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THE WOMAN WHO HELPS THE MEGA-RICH GET CLEAN Vodka disguised in a bottle of mouthwash, hard drugs stashed in the toes of £600 shoes and boutique fitness addicts killing themselves to get lean… all in a day’s work for an at-home ‘sober nurse’. Cosmopolitan steps inside her world › As told to L O U I S A P R I T C H A R D Photog raphs A N T O N I O P E T R O N Z I O
Charlotte Williams, 34, provides addiction counselling in clients’ homes · CO S M O P O L I TA N
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’m crouching on the floor surrounded by Jimmy Choo, Christian Louboutin and Prada heels – they’re all scattered across the thick carpet like confetti (I was instructed to remove my own shoes – a pair of plain white plimsolls – as soon as I stepped through the front door). Now upstairs, I root around the walk-in wardrobe, picking up shoes and discarding them one by one. The sound of a woman sobbing echoes up the stairs. I reach deep inside a snakeskin Isabel Marant boot. I have to stretch my fingers so they can feel right into the toe, where I grab what I’ve been looking for: a tiny bag of pills, wrapped up tightly in clingfilm. I pull it out and pop it into my pocket. Then it’s into the bedroom, where I begin padding down the long ivory curtains, searching for more carefully hidden contraband. It’s Monday morning and this is how I begin my week as a nurse for The Psanctum Practice, which offers addiction counselling in people’s own homes. We are contacted directly or have referrals from Sober Services, who offer everything from light support to 24/7 care. My job means that our clients – who range from former teen pop stars to socialites found in the back pages of celebrity magazines – no longer need to check into The Priory to dry out, and escape the risk of being papped entering a clinic. For the past year I’ve been on hand, as the clinical services manager, to keep a watchful eye over them. I had been working in a GP surgery before this, but found myself getting so frustrated at the lack of mental health care provisions I could offer people. When I was headhunted for The Psanctum Practice, it appealed because it’s so hands-on – you’re in these people’s
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private homes, willing them to have hope, and to trust in someone or something again. But Renton from Trainspotting barricaded in his childhood bedroom this is not. These homes, which are often four storeys high, offer a wealth of hiding places – and the thorough house search to remove all temptation is the first part of the process. The owner of the Carrie Bradshaw-rivalling shoe collection, who I am taking to task today, is 30-year-old Eve*. The daughter of a financier, she lives alone in her three-bed townhouse in central London, with everything funded by Daddy dearest. I find laxatives in her boots, diuretics stashed in the lining of her curtains and vodka hidden in her bottle of mouthwash. She’s an alcoholic with an eating disorder, and as soon as I entered her bathroom, the first thing I did was unscrew the lids of all her bottles – this is the most common hiding place for alcohol, as our clients know that it’s the one place they can be alone. All it took was one sniff to identify that it definitely wasn’t mouthwash inside that bottle. And I didn’t stop there: I opened every box and drawer. I’ve found whisky miniatures inside tampon boxes before, so I know how creative addicts can get when it comes to hiding their vices.
“You’re in these people’s homes, willing them to have hope again”
BEHIND CLOSED DOORS
As I shut Eve’s door behind me, after leaving her in the company of one of the 25 nurses I manage, I look up at the Grade II-listed properties with their shiny black doors and brass knockers and know that chaos could lie inside. One client of mine had two beautiful stately homes, the kind with long drives, perfectly pruned rose bushes and land that stretched for miles behind. But as soon as I stepped inside, the stench of rotting food hit the back of my throat, and I wandered through the rooms stepping over bin bags rustling with rats and cockroaches. Deep in the throes of an alcohol and
drug addiction, she hadn’t thrown anything away for months. Next on my tour of London’s wealthiest properties is Knightsbridge, inside an apartment a stone’s throw away from Harrods. It belongs to Kat*, a 21-year-old self-professed ‘It’ girl with a serious alcohol problem. It all began at boarding school, when she would hide in her dorm and drink up to six bottles of white wine a day. She became known for her love of partying, and this persona has carried on: her friends love that when they’re out, Kat orders bottle after bottle of champagne on her Gold Amex. But they don’t spot her doing shots by herself at the bar, or know that before she met them that night, she walked to her local shop, in jogging bottoms and a baseball cap, and bought a bottle of vodka that she began to swig from on her way back to her flat to get ready. I’m with her now to carry out a psychological assessment – I want to find out what hole she is trying to fill with drink and drugs. This is the part of our treatment that makes us unique: other at-home services just deal with the ‘cold turkey’ part, whereas we focus on mental health, the fee tailored to whatever bespoke therapy we offer. In Kat’s case, it emerged, through a series of questions over a two-hour session, that she was sexually abused when she was younger and drinking to try and avoid this trauma.
COMING CLEAN
Charlotte deals with self-destruction inside her clients’ homes
In the past, I used to deal mainly with older women, the aristocratic types, and men, usually within the banking industry. But recently I’ve been seeing more and more young female addicts. They come to us for help with something different – perhaps anxiety or depression – and then we discover that they are trapped in a cycle of self-medication, drinking until they black out in the evenings or ordering legal highs online in an attempt to treat their depression alone. I’m currently trying to work out a care package for 20-year-old Amber*, › C O S M O P O L I TA N ·
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the daughter of very wealthy investors from Oxford. She was badly bullied throughout her teens and this impacted her confidence hugely. At university she started taking drugs to combat how shy she felt around new people – but would wake up in fields not knowing how she got there. Incredibly bright, and determined to still get a good education, she’d then go back to her halls, change and head straight to lectures. She had to drop out after her first year. Her drug dependence is now so high it looks like she’s going to need 24-hour live-in care, which is quite unusual for someone her age. I’m also increasingly dealing with addictions to exercise, social media and shopping. Laura*, 33, checked her phone and tablet constantly – I’m talking almost 22 hours every day. When I told her that we had to take her iPad away for a while, she began sobbing hysterically, screaming obscenities at me. Then there is Anna*, a 26-year-old singer and model, who was going to the gym six times a day and walking miles in between. She had body dysmorphia and detested the idea of anyone seeing her naked so would rise at 5am to do a spin class, come home to shower, then walk back to the gym for another class. Most of these addictions live alongside the more noticeable and well-known ones – I could be seeing a client for alcoholism and find that their houses are filled with designer clothes and shoes, most with the tags still on, while Net-A-Porter deliveries continue to arrive. The first stage of any detox programme is, of course, stopping whatever it is that you are addicted to. But we don’t enforce complete cold turkey: the body reacts severely to a rapid-detox, and it can be incredibly dangerous. Cutting out a substance that someone has developed a reliance on causes the chemical processes in the brain to become disrupted: alcohol, opiates and
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benzodiazepines (drugs like Xanax or Valium) interfere with the receptors in our brain – and complete and sudden abstinence could lead to potentially fatal seizures. For a medical detox, our clients would be put on medication, including antidepressants, anti-anxiety and antitremor drugs, and we’d slowly get the alcohol out of their system over a period of a week or two. But, even when done safely, alcohol and drug withdrawal is horrible to watch. Patients have been curled up in balls screaming, had hallucinations, been throwing up constantly and violently shaking. But a detox alone isn’t enough. Which is why I constantly check up on clients, at times of the day when they won’t expect me. I head to businesswoman Ellen’s* house: she was working 90 hours a week and
drinking to cope – and sure enough I find her lying in bed, clutching a bottle of vodka. It’s not up to me to wrestle it out of her hands, that won’t help; as soon as I leave she’d just go back for more. Instead I ask what she hopes drinking will achieve, and remind her of the past progress we’ve made. She hands me the bottle.
“Patients have been curled up in balls screaming”
LEARNING TO LIVE AGAIN
I spend the afternoon standing outside a corner shop in leafy Wimbledon, with 26-year-old Kate* crying on my shoulder. This is part of her rehabilitation back into society, and I’d accompanied her to buy a pint of milk at the place she used to buy alcohol. It’s one of the final stages of the process: we have to help break associations with places so our clients can cope without one of our nurses
*NAMES HAVE BEEN CHANGED. HAIR AND MAKE-UP EMILY-JANE WILLIAMS. STYLING SAIREY STEMP. DRESS, NEW LOOK. BAG, MATT & NAT. SHOES, VANS. SHOT IN A HIRED LOCATION HOUSE. SOBERSERVICES.CO.UK
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constantly by their side. I remember once, during the treatment of Hannah*, an alcoholic former child star, I took her to the supermarket. I told her to get a trolley and she just looked at me, all lost and bewildered. It turned out, at 27, she’d never had to do something like this before: her whole life had revolved around other people telling her what to do, what to wear, what to eat. As we walked up and down the aisles together, she had no idea what to buy or even what she liked eating. At the time she laughed it off, but the next day she phoned me saying she couldn’t carry on with the treatment, that she was useless and it was just too hard. Unfortunately if someone pulls out of the programme, there’s little we can do. It’s their choice. But I will try to do whatever I can to stop it happening. Later, when I go to meet a new client, Jess*, and find she isn’t home, I don’t give up. Instead, I tell her husband I’ll leave my phone on and I check into a nearby hotel – something I have to do occasionally when clients go AWOL.
It’s 2am when Jess’s husband calls to tell me she has been picked up by the police near Beachy Head, East Sussex. It’s a common suicide spot, and the police found her heading that way, her car swerving. They charged her with drink-driving and she told her husband she’d wait at the police station before catching the first train back. Her husband blindly believed her, but I know she isn’t safe to come home alone, so I jump in my car and start driving, repeatedly calling Jess. After 30 tries, she eventually answers, and through the sobs she tells me where she is. When I reach her, she’s huddled over a bench on a freezing train platform. She looks up and says, “I can’t do this any more. I’m just thinking about which train I’m going to jump in front of.” I crouch on the floor in front of her as she veers between sobbing hysterically about what her life has become and resolutely vowing that she’ll end it all and jump. We’re there for a few hours, until other commuters start arriving. Dressed in their work clothes, they are a vivid reminder of the career pressure that has, in part, driven Jess, a hugely successful barrister, to such depths. Eventually she agrees to leave the platform – and I support her back to my car. Once Jess is back home with her husband, I head home, feeling slightly shaken by the experience. This job does get to you – it can be so frustrating if someone relapses, or isn’t accepting your help. But part of the job is having to stay on top of my own emotions: if I went home after a day like today and said, ‘It was fine,’ then that wouldn’t be human – I do get upset and I do get angry, but I have to put that aside when dealing with my patients. I also have to make sure that while caring deeply about them, I don’t let myself become too attached or take on their problems as my own. There’s a dark hole out there and I see it daily – I have to be careful not to throw myself in it. ◆
The most luxurious rehabs in the world These centres have all the resources needed to help their clients get clean
THE COTTAGE, SURREY, UK The Cottage only treats one client at a time, with therapists on hand to arrange a personalised treatment. Kitted out with Egyptian cotton sheets, a private chef and chauffeur, it may end up being difficult to leave.
PASSAGES, MALIBU, USA There’s only room for 12 guests here, and at a whopping $67,550 for a month, it’s no wonder this has been named as one of Forbes’ most luxurious places to dry out.
THE DUNES, EAST HAMPTON, USA Set over four acres with a pool, spa, tennis court, personal trainer and bespoke nutritional meals, this place aims to feel just like home.
BEHIND THE SCENES
Louisa Pritchard “One of the stories that struck me most was a client of Charlotte’s – who also struggled with bulimia – eating food from the communal bins at 2am after a house party. Addiction is devastating – no matter how privileged your life or the size of your bank account.”
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