to give back, to reconnect with family and their communities, and to contribute to the world around them.

Today’s Promise to consider: We have much to learn from people in recovery. They have suffered, have been marginalized and have been loathed by society. As Dr. MacAfee says, “They have looked death in the eye.” Today, I will open my heart and listen to the wisdom of those in recovery.


heroinYears ago, Dr. MacAfee told me, Only by taking addiction out of the shadows where it does its best work and bringing it into the light will we be able to heal addiction. 

Reflection: Now more than ever we’re being forced to look deeply into the many ills that impact our societies. From the most marginalized groups to populations in the millions, countless hard issues are being addressed. On December 28, HBO will unveil a new documentary titled Heroin: Cape Cod USA where they expose the heroin epidemic screaming at America, focusing on eight young addicts. In 2014 alone, Massachusettes had more than 1,250 deaths from heroin overdose. These numbers are terrifying.

Today’s Promise to consider: Today and every day, let us join together to fight the things that degrade our families and tear apart our communities. We must continue to keep the spotlight on addiction, without shame and silence. Truth must win.




Grandchild Iysa

Grandchild Iysa

A friend asked me, Is sobriety a result of will power or spiritual awakening? He continued, some people are said to have found sobriety through will power. They simply stop using drugs. In the Big Book, however, the thought is that sobriety is the result of a spiritual awakening.

My reflection: I asked Dr. MacAfee, who said, A lot of people go cold turkey, but this strategy rarely works over the long term. The disease of addiction is rooted in emptiness and cold turkey doesn’t fill the void within. A spiritual awakening is about belonging, finding our place in the world and connecting with the life-giving spirit inside us. 

Today’s Promise to consider: Many experts believe that addiction is rooted in emptiness – in discontentment, not belonging and in disconnection. Cold turkey and will power are commendable, but they’re often not recipes for sustained sobriety and a holistic life. I pray that my loved will learn to fill the emptiness inside him in an environment of love and camaraderie. I pray that he finds a sense of belonging to the universal energy that’s within all of us.





Photo Credit: Michelle Elvy

A mother wrote to me: I’ve found strength in a very close Nar-Anon group and continue to attend meetings regularly. My husband, my son’s sister and I are here for him when HE is ready to change. We know we can’t force him to change – we’ve tried. After three failed rehab attempts, we have nothing else to give him, only love.

My reflection: Dr. MacAfee says that addiction takes the healthiest parts of love and smashes them into worry, helplessness and hopelessness. In family groups like Al-Anon or Nar-Anon, we discover that we are not alone. We find other families who understand our pain, heartache and powerlessness. Waiting for our addicted child to return to us is like walking through hell, but there are hundreds of thousands of people who are suffering just as we are.

Today’s Promise: I will not isolate myself during this traumatic time, but will accept help from other parents who know my pain. I am not alone. I’ll reach out my hand and trust that someone will reach back.


Photo Credit: Mikele Roselli Cecconi

Photo Credit: Mikele Roselli Cecconi

A mother wrote to me: Today I went to my first Al-Anon meeting or at least that is what I thought I was going to. Instead it was the Narc meeting for the users. So instead of hearing from family members about their loved one’s addictions, I heard from the addicts themselves. It was very eye opening and humbling to be there and to hear their struggles.

My reflection: During the many years that Jeff was swallowed by addiction, I never realized the pain that he felt. Dr. MacAfee told me that it was impossible for me to imagine how poorly my son saw himself, that living inside his skin was more than Jeff could bear at times. The heaviness of his reality, combined with all the lies he struggled to maintain, was soul crushing. 

Today’s Promise to consider: It’s so very hard not to make our loved one’s addiction about us, not to take their continued missteps personally. Once I told my son, “You have a lot of courage to try to get well again.” He responded quietly, “Courage. That’s a word rarely used with addicts. Yeah, it takes courage.” As a mom, my pain is huge, but I must understand that I will never truly grasp what he is going through. Today, I will pray for strength and compassion.



TM.7 (1)A friend sent me an article from the Washington Post about a small county in western Pennsylvania – a county of slightly more that 200,00 people and just 40 minutes from my home town – where there were reported eight overdoses in 70 minutes. “There’s been a progressive increase in overdoses the last two years, and it just went out of control,” said Rick Gluth, supervising detective on the drug task force. “I’ve been a police officer for 27 years and worked narcotics for the last 15, and this is the worst.”

My reaction: Articles like this are important. They help, as Dr. MacAfee says, to take addiction out of the shadows and into the light where it can be healed. There is no silver bullet for stopping the flow of narcotics into the hands of our loved ones, but pieces like this unveil the hard facts around an epidemic suffocating so many of our families.

Today’s Promise to consider: Addiction is anchored in Stigma, Shame and Silence. Today, I join together with other parents to break the backs of these three S’s. People are dying and the death toll is increasing.

(the full article:



Photo credit: Mikele Roselli-Cecconi

Photo credit: Mikele Roselli-Cecconi

A mother wrote to me: My son is homeless. I will not allow him to live at home as long as he is using. I asked him what his plan was and I explained that it was hard for me to tell him he couldn’t stay with me. Normally he would have yelled at me, slammed doors and walked out mad, but he didn’t this time. I saw something different in his face that made me think that he was finally seeing that his problem was bigger than he had thought. I pray he chooses a different life, but I know that he must choose.

My reflection: Dr. MacAfee wrote, Complaining, threatening, forcing and handwringing rarely, if ever, succeed. Instead, such approaches tend to drive the condition underground. Defensiveness must be lowered and communication must be clearer.

Today’s Promise to consider: Addiction is cloaked with heavy blankets of shame. Today, I will recommit to fostering an honest, compassionate environment with firm boundaries in place. I pray my child will choose to bring his addiction into the light where we can address it, for his life and for his health. Only he can make this choice.