Johnny Winter playing the Santa Monica Civic Auditorium in 1969. (Photo: JohnKadvany/Wikimedia Commons)

The praetorian entourage that has attended to Johnny Winter over the past decade has one principal brief: Don't tell Johnny.

Don't tell Johnny we're trying to “fatten him up”—a phrase his manager, publicist, and several of his friends repeat like gospel. Don't tell Johnny what he's drinking (usually a nutritional supplement like BOOST). Don't tell Johnny that the croissant we are about to serve him contains a second, hidden croissant inside it. Don't tell Johnny what time it is, unless you lie and say it's 45 minutes later than it is.

And, until recently: Don't tell Johnny that those methadone pills aren't actually methadone.

In October of 2012, Tommy Curiale left Rick Derringer's touring band to play drums for Winter. “He was walking around like a skeleton,” Curiale marvels. Paul Nelson, a Berklee-trained guitarist who also studied under Steve Vai, has served as Johnny's manager, touring partner, and Grand Vizier for over a decade. Nelson paints a yet grimmer picture.

“It was hard to see Johnny like that,” Nelson says. “We're talking 90 pounds—he weighed 90 pounds back then.” For a tallish dude, 90 pounds is sparrow-meat—especially when you're about to turn 70.

"The person of course doesn't know he has OCD, and the OCD doesn't want to let you know you have it. When Johnny was diagnosed in 2010, we finally noticed the fingers started twiddling."

It shouldn't have been this way. Winter entered rehab over three decades ago to kick 10-plus-years of heroin addiction. But he kept drinking. And drinking. And smoking like a Texas brisket-house. Most important, he refused to give up methadone, which helped him establish an illusory sense of control over the keening demands of his body and brain.

The switch came in 2010, when a doctor diagnosed Winter with obsessive-compulsive disorder. And Nelson had an idea.

“It was a ritual,” Nelson says: “'I have to take this, I have to do this.' Johnny didn't need methadone; he needed the idea of methadone. So I took his OCD and used it against him to help him. Like the Force in Star Wars or something.”

We're in Winter's dressing room in Austin, where he is stealing a moment of rest between rehearsals for Jimmy Kimmel's show from South By Southwest on Thursday, March 13. Paul leans forward in his chair, interpreter, finisher of Winter's sentences, the teller of Winter's tale. Winter is wedged into a pleather couch at an acute angle, his head slouched slightly toward me, a smile under his cowboy hat around which two rattlesnakes are coiled and bare their fangs.

“OCD is a very funny thing,” Nelson says, “because you don't merely like stuff; you like stuff. So if you're a smoker, you smoke. If you're addicted to—I mean he could get just as addicted to a vanilla milkshake as he could to heroin. And, the beauty was, he can stop it, on a dime, if you work things right.” Nelson snaps his fingers: like that. “No different from eating a Pop-Tart every day.”

Call it tragedy, blessing, or fuzzy science: For a certain type of addict, a lesser disorder can prove balm for a greater and far more destructive disorder. As the writer Steve Kolowich once said: “Sometimes you've gotta fight the fire you can't control with the one you can.”

Until the mid-'90s, medical researchers had been slow, even recalcitrant, to acknowledge, or even entertain the idea of, a link between compulsion and addiction. In 1996, Lance M. Dodes, M.D., formerly of Harvard Medical School and a distinguished fellow of the American Academy of Addiction Psychiatry, published a landmark paper in the Journal of the American Psychoanalytic Association that argued for re-categorizing addictions as a “subset of compulsions”:

In my own work, I have viewed addictive behavior as functioning to ward off feelings of helplessness or powerlessness, which are experienced by the addict as terrifying and overwhelming. The addictive behavior reasserts a sense of power by seizing control over the individual's own affective state. Drug use provides a particularly clear example of a behavior that asserts control over one's affective experience, but this control may be achieved without the ingestion of a psychoactive drug. Indeed, what is important in addiction, in my view, is to respond to the largely unconscious sense of helplessness and to demonstrate to oneself that one has the capacity to control one's internal affective experience. For example, alcoholics regularly describe feeling better as a result of simply ordering a drink. I have regarded this as a signal satisfaction (analogous to signal anxiety) of the effort to reestablish a sense of internal mastery.... My experience with over a thousand addicts in inpatient and outpatient settings has led me to conclude that the dynamics I am describing are often present across a wide spectrum of patients. My thesis is that the traditional distinctions between addiction and compulsion are not justifiable and that all addictions are ... a subset of compulsions. This view suggests the treatability of many addictions by a psychoanalytic approach, including psychoanalysis itself.

These notions may seem commonplace, but prevailing notions in the psychotherapeutic community had for too long hewed to a ludicrously outmoded symptomatic understanding of addiction; to quote Anna Freud, writing in 1966: “The behavior of addicts ... far from being compulsive, i.e. reactive, defensive ... is merely compelling.” A glance at the semantics here is illuminating: What's the difference between an “impulse” to drink, and a “compulsion” to do so? And why did this quibble over prefixes convince so many therapists that OCD was treatable, while addiction was not?

Nelson didn't trouble over these questions. Instead, he developed a strategy to use the disorder against the addiction. In concert with Winter's doctors, Nelson shaved pills with a razor-blade and weaned the guitarist off his dose over the course of a year, then gave him a year of placebo—literally grains of rice inside gel caps—to forestall some manner of compulsive relapse.

“The person of course doesn't know he has OCD,” Nelson says, “and the OCD doesn't want to let you know you have it. When Johnny was diagnosed in 2010, we finally noticed the fingers started twiddling, how he's always blowing—is it trouble breathing? No, it's anxiousness; it comes with the OCD. And eventually, it can go away with help. There's been times when he said, 'Why am I doing this? How come I rub my nose every time I have an autograph signing?' And now we know.”

“We know, or I know, that with his OCD, the doctor had to tell him that the urge is so strong to go back that if you know what's going on, then you go nuts with the withdrawals,” Nelson adds. “Johnny didn't go through withdrawals.”

It worked, he quit smoking, and gained around 40 pounds. One Christmas, Nelson presented him with a small box. Winter unwrapped the box, squinted through his half-crossed albino eyes, and said, “What the hell is this pill?”

“Merry Christmas, Johnny. You've been off methadone for a year.”

At SXSW, where a new documentary Down and Dirty: Johnny Winter had its world premiere, this scene—captured in the grainy frames of an iPhone video—played like something out of Frank Capra. There was an immediate standing ovation.

“That was the best Christmas present I ever had,” Winter tells me. “Way the best. I just couldn't believe it, 'cause I'd been on it for 30 years, and I was just extremely happy. Imagine that—I didn't have to worry about methadone any more.”

And here, for what may be the first time of the day, Winter makes eye contact with me, as do the twining rattlesnakes atop his hat.

“Have those been the same rattlers the whole time?” I ask. “Like, I've been seeing that hat in music videos for years.”

“Aw yup, it's the same hat. I've had it like 30 years. I mean, you don't change snakes. I don't know if it'd be bad luck, or what, but I won't change snakes.” He pauses—am I sounding OCD right now? “These two rattlers work real good. Actually, one come off on the airplane, you see—we lost one of the heads and we found it and glued it back on.” The fingers start twiddling. “I figured, 'I can't go out with one snake-head on my hat.'”

“No, you'd look naked.”

Winter laughs. “Naked? Maybe. Anyway I'm gonna miss having someone following me, making a movie and all. I liked that.”

“And now—you just go back to being Johnny Winter?”

The guitarist paused on the idea, rubbed it between his fingers as a grin twisted the flesh of his face. “Yes sir. Which, these days, isn't really so bad.”