28 Days

Introduction

Well, there’s my excuse. I’m late because my tits caught on fire.

I have a soft spot for movies that were made in the same year as me. Is 28 Days an enjoyable movie? I would say yes. Is it a good depiction of addiction? I would say meh. It’s the type of movie you might watch in rehab so that you can poke fun at how it differs from reality while being similar enough to merit the comparison in the first place. Overall, I think it comes closer to treating rehab as a summer camp through which a young woman matures to discover the type of love she really wants than the first step in dealing with the struggles of trying to survive with a mental health disorder that has fatal implications and roots in unhealed trauma. Those concepts are certainly touched on in the movie, but their narrative purpose is strongly structured around the standard rom-com formula of a past that must be overcome, with success symbolized by finding one’s “true” love. Compare this to something like Trainspotting, which deals much more directly with the raw ugliness of addiction, withdrawals, and the consequences to everyone around.

Also, the soundtrack really does not let you forget that this was made in the early aughts.

Live Commentary

You make it impossible to love you.

I would say the beginning of this movie sets up the basic premise of an archetypal addict’s life prior to entering rehab fairly well. We’ve established that Gwen has a pattern of nonstop drinking or using, that she has a codependent relationship with her boyfriend (Dominick West plays a great alcoholic, see McNulty in The Wire), and that the other loved ones in her life have been routinely hurt by attempting to manage their love for her when it comes with the consequences of addiction. Granted, there’s still a slapstick element to the portrayal that an audience might laugh at, and Gwen’s character is written to be unusually witty as the movie’s protagonist, but the core ideas hold up. Both Gwen and her boyfriend say, on the way to Gwen’s sister’s wedding, that the whole point of their lifestyle is “to care less.” The inherently self-destructive nature of addiction is articulated early on between these two sentiments: the point of Gwen’s drinking and using is to care less, and as a result, she can’t care about showing up for the people in her life and becomes impossible to love. Only her equally detached and destructive boyfriend is capable of following her rollercoaster.

When Gwen ends up stealing a limo and crashing it into someone’s house, we get a cutaway to her going to rehab. We infer (and shortly get confirmation) that she’s court-ordered to attend rehab because the alternative was prison.

Well, you know, you never hear of anyone being raped with a plunger in rehab.

Well, no, you don’t hear about it because they cover it up.

Anecdotally, I have heard of instances of sexual harassment or assault happen in rehabs and treatment centers that went completely unaddressed by staff because it boiled down to “he said, she said,” or some variation of that as per the genders involved. I’ve heard it happen between clients and between staff members and clients. Many people who come to treatment have already been victims of that exact kind of assault and abuse, and many failed to see justice come of it when reporting it through official channels. The instances where they were dealt with appropriately were usually cases where cameras in and out of houses were available to substantiate allegations, though you’ll also have many people complain about the cameras themselves being invasions of privacy. I would cautiously guess that no set of rules or regulations can meaningfully prevent harassment or assault if someone is truly motivated to get away with it, so ultimately we need to tackle the issue through mechanisms found in socialization and cultural attitudes. The movie doesn’t address this except for the throwaway joke I quoted above.

We carry our own bags here. This isn’t the Sheraton.

I actually think a decent number of places help you out with carrying your luggage and belongings. A, because you’re probably too high, drunk, and/or in agonizing withdrawals, and B, because they need to inspect it anyways to make sure you’re not sneaking in contrabrand, including instruments that could be used to harm oneself or others (the “sharps”). For instance, Gwen’s eyelash curler, mirror, and prescribed Vicodin for “back pain” are all thrown out.

Gwen’s intake in general is smoother than most, which can involve an hour of questions and potentially taking blood samples or doing a TB test. Most centers will take a picture of you upon entry for both identification reasons in their computer systems and as a “Before” picture for you to compare to your “After” self. One of the most unrealistic parts of the movie so far is how great Gwen looks in this picture.

No phone calls, except during posted phone time and then only for 10 minutes.

Phone policies vary a ton from facility to facility. Some places don’t allow phone access at all unless it’s a facility phone (in residential settings, a home phone) under supervision and for a specific duration like 10 minutes. Other facilities have a “blackout” period, generally around a week or more, in which someone has no phone access at all. This has a few functions: digital detoxing to break compulsive technology habits, preventing coordination with someone on the outside who might deliver drugs when someone is at their most vulnerable, and guiding clients to focus on their recovery instead of dissociating through doomscrolling.

No fraternization. That’s romance and/or sex between patients.

Yeah, this one is just plain impossible to stop. If people want to fuck, they will find a way to fuck. I’ve known people to have sex at the center where classes and therapy sessions are held. I mean, you take a bunch of people severely deprived of dopamine who more likely than not have some type of trauma that hampered their ability to make healthy decisions and desperately seeking some validation and comfort from a life that was likely being burned to the ground alongside codependent relationships, and you’re going to have people seeking intimacy through romance or sex right away. It’s like a college dorm, except everyone is filled with severe dysfunction instead of parental expectations and career pressures.

Oh, and we chant here. Don’t be put off by it. It’s just some people prefer it to the Serenity prayer.

Boy oh boy do I have thoughts on this.

The Serenity prayer reads:

God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference

Reinhold Niebuhr wrote it in the 1930s in the context of the Great Depression and fascist uprisings in World War II, particularly Nazi Germany. He intended it to bring solace to religious activists who participated in active, collective resistance to oppression. Niebuhr was a staunch, vocal critic of the Oxford Group and Frank Buchman, whose evangelism directly inspired the philosophy of Alcoholics Anonymous according to William Wilson (Bill W.) himself. For context, Buchman once stated “I thank heaven for a man like Adolf Hitler, who built a front line of defense against the anti-Christ of Communism.” Niebuhr was, understandably, appalled at the idea that a utopia could be brought on Earth through the conversion of Hitler and the Nazi leadership to Christianity. He considered the notion of individual top-down transformation to be a backwards approach compared to collective action that allowed everyday people to pool their leverage together to overcome authoritarian structures, whether found in corporate bureaucracy or fascist totalitarianism. The Serenity prayer was intended for social justice activists, not for individuals with an ego problem to detach themselves further from accepting responsibility for the society around them. AA has certainly taken steps to distance itself from Buchmanism, such as appealing to social outcasts and destitute unemployed classes rather than totalitarian leadership and focusing on anonymity as rather than explicit cults of personality, but AA is fundamentally incompatible with collective political action. On top of a mandate to not have stances on “outside issues,” AA philosophy more often than not encourages one to step back from attempting action if it can be rationalized as “out of one’s control.” It’s a hyperindividualistic philosophy, though I do commend the anarchist structure of its localized groups.

Long story short, many people who attend AA or other 12-step meetings are wary of reciting the Serenity prayer, or any prayer for that matter. Many groups close out their meetings with the “Lord’s Prayer”, which is even more explicitly religious. Sometimes groups accommodate this by changing what their closing out “chant” is, but other times you just have to walk out if you’re not comfortable.

Your room. You’re responsible for keeping it clean.

This is definitely the general expectation you’ll get from rehabs, although enforcement varies. Sometimes you’ll have a roommate who eats in their room despite rules against it and leaves trash and dishes, lets piles of dirty laundry build up, and go a week without showering no matter how sweaty they get while trying to cover up their BO with AXE spray. I have come to appreciate strict and uptight staff members more than lax ones as a result.

Oh, um, what’s your drug of choice? Alcohol, cocaine, Percodan, heroin, glue?

I have to pick just one?

Your gateway drug. What you go for first.

I guess I drink.

You will have this conversation many, many, many times in recovery. And for good reason. As much as you’ll hear that “we’re all addicts, we’re all trying to get better,” there actually are differences between patterns of substance use. In my anecdotal experience, people whose drug of choice (DOC) is alcohol are the least likely to be marginalized, simply by the virtue of being the least likely to be in environments where other illicit substances are present. Even those who start drinking as teens usually stole from their parents or older friends, whereas those who start using harder drugs are more likely to have a social network involving in ongoing drug trafficking. I have never heard anyone say their DOC is nicotine, since people smoke like chimneys in recovery.

I don’t think she was staring, Daniel.

Oh? And how would you know, faggot? You’re about as perceptive as Helen Keller.

Recovery spaces are not the most progressive places, generally speaking. If you’re anything like me and grew up in Call of Duty lobbies or the pre-filtered Internet that made it really easy for kids to find videos of ISIS beheadings, this might just go in one ear and out the other. Otherwise, you might end up with a little culture shock when you see that hardly anyone raises objections to that kind of language. Deeply opinionated bigotry is still jarring to me though, like when someone has clearly thought through their justifications to issue opinions about race or gender and proudly announces them.

Don’t worry about Daniel. He’s just self-conscious about his neck because he did it to himself. He had this thing where he’d pump his stomach so he wouldn’t get a hangover. l guess he knew how, because, you know, he’s a doctor. Or was. He lost his license after he killed that patient, but… Anyway, l guess one night while he was scraping that tube to his stomach…somehow he screwed up and he couldn’t breathe and he had to…poke a hole in his throat with a pen or something.

My entire goofy shit page exists because you hear or experience stories like this all the time. Shoutout to the guy who told me about working in a lab as a tech with access to experimental horse tranquilizers whose co-worker/co-user gouged out his eyes on a bad trip.

This scene also gives us the first instance in which Gwen experiences something of a dizzy spell that accompanies withdrawals, marked by editing that slows down time and adds a white filter over the screen. It’s not the best visual depiction of the disorientation, but it’s alright for 2000s editing.

Chocolate. Heroin addict.

Gwen’s roommate, a heroin addict, wakes up late at night to eat chocolate as a way of managing cravings. There’s actually some science behind this. Heroin is an exogenous opioid that binds to the brain’s mu-opioid receptors intended for endogenous opioids. Eating chocolate, particularly the high fats and sugar concentrates, prompts the brain to release enkephalins and endorphins that bind to the same mu-opioid receptors as heroin, which can provide relief to a brain suddenly starved of exogenous opioids to stimulate those neural pathways. Other substances like alcohol primarily operate on different neural pathways like GABA and glutamate, so while alcohol withdrawal can induce cravings for sweets as well, this stems from low blood sugar from lacking the simple carbohydrates of alcohol.

Also, I too am guilty of eating snacks loudly in the middle of the night. I’m sorry, but they shouldn’t make the wrappers so fucking loud. I do my best.

You girls are a lot of fun. And that’s the most important thing. Because if you’re not having fun, peanuts, what’s the friggin’ point?

The way Gwen ends up sprawled on the bathroom floor, caught between vomiting in the toilet and tossing cold water at her face, is painfully familiar. The flashbacks to her childhood with her mother and sister, as well as her at a party with her boyfriend, are also typical in the first few days of withdrawal.

With alcohol withdrawal, which is presumably the dominant type depicted on screen for us, the brain is suddenly deprived of the alcohol that mimics GABA (associated with calming neural activity) after becoming more sensitve to glutamate (associated with exciting neural activity). That means the central nervous system loses the ability to calm itself down while becoming hyper-excited, causing the amygdala to nonstop alert the brain that survival mode operations are necessary. One might repetitively manufacture worst-case scenarios or intense anxiety about the future. Simultaneously, the hippocampus has been conditioned by the suppression from alcohol to become more sensitive to glutamate as well, so the hyper-excitement results in disordered thoughts about the past constantly resurfacing, including trauma and feelings of intense shame.

Gwen’s memories involve her mother as a clear influence on her own drinking habits. However, compare what she remembers now to what she said in the cab on the way to the wedding: her mother says there’s no point to anything if it’s not fun, but earlier Gwen said the point is to care less. Those aren’t really the same thing, and in fact, we can see the thematic journey of Gwen’s addiction already spelled out for us. At first, substance use can be fun and recreational, but as it becomes a chronic crutch that leads to dependence, it becomes a way to drown out an otherwise intolerable life in which caring about anything is too painful.

You can keep your drugs and your whiskey sours. We got us a higher power! Yay, God!

I don’t know how this chant is preferable to the Serenity prayer. It’s lame while still invoking the same religious context. I do appreciate that the movie doesn’t pretend like a “Higher Power” isn’t just obviously meant to be God though. Even AA official literature says that references to God should be seen as a shorthand for Higher Power, which just cements how interchangeable they’re designed to be.

There’s no caffeine, it’s mood-altering.

This was unusual to see, in my experience. Every recovery meeting and facility I’ve ever taken note of provided caffeinated coffee, and some even allow energy drinks despite certain clients being definitively dependent on them to start their day. The line between acceptable and non-acceptable drugs that I’m most familiar with is “mind-altering” rather than “mood-altering,” the distinction being that a mind-altering substance changes your actual cognitive processes while mood-altering substances just change a specific feeling. Marijuana is considered mind-altering, but nicotine and caffeine are considered mood-altering. Prescription drugs obviously span both, but are given an exception when taken through a medical recommendation. There are definitely arguments to be made that these distinctions are ultimately socially-constructed rather than empirically-justified.

Lady, the people out there are addicts, okay? They need cigarettes like they need air.

Case in point, I can count on one hand out of the hundreds of people in recovery I’ve met who actually stated they don’t vape or smoke, not counting those quitting or attempting to quit.

It works if you work it. It’s worth it!

The first group therapy session is just plainly funny to me for how relatable it is. I am often bored out of my fucking mind in most groups. There’s always someone who wants to say something and takes an inordinate amount of time to articulate something simple, a facilitator whose uncanny positive regard for their patients leads to praise for the slightest effort to participate, and, for me, staring around the room studying literally anything and everything from the walls to people’s shoes in the hopes of seeing something mildly stimulating. I know, that’s mean, but at least I’m honest sometimes. They end the meeting on the normal Serenity prayer, which you might be inclined to write up as an inconsistency in the script since Gwen was told earlier that not everyone feels comfortable with it in the group chants, but I’m almost inclined to say that it’s just true to how inconsistent the policies about prayers are in any particular recovery setting. You will almost certainly be asked to participate in a prayer in any environment that’s fundamentally wrapped around AA philosophy, regardless of how secular it advertises itself.

Hey, Gwen C! Your bed was not made up, your clothes were all over the place. I’m giving you an F for daily inspection and fining you a dollar.

I’ve never seen monetary fines for failing to make up one’s bed or clean one’s room in a recovery context, probably because a lot of people in treatment are incredibly broke. Unfortunately there aren’t too many disciplinary measures a facility can take if someone doesn’t want to comply with guidelines around respect and civility. In general, I would warn the average person looking to enter a rehab that you shouldn’t count on house managers or staff members to enforce ground rules because they really don’t have too many hard power options to use. They function more as mediators than disciplinarians. If someone is facing jail time or prison time as an alternative to treatment thanks to a diversion program, then being kicked out of the program can be a meaningful consequence, as is Gwen’s case. Although, because this is a story with a protagonist who has to undergo an internal change that we can root for, this isn’t the consequence that works for her.

It’s literature about your disease. AA Big Book, some worksheets, a journal I want you to write in every day.

I suppose I have to do this.

You got better things to do with your time?

As of 2026, I think there’s less emphasis on the AA Big Book in most centers, though other AA literature and its adjacent mateiral is certainly still prevalent. Worksheets are everywhere, usually derived from the same handful of CBT/DBT manuals that focus on cognitive reframing and communication skills. If you stay in a treatment setting for longer than a month, they’ll most likely feel extremely repetitive.

Adult Children of Alcoholics

This refers to distinct 12-step programs like Adult Children of Alcoholics and Dysfunctional Families, sometimes abbreviated as ACoA.

Co-deps starts at 8:00 p.m. in B

Codependence Anonymous (CoDA) is a 12-step program that’s used by those with substance use disorders who might attend AA, but also anyone else who finds themselves in co-dependent relationships. The conventional wisdom goes that people in relationships with those who struggle with substance use are often compulsive rescuers or people-pleasers who fear being alone so much that they tie themselves to someone who might need a lot of support, like someone whose life may have become unmanageable through their addiction.

CAs and NAs meet tomorrow

CA stands for Cocaine Anonymous and NA stands for Narcotics Anonymous. Anecdotally, NA is probably second to AA as the 12-step program that’s most widely known and cited, with NA having its own version of a foundational book. I haven’t heard too much about CA myself.

and overeaters, sexual addicts

You guessed it. There are 12-step programs for these too. Overeaters Anonymous (OA) and Sex and Love Addicts Anonymous (SLAA) are also real, though they’re distinct from other types of program in that the abstinence from the core activity is not the goal. Eating and sex are still considered, on their own, to be a part of a healthy life unlike cocaine and alcohol. Instead, abstinence from the harmful extents to which these activities are taken becomes the goal, such as refraining from bingeing or one-night stands.

I’m not like those people out there. I can control myself. I can, if I… If that’s… If I wanted to, I could, if that’s what I wanted. I could. I can. I can!

This is the stereotypical denial phase that addicts are supposed to go through, and it’s no surprise that it shows up in the movie as part of Gwen’s character development. “I could stop any time I wanted” is a cliche as far as addiction goes. One of the reasons AA asks people to introduce themselves with the “I’m Mank, and I’m an alcoholic” format is to both work past denial and to build a sense of shared identity.

In reality, a lot of addicts are perfectly aware that their substance use patterns are destructive and that they have a problem they can’t stop on their own. What they might be ambivalent about is the merits of seeking treatment or admitting their problems to others out of fears related to stigma and judgment. Some people are simply too depressed to value themselves enough to think treatment is worth pursuing. Others don’t think it would help anyways, especially if they come from families where someone suffered from their substance use without ever seeking help. Something something quiet desperation. And there are those who simply don’t want to stop. Whatever your opinion of that may be, some people have simply crunched the numbers and decided they prefer not being sober despite the tradeoffs. But, that’s not as narratively gratifying for a general audience.

If that’ll make you happy, I will stop drinking. And then, I would tell myself, “tonight, I will not get wasted.” And then something would happen. Or nothing would happen. And, I’d get that feeling, and you all know what that feeling is, when your skin is screaming and your hands are shaking, and your stomach feels like it wants to jump through your throat. And you know that if anyone had a clue how wrong it felt to be sober, they wouldn’t dream of asking you to stay that way. They would say “Oh, jeez, I didn’t know. Here. You know, it’s… It’s okay for you. You do that mound of cocaine. Have a drink. Have 20 drinks. Whatever… Whatever you need to do to feel like a normal human being, you do it.”

God bless Steve Buscemi. This monologue is highly referenced by people who like this movie as striking a particular chord with them. It really is impossible to explain the craving and compulsions of addiction to someone who hasn’t had it. You can tell them to imagine being dehydrated in a desert for 5 days and being offered a glass of water if they run over a stranger, or you can tell them to imagine the worst case of poison ivy they ever felt ravaging their body with the need to itch, or any of the other analogies, but none of them really describe how much more intense and holistic the actual thing is. I can’t call it insanity, because the impulse is so strong that, as Buscemi’s character says, if you knew it, you completely understand why someone would give into it, and how miserable of an experience it can feel to not give into it. You know that people who haven’t experienced it lead their everyday lives falling into temptations that aren’t even a hundredth as strong as the one to drink or use: ruining their diet for Oreos, speeding, gossipping, sleeping in and calling sick to work, snapping at their family, bingeing a show on a streaming platform, doomscrolling social media, unsafe sex with a toxic ex, dropping a racial slur, all those other little bad habits that should be trivial to stop if your life was on the line, though it virtually never is. You know that people can scrape by with manageable consequences for those kinds of things, and it won’t ruin their life and people will sympathize with those flaws, but you will be judged for the inability to hold back from something stronger than they’ve ever experienced. It will never be fair, but that is what it is. You have to be able to find a reason to live in spite of that, and unfortunately, that won’t happen for a lot of people. We don’t live in a world that makes that possible for everyone. For all the elaboration on this blog about recovery and behavioral interventions rooted in meaningful incentives, I think George Carlin said it best: you need people around you who care, and you need something to look forward to.

And then one night something happened. You know you’re screwed. I woke up. I woke up on a sidewalk and I had no idea where I was. I couldn’t have told you the city I was in. And my head was pounding, and I looked down and my shirt is covered in blood. And as I’m lying there, wondering what happens next, I heard a voice. And it said, “Man, this is not a way to live. This is a way to die.”

Buscemi’s character, Cornell, narrates this between cuts to Gwen climbing out of her window to try and retrieve Vicodin she earlier threw out of her window in frustration at her own compulsion to use. Gwen has a vision of a version of herself still at the window right before she falls and hurts her leg, shaking its head at her.

Unfortunately, you’re going to have to live with the pain because I can’t give you anything.

This is true. Many people in rehab either come in with injuries or end up with injuries as a result of rehab shenanigans. If so, it is very likely you will not get the standard painkillers others do if there are considered habit-forming. It’s one of the many instances in which you realize how much the tradeoffs around substance use are centered around this theme of borrowing from the future. If you use drugs to kill pain now, you might end up having to face worse pain without them later. If you use it to fast forward through uncomfortable moments now, you’ll have even more discomfort that’s agonizingly slow to fade.

In typical 2000s Hollywood fashion, Gwen’s big wakeup call as a young woman is having unkempt hair that triggers an existential crisis. Still, she pays a visit to Cornell begging for help:

There’s something wrong with my hands. Um, well, with me. Cause, uh, what kind of a person just jumps out of a… What kind of person jumpts out of a window, and uh, you know, because she can’t sit still, you know? And be alone, and, you know, in a room without… You know, a person should be able to just be alone, right? You know, human beings should be able to just breathe. I can’t breathe. And I feel that… I think I know… I think I know that if I go to jail like this, you know… I’ll die. And uh, I don’t wanna die.

This moment is what’s often called the gift of desperation within recovery circles. It’s what Cornell describes experiencing upon realizing that he wasn’t living, just waiting for death. It’s what Gwen goes through in this moment. It’s what I went through when the person closest to me at the time saw me trying to drink myself to death and said, “Please don’t leave me.” It’s what I’ve heard on the bedside at hospitals before. I’ve never been a fan of the idea that people need to be “scared straight” or taught lessons through pain, but I have to admit that I haven’t seen too many people pull themselves out of that kind of spiral without hitting the realization that they didn’t wanna die - the proverbial “rock bottom.”

Another piece of media I often cite is House, except the addict in that show is the doctor himself. A recurring theme in the show is the question of whether people change, and how much of our answer to that is a self-fulfilling prophecy. Early on, House’s position is that “People don’t change, they just become more of who they really are.” Another iteration of this principle comes out later: “People only change after a major trauma if they wanted to change before the trauma.” I’m inclined to think that’s true. The people I’ve seen make a change in their life after a major trauma are those who held values and principles beforehand, and they could be convinced that they had temporarily lost their way from those things to look forward to. They could use their trauma as a way to ground themselves in levers of change they had access to. A diabetic who suffers from heart failure and strokes with a permanent blow to their vision has a daily reminder of the consequences of failing to eat and exercise right. An addict who burns down every relationship and reputational credit to their life has a daily reminder of the consequences of escaping problems as their ego insists instead of facing them head-on and asking for help when needed. But, people who are convinced they can go back to their old patterns in some way or form generally don’t make changes.

Anyways, back to the regularly scheduled programming.

You don’t remember last night, do you?

Well, I got a little drunk on the airplane.

Oh, well, of course you did.

Fun fact: if someone is on their way to treatment, they generally are not discouraged from drinking more. There are two motivations for this. One, they are considerably more likely to go along with a structured plan to get into treatment if they aren’t looking for a way to get out and use more. Two, having withdrawal symptoms on the way to treatment can be dangerous, particularly in the case of alcohol and benzodiazepines where withdrawals can be fatal. It’s best to let that process begin under medical supervision. This leads to a lot of people getting pretty drunk on airports and airplanes on the way to treatment.

Cirrhosis is the ninth leading cause of death in the United States, and 45% of the time that is alcohol-induced.

As of CDC statistics from 2024, cirrhosis is still ranked as the 9th leading cause of death in the United States. The World Health Organization ranks it as the 11th leading cause across the world. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) states that about 50.3% of those cases in the US are alcohol-related, although they also note that the true percentage is likely higher since physicians might omit alcohol use as a result of social stigma or incomplete medical histories.

This is not a test about you and how you act in relationships. It’s called Equine Therapy. Tennessee doesn’t lie and manipulate. He’s just gonna respond to how you feel. And your job is to clean his hoof.

As a general rule I do not like animals that are bigger than me. I like small animals that I can punt in case of an emergency. I do not do equine therapy.

It is a real thing though, usually called Equine-Assisted Psychotherapy, and there are some promising studies that demonstrate its potential benefits. Given the natural difficulties in procuring horses, a lot of studies have small sample sizes, and it’s difficult to tell which benefits are specifically the result of interacting with horses alongside a trained mental health specialist and which benefits are simply the result of being outside around animals instead of doomscrolling in bed. Still, where it might be able to help is in repairing people’s capacity to trust and feel useful. Many come into treatment with trauma that makes it difficult to trust people and consequently ask for help. As the horse handler says, the horse has no ulterior motives and responds directly to how you feel. Cleaning the horse’s hoof, or otherwise grooming it, can both bolster someone’s self-esteem by giving them a living thing to take care of and helping them take a step toward trusting living things again rather than trusting substances.

In Gwen’s case, she stubbornly refuses help despite her injury giving her a justification to ask, and she attempts to brute force a solution that hasn’t worked by simply doubling down and trying harder. It reflects her general approach to problems in her life; she struggles to ask for help finding a new way to do things, so she’s stuck just trying the old things with even more conviction to make it work.

All right, look, Cornell, just, just give me a pill, give me a shot, give me a, I don’t know, give me a lobotomy.

There really have been lobotomies performed as an attempt to treat addiction. One of the most famous instances is that of Case No. 15 in Walter Freeman and James Watts’ work at George Washington University Hospital in 1936. After a prefrontal lobotomy, the patient got out of his hospital bed, got dressed, put on a hat to cover his surgical bandages, and walked right out of the building. I imagine it was like something out of The Lost Weekend. Freeman apparently left his pregnant wife in labor to track down the patient, who had gotten black-out drunk at a local bar and had to be carried back to the hospital. This did not deter Freeman and Watts from pursuing thousands of lobotomies after, with Freeman being banned from further surgeries in 1967 after a patient died of brain hemorrhage.

Right, because instant gratification has worked so well for you in the past.

Instant gratification is one of the most common framings to describe the target of addictive compulsions. In SMART Recovery meetings or literature, you might hear someone describe it as the Problem of Immediate Gratification, which nicely forms the acronym PIG. You might hear “don’t feed the PIG” as a way of remembering that the habit of seeking instant gratification is gradually broken in favor of delayed gratification.

I am so tired of the way you people talk. You know, I mean, ‘One day at a time.’ What is that? I mean, like, two, three days at a time is an option?

Admittedly, I still have this attitude. Sometimes the problem really is just feeling overwhelmed by your emotions, but sometimes the problem is not having a vision of the future that makes it hard to justify the effort of the present. If you know there’s no possible way to pay your bills or rent on time, “one day at a time” can feel like a dismissal of your very real anxieties about material outcomes. I know there are times when the sentiment behind the cliche is appropriate, because there really is a tendency to self-sabotage after catastrophizing over things that are very unlikely to happen, but I find that risk-averse personalities actually can be dismissed with this. Another one of these phrases that was mentioned earlier in the film was “God doesn’t give you more than you can handle.” First, if you’re not religious or don’t believe in a benevolent omnipotent deity, this is a meaningless phrase. To many people, the universe is random, absurd, and apathetic. Babies die in flaming car wrecks and schoolchildren get blown up in military strikes over pointless wars. Second, the phrase isn’t falsifiable. If you survive whatever you’re going through, you become proof that you could handle whatever it was. If you don’t survive, it’s because you didn’t accept that you could handle it. There’s no way to contest the phrase.

Narratively, the point of Gwen making this complaint is to acknowledge some of the cynicism that everyday people might have towards the optimism found in recovery circles, which can cultivate something of a subcultural feedback loop of hope and positive mantras in the desire to overcome the despair, depression, and disillusionment that comes with hitting a rock bottom. It can wear on even the most diehard AA members on some days, but there’s a good fundamental concept underneath the cliches that does more work than the cliche itself: answers to our problems are often simple, but not easy. Ask for help. That’s simple to do, but not easy to do, and the reasons why it’s not easy might be complicated, but the actual task at hand is easy. Even with depression sans substance use, Behavioral Activation (BA) is one of the most effective interventions available, and the core premise is simply to structure yourself for tasks so small that they’re almost trivial to do while allowing yourself to acknowledge its completion as a reward. Alongside antidepressants, this gets the ball rolling on the loop of doing a task, getting a reward, and feeling empowered to do more. That’s what I try to focus on myself.

Betty, you gotta get me a new roommate. This guy stinks.

Listen, I get it. When your mental health is demolished, it can be impossible to make it to the shower. I’ve been there a couple times myself, especially when you’re living in an arrangement where the shower is shared and you simply do not get a guarantee to get in there without waking up at 5am. That being said, holy shit sometimes it’s like a urinal came to life and won’t stop asking to bum a cigarette.

Okay, Traci. I want you to tell your mom, ‘When you do drugs, this is what happens’, okay?

When you do drugs, you don’t do any of the fun stuff like you used to.

The family day thing is very real. Different rehabs do them in different ways, but they do usually involve preparing some kind of letter to be read to a family member in a group setting. This can also go hilariously wrong. I once heard a client asked to prepare a letter to her dead grandfather, who a facilitator then roleplayed as, leading to very awkward “hugging the trauma of familial loss out.”

Gwen’s flashbacks during this scene are also very real. One of the reasons family day happens as a group is so people can see that the dysfunction and subsequent healing phases are shared by others. For Gwen, hearing a daughter express that addiction took away the fun times had with her mother reminds her of her own mother’s drinking habits, which she actually had an inverted association with. Gwen associated her memories of her mother in childhood with a chaotic fun that she tried to emulate as an adult, but seeing Traci’s daughter prompts her to reconsider and recontextualize those memories. There’s a neurological component to this too. Sometimes when we access a memory, our brains modify them based on the contrast between the past emotional and mental state and the present one. For instance, if you’ve been bitten by a dog, you might have strong emotional conviction tied to that memory that informs you that all dogs are dangerous. If you recall this memory while petting a safe and loving dog, your brain registers a discrepancy that leads to an update in the way this past state of fear and pain. EMDR and other forms of therapy are built on this mechanism of unpacking traumatic memories to lessen their grip or influence on the present. In Gwen’s case, hearing Traci’s daughter express how the fun stopped with addiction allowed her to realize that the fun chaos she associated with her mother was in fact neglectful and even an active risk to her safety. We in the audience experience the whiplash between a fun mother and one passed out on the floor after heavy drinking whose kids slap her hard to wake her up, but the way we meet these memories for the first time reflects the way Gwen is seeing them in a different light for the first time too. We also get a glimpse into the disparity between Gwen and her sister in these flashbacks. Gwen was too young to understand that her mother’s life as an alcoholic had led to her early death and without a parent to guide her through life, whereas Gwen’s older sister could connect the dots and attempt to make distance from the chaotic fun Gwen internalized.

Gwen, you never mean anything.

I appreciate the layers to this line.

Addiction is paved with the perception that the process is correct but the outcome is unsatisfiying. Someone in active addiction can truly mean to be doing their best because their neural pathways are fundamentally conditioned to perceive substance use as intensely rewarding. “I’ll be so much more fun at the wedding if I get drunk first” is a well-intentioned thought that is ripe with the potential for a disaster. Gwen didn’t mean to be a mess at her sister’s wedding, she genuinely wanted to be there and have a good time with everyone else. This is echoed in her approach to the horse; she can’t get it to lift its hoof despite sincerely meaning to, and her response is to become more frustrated and double down while denying help. She doesn’t mean to mess up, but she does anyways.

This isn’t necessarily contradictory with the empty promises or outright lies that someone might give. It might even neatly explain them. “I’m fine, you can trust me to show up and be well-behaved” is something you can totally mean with complete sincerity, but also say so flippantly given the volatility of substance use that the sincerity is meaningless.

And lastly, it directly probes whether Gwen’s life itself means anything to anyone. No one can rely on her. No one is counting on her. If she did overdose or have a fatal accident, what about the world would be different? People like her boyfriend and her sister might mourn the loss for a while, but neither of them actually need Gwen in order to live by their overall goals in the lives they want to lead. She hasn’t grown into a person who offers something she can take pride in. The very next scene adds to this:

Listen, everyone’s asking after you.

Like who?

Like, uh, Mrs. Lefkowitz from downstairs. Remember her?

What, the non-talker?

Right. Five years, not a peep. I’m crossing the lobby yesterday, she stops in her tracks, looks at me and says, ‘Thanks God you got rid of that girl. She’s nothing but bad news.’

That’s not funny.

Of course, it’s funny.

No, Jasper, it’s not. Anonymous strangers thinking I’m bad news, that’s not funny.

It is funny, believe me. Everyone I’ve told has laughed really hard.

This exchange is painfully true. The trail of destruction that addiction can leave can seem funny, although much of this is a rationalized coping mechanism to avoid reckoning with the damage being done. If you don’t laugh, you cry. Radical acceptance and radical forgiveness emerge as topics in recovery because the guilt and shame from processing the past can be crushingly brutal, if not triggers to relapse all on their own. One of the reasons that sobriety involves making new sober connections is to be around people who encourage these types of transitions in one’s mindset. Returning to an environment where the people around you are still using and treating the consequences of using as sources of humor makes it really hard to not feel alienated in your own sobriety.

This is a ring.

Yep.

What are you… proposing or…

Yeah, I am.

At rehab.

This kind of does happen, in a way. I’ve met multiple couples who met each other in rehab and either got engaged or have had the marriage conversation while still in treatment. Gwen’s boyfriend Jasper isn’t in rehab but is definitely a hard user of substances, so some of the same relationship schematics apply. Recovery involves dealing with a lot of guilt and shame, as discussed above, and the environment of treatment encourages a certain “let the one without sin cast the first stone” mindset. It can be really appealing to form a relationship with someone who has shared that experience of rock bottom and bared their vulnerabilities to each other.

However, it also means forming a relationship with someone at the time when both your dysfunctions are at their peak, enough that you had to separate from your old environment and receive 24/7 medical supervision and daily group therapy sessions.

Where did you think we were gonna get married? McSorely’s Pub?

Why not? Make a good story.

I don’t need anymore stories. I have enough stories. I would like a life.

There’s a quote from Parks and Rec that sticks out to me as particularly relevant here (and my biggest takeaway from the show in general):

He’s a tourist. He vacations in people’s lives, takes pictures, puts them in his scrapbook, and moves on. All he’s interested in are stories. Basically, Leslie, he’s selfish. And you’re not. That’s why you don’t like him.

There’s a certain kind of person I’ve met who can be relentlessly charming and carry an intoxicating air of adventure around them, but if you hang around them long enough, you notice that their life is defined not by their character but by their adventures. You don’t really live in the present moment with them. They’re living in a future where they tell their experiences with you to someone else or write about it in a memoir. If they’re actively using substances, then they’re really not in the same present that you’re in. Jasper is that kind of person, and I appreciate that we see him expound on his philosophy so we can process how dark it really is underneath the fun exterior.

You’re just in a rut. It happens to everyone.

No, Jas. There’s an entire world of people out there who do everything right. They live right, they don’t drink, they don’t do drugs-

That’s a crock of shit.

-and they are happy.

They’re not happy. No one adult human being is happy. People are born, they have a limited amount of time going around thinking life is dandy, but then, inevitably, tragedy strikes, and they realize life equals loss. The whole point of the game is to minimize the pain caused by that equation. Now some people do it by having kids or making money or taking up coin collecting. And others do it by getting wasted. Letting that little switch in the head turn the hot light off and the cool light on.

Nobody gets hurt collecting coins.

Everybody hurts everybody. It’s the human condition!

The Hedgehog’s Dilemma was a parable proposed by Arthur Schopenhauer in 1851. In short, animals often huddle together for warmth, but hedgehogs have sharp quills that prick one another in the process. Without huddling, the hedgehog risks the suffering and sickness of the elements. With huddling, hedgehogs risk poking each other with their quills. This is an analogy for the human condition: we are social creatures who suffer if isolated, but we also hurt each other with our basic behaviors and attitudes when we become vulnerable enough to get close to each other. One of the most compelling reasons to use drugs is for the illusion of huddling in a herd that will never poke at you, at the expense of becoming more prickly and isolated outside of the illusion. If someone has given up on the negotiation that comes with huddling entirely, as Jasper has, then using drugs is the logical next step to deal with the isolation and pain of being alone. You simply never stop, so the consequences outside of the illusion never register to you. He already hinted at this philosophy earlier on when he and Gwen were on their way to the wedding when he says the point is to “care less.” Despite the external chaotic fun he embraces that suggests he’s easygoing and takes life as it comes, his philosophy is fundamentally life-negating and nihilistic. In escaping the pain of the human condition, he escapes the human condition entire. His proposal to Gwen isn’t about building a life together, but about replicating a semblance of the intimacy of huddling without the work of negotiating vulnerability by pairing with someone who accepts self-destructive escapism.

Here, hold on to this. I’m gonna go get someone-

No, no, don’t tell anybody!

No, no, it’s okay. We have to. It’s very serious.

No, they’ll take me to psychiatric! They won’t let me stay here. Please, I can’t get kicked out again.

This moment around Andrea’s cutting is painfully familiar to me. If you’re around people who struggle with mental health long enough, you will eventually be faced with this dilemma of choosing whether to report someone’s crisis. I cannot honestly say that, as much as institutions and services encourage reporting, it is in the best interests of the person in crisis. I truly can’t. Crisis services are exclusively useful for ensuring someone stays alive in the short-term, but they are also traumatizing, alienating, and isolating even when the responders are medically-trained professionals instead of law enforcement. At worst, their interventions can leave people in a worse long-term condition than before. I regret making calls myself. I would rather direct someone to Suicide Anonymous than 9-1-1 or emergency hotlines. Institutions that are based on oversimplistic metrics to measure their performance, where each individual is primarily motivated by their paycheck for participating in boosting those metrics, are simply not equipped to deal with the nuances of mental health, or anything to do with a person’s holistic wellbeing. Voluntary associations of people rooted in a shared culture, identity, or background are far more likely to provide support without the trauma that accompanies institutionalization.

Narratively, this represents a turning point for Gwen in her willingness to be vulnerable with another human. Andrea is only 17 and lacks both life experience and supportive older figures, hence her fixation on the soap opera Santa Cruz, and so her innocence is not too unlike Tennessee the horse. Gwen steps in as something of an older sister, which is a step towards maturity from being a younger sister herself who shunned responsibility and obligations. After bandaging Andrea’s cut, Gwen sincerely takes steps to bond with her, including sharing details of Jasper’s proposal.

And is he a drunk?

I don’t know, maybe.

Well then, you’ll have to say no. It’s just like Darian and Falcon. He was addicted to gambling, and even though she completely and completely loved him, she had to walk away.

Am I supposed to know these people?

From Santa Cruz.

Every dynamic is obviously different, but in my experiences and observations, relationships don’t work if the partners involved don’t agree on the trajectories they want their lives to take. If one person feels guilt and shame for a particular lifestyle and wants to change through recovery, and another person is embracing nihilistic hedonism, they’re imagining entirely different futures built on entirely different decisions in the present. If one partner struggles with addiction but wants to change, and another partner has never struggled with substance use but is willing to work with a partner who does, there’s hope through a shared investment in the same future.

Believe it or not, I can make this decision on my own, okay? I don’t need your help.

That’s not what your neck sign says.

Oh, forget what my neck sign says! He doesn’t know the first thing about me! Neither do you people! You don’t have to live my shitty little life. And until you do, do not tell me to give up the one person that matters to me, okay? Because I know he’s not perfect, but he’s the one person that’ll show up on my birthday and he’ll say, “I’m glad you were born!”

This is classic codependence. Jasper needs Gwen to provide the soothing functions of intimacy in a life built on rejecting the vulnerability and meaning that makes intimacy worth something. Gwen feels that no one except Jasper is capable of understanding and therefore loving her dysfunctional self.

I don’t really have much to say about Viggo Mortensen’s character, Eddie Boone, the pro baseball player in recovery. He’s a foil to Jasper, but he doesn’t have much nuance beyond that. None that catches my interest at any rate. Anyways, Gwen’s sister actually does show up for a family day and brings up the beginning of the movie:

I mean, she shows up drunk, stumbles through the entire ceremony, and after at the reception, she gets up, and, in front of my friends, my new in-laws, she gives this toast that was completely-

What? What toast?

What toast? ‘Well not everybody can be perfect, but at least some of us can try. We all know that grownups have to make compromises. And Lily is very, very grownup. So that’s what she did. She said, is Andrew the very best man for me on this Earth? No. And I mean, no! She says, hey, I’m not getting any younger, and he makes a hell of a lot of money so, so I’ll marry the little sucker. To Lily and her little sucker.

Gwen was too intoxicated at the time of the wedding to recall her toast, though evidently her sister remembers it vividly.

And she walks around like some victim, like life just handed her this raw deal. Well, you know, my father left, too, and my mother died when I was little, too, and you don’t see me using that as some excuse to just completely abandon all self-control and indulge myself in-

Indulge?

Yeah, indulge.

You, what, you think I like this?

There’s quite a few things going on in this exchange at the same time.

For one, no two people ever have the same parenting dynamics, including siblings. Elder children, whether through external pressures or internal adaptations, are more likely to be thrust into obligations that younger siblings are spared from. Based on the flashbacks we’ve seen, Gwen was too young to see her mother as reckless or dangerous, instead internalizing the mantra “if you’re not having fun, what’s the friggin’ point?” Gwen’s sister Lily was able to recognize the harm caused by their mother’s drinking and grew up to structure a life differently. Presumably, this divergence in the way they reconciled with the trauma of abandonment has been a point of conflict between the siblings, and it’s easy to see how Lily’s frustration with Gwen is a parallel to her frustrations with their mother. Gwen’s toast mentions Lily being so “grownup” as a reciprocal resentment to Lily’s focus on developing a responsible character to live differently than their mother.

Another disparity on display here is that between someone who has never experienced struggles with substance use and someone who struggled with it chronically. From the perspective of the former, addicts are people who refuse to accept normal adult responsibilities by using past trauma or present pain as an excuse to be a burden on others. From the latter’s perspective, normal life feels intolerable in a way that causes physical distress and intense compulsions to escape that state, since their brain is screaming at them to chase a reward they consciously may not find a rationale for. They might point to trauma afterward as a rationalization for their use, but there are physiological changes in someone’s brain and body that complicate the idea that they just make bad decisions and blame others. Self-control is certainly lost in addiction, but there’s more escapism and dissociation involved than the word “indulging” suggests.

Folks, the definition of insanity is repeating the same behavior over and over again, expecting different results.

You’ve almost certainly heard this phrase before. The earliest instance of it appearing in print is a 1981 Narcotics Anonymous pamphlet, which is to say that it’s another recovery truism thrown around as a reminder to address bad habits. It gets misattributed to Albert Einstein, Benjamin Franklin, and Mark Twain, but there isn’t any evidence they said or inspired the phrase. In many ways, it’s actually not true at all. Humans who repeat a behavior are more likely to reinforce it as well, hence the other truism “practice makes perfect.” And what about rolling a die or flipping a coin? Running probabilistic experiments multiple times yields different results by definition. Maybe this is all semantics, but folk psychology and pop psychology annoy me enough to mention it anyways.

Lots of people in recovery want to know when’s a good time to star dating. And my rule of thumb is, when you get home, get yourself a plant, okay? I like those spider plants, but you know, whatever turns you on. Then in about a year, get a pet. And then, if, in say two years, the plant and the pet are still alive, then you can start to think about having a relationship.

So, practically nobody adheres to this. It’s hard enough to get people in treatment to not hook up with each other before they get out of rehab, and there are plenty of problems with 13th steppers as is in recovery circles. A more practical rule of thumb I’ve heard is to just avoid dating during your first year in recovery. Early recovery is a vulnerable time in which old trauma might resurface, financial stability might be challenged, health issues might need to be addressed, and existing relationships might need to be mended. Introducing the emotional rollercoaster of new romances during all of these changes can be overwhelming and a trigger for relapsing or otherwise a new obstacle in recovery.

Well, I hope he makes it.

Well, statistically, only three out of ten of us will. So, in a way, it’s good for us if he goes back to using, you know? Odds-wise.

Someone will eventually bring up one of these statistics to you in recovery. It’s not necessarily motivating. Some people will relapse and tell themselves “well, I guess I was statistically doomed to fail.” Others will be more cautious about making connections given how many more friends you might get funeral invitations for.

Hey Jasper, what- what are you doing here?

Well I was looking for you. Successfully, as it turns out.

Oh, yeah, no, I meant um, why aren’t you at your parents’ house?

Oh, that, well you know, I realized, what with them both being completely senile, I could just call them in a week, tell them I had a great time, they’ll probably think I made the trip.

Again, we see Jasper as someone who turns his lack of care for life into a point of pride, delivered humorously through stories that are otherwise dark to consider. Even the way he entices conflict to address the obvious romantic tension between Gwen and Eddie, leading to him getting punched, has all the extravagance of a future story he might tell.

Oh, and then there’s Andrea’s death.

We as a community have all been deeply affected by our loss. I’d like to begin with how I feel. And that’s… scared. Because I’ve heard so many people here say, “I just wanna use one more time.” Andrea’s one more time was what killed her.

She didn’t kill herself. She used. She overdosed. That’s what happens to you or I…

Yeah, that’ll happen. Sometimes you’ll go to group and notice someone’s gone, and you’ll hear a rumor that they hopped a fence in the middle of the night or asked a friend to pick them up, and that’s the last you hear of them. Sometimes you hear it through a friend, “did you hear so-and-so died? I heard it was fentanyl…” Sometimes you realize someone hasn’t replied to your texts or calls in a while. I’ve been fortunate enough to have never seen an overdose myself, and I’ve been fortunate enough to have intervened before. But it’s a matter of time.

One of the worst parts of the aftermath is the way someone’s life becomes reduced to a cautionary tale. Gwen zoning out as the staff follow stiff protocols to remind everyone to stay sober is a familiar beat. What else can you instruct someone to do as part of their job? You find some lesson in the tragedy, you package it as moving on, and then you get back to work. The show must go on for everyone else. Mourning is one of those defects of the human condition, one of those quills from huddling too close to each other for warmth. Right?

I don’t have any answers here. I just know that mourning, strangely enough, makes me feel more alive. It reminds me that the love and intimacy were real, and that there’s still something inside me that connects me to others, because it hurts when they hurt and it misses them when they’re gone. I have great contempt for the formulaic way lessons are manufactured out of the memory and legacy of people’s lives. It just sucks, and I think it should suck.

You wanna know how I feel, Gwen? How I always felt around you? Small. You have this way, you know it’s that “Mom” thing, that amazing gravitational force. Even when she was a mess, you know, the world noticed her. You have that. And I guess, I figured that you always knew that. I don’t know. When I went back home, I started thinking, and maybe you don’t know that… about yourself, I mean. I mean, who would’ve told you, you know? Not me. The only thing I ever told you was what a pain in the ass you were.

Well, I am a pain in the ass.

Even a pain in the ass needs someone to take care of them. I didn’t do that. I didn’t, and I should have. I should have helped you with your homework. I should have walk you home after school. Sometimes I’d be walking with my friends, and I’d see you half a block ahead, all alone. You were so little.

Well, so were you.

Yeah.

Well, I never asked for help, so…

But you needed it, didn’t you? I mean, everybody does.

Yep… I’m sorry I make it so impossible to love me.

You make it impossible for me not to love you, Gwen.

Death has a way of reminding everyone to live. In my opinion, this conversation between Gwen and Lily serves as the main resolution to Gwen’s character arc.

A lot of addicts have this quality spoken of by Lily. The idea of a discrete addictive personality is a pop psychology construct, but there are traits that correlate both with having a larger-than-life presence and risks of substance use. These include strong novelty seeking and risk-taking dispositions, high levels of extraversion or expressiveness, and the rollercoaster of what are called Cluster B personality traits that lead to high highs and low lows. To those outside of this description, those within it naturally draw attention since their moods can be unpredictable while also dictating future events. They’re more likely to transgress boundaries, declare uncommon and unpopular opinions, and assert conflicting views that disrupt a status quo.