What’s a bottom? It’s an emotional episode so traumatic it pierces the dense fog of denial for a moment of clarity and surrender. AA’s Big Book describes it as “incomprehensible demoralization.”

Addiction is a progressive disease. Untreated, it’s fatal. Late-stage addicts may deny it, but they have intimations of the ultimate consequence in a no-exit trap: their rational brains know they’ll die if they continue using drugs, but their emotional brains believe wholeheartedly they can’t live without them. A bottom brings these mutually exclusive realities to a head. It crystallizes the life-or-death choice an addict faces and impels him to take action — seeking help, something unimaginable until then. It’s an emotional breakdown that leads to a breakthrough: giving up on mere willpower as an answer to addiction, shifting from an intellectual solution to an emotional/spiritual one which finally battles addiction on the same emotional neural plane where it resides.

What triggers a bottom? No one really knows.

I’ve listened for clues to what might have precipitated them in the stories I heard at a plenitude of AA meetings. I’ve heard the ray-of-sunlight story and the still-quiet-voice story. The cry-from-the-past story and too many variations of the oh-god-please-help-me story to remember. I’ve heard versions of the I-haven’t-a-clue-what-happened-or how-it-happened stories. There were the took-a-walk-in-Muir Woods stories, the interventions and the miracle-made-me-no-longer-crave-alcohol stories. For all the moments of clarity I heard about, however, none could come close to explaining what triggers them.

But, based on these stories and what’s understood about the science of addiction we can make some educated guesses.

Bottoms are highly emotional experiences, not intellectual ones. Bottoms aren’t cost-benefit analyses at the conclusion of which an addict chooses the most rational option. If that was successful at getting addicts into treatment, bottoms wouldn’t be necessary. No, bottoms are motivational precisely because they’re soemotionally devastating. It takes complete demoralization to surrender, to stop trying to figure out what’s wrong, give up all pretense of choice or control and be desperate enough to seek help.

Many bottom stories share a common denominator: the no-exit conundrum brought to a head, that you can’t continue to live the way you’ve been living and yet you can’t stop living that way. Bottoms are a state of utter hopelessness and despair. When all your choices are impossible, when every battle has been lost, all that’s left is capitulation. When you’re so baffled and bewildered, so incomprehensibly demoralized that you can’t fight anymore, the only option is surrender.

Because bottoms are quintessentially emotional moments, it’s seems many are triggered by the realization that you’re about to lose the last thing you truly care about, often the last vestige of love that you can’t bear losing. That was my experience. My bottom was a brutal, searing, emotional confrontation that took place in a nano-second entirely inside my head. It was triggered when I faced the immediate possibility of forfeiting my toddler-son’s love, the only person left who I thought still loved me as I spiraled downward to drinking myself to death.

In that instant, my dueling addictions, my son’s love (which scientists say is very like an addiction) and my alcoholism confronted each other in an unbridgeable showdown. Fear of losing my son’s love overcame fear of living without alcohol long enough to cancel out the blinders imposed by denial. This allowed what was left of my rational brain to emerge and see that there was no option left if I wanted a chance at regaining and retaining my son’s love except to surrender. And both times I relapsed into drinking, it was a similar realization that brought me to my senses again.

A child’s love isn’t the only force that can cause a moment of clarity. I’ve known too many successful sober addicts who had no family support to believe that. But it’s one way. It was mine. I’ve heard similar stories so often I’ve concluded that the love of a child, a spouse, an intimate friend, or a Mom or Dad, has instigated moments of clarity for many addicts besides me.

That’s one of the reasons interventions focus on love. In the professional interventions I’ve been a part of, the leader instructed the participants not to talk about how angry and disappointed we were, but rather to tell the person being intervened on how much we loved him, how we couldn’t bear the thought of losing his love, and how afraid we were he’d die. Reminding someone who feels unloved and unworthy of it that there are still people in his life who love him can be very powerful. But this approach doesn’t always work. Unfortunately, not all interventions are successful.

So no one knows for sure what prompts a moment of clarity. AA says it’s God’s grace, something we can’t understand.

Neuroscientists don’t know either. In fact, though it may reflect on my mediocre research skills, I haven’t seen a single scientific study even exploring the issue. Perhaps that’s not surprising. Bottoms aren’t something you can plan to have while undergoing an MRI.

The founders of Alcoholics Anonymous originally believed that bottoms were of only one kind: incomprehensible demoralization. But over time they changed their minds. With years of experience they realized that some bottoms were worse than others, that there were “low bottoms,” like what’s described above, and “not-so-low” bottoms. The difference, they believed, probably corresponded to the severity of alcoholism.


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One Response to “ Bottoms ”

  1. Yes, it is the reality of hitting bottom that made a difference to me. Thank god I was able to find AA almost immediately. I do not want to ever feel like that again!

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