Insomnia – an Exercise in Frustration

Insomnia, or being unable to sleep at night, is one of the most frustrating things I have had to deal with.

Overwhelmed by fatigue and so sleepy that I could barely keep my eyes open, I would crawl into bed at a good hour, looking forward to a good night’s sleep. My mind was at peace, content, even empty of thought - yet I would lie there, awake, hour after hour. Sleep simply would not come.

As this continued, I began to crawl into bed in an anxious state of mind. I knew I desperately needed sleep but was worried it would not come. This tension made sleep even more evasive. My heart raced, my mind developed a habit of glancing about fearfully, which often trigged panic attacks.

As insomnia became more frequent, I tried to wait patiently for sleep to come. Yet as the hours continued to tick by I became more and more frustrated. My body was telling me that I needed sleep. I was so tired that I could not keep my eyes open, so why was I lying awake hour after hour? I would pray, beg, and plead with the Lord to give me sleep, quoting scriptures at Him, trying to convince Him to stretch out His hand or speak a word over me to put me to sleep. Then, after lying awake for five or six hours, frustration would blossom into rage. I lost count of how many times I shook my fist at the ceiling and said, “Jesus, why do you just sit there! Can’t you see that I need sleep? Why don’t you act? Don’t you care?”

As well as getting angry with God, I became enraged with my mind and body. What was wrong with them, couldn’t they see what they were doing to me? I was so tired and sleepy yet my useless, stupid mind simply would not shut off! It was as though my body conspired against me, and I hated it, I wrote in my diary.

Following these sessions of rage against God and myself, came anguish, repentence and guilt. I knew I should not react like this, but I needed sleep!

Eventually the insomnia became so bad that for five days I would fall asleep when the sun came up, and on the sixth, sleep would not come at all. On those days I felt robbed, cheated, betrayed. When I rose, I felt dirty and unclean. Then the cycle started again.

Finally, due to a number of factors, I fell into strong depression towards the end of 1989. Panic attacks afflicted me 24 hours a day, my mind never ceased to churn through terrifying fearful thoughts, and insomnia continued to afflict me.


Attitudes We Cannot Afford to Have Towards Insomnia

As you can see from what I have shared above, the ways I reacted to insomnia made it worse. These negative reactions of fearing or fighting it released negative adrenalin into my system, elevated my anxiety levels and made it harder to sleep. What a vicious cycle – insomnia begets tension and fatigue, which in turn make insomnia worse, which causes further tension and fatigue.

Here are some reactions we cannot afford to have towards insomnia:
1. going to bed fearful that we may not sleep
2. becoming frustrated when we cannot sleep
3. worrying how this lack of sleep will affect us tomorrow
4. letting the frustration boil over into rage


Helpful Attitudes Towards Insomnia

Here is a list of what reactions we need to have towards insomnia.

1. when we go to bed, be prepared to stay awake all night
2. be content to stay awake all night instead of getting frustrated or angry
3. recognize that resting contentedly all night in bed, even without sleeping, is still beneficial
4. if we don’t sleep tonight, there is always tomorrow night.


Some Things that May Help with Mild Insomnia

In my dealings with insomnia over the decades, I have learned a few tricks that can help alleviate mild insomnia.

1. a glass of hot milk, or a bowl of hot cereal, taken immediately before bed, can be helpful
2. if still awake two to three hours later, have another glass of hot milk or cereal
3. regular exercise is crucial. This may be going on brisk 30-45 minute walks three times a week, or doing aerobics, swimming, jogging, etc. Working out with light hand-weights several days a week also helps. (Small note - avoid the above types of exercise near bedtime!)
4. eat a good, balanced diet, with lots of fruit. Drink plenty of water
5. if you must have a nap during the day, make it a 15 minute power nap, no longer. Set an alarm.
6. listening to soothing or relaxing music immediately before going to bed can also be helpful.

Another point I would like to make is that we humans have a tendency to take on too many responsibilities and get involved with too many activities. Sometimes it is good to take a step back, sit at Christ’s feet and wait on Him, and then prayfully examine our life. Are we doing too much? Are there some aspects of our life that are placing us under pressure unnecessarily? Are there some things that we can quit or that can be put off until next year? Frantic, stressful lifestyles can cause insomnia or make it worse. I learned this lesson the hard way. (Twice…)


Severe Insomnia

If insomnia has become so bad that we cannot sleep night after night, (this is typical for those suffering from depression), seek medical assistance - we must not struggle through it by ourselves. A doctor can help determine insomnia’s causes (there are many different causes) and recommend medical treatment. For someone suffering from strong depression, sleep is a necessary part of the healing process. I am so glad that after three to four months of trying to cope with depression and insomnia on my own, I finally saw a doctor and went onto anti-depressant medication that included a mild tranquilizer. The combination of the medication and being able to sleep again were important factors in dulling depression’s effects, which helped me to concentrate on the task of recovery.

It was not until seventeen years after insomnia began to plague me that I discovered that I was suffering from complex partial epilepsy. This typically begins to become apparent in one’s late teens, and I believe this was the primary cause of the insomnia. (However, the way I reacted to it during the first few years made it much worse.)

I no longer take anti-depressant medication, only epilepsy anti-seizure meds. On most nights, I fall asleep easily, but several times a year I still have those sleepless nights. Instead of getting frustrated or angry, this is what I say to myself when it happens, “If I stay awake all night - that’s fine. I’ll make myself comfortable and snuggle up in the blankets. If I fall asleep eventually - great! If not, that’s fine too. Resting all night in bed is still beneficial.” I submit my mind to Christ, dwell in His peace and take refuge in His presence. I have learned to be content, whatever my circumstances, including those sleepless nights.

Philippians 4:12-13 ‘I know what it is to be in need, and I know what it is to have plenty. I have learned the secret of being content in any and every situation, whether well fed or hungry, whether living in plenty or in want. I can do everything through him who gives me strength.’

Colossians 3:15 ‘Let the peace of Christ rule in your hearts, since as members of one body you were called to peace. And be thankful.’

Philippians 4:6-7 Do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus. (Special thanks to a reader for reminding where to find this verse!)

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All verses from the NIV.

Adult Children Who Cut Off Their Parents an Interesting Variation on This Theme

My posts on this blog (May, 27,2014) and on my Psychology Today blog (November 17, 2014), Are Parents Who are Cut Off by Their Adult Children Really That Clueless, generated more comments than almost any of my other post (37 and 163 respectively). Additionally, the post itself on this blog has had more hits than any of the others.

In the posts, I reproduced letters to newspaper advice columnists from parents who had been cut off by their adult children, and who claimed to have no idea why their adult children felt the need to do this. I also printed one letter from the adult child of one of those letter writers telling the other side of the story. Without addressing the issue of who's "fault" it was that the cutoff took place, or who was "wrong" and who was "right," I opined that the apparent cluelessness of the parents was in most instances feigned. They usually knew to a greater or lesser extent exactly why what had happened had taken place.

Well the comments from readers came fast and furiously from family members on both sides of this divide, and they were very predictable. Adult children who had cut off a parent generally wrote about all the bad things their parent had done to them and how the parent would never admit to any of it. Parents came back with a vengeance saying, in so many words, "I didn't do anything wrong," and they accused me of parent bashing.

Here's a typical exchange:

Anonymous: Yes, you are correct. Virtually all of the time, when people cut off parents, or anyone else in their immediate family, you can bet there's a damn good reason. The parents will act like the poor victims. Don't believe them. There's actually a forum on the Internet where they can all get together. At first they maintain their innocent victim stance, but you will soon see their vicious hatred expressed toward their children.

Emelu: Not so. I have done nothing wrong. I've been in counseling. Been open to understand if I did wrong. Been totally honest with myself. And there is nothing I've done wrong.

I always find it interesting that whenever I write posts - particularly on the family dynamics of borderline personality disorder - adult children with the disorder who make comments often seem to accuse me of blaming them, while the parents of such children often accuse me of exactly the opposite: blaming the parents.

In most of these cases, I think the reason for these opposite reactions has to do with selective reading of the posts. This, in turn, is triggered by guilt and defensiveness. Or, occasionally, some of these folks just hate it when I give away their secrets.

In general, both of the positions "It's all my fault" and "I had nothing whatsoever to do with this" are, equally, both irrational and cowardly for any of the involved parties. 

In cutoffs, however, can it sometimes be that the parents really are completely clueless about why their children are avoiding them? That they are absolutely at a loss to understand what has happened? Some commenters said their cut-off children even accused them of things that they know they did not in fact do. Is that always denial?

As everyone was taught in school about true-false tests, beware of any question containing the words "always" or "never." I do think that, in a very limited proportion of these cases, the letter-writing parents are indeed genuinely flabbergasted at their adult children's negative responses to them and the phony accusations. In these cases, IMO the adult children are hiding their real reasons for the cutoff.

So why would a child cut off a parent who was not guilty of any significant abuse, neglect, or invalidation?

One common reason occurs in situations in which the parents feel tremendously overburdened and overwhelmed by the responsibilities of child care, or feel that the child's needs are preventing them from doing other things that they really badly want to do. They feel guilty when they admit this, even to themselves, and they always take care of their children when they are supposed to, and do so appropriately for the most part. They do not usually take their internal frustrations over being exhausted directly out on the children to a major extent, and genuinely love them.

They think that somehow their children are not aware of how tired and frustrated they are, but they are kidding themselves. The attachment theorist John Bowlby theorized that children observe their parents very carefully, without attracting too much attention when they do, and become experts on what their parents are all about and what motivates them by the time the children are just two years old.

In videotapes of family therapy sessions with small children in the room that I have seen, as the therapist speaks with the parents, one may observe the child playing with a toy in the corner. The child seems to be oblivious to the adult conversation. But then, when something concerning them comes up in the conversation, the child suddenly makes a comment about it. Without even looking up. Clearly, they are listening the whole time.

Parents in the situation under discussion in this post do in fact give a lot of clues as to how burdened they feel. They might for instance constantly and compulsively complain to their friends and anyone else who might listen, saying something along the lines of, "I'm always there for my kids! They're my #1 priority. I respond to everything they need, even though I have to work full time. I so wish my boss would understand this better. There's just never enough time. And I'm sooooo tired. I used to have hobbies I really enjoyed, but I've had to put them aside. I sure do miss those days!"

Even after their children reach adulthood, parents like this may have a very hard time trying to not cater to their adult child's every need - or even his or her every whim. While still complaining about it to everyone else.

In such cases, children may get the impression that the parent really wants to be free of them, but just cannot admit it. In response, they sacrifice their own desires for a good relationship and make themselves scarce. They cannot tell their parent the real reason for their doing that, because they know that this will make the parent even more miserable than he or she already seems to be. 

A truthful statement would make the parent feel even guiltier for wanting to be free of any family burdens. The parent would probably deny these feelings anyway, because the parent is under the mistaken impression that admitting this would drive their children even further away.

In order to avoid causing their parent to feel this way, the adult child may in difficult cases volunteer to be the villain in the piece. They may purposely make it look like they are cutting off the parents because they are selfish or narcissistic. If that does not work, they can escalate. They up the ante by making what they know are false accusations about parental misdeeds. That way, the parent can easily maintain the belief that he or she had nothing to do with the cut off. 

As an alternate strategy, or in addition, they may influence their spouse to make it look like the spouse has taken control over them and is domineering and purposely creating trouble with the parent and enforcing the cut off. For more on this, see the post, Your Spouse's Secret Mission.

Anything to help parents avoid looking at their own conflicts!

This is a sad state of affairs because, ironically, if the parents could admit to their ambivalence and negative feelings, any problematic resultant family conflicts can in most of the cases be fairly easily resolved through metacommunication and negotiation. The children's efforts to "help" the parents to deal with their guilt backfires and prevents a solution.

I know that many readers react to these kinds of formulations by thinking I am giving people too much credit, and that most of them do not operate with this level of sophistication. When it comes to fitting in with one's kin, church, or ethnic group, I strongly believe that they not only can, but they do. 

In which I see an owl And rivers of blood!

I am undarkening my blog ever-so-briefly to tell a tale of my woodland adventures in NH. As a wilderness trip leader, I recently took a group of four young girls (age 9-10) and their counselors to Kinsman Pond in Franconia Notch. As we arrived in the parking lot, we discovered that every space was occupied. One fine fool had parked his car, plastered with Boston College bumper stickers, smack across two spaces. Upon finally finding our own space after much circling, the "adults" in our group left him a note that read: "Your genitals will be snacked upon by lemurs as punishment for your hideous parking skills." I included a smiley face to let him know that the snacking would be done in a kindly, lighthearted manner.

Onward to the trail. Each of the young girls had been given a horrible load to carry. One had a sack of 6 bagels. Another had five pieces of pita bread. A third had a few packets of hot cocoa. In addition, each of the girls was forced to carry her own chewy bar, an apple, and orange, and a cup/bowl/spoon set. (Unlike my previous trip, on which I'd failed to bring bowls and cups for the children and thus almost resorted to dumping globs of Mac n' Cheese on a tarp for each place setting, I'd successfully remembered to stow these items.)

"Any of you want to give up your arduous load of food?" we offered. But the girls were stout-hearted; they would carry their lumps of bread to the very top!

We mastered the first couple of miles to arrive at a trail junction at Lonesome Lake. Day hikers strolled by, some with young children toting stuffed animals and wearing flip-flops. This was clearly a strenuous and dangerous trail. A family of four with a dog passed us and headed down toward the parking lot; one member of the group was wearing a distinctive Boston College T-shirt.

Past Lonesome Lake, the journey took on a more sinister character. We had chosen the Fishin' Jimmy trail, part of the larger Appalachian Trail. As such, thru-hikers on their way to Maine, fragrant and sometimes bloodied, left us gasping in clouds of body odor. Long-legged fellows with trekking poles would stride with ease down over slippery roots and near-vertical rock faces studded with wedged, wooden steps. The girls struggled up the same route, sourcing out the best holds for their little hands. We leaned to the side to allow the thru-hikers passage and the girls pinched their noses and said "faugh." And so we clambered higher and higher into the woods along the edge of the mountain. We crossed mossy streams where mushrooms grew, so round and bright that I thought one was an orange tumbled from someone's pack. A foot would slip; someone would squeal and right herself.  A toad trundled across the trail.

My pack was from the 1980s--a gift from a former trip leader. It was old-school indeed, a classic frame pack covered with small sewn patches from the various AMC huts I'd visited in an earlier lifetime as a trip leader. And it was the most painful and wretched pack I could imagine carrying. I'd thought it would be kind of cool and retro to use this pack on the trail this summer. However, I had failed to recall some of its lesser virtues from the last time I'd used it. One, whenever the waistband was tightened to anywhere nearing comfort, it would pop open at the moment of greatest stress, thus sending something in the realm of 40 pounds of weight down on my shoulders. The best recourse was to leave it loose, which also let the 40 pounds sit firmly on my shoulders. Second, the pack was ungainly and off-balance, so that when I clung to a rock face on the Fishin' Jimmy trail, I came within an inch of toppling over backward into scrubby gullies. I reeled like a drunk on the edges and clung to tree branches. The tent bound at the top swung wildly and caught on pine branches. And third, if I decided that I needed to crouch low and clamber over a rough spot, the external frames at the base of the pack would scrape and catch on the rock. Scritch, scritch, the pack would scream, as I slid down the rocks.

We made camp at the lovely Kinsman Pond shelter. Our second day in the woods was uneventful, and included a hike to the top of North and South Kinsman in the fog. On the way up, we passed an older hiker who appeared to have wrapped his head in cheesecloth. He had a ragged gash on one arm and a haunted look in his eyes. "It's very rough," he said. "Very steep. Very dangerous. Hold onto anything you can!" He took a peek at the young girls and shook his head mournfully.

This fellow must have come up via a different trail, for we encountered nothing more hair-raising than that which we'd seen on Fishin' Jimmy. No trauma ensued but for two girls scratching their legs near the peak of South Kinsman and howling bitterly about it. They insisted on giant gauze patches lashed on by surgical tape. Another girl had to go poo near the peak so I dug her a hole with my hiking pole and handed her a patch of moss. (Moss soaks up urine well enough but can be grubby on the undersides.)

On the second evening, we sat by the pond and watched clouds roll down from the mountains. J and M were snogging and lover-making or some such, as 17-18 year olds will do when presented with romantic scenes such as remote mountain ponds under darkening skies. I didn't blame them a wit. E and I departed and were snuggling into our sleeping bags when I heard something whisking by my head. I trained my headlamp on the creature. It was an owl. A very petite and round-eyed owl that we later determined to be a Saw-Whet owl.

The owl flew about the shelter, lighting on various beams and gazing at us as if for advice. Eventually it settled atop my garbage-bag-wrapped sack of clothing, not more than a foot from my head. It blinked at me.

"It's sitting on my luggage!" I said. The presence of the owl, so otherworldly, rendered my speech loose and excitable, like a child who has seen his first lion. "It's on my luggage," I repeated. "There it is, on my luggage!" The owl gave a little hop and landed back on the bag. I slowly withdrew my camera and as I did so it flew straight out of the shelter. It was better that way, really. I didn't want to see my last glimpse of the owl through a camera lens. We were assured that our bonny owl was a good omen and would bring us doubloons and blessings for the year to come.

The blessings began the very next morning! I woke up and prepared to light the camp stove. Then my nose started gushing blood. I used to have a lot of nosebleeds as a kid, so I pinched my nostrils shut and waited a minute or two. It didn't stop. I figured it was due to altitude or something and didn't panic, although I thought about panicking. Through some fluke, I had also acquired a cut on the side of my nose and that, too, started to bleed profusely. So I was lying on my back in the shelter with a pack towel over my face, wondering if the bear that had been reportedly sighted in the area appreciated the scent of blood in any way. The shelter featured a large "Bear Box" where we stored our pepperoni, chicken, and other items of interest to a bear, and the bear had visited and fumbled with the lock on the first night and had loped away without satisfaction. Now he would come back, and he would eat me. And the Saw-Whet owl would observe this from atop my luggage.

Finally, finally, I got the bleeding to stop. I affixed a Band-Aid to the side of my nose. I'm sure it was unsightly. When the campers woke up for breakfast and noticed my blemish we hatched a scheme in which we would all put Band-Aids on our faces and make many ominous comments to the day hikers heading up the trail. We'd scare the wits out of them just like that old feller had scared us!

We set out to hike down the Fishin' Jimmy. I had researched a few alternate trails but they all listed things such as "rough and intolerably steep" and "lousy with trolls" and "slippage to certain death inevitable." So we went back to Farkin' Jimmy. It was slow and wet from the previous night's rain. The girls took their time and made their way with steady progress.

We were crossing a small stream in a flat section of the trail when I heard a cry. One of the little girls, L, had pitched forward and was lying prone atop the rocks. She had failed to put her hands out to arrest her fall in any way. And her forehead was spurting blood. Having seen head wounds before, I knew they could bleed badly even if superficial. We gathered around and soothed her. She was remarkably calm, until another little girl squealed in a high-pitched voice: "Oh my God. So much blood! It's GUSHING. I have never seen so much blood! Oh my God, it's like a fountain of blood! The blood! The blood!"

This dramatic outpouring sent poor L into tears. And the tears themselves were filled with blood, too. L was a pretty girl with long, thick hair, which she'd brushed and brushed until it was gleaming and then had sorted it into a braid. Even the braid, which had fallen forward, was bloodied. We pressed the wound with my pack towel (already encrusted with dried blood), and then E pulled it away and looked and went white and mouthed two words: "Puncture wound."

I looked and my stomach dropped, for this little girl had a hole in her forehead. It wasn't a huge hole, but any hole in the forehead is a bad hole. It was shallow enough, but the skull isn't far from the surface. Touch your forehead now and you'll see what I mean. I thought I might be able to see the glimmer of bone at the base of this hole.

Adrenalin is a strange thing. Readers of my blog know that I suffer from panic attacks and have experienced the push of adrenalin, misplaced and false and unneeded. This time it did what it was meant to do. We all acted quickly and cleanly. I flung the shoes lashed to the outside of my pack onto the trail in order to access the med kit. (I never saw the shoes again in this lifetime.) We stuffed in a gob of Neosporin and bound up the wound.

A man with a dog stopped by and informed us that he worked at a local hospital. No, he wasn't a doctor or a nurse, but he offered to carry the little girl's pack, and that was good enough and made him a hero. We legged it to the hut, one mile away, where the crew wrapped up little L even more thoroughly such that she looked like a Revolutionary war solider. Her face was blotchy and her eyelashes were gummed with blood.

At this point E and I decided we'd hike her out to the hospital while the rest, commandeered by hardy crew members M and J, lagged behind. I hadn't eaten anything, so I opened the communal jar of peanut butter and thrust a grimy paw into it to bring up a big scooping handful. This I licked as we hiked down. Some ways down the trail a bee shot out and stung me on the leg. E was carrying the little girl's pack on her belly, with her own pack on her back, so that she looked like a strange double-humped creature. I was wearing two knee braces and wielding two trekking poles. The day hikers with their teddies and lollies and pinafores continued to pass us as we made our way down, and at one point little L (cheering up now) turned back to us and conspiratorially said: "I think our plan to intimidate them is working." What a champ that kid was. Her eyes were still gummed-up with blood and still she had a hole in her head and still she managed to laugh.

We hiked on, cooking up stories for how the scene had played out. In one scenario, a bear with the ghost of Fishin' Jimmy riding sidesaddle on its woollen hide had lunged from the woods, knocking L into a troll-spike.

Finally we reached the van and drove 15 miles north to the hospital in Littleton, NH. A few miles into the drive my nose inexplicably started bleeding again, and I grabbed a beach towel to staunch the flow. In doing so I opened up the cut on the side of my nose again.That bled too, profusely. I drove one-handed, silently cursing. By the time we stumbled into the ultra-clean waiting room of the Littleton hospital ER, my face and hands were soaked in blood and my leg was bee-sting swollen and I had a rime of peanut butter around my mouth. We stank of the woods and of old cheese and probably a little bit of urine, as leaves don't wipe as well as they ought. The triage nurse opened her eyes wide and wondered who was the patient? Lucky for us, the waiting room was entirely empty, and L was whisked in for gluing and reparation faster than one would have hoped.

I left them there for rescue by the camp nurse and took the van back to collect the others, now waiting at the trailhead.  They would want ice cream, and would want to know: Was L all right? She was, and they would get their ice cream.  When I turned on the van's crusty old radio a song featuring the little girl's name was playing. What were the odds of that? (And I'd like to say her name aloud here, because she deserves honor for her bravery and her laughter, but one doesn't write about other people's children online, of course. But I'm saying her name to myself all the same.) The odds.

Maybe 10 years from now she will be on a trip herself, now bold and 18 and in love with something of the mountains and maybe with a boy, and she'll remember M and J and the way they glanced at each other over the stones. In 15 years, she will be 23 and I will be old and intolerable and maybe I will have forgotten how to skip--my parents, in their 80s, say that when you can't skip anymore that might mean that you are old. Does it? Maybe in 20 years, someone will ask: How did you get that scar? And she'll touch it lightly and remember the light on the water and the shiver of the lilypads in the wind when she was eight and high in the mountains  and far from home. And how when she fell she dove rather than faltered and engraved this instant on her memory.

The Impact of Intervention in Addiction Through an Amy Winehouse Scope

Today's post in a guest post courtesy of Allison Gamble, a writer for psychologydegree.net. 

“They tried to make me go to rehab, I said, "No, no, no"

Yes, I've been black but when I come back you'll know, know, know

I ain't got the time and if my daddy thinks I'm fine

He's tried to make me go to rehab, I won't go, go, go”

           ~ "Rehab" Amy Winehouse

The late singer Amy Winehouse released “Rehab” in 2007, a now haunting song that revealed her struggles with drug and alcohol abuse, her reluctance to seek help, and the role her family and friends played in her life. Some attempted to push her towards treatment, while others seemed to enable Winehouse's destructive behavior and ignored warning signs that may have caused her sudden death. While Winehouse’s plight has gained media attention, her celebrity is one of the only factors that separated her situation from the problems that many individuals who abuse drugs and alcohol deal with every day.

Like many other families who have loved ones with a substance abuse problem, Amy’s family is placing fault on others for her sad demise. It doesn’t take a degree in psychology to smell the denial in the air. Interviews with her parents show they lay blame for her death on detox methods instead of also looking at both their behavior and having not intervened in time to possibly help Amy.  Of course, losing a child is awful enough, but they are likely also feeling tremendous guilt that they had not taken more steps to try to protect her from a fate no one wanted to believe would come to fruition.

In American and the UK alike, due to the absence or failure of family members and friends intervening, many addicts like Amy are left to cycle through pricey rehab clinics and wind up taking endless supplies of anti-psychotics, anti-depressants, anti-anxiety meds and more. Gaining the approval of doctors, rehab clinics and pharmaceutical companies, families are held harmless as they look at addiction as a disease. With this medical model, the one loser winds up being the addict.

While little has been revealed about Winehouse’s upbringing, it is known that her parents separated when she was 9 years old. Father, Mitch Winehouse, claimed in a 2008 interview, titled “How my affair made Amy suffer,” with British newspaper The Daily Mail, that a longstanding affair with a colleague was an open secret in their home. Winehouse’s paramour was even known by Amy and her siblings as “Daddy’s work wife.” Mitch Wineshouse claims he never realized that their family’s dysfunction had impacted Amy so negatively until years later when he heard her song “What it is About Men” that the line “all the shit my mother went through” referred to his deception.

Amy’s mother Janis claims her Amy had always been a rebel but that her defiant streak intensified when Amy became a teenager. In an unusual move by Janis, Amy was allowed to leave home to live with a friend at the age of 15. "It would have been fine but she moved out for her own convenience. She wanted to live with a friend. Perhaps she wanted her mum to fight to make her stay. But I felt she had grown up by then,” her mother said in a January 2008 interview, eerily titled “Amy Winehouse’s mum says she’ll be dead in a year,” with the Sunday Mirror. This is not to say that Janis is solely responsible - there are surely hundreds of children who move out early without overdosing at 27. But could a firmer hand have helped steady the wheel? We’ll never know.

Janis went on to say that she while she doesn’t feel responsible for Amy’s decline into drugs, she reveals being lackadaisical when Amy started running into trouble. "Amy was never an easy child and she was always open to any new bad influence. Her life became a bit muddled when she left home. She started smoking marijuana and got her first tattoo - a Betty Boop on her back. I just said, 'Oh well.’”

Amy’s family always seemed to have a disturbing dynamic. Janis was unhappy; Amy was rebellious, but always trying to please her out-of-the-picture father Mitch. "I don't do happy. [Amy] doesn't, it seems, do emotion either. But it's just her way of coping,” Janis explained.

As a Amy became an adult, her family unit added another dysfunctional member: ex-husband Blake Fielder-Civil. A self-admitted addict, Blake claims to have introduced Amy to narcotics usage. “I’m not trying to defend his behavior and I know him for what he is: he’s an addict and he has done some terrible things. He feels enormous grief and responsibility for some of the things that have happened, as well he should,” Fielder-Civil’s mother, Georgette, told the Daily Mail in “Don’t blame my son for Amy’s death: Blake Fielder-Civil's mother's plea as she insists the couple were still in love.”

Although some families shift the blame for a substance abuse problem on medical issues, they are often the ones who have, perhaps unwittingly, facilitated the problem to a significant degree. In 1991, The Journal of the Academy of Child and Adolescent Psychiatry reported that researcher James R. McKay and colleagues had studied adolescent substance abusers and confirmed what we know anecdotally: that greater perceived degrees of dysfunction were linked to increased levels of substance abuse prior to hospitalization.

With modern medicine focusing on the disease model of addiction, pharmaceutical companies have been instrumental in keeping substance abusers like Amy addicted by flooding the market with painkillers and psychoactive meds, while also profiting from drugs to counter addiction.

In July 2011, financial website This is Money reported that one such company, Reckitt Benckiser Pharmaceuticals, was delighted to announce that its newest delivery system for the heroin addiction drug, Suboxone, would now be a big moneymaker. “As is well known, our Suboxone tablets can become subject to generic competition in the U.S. at any time, and moving more of our business into the film remains a key priority. At the end of June 2011, the Suboxone film had captured a 41 per cent volume share of the U.S. market,” he said.

Talk show host and former journalist Piers Morgan knew Winehouse and told Entertainment Tonight in “Piers Morgan hits out at Amy Winehouse’s record company after singer’s death,” that while the troubled singer ultimately succumbed due to her own addictive behavior, others in her life failed to take responsibility. Echoing a common question, Morgan wanted to know where everyone was when she needed help. He stated, “I do blame people. Where were all the people making money out of her when it mattered? Really, where were they? You know, it's just not good enough that they're all going to make millions out of it now she’s dead.”

Blake Fielder-Civil’s mother seems to agree. “We all played our part in what happened to her. I have had to look deep into my heart and wonder if I could have helped, done things differently,” she said.

While we may never know what caused Amy's death, ultimately she was responsible for her actions. However, family members, “friends,” doctors, rehab centers and pharmaceutical companies must also accept responsibility for the role they played in her destruction. We need to move towards a more cohesive model that merges psychology and psychiatry to prevent more parents from losing their daughters.