“Manchester By The Sea”
“I can’t beat it,” says Casey Affleck’s character in “Manchester by the Sea.” Lee Chandler tries to lead a simple life, but when he is forced to return to his hometown, we realize that he just can’t shake his past demons.
As a former doctor to homeless men and women now overseeing addiction efforts at Rikers Island, I have heard my patients, time and again, express the same heart-wrenching despair. And I’ve routinely witnessed the close relationship between traumatic events — divorce, death, unemployment, physical or sexual assault, poverty, incarceration — and alcohol or drug addiction.
Watching Affleck’s performance, the doctor in me wanted to tell the troubled janitor: “Get help. Go to therapy. Just talk to someone!” It soon becomes clear that there is no simple way to cure his pain. While he appears to be in control, post-traumatic stress regularly rears its ugly head. Lee escapes to a different city and cuts ties to family and friends until another tragedy brings him back. Lee re-experiences the unspeakably tragic death of his children through flashbacks. And he refuses ― or is unable ― to discuss it.
The death of his children in a fire caused by his own drunken hands cripples Lee into silence. He can’t make simple conversation, like chat up the neighborhood mom. Instead, he makes regular visits to the local watering hole, provoking fist fights with strangers. Lee doesn’t know how to cope. He turns, as many have, to liquor and violence. But why?
We don’t know whether he seeks counseling, although it doesn’t seem like he does. We do see, however, how the film skillfully explores the different ways trauma can impact different people. Lee’s ex-wife (played by Michelle Williams, who suffered the same devastating loss) finds a way to move on. She doesn’t forget the tragedy, but she is also not paralyzed by it. She remarries, has a child. Her wounds begin to heal. Maybe she opened up to those around her? Perhaps she went to counseling? What director, Kenneth Lonergan, shows us is that it IS possible to heal. Different people heal, in different ways, at different rates.
Barry Jenkins’ tender masterpiece, “Moonlight,” is a story that beautifully weaves together the interplay of trauma and addiction. We witness firsthand how poverty and a parent’s crack habit can contribute to a child’s developmental trauma. When Naomi Harris’ character, Paula, desperately pleads to her son “I need money, Chiron,” we can see that child’s need and desire for love and support become thwarted by a parent who is no longer in control.
Chiron is beaten up by schoolmates. His mother turns tricks to support her habit. And like the many men around him, Chiron also becomes incarcerated, likely drug-related. He, too, becomes a dealer. And the vicious cycle of addiction-related repercussions and trauma repeat.
Trauma has lasting physical, neurological and emotional consequences ― particularly when endured at a young age. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), trauma results from an event or series of events that is experienced by an individual as physically or emotionally harmful or threatening, with lasting adverse effects on the individual’s well-being.
People who experience trauma can sometimes develop self-destructive coping skills such as substance use, binging/purging, cutting or gambling. Exposure to traumatic events increases the risk of developing a substance use disorder (SUD), according to the National Institute of Drug Abuse.
While the trigger(s) behind Harris’ cocaine addiction were unclear, according to SAMHSA, 55-99 percent of women with substance use issues reported a lifetime history of physical and/or sexual abuse. Young Chiron clearly loved his mother, but he was also ashamed. As were the family members of young Patrick’s alcoholic mother in “Manchester.” In fact, the latter was shunned from seeing her son, even deprived of supervised visits. It was decades before either character achieved any sense of recovery: Chiron’s mother went to rehab, and Patrick’s mother found sobriety through religion (though she seemed tormented by anxiety and possibly guilt, unable to even have lunch with her teenage son).
Jackie Kennedy ― and the entire world, through the power of television ― watched her husband shot to death, right before her eyes. When a bullet pierces his skull, we see fragments scattered in her lap. Words fail to capture tragedy of this magnitude.
In the aftermath of John F. Kennedy’s assassination, Jacqueline Kennedy ― played impeccably by Natalie Portman ― was pulled in a million directions. She needed to maintain her composure in the most public of spotlights while grieving her husband’s death. She planned an exquisite funeral procession, swore in the new president, comforted her children (“Daddy is with the angels”) and continued her stoic resolve. How did she do it?
Periodically throughout the film, Jackie is counseled by her priest, played by the late Sir John Hurt. But we also catch her popping pills and consuming alcohol. It was never clear what she was taking (anxiolytics? painkillers?) or for how long. But I think it’s safe to assume that the combination of pills and alcohol calmed her nerves, at least temporarily. In fact, her nightmares, alcohol use and suicidal thoughts were well-documented by biographers. Steely resolve in the face of tragedy comes at a price.
Addiction, according to the American Society of Addiction Medicine, is a chronic medical disease impacting the brain, affecting motivation, memory and judgement. Relapse is expected. People often try to “self-medicate” with substances like drugs or alcohol, or behaviors (e.g., cutting, gambling, risky sex). These behaviors can affect others, as we saw with Lee Chandler, Paula and Jackie Kennedy.
But what’s underneath the pain? Often it’s sadness, anger, fear, frustration, confusion or emptiness. Addictive substances and behaviors can provide temporary reprieve but long-term, those initially “self-soothing” acts become uncontrollable.
As a physician, I’ve seen how the “system” ― medical, educational, correctional, political ― often stigmatizes addiction. Labels like rape “victim,” “alcoholic,” or “junkie” can thrust people seeking help even deeper into a well of inner turmoil. Language matters. And stigmatizing language not only propagates stereotypes but deters people from seeking care. But treatment can help if it addresses the physiological AND psychological aspects of addiction. In fact, once connected to the appropriate treatment and recovery services, most people get better and go on to lead productive lives. As a doctor who has cared for numerous patients with traumatic pasts and ongoing substance use, I have seen people GET BETTER.
So, what can you do? Lend a compassionate shoulder, a nonjudgemental ear, or provide some words of comfort. These efforts can go a long way to ease the suffering. Referral to a professional (physician, psychologist, counselor, rehab facilities) is always wise. In time, hurt can be replaced by healing and hope. We can indeed triumph over pain and “beat it.”
Need help with substance abuse or mental health issues? In the U.S., call 800-662-HELP (4357) for the SAMHSA National Helpline.
Need help? Visit RAINN’s National Sexual Assault Online Hotline or the National Sexual Violence Resource Center’s website.