Contemporary Teaching

The Addictive Disease and Recovery

The World Health Organization defines addiction as a recurring pathological relationship with a person, thing or event with life damaging consequences. It’s not what you do or how often you do it: it’s what happens to you and your relationships as a result of the use that determines whether or not the behavior is pathological or addictive. In order for something to be addictive it must have the ability to alter ones mood or produce euphoria, it must be available, quick acting to feed the addicts need for immediate gratification, have unclear cultural guidelines surrounding its use, and the individual will experience tolerance changes with continued use over time.

The addict will eventually experience increased levels of loss of control over his behavior. Initially, the process is invisible or only slightly apparent to the addict, except for the faster acting chemicals like crack, heroin, some designer drugs, cocaine and behaviors like pathological gambling or computer sex in some cases. The addict may experience many good times using and then one-time experience negative consequences as a result of their use. However, being good people, who may never have experienced these negative consequences, may feel ashamed and make promises to themselves not to allow that to happen again. The non-addictive individual can carry that off with little or no problem, but for the addict it is often the beginning of a pattern that takes him, his loved ones, business associates and often his career down a painful path.

The next decline in the addict’s life is when he continues to make promises to himself and others that he is unable to keep. He is hiding and denying his true reality and is usually unaware of the extent of the denial. Those close to the addict are commonly confused by this out-of-control behavior and do not know what to do. If they grew up in a dysfunctional family that denied abusive or addictive behavior, they will usually enable the addict to continue his behavior rather than confront and rock the boat. The hope is that the addict will just straighten out. The family, employee and close friends are being affected by the addict’s behavior and in many cases developing their own defense patterns and distorting reality along with the addict. Dr. Max Schneider has an excellent video titled Medical Aspects of Co-dependency, describing the physical problems of the addict and the co-addict. The addict’s physical problems are caused by the chemical or additive lifestyle, and the co-addicts are caused by their inability to tell the truth about their feelings associated with living with the addict. 

The last phase is when the addict has lost control over his behavior to the extent he is now losing family, career, health, job, possessions, etc. Their very association, if they choose to stay involved with the addict, will more negatively affect family and close friends, by living with this insanity? The family and friends need to involve themselves in their own recovery program separate from the addict if they hope to maintain a level of sanity in this environment. The problem is that family, coworkers and friends tend to enable the addict. People just do not want to accept that their loved one is out of control and that they can do nothing to stop them. No one likes to admit being powerless or to acknowledge that his or her loved one is dying from a terminal disease, which is what addiction, is if left untreated. Family, friends etc. are blinded by the fact that the addict was all right for such a long time and they struggle with accepting the reality of the effects of the disease. The reports of verbal, physical, sexual, emotional, spiritual and financial abuse are common among active addicts. These abuses cause the family and the addict incredible pain and anguish. The children in the addicts home learn that dishonesty, denial, delusion, distortion, defensiveness, despair, abandonment, abuse, neglect, chaos, and fear are normal and how loved ones express love and intimacy to each other. Everyone has lost self-trust, self-esteem and self-honesty to a degree.

It has been found that it is these unresolved relationship issues of loss caused by abuse, neglect, abandonment, and trust that play a major role in the set up for all addictive behaviors. Most addicts come from homes where there was some type of abuse or addiction. National static’s indicate that there is a 60% to 75% probability that if someone comes from an alcoholic or drug addicted home that they will develop the disease as well. Conversely those that grew up experiencing physical, emotional, verbal, sexual, financial, spiritual abuse or incest will possibly bring this on to their children as well. In my now 27 years of experience as a clinician I have noticed that 90% to 95% of my female clients and about 85% of my male clients are survivors of incest or physical abuse with 100% having reported experiencing some other type of abuse when growing up as well.

The adult addict today learned about burying feelings a long time ago and being a good student of life simply followed suit. Just because we do not like a parental behavior or how we grew up and make a vow not to do it ourselves does not give us the skills to develop new behavior. I am not dismissing medical information that indicates a physical predisposition to alcoholism, and drug addiction. These medical facts are only a portion of the story. Also after the addict is detoxified he still needs to resolve the psychological causes of his addictive behavior.

Addiction treatment involves many steps that must be taken in order for recovery to be accomplished. Recovery is more than simply not using the addictive behavior; it is also effecting significant changes in the beliefs about self and how to interact with and in the world. The following description of the cycle of addiction is taken from Dr. Patrick Carnes and John Bradshaw’s work. The cycle begins with a self-limiting belief system. The negative self-defeating core beliefs drive the addict’s behavior. Some common self-defeating beliefs about ones are Self concept are 1. I’m basically a bad person, 2. beliefs relating to relationships to others, No one will love or care for me as I am, 3. beliefs as they relate to ones need My needs, and wants will never be met if I have to rely or depend on others 4. Beliefs as they relate to ones addictive behaviors Drugs, Alcohol, Sex, Relationships, Money, Power, Food, Work, Love, etc. is my most important need. These beliefs and the charge they have on the addict and the addict’s family needs to be fully explored. The internalization of these beliefs is part of the pain the addict feels and tries to escape from through their addictive behavior. In order to keep the faulty belief system in place, the addict and all their enablers i.e.: the family, their employee, their friends need Impaired thinking i.e.: denial, dishonesty, delusion, distortion, defensiveness, despair. This impaired thinking process is what keeps everyone from telling the truth about the addictive behavior thus prolonging and enabling the addiction to continue. It may help to define some of the above-mentioned terms:

• Denial - protecting self from unpleasant aspects of life by consciously or unconsciously refusing to perceive, acknowledge or face them. Denial eliminates the possibility or opportunity to resolve the problem/s.

• Rationalization - Attempting to prove ones actions made sense or were justified, excuse making.

• Intellectualization - Avoiding or hiding ones emotions and feelings about something that is painful behind ones thoughts using intellectual logic-like compartments.

• Defensiveness - Focusing on others, their role and behavior to insure that no one gets to close too see the addict, i.e.: manipulation, projection, blaming etc.

• Distortion - A different perception of reality from the rest of the world, a altering of reality.

• Delusion - Sincere self-deception that allows the addict and those involved in the addictive system to survive with the problem in tact.

• Dishonesty - Lying to self and others about feelings, reality, consequences, it is a distancing of self from self.

These terms are a sampling of ways the addict and their loved ones keep the cycle of addiction going and reinforcing the faulty belief system.

As a result of the impaired thinking, the addict can now move into the phase of the cycle, which involves preoccupation with the addictive behavior. Preoccupation is an intense thought focused on involvement with the addictive behavior. It has a power of its own and the addict’s preoccupation usually shows up in the form of concentrating on using or previous use, talking about using or past using experiences. At work or home, it demonstrates itself as distracted conversation, loss of concentration, productivity, and output. Conversation is centered on using episodes or future using events. This heightened thought process focused on using leads naturally into the next phase in the cycle, which is Ritualization. The addict’s ritual produces an altered state of consciousness that further empowers the addiction.  The ritual is the addict’s own special routines that lead to the addictive behavior or behaviors. It intensifies the preoccupation, therefore adding to the arousal and excitement. Rituals will depend on types of addictive acting out behavior, the individual and their history. Rituals are behaviors that are engaged in prior to the actual addictive behavior. They include but are not limited to the following: an alcoholic frequents a certain bar at a certain time of day, a cocaine addict rolls a specific denomination bill to snort their cocaine, a sexual addict dresses a certain way, a compulsive gambler may only bet when certain numbers match a particular system they have devised.

As I stated, all addicts have rituals they follow, and it is most helpful in recovery and relapse prevention to have awareness about the rituals with awareness of the ritual, if the addict gets triggered, he and those around him and use this awareness to set up an intervention or plan of action rather that a relapse.

The next step is the addictive acting out behavior or behaviors, which may begin, by sexual acting out (sexual addiction) progressing to alcohol and/or cocaine to numb the pain (alcoholism and drug addiction). The addict may even have another pattern like smoking pot or crack, then drinking and gambling. We could go on forever, the possibilities are limitless. The point is that the addicts using follow the ritual. Addiction is very simply loss of choice, and there is always, or most always, despair following every high. The despair speaks to the negative consequences associated with the addictive use. This feeling speaks to the sense of hopelessness some addicts have concerning their inability to stop the addictive behavior. The despair adds to the addict’s sense of unmanageability in their lives. The pain of all this can be easily numbed which in turn triggers the addict’s preoccupation and the cycle continues. If we observe the cycle, we notice that the addict’s belief system is kept intact by this behavior. His feelings of worthlessness, being alone and abandoned, outcasts and unique are supported in this cycle. They remain true to their addictive selves.

Until the addictive cycle is broken the addict will continue his downward path, which is similar to the families, or co-dependents path. Everyone losses in the cycle of addiction. There are no winners, only people losing themselves, their talents, gifts, and abilities. In order to break the cycle of addiction, the addict must come to grips with the emotional and possible physical cost to self, family, career, health, spirit, finances, sexuality, etc. As I have heard it said before in a fleeting moment of sanity I made a major life decision. The addict is beaten into a state of reasonableness. By becoming teachable the addict and the family can begin a recovery process. Recovery does not mean a life without problems; it means that when one experiences problems and joys in life, one is armed with effective tools to experience life. Feelings are our gauge to help us define who we are and how we are responding to life events and relationships. Feelings require connection to self and others. Addiction breaks that connection. Recovery means learning to tell the emotional truth about what happened to us not only in early years but also when using. The debriefing can only happen when the individual is free from addictive behaviors and takes action on his desire to recover. Besides just telling the facts about what happened debriefing also means that one connects to the feelings about what happened, then grieving ones losses associated with the events.

The 12 step programs coupled with appropriate counseling and support services can help the addict and his family moves into recovery. In brief, some of the 12 step Anonymous programs include Alcoholics, Narcotics, Compulsive Gambling, Sex Addicts, Sex & Love Addicts, Compulsive Overeaters, Incest Survivors, Cocaine Addicts, Debtors, and Workaholics. Affected family members programs are ALANON, NARANON, Co-dependency, Adult Children of Alcoholics, Families of Gamblers Anonymous and many others.

The 12 steps are designed to help the addict and their family to tell the truth about their relationship with the addictive behavior or the effects of the addictive or dysfunctional behavior. The first step requires that the addict or family member fully acknowledge that their life is out of control and this admission of powerlessness is made without judgment of self. The second step opens the door to a relationship with a power source that the addict can begin to rely on for his strength and hope. The third step implies that he has developed the relationship with his conception of a Higher Power to the point that he can trust this power to aid him in telling himself and others the truth about his live. The fourth step is a chance for the addict or affected family member to tell the truth about his live without placing blame or negative judgment on himself, people, things or events. The fifth step is a demonstration of the trust that was established with a higher power (in the third step) and the person, and it is now projected out to others.

Trust that others will be there for the addict confronts the core belief that states No one will love me as I am. The sixth step provides a way to seek help and ask for support to release old addictive behaviors and self-defeating beliefs. The seventh step guides the addict through humility to have their shortcomings removed. The eighth step affords the addict an opportunity to list people, places, things and events that he has harmed and is willing to make amends to them as a component of releasing the hold the past has on him. The ninth step states that the addict is to honestly do what he can to right the wrongs he committed. The tenth step gives the addict a way to keep current on his problems in life and how to address and release mistakes they make in recovery. The eleventh step is about ongoing communication with their higher Power seeking answers and power to take appropriate action. The twelfth step is an affirmation and demonstration in changed actions and attitudes that result from the work done so far. It is also about sharing what he has learned with others. The trauma resolution is that he is now able to acknowledge meaningfulness out of seeming meaninglessness. The steps become an integrated way of living for the addict and his family that replace the old way of living the addict has given up.

I never deal with addiction recovery without talking about grief. Grief is not a disease, and the griever/addict is neither broken nor does he need to be fixed he simply need a safe place to tell the truth. Grief had been described as a conflicting mass of human emotion that occurs when the griever reaches out to a person, thing or event that has been there for them and they reach out one last time and it is no longer there. The 12 steps are for disease recovery and do not work to help the addict or their family grieve their losses that resulted from the addictive behavior and lifestyle.

Losses that the addict or family may sustain prior to recovery are loss of trust with self and others, loss of control, loss of boundaries, loss of respect, loss of health, loss of career, finances, freedom, loss of connection, loss of time, loss of self esteem.

If they come from a dysfunctional family addicts may have incomplete losses associated with physical, emotional, verbal, sexual, spiritual, financial abuse or incest. Losses here may be loss of control, innocence, self esteem, self and others trust, power, control, choice, safety, freedom, etc.

These incomplete losses must be identified and processed before the pain associated with their memory can go away. The following will give a brief description of how to do this most powerful work.

1. The griever, in order to complete their relationships, must have some awareness of what their losses are and this is accomplished by creating a time line graph and identifying every loss in their life. The griever is not only to identify the loss event like lost my job but also what the loss event meant to them. This will bring up feelings. Some of the loss events will be complete and other will still hold an emotional charge. It is most helpful if the addict (griever) acknowledges what early messages he learned when losses occurred. If he was not allowed to process his feelings about the loss, identify what was done to help repress feelings. Also notice any accidents or illnesses the occurred at or about the time of each loss that he may have created to defocus the attention way from the loss onto a real but created issue that was less painful.

2. Identify the most painful loss and write a time line graph that tells the entire truth about the relationship. Often people will live their lives without telling the whole truth about an incomplete relationship. Some will memorialize the relationship focusing on the good and not acknowledging any negative aspects while others will focus on the bad and not acknowledging the good. In order for completion to be accomplished the whole truth needs to be told and that means acknowledging both the good and bad in the relationship. It is also necessary for the addict (griever) to acknowledge what amends, forgiveness and other significant communications he wants to make to the relationship that is not in his life currently. If the addict (griever) is holding onto resentments and he still wants to release the pain associated with the relationship, it is suggested that he identify what it cost him emotionally, physically, spiritually, sexually, financially to hold onto the resentment. Weigh the cost against the payoff received for holding onto the resentment. Does he get to feel superior, avoid relationships, intimacy, etc? If cost outweighs payoff, he most probably will release the resentment. If payoff outweighs cost he probably will not release the resentment. Should this be the case he can not grieve the relationship loss. Grief is a reaction to loss. Holding onto resentment means that the relationship is not gone. These undelivered communications hold the painful emotional charges that need to be released to end the pain. Also, by telling the truth about the relationship the addict (griever) can project what he may have been withholding.

After the graph has been written and discharged, vocalized, the addict (griever) writes a Completion letter. This letter is to state with a positive intent statement I am writing this letter to release the negative emotions I hold and to discover the love and forgiveness you deserve. It is to be short and to the point and cover the following emotions used in this format.

Anger - Sadness - Fear - Amends - Forgiveness - Thank you - Goodbye. 

The addict (griever) needs to remember to breathe the entire time he is communicating his feelings. Goodbye is one of the most difficult words people have to say in life. It means this is over. If the addict (griever) has told the truth and honestly expressed the emotions associated with the relationship, the pain simply does not return, or if it is triggered it is manageable and the addict (griever) can say what he needs to say. Then say goodbye again.

Listed below is a bibliography for further study on all I have written. I am reporting on successful techniques that work for all who choose to do them. I have personally been transformed by using these techniques, and have observed dramatic changes in my clients when they do this work.

Bibliography

• Broken Toys Broken Dreams and Finding Balance by Terry Kellogg

• Adult Children of Alcoholic by Dr.s John and Linda Friel

• Back from Betrayal by Jennifer P. Schneider M.D. (living with a sexual addict)

• Women Who Love Sex Addicts by Douglas Weiss and Dianne DeBusk

• Behind the 8-Ball by Linda Berman and Mary - Ellen Siegel (gambling)

• Losing your Shirt by Mary Heineman (gambling & family)

• How to get out of debt; stay out of debt & Live Prosperously by Jerrold Mundis

• The Verbally Abusive Relationship by Patricia Evans

• Male Survivors of Sexual Abuse by Timothy L. Sanders

• The Grief Recovery Handbook by John James and Frank Cherry

• Men and Grief and Beyond Grief by Carol Staudacher

• 12 Steps a Way Out by Recovery Press

• Celestine Prophesy by James Redfield

• Facing Love Addiction by Pia Mellody

• When Money is the Drug by Donna Boundy

• Stage II Recovery by Ernie Lawson

• Healing the Shame that Binds You by John Bradshaw

• What You Feel You Can Heal by Dr. John Gray

• The Anger Workout Book by Dr. Weiseiger

Article by Michael Yeager B.A., LCDC, C.Ht. RMT, CAS, CTC Clinical Director/Owner of Whole Person Healing Center an Outpatient Clinic and Contemporary Teaching an International Continuing Education Training Institute and President of the Association of Certified 12 Step Counselors at P.O. Box 980214, Houston, Texas 77098, phone 800-365-5950, website http://www.contemporaryteaching.com and http://www.12steprecoveryprogram.com