My life right now revolves around trying to rescue someone very dear to me. Jeanne is a crack addict and an alcoholic, resisting detox, resisting rehab, resisting the possibility of life. She may very well die and I feel guilty about not doing more to save her.

I know all the wisdom about allowing addicts to find their “bottom.” To find their own solution, because it is the only solution to which they will ultimately commit themselves wholeheartedly. I know all about enabling behaviors and I devote much of my therapy time talking about how to restrain myself from getting in the middle of her downward slide. In some ways, I wish I could simply turn my back on Jeanne. I try to remember that turning your back on someone you love, and choosing to say “no” to them, are two very different things.

Recently, Jeanne asked me to “watch” her while she went through a medical detox: this meant I would be the one to administer to her, at my home, the necessary drugs (prescribed by a physician expert in the field of substance abuse) that would help her get through those first difficult days without terrible pain. It would require giving her the medications every two hours on a decreasing basis over five days. This is one way withdrawal from drugs is often handled now; different medications decrease the odds of stroke or seizure, banish the terrible delusions and the sensation of bugs are crawling beneath your skin.

But if I took a catnap during the five day siege, and a sedated, befuddled Jeanne stumbled around in my house and hurt herself, it would be on my head. Additionally, a member of my family, or me, could be injured if she grew violent during withdrawal. Or, what if she had a seizure and died before the ambulance could get to us? And so when she asked, I said: “No. I’m not comfortable with that.” I explained to her that I believed she needed to go to someplace where she could be properly supervised. I was protecting not only myself—but Jeanne as well—and so I found some alternatives, clinics where she could go to detox rather than staying at my home. I wanted to give her an alternative, rather than just saying “no.”

I believe that she should go to a hospital, rather than relying on the guilt of those who love her so, who may give in and say “yes” because they feel that saying “no” would set her back. All of us wonder: will she ever get sober if we all deny her this request? Will she continue using drugs until she dies from any one of a plethora of reasons?

She is furious with me—insisting that I have denied her the possibility of getting well. Yesterday, she insisted that my first suicide attempt was the root of her drug addiction because she had felt so deserted back then. Even though I knew intellectually that this was only a manipulation, it nevertheless simultaneously hurt and infuriated me. And, though I don’t like to admit it, I felt guilt as well.

I had worked hard to recover from my depression and my terrible acts of self-destruction. I had asked for forgiveness from those I love. In getting well and in apologizing, I believe that I have done all I possibly can to mitigate the effects of acts that can never be erased.

Perhaps, I shouldn’t have felt guilty—but I did. And she relied on that guilt to try and get me to change my mind. As she made the rounds of those of us who gather around her so fearfully with her appeal for this particular kind of help, we all wonder: will she ever get sober if we all deny her this? Do we refuse her the only “last chance” possible? It’s a complicated question, and suddenly I realized that I had to accept the prospect that Jeanne might never forgive me. Not only did I have to accept it with my mind, but I had to accept it with my heart as well.

Much of this brings me back to the final years of my mother’s life and resonates there in my heart and mind. As she slid steadily downhill toward suicide, I—and many of her friends—told her that we would not enable her alcoholic behaviors. She was not to call us when she was drunk. She could not lie on the floor of our kitchens, kicking her feet and drumming her fists in a tantrum when she didn’t get her way. She could call us if she hadn’t been drinking and was calm. She could come to our homes and have a peaceful dinner.

We hardened ourselves to her the way some parents lock their doors to their children and leave them in the street—in despair, believing that by forcing them to live with the consequences of their addiction they will at last seek the help they need.

All of us, both family and friends, came to the conclusion that we could not save my mother. Until she was sober, we could not gather by her side. And thus we stopped trying to rescue her. She chose to kill herself rather than to seek the help she needed, and so she died, tragically, alone. In the end, we too—with all the goodwill and love in our hearts—were felled by her addiction.

I wanted to save my mother then, as I want to save Jeanne now. I bear terrible guilt that my mother died when all of us had said, in effect, “We can’t take any more. We can’t live this way any longer—and neither can you.”

I know all the conventional wisdom that groups like Al-Anon espouse. I know that it is okay, and perhaps even right, to refuse this request of my friend because it would endanger her. Nevertheless: the guilt remains in my heart and soul, like an infected rash that tortures me with an itch I cannot help but scratch.

Some people say to me, “lay it down. “ Or worse, “cut her off.” I wish they could really understand what a torturous path this is. I feel like a failure, trapped by love and guilt. Even after all these years, maybe I still feel that my mother wouldn’t have died if I had just stayed by her side. Maybe, this time around, I feel my friend will die if I don’t do what I didn’t do with my mother, so many years ago.

It’s an endless circle, a snake eating its tail, devouring itself bit by bit. I said “no” again last night to the persistent crying and raging, the persistent desperation of her plea. I will keep saying “no” and in all probability, I will continue to feel guilty. Maybe this is just a human condition that we simply have to bear. We want to save those we love—even when we know we can’t, and guilt is just part of the package.

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