The intense and turbulent relationship between Elizabeth Gilbert and Rayya Elias was marked by profound caring—alongside a devastating struggle with addiction that pushed Gilbert to a dark psychological extreme. After Elias passed away from cancer in 2018, Gilbert undertook a journey of self-reflection that led her to recognize her own patterns as a sex and love addict.
In All the Way to the River, Gilbert reflects on how her relationship with Elias began, blossomed, blew up, and bloomed again at the end of Elias’s life. The memoir is a collection of drawings, photos, poems, journal entries, prayers, aphorisms, and narrative. The title refers to a metaphor Gilbert and Elias used to describe the depth of their relationship: They would do everything side by side, even walking each other to the “river” of death.
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Elizabeth Gilbert and Rayya Elias’s Relationship
Elizabeth Gilbert’s relationship with Rayya Elias, a queer Syrian creative from Detroit, was one of the most impactful connections she has ever shared with someone. Although they cared for each other dearly, they also fueled and fed off each other’s flaws, which made their relationship tumultuous. Gilbert describes the ups and downs they went through—tracing their relationship through eight stages of evolution, from early friendship to fraught romance and beyond.
Early Friendship
Gilbert met Elias in 2000. At the time, Elias was working as a hairdresser, and Gilbert’s friends recommended her. Gilbert says that, during the first appointment, the two felt an instant connection. They talked about their lives openly. Elias told her that she was three years sober from heroin and cocaine and that she worked a 12-step program to maintain her sobriety. Gilbert was drawn to Elias’s honesty, sense of freedom, and self-assuredness—qualities that contrasted sharply with her own lifelong habit of people-pleasing. As a child, she’d learned it was safer and more rewarding to make other people happy than it was to be her authentic self, and she had lived that way ever since.
This pattern had propelled Gilbert through a series of chaotic relationships. By the time she met Elias, Gilbert says she felt trapped by the demands of her unsatisfying marriage. Over the next few years, she would leave her husband, travel internationally, and fall in love and remarry—a journey she detailed in her 2006 memoir Eat, Pray, Love. Meanwhile, Elias continued to work her 12-step program, built a committed relationship, made music and short films, and tried to launch a real estate career. All the while, Elias was doing Gilbert’s hair (she was the best hairdresser Gilbert had ever had, so she kept going back), and an easy friendship blossomed between the two.
| Complementary Roles in Friendships When Elias and Gilbert first connected (hairdresser and client, straight-talker and people-pleaser), their friendship followed a pattern science actually backs up. Hairdresser-client friendships are a well-documented phenomenon. Sociologists point to stylists as “loose ties”—outsiders to a client’s inner circle, which lowers the stakes and invites emotional openness. Meanwhile, stylists are professionally incentivized to be warm and personable and often reciprocate by sharing their own lives, as Elias did with her sobriety. Since friendship thrives on mutual vulnerability and support, it’s no surprise these relationships sometimes go deeper. In Gilbert and Elias’s case, contrasting personalities added another layer. Research shows we’re sometimes drawn to people whose traits we admire but lack ourselves—and that those friendships can push us to grow. More often, though, we gravitate toward people like us, which also rang true: Both women were creatives and spiritual seekers. Their bond, it seems, was built on a little of both. |
Deepening Codependency
By 2008, Gilbert had achieved wealth beyond her wildest dreams, as Eat, Pray, Love was a huge commercial success. But, emotionally, she was a mess, dogged by a sense of malaise she couldn’t overcome. In the past, she would have coped by finding a new romantic or sexual distraction, but she was trying to make her second marriage work, so that wasn’t an option. To cope with her malaise (and a gnawing sense of guilt over her financial privilege), she started giving away large sums of money to strangers and loved ones.
| The Eat, Pray, Love Phenomenon Eat, Pray, Love‘s runaway success caught Gilbert herself off guard—she never anticipated the book reaching such a wide audience. Its timing, many argue, was everything. For decades prior, solo female travel had been hampered by safety concerns and cultural barriers, but the early 2000s changed all that, with cheaper flights and handy new tech such as portable GPS and translation apps giving women the confidence to explore the world on their own terms. The book rode that wave and became a genuine rallying cry, selling over 18 million copies, spawning a Hollywood blockbuster, and inspiring so many women to pack their bags alone that the publisher gathered their stories into a travel anthology. Gilbert earned more than $10 million in royalties on top of her $200,000 advance. But, after years of financial struggle, the sudden windfall proved tricky to navigate; her instinct to share the wealth backfired badly, costing her several friendships in the process. |
Later, Gilbert would learn that her tendency to overgive was a hallmark of codependency. Codependency, she explains, is a pattern of seeking relief from inner distress by managing, rescuing, or otherwise pouring energy and resources into others. Codependent people use caretaking and self-sacrifice to regulate their emotions and secure a sense of worth, rather than tending to their own unmet needs. Gilbert also notes that this behavior is more common in women, to the point of being normalized—women might not even notice that they’re doing it because they’ve so internalized the idea that they must earn love by being of service to others.
Gilbert’s relationship with Elias soon came to be defined by codependency. Elias’s life was crumbling: Her relationship fell apart, her health issues flared up (including a Hepatitis C infection from her years of drug abuse), and the 2008 financial crisis ended her real estate career, which diminished her income and led to housing problems. When Gilbert learned that Elias was struggling, she offered her three months of free residence in a renovated church she had bought years earlier, even though she had intended to use it herself as a writing retreat. Elias accepted, having few other prospects and feeling dazed by Gilbert’s generosity.
After this, Gilbert and Elias became best friends. They spent more and more time together, and Gilbert became increasingly emotionally reliant on Elias, deepening her codependency. Gilbert writes that Elias made her feel completely at ease, as though she could relax instead of constantly appeasing others. Elias also helped her manage her relationships. Because of her codependent tendencies, Gilbert was sometimes easily taken advantage of, and Elias would exhort her to advocate for herself. At other times, Gilbert resented others for not being as self-sacrificing as she was, and Elias would remind her to be compassionate.
| Understanding Codependency Codependency is a controversial concept; it’s absent from the DSM and lacks strong research support as a distinct condition. Some experts believe the label unfairly pathologizes normal empathy and caregiving, while others find it useful for identifying self-destructive relational patterns. In her seminal book on the topic, Codependent No More, Melody Beattie defines codependency as becoming so fixated on another person that you lose yourself. She identifies three hallmarks: taking responsibility for others while neglecting yourself, over-focusing on others at the cost of your own needs, and suppressing your own feelings and identity so thoroughly that you can’t see yourself clearly. The term itself originated in the 1980s to describe how loved ones of addicts can fall into enabling, caretaking patterns—and experts note that addiction’s constant crises give codependents fertile ground to feel needed and in control. Finally, these relationships can be hard to question early on because codependents often lead with intense warmth and attention (sometimes called “affection flooding“), which creates a fast, intoxicating sense of closeness that can be especially irresistible to someone already feeling vulnerable. |
Unspoken Love and Quiet Relapse
When Elias’s three months of residency at the renovated church were up, Gilbert couldn’t stand the thought of her moving away—so she asked her to stay longer and write a memoir. Gilbert writes that she did this because she was falling in love with Elias, but she was still married and didn’t feel she could confess her feelings. In hindsight, she says, that’s exactly what she should have done so that everyone involved could have made informed decisions about their next steps. But, instead, Gilbert subconsciously manipulated Elias into remaining by her side by making her an offer she couldn’t refuse. Elias would end up living at the church building for nine more years.
(Shortform note: Gilbert’s relationship with Elias might have constituted an emotional affair. Experts define emotional affairs as close, intimate connections that cross relational boundaries—often involving secrecy and a level of vulnerability or prioritization that’s typically reserved for a romantic partner. They can be as destructive as sexual affairs, or even moreso, since they often erode the emotional foundation of a primary relationship. By redirecting intimacy, trust, and daily emotional investment elsewhere, emotional affairs can leave a partner feeling replaced or shut out, even if no physical boundaries were crossed.)
Around the same time, Elias quietly relapsed. It began with a small backslide; she started occasionally drinking Angostura bitters (an alcohol-based ingredient in some cocktails). But, by 2011, she was drinking them constantly. She justified this by saying her doctor prescribed it for her stomach problems and by pretending not to know that it had a high alcohol content.
(Shortform note: Angostura bitters take their name from the Angostura tree, native to Trinidad and Tobago, where the bitters were first bottled. Some people use Angostura bark medicinally to treat stomach problems, and that was the original purpose of Angostura bitters. However, Angostura bitters don’t actually contain ingredients taken from the Angostura tree and never have. The recipe for Angostura bitters is a secret, but it’s known to contain gentian, a European plant with medicinal properties. Most experts warn against drinking any kind of alcohol when you have stomach problems, since it inflames the stomach lining and increases acid production.)
Pretending not to know that Angostura bitters had a high alcohol content allowed Elias to maintain the illusion that she was still sober; all the while, she continued to talk about her hard-won sobriety in 12-step program meetings and in the memoir she was writing. Still, on some level, Elias knew her behavior was concerning; she said as much in her journals. (Gilbert notes that Elias gave her the journals to read after her death so that Gilbert could write a book about her.)
Gilbert’s unspoken love and Elias’s quiet relapse began spiraling out of control in 2013. Both published the books they had been working on—Elias’s memoir Harley Loco and Gilbert’s novel The Signature of All Things. They went on an international book tour and got even closer; Gilbert’s feelings intensified, and she found it difficult to hide them. She sometimes slipped up, saying things she felt she shouldn’t say. Meanwhile, Elias started drinking openly at social events. Initially, she would have only a glass of wine. But, over time, she began to drink more, eventually binge drinking to the point of blacking out. Her sober friends tried to talk sense into her, but she denied she had a problem and distanced herself from her sober community.
(Shortform note: In Mistakes Were Made (But Not by Me), Carol Tavris and Elliot Aronson explain how someone could relapse without acknowledging it. When people act in ways that conflict with their self-image [such as drinking when they identify as sober], they experience cognitive dissonance. To reduce this discomfort, they often rationalize or minimize their behavior rather than confront it directly—for example, by redefining what “counts” as a relapse or convincing themselves their behavior is under control. Usually, people aren’t consciously aware that they’re doing this; instead, they subconsciously justify their behavior, ignore evidence that makes them uncomfortable, and forget events that contradict their preferred self-image.)
Cancer and Romance
The watershed moment in Gilbert and Elias’s relationship came when Elias was diagnosed with terminal pancreatic and liver cancer in 2016. Elias had these organs scanned in hopes of qualifying to receive a new treatment that could cure her Hepatitis C; she’d been unwell and in pain for some time but attributed this to her disease, so she was blindsided by the cancer diagnosis. Gilbert was, too, and says she realized that she didn’t want Elias to die before she had a chance to act on her feelings for her. She ended her marriage and confessed her love, and the pair initiated a romantic relationship.
Elias’s doctors estimated that, without treatment, she would have six months to live. Elias opted to spend that time in romantic bliss with Gilbert rather than undergo treatment that would leave her too sick and weak to enjoy the rest of her life. They spent the next few months in a love-, drug-, and spending-fueled haze of happiness. Gilbert lived as if she, too, were dying and gave Elias whatever she wanted—luxury gifts, a penthouse, and so on—because it made her happy to see Elias happy. She explains that she believed she could squeeze enough love and happiness out of the time they had left that she would be set for life and wouldn’t feel sad after Elias died.
| The Motivational Power of Death A terminal diagnosis can be profoundly clarifying. Palliative care experts observe that it cuts through life’s noise, forcing a reckoning with what truly matters—relationships deepen, long-suppressed feelings surface, and hollow obligations fall away. This could explain Elias’s choice to forgo treatment and spend her remaining time with Gilbert. Loving someone who’s dying can be equally clarifying. Philosopher Martin Hägglund suggests we genuinely care about only the things that can be lost; immortality would strip away the urgency to nurture or cherish. In that sense, the awareness of mortality itself becomes a motivator, compelling us to live with greater honesty and intention. |
Caretaking and Abuse
Gilbert says their honeymoon phase began to wind down when Elias started chemotherapy, three months after her diagnosis, under pressure from friends and family. The chemo made Elias miserable. She was always vomiting, had constant pain, and could hardly sleep. She felt sad, angry, and confused all the time. Because of this, she stopped the chemotherapy after three months, and soon the cancer began to take its toll. Throughout all this, Gilbert was her devoted caretaker, which satisfied her codependent desire to prove her worth by caring for others.
However, Gilbert explains that Elias became increasingly demanding and verbally abusive. She was disqualified from hospice care because of her abusive behavior, and she rejected care from other nurses, so all the caretaking responsibilities fell on Gilbert. When Elias couldn’t sleep because of her pain or fear of dying, she insisted that Gilbert stay up with her—which meant that, for long stretches of time, neither of them was sleeping more than a couple of hours a day.
(Shortform note: Caregiving is physically and emotionally exhausting even under the best circumstances, but it often becomes far more difficult when the person receiving care is in severe pain or distress. Chronic pain, sleep deprivation, and fear—especially fear of death—can overwhelm the brain’s capacity for emotional regulation, making people more irritable, impulsive, or verbally aggressive. In these states, the body prioritizes survival over social niceties, leaving little energy for patience or empathy. Some frameworks, such as spoon theory, suggest that sick people have a limited pool of energy to manage both their symptoms and their behavior; when most of that energy is consumed by pain, little is left for maintaining kindness or self-control.)
To treat her unbearable pain, Elias’s doctors prescribed morphine. They estimated that she had only about two months to live, so they weren’t worried about the drug’s addictiveness. Morphine brought Elias, and therefore Gilbert, tremendous peace at first. But Gilbert says that, due to Elias’s history of addiction, her brain processed narcotics differently, so the morphine became less effective, and she was prescribed stronger and stronger drugs.
(Shortform note: End-of-life pain management often entails powerful opioids such as morphine. At this stage, providers usually prioritize quality of life concerns [such as reducing suffering, promoting sleep, and easing emotional distress] over concerns about addiction. But adequate pain management requires careful monitoring. Even in patients without a history of substance use, the brain can develop a tolerance for narcotic drugs, making standard doses less effective.)
Then, at Elias’s request, Gilbert began supplying her with cocaine and helping her inject it. Elias felt she needed the drugs to numb the pain, and both reasoned that, since she was dying, sobriety didn’t matter anymore. Furthermore, Gilbert—codependent as ever—was willing to do whatever it took to make Elias happy and to keep earning her affection.
(Shortform note: In addiction recovery communities, helping an addict get or use drugs is known as enabling them. Enabling can take many other forms, such as agreeing with an addict’s justifications for their continued substance use—as Gilbert did by reasoning that Elias’s sobriety no longer mattered. Enabling also can mean using substances with an addict, which Gilbert had been doing throughout their honeymoon phase. Enablers often believe they’re acting out of compassion, but in reality, their behavior is usually rooted in their own needs—such as the desire to feel needed, maintain closeness, or avoid conflict—and it tends to cause more problems for the addict than it solves.)
Murder Plot and Separation
Elias outlived her prognosis. As time went on, her drug abuse ramped up. The longer she used drugs, the more she suffered from paranoid delusions and the more verbally abusive she became. Gilbert was depleted emotionally and physically. She explains that, in this exhausted state, she began to think that the only way out of this situation was to murder Elias. She couldn’t continue living like this, and she knew she wouldn’t be able to convince Elias to stop using drugs. She left their penthouse one day to plot her murder via overdose. But, when she came home, she suspected that Elias knew what she was up to and that her plan was of no use. Feeling helpless, she began thinking of suicide.
Gilbert says that, as she contemplated suicide, she heard God’s voice tell her to seek help instead. She called everyone she could think of, opened up about the situation she had been outwardly pretending was fine, and asked for advice. People told her that Elias’s addiction wasn’t her fault and that a lot of addicts manage illnesses such as cancer without relapsing. They also told her that she needed to take care of herself and possibly extricate herself from the situation before she collapsed. They encouraged her to go to a 12-step program for the loved ones of addicts or a 12-step program for sex and love addiction.
| Hitting Rock Bottom “Rock bottom“—the lowest point in an addict’s spiral—is when the consequences of addiction can no longer be denied and life feels completely unsustainable. Gilbert reached this point so acutely that she contemplated murder and suicide, though rock bottom can look far less dramatic: a lost job, an overdose, homelessness, or a broken relationship. Whatever the outward shape, the inner experience is the same—a feeling of total hopelessness with no visible exit. Paradoxically, this crisis often becomes the turning point. With nowhere left to turn and old coping strategies exhausted, many addicts finally seek help. Gilbert did exactly that, following what experts recommend: reaching out, connecting with supportive people, and tapping into communities such as 12-step programs to find hope and a path toward recovery. |
Gilbert says that, after this, she staged an intervention for Elias. It went poorly. Elias denied she had a problem, made excuses for her behavior, blamed Gilbert for controlling her, and said hurtful things that seemed to confirm Gilbert’s worst beliefs about herself. This prompted Gilbert to leave their shared apartment for weeks. During that time, she went to 12-step program meetings, where she learned the importance of focusing on her own needs rather than losing herself in someone else’s. At this point, Gilbert realized she needed to set boundaries—not only for her sake, but also for Elias’s. She believed cutting Elias off would help her realize that she had a problem and needed help.
Gilbert asked Elias to have a heart-to-heart conversation with her. She explained that she couldn’t go any further on this path with Elias because it was too destructive and apologized for the role she played in it. She also told Elias that she loved her deeply and would help her if she wanted to get sober again. Gilbert says that, this time, Elias seemed to understand where she was coming from. After their conversation, Elias moved back to her hometown of Detroit to get sober with the help of her friend and ex-partner Stacey.
| How to Support an Addict or Alcoholic When someone you love is struggling with addiction, helping them get sober is no easy feat. Al-Anon’s three C’s offer a grounding reminder: You didn’t cause the addiction, you can’t control it, and you can’t cure it. Ultimately, recovery is the addict’s choice alone. That said, there are ways to help. Be cautious with interventions, as they can backfire and damage relationships. If you go that route, involve a mental health professional and lead with compassion over judgment. Set firm boundaries to protect your own wellbeing. That means no enabling, no covering up mistakes, and limiting contact if things turn unsafe. Offer support in reasonable doses—emotional encouragement, assistance finding treatment, and sober activities you can enjoy together (without running yourself into the ground). |
Reunion and Death
Stacey helped Elias detox, took over her pain management (since Elias wasn’t capable of handling her pain medication responsibly), and got her back into hospice. She continually updated Gilbert on how Elias was doing, and Gilbert visited in the fall of 2017. It was immediately clear that Elias would die soon. Gilbert explains that Elias was frail and had trouble eating, and she had been dreaming about deceased loved ones, interpreting this to mean that they were shepherding her to “the other side.”
Because Elias hadn’t been in her right mind, she remembered little about how their relationship ended. Gilbert told her everything, including her plan to murder her. She writes that Elias was strangely proud of her for the murder plot because it meant she had finally accessed a primal part of herself that she had buried. Because Elias didn’t have enough time left for them to work on repairing their relationship, they decided to simply forgive each other, move on, and spend the rest of Elias’s life together.
(Shortform note: Forgiving someone who has hurt you isn’t easy. I’ve written about my own experience with the difficulty of forgiveness and how it actually can be done from a Christian perspective. Religious leaders such as Archbishop Desmond Tutu and the Dalai Lama lean into the restorative benefits of forgiveness, describing it as a path to freedom. They explain that holding onto anger makes you a prisoner of the past, forcing you to replay your wounds over and over rather than heal from them and move forward. Forgiveness ends this cycle of suffering by helping you distinguish between the person who harmed you and their actions so you can release your anger at them. In some situations, this creates space for reconciliation. In this case, it made it possible for Gilbert and Elias to fully embrace the time they had left together.)
Elias’s final weeks were difficult for Gilbert. Elias sometimes felt peaceful about dying; other times, she was enraged or in denial. She began sleeping more, experienced hallucinations, and stopped eating and drinking. It was difficult to watch, and Gilbert says she was struck by the fact that a dying person is on the brink of losing literally everything—once they die, they’ll have no more chances to do or experience anything they love.
(Shortform note: Some thinkers, such as philosopher Thomas Nagel, share Gilbert’s view of death as the ultimate loss. Others see death differently. In No Death, No Fear, Buddhist monk Thich Nhat Hahn suggests that death is merely a transformation after which conscious experience continues in a different form. The Bible teaches that death is like sleep and that God will raise the dead back to life in the future, although the unrepentant will be raised only to face judgment and the second death, from which there will be no resurrection.)
It looked as though Elias might die on Christmas day; she wouldn’t wake up, turned blue, and had trouble breathing. But she lived until the beginning of January 2018. Gilbert writes that it wasn’t peaceful—the closer death came, the more Elias fought it. The dying process also seemed painful, despite the sedatives and painkillers hospice provided. Gilbert believed Elias’s long history of opioid use had likely blunted their effectiveness. However, as soon as she died, Elias’s face relaxed into an expression of contentedness, which brought Gilbert some comfort.
| The Dying Process As death nears, people commonly report vivid experiences such as visits from deceased loved ones or spiritual figures. Physical changes follow—reduced eating, more sleep, withdrawal from the world, and eventual loss of bodily functions. Closer to the end, skin and breathing deteriorate, and some experience terminal agitation, where the brain’s survival instinct creates visible restlessness or distress. While this is hard to witness, it can be soothed through gentle care or medication. No two deaths unfold the same way. The sequence, duration, and nature of these changes vary widely based on a person’s health, emotions, and cultural or spiritual background. End-of-life doulas can offer meaningful support to both the dying and those they leave behind. |
The Aftermath
Gilbert and Elias’s relationship persisted after Elias’s death, believes Gilbert. In the weeks after Elias died, Gilbert visited a medium, who relayed a message from Elias: She still existed, only in another form, and she would see Gilbert again when Gilbert eventually died; in the meantime, they could keep communicating with each other—directly, without the use of a medium. After this, Gilbert says she received ongoing visitations and communications from Elias, and she also got in touch with her when using psychedelic drugs. In this way, Elias continued to rule her emotional world for the first year or so after her death, even though Gilbert busied herself with other pursuits, such as finishing her novel City of Girls.
Eventually, though, Gilbert began to feel the need to pursue a new romantic partner. She went on what she describes as a binge, in which she hurt herself and others because, as usual, she was using sex and love only as a crutch.
At the end of her binge, Gilbert realized that she couldn’t continue living this way because it was too destructive. And, because she had been introduced to 12-step programs during Elias’s relapse, she knew where to seek help. She started going to Sex and Love Addicts Anonymous (SLAA) meetings, kickstarting her journey toward recovery. As she healed, she heard Elias’s voice less often, but they still maintained a relationship. She writes that Elias encouraged her to keep healing and to write this memoir.
| Speaking to the Dead, or Speaking for the Dead? Nearly half of all Americans report some form of contact with deceased loved ones, and the experience tends to bring comfort and meaning regardless of one’s religious beliefs. Whether these encounters are real is hotly debated. Skeptics attribute them to grief-induced hallucinations, heightened pattern recognition, or the brain’s slow process of accepting a person’s death. Psychologist Mary-Frances O’Connor supports this view in The Grieving Brain, arguing our brains are simply wired for connection and struggle to let go. Believers, on the other hand, hold that the dead genuinely reach out (through dreams, scents, animals, and other subtle signs) and that dismissing these experiences out of hand does them a disservice. The topic also carries real ethical baggage. Mediums are frequently accused of exploiting the grieving. Gilbert herself has been criticized for speaking on Elias’s behalf, since Elias can’t tell her side of the story. Elias’s sister voiced concern that Gilbert has used Elias’s story without Elias’s consent to turn a profit. Meanwhile, other critics see Gilbert’s claim that Elias told her to write this memoir as a rhetorical move meant to put readers at ease with what may otherwise seem like a massive invasion of Elias’s privacy. |
Reflections on the Relationship
Gilbert’s relationship with Elias led her to believe she was a sex and love addict. She realized that her attempts to control Elias, her relationships, and even life itself had only fueled her addictive patterns and emotional suffering.
Gilbert also came to see her relationship with Elias as part of God’s plan for her. She explains that she finds it helpful to think about life as a school: Before we enter this world, we decide which lessons we want to learn and volunteer to teach those lessons to each other. According to this view, Elias wasn’t simply a partner or friend but a spiritual teacher whose presence helped Gilbert confront her deepest fears, compulsions, and patterns of self-abandonment. By viewing their relationship as a divinely guided learning experience, Gilbert has been able to find meaning in the pain and intensity of their connection—and embrace both love and loss as essential parts of her growth and recovery.
Learn More About Elizabeth Gilbert and Rayya Elias’s Relationship
To dig deeper into the details of Gilbert and Elias’s relationship, check out All the Way to the River and Shortform’s comprehensive guide to it, which includes analysis and connections to the ideas of others.
