the disease within all addictive diseases

1. The Disease within all Addictive Diseases CAPTASA -- January 25, 2008 By Carol Cannon, M.A., C.A.D.C.

3. Addictive Issues Primary conditions (dependencies) Substance addictions Non-chemical addictions Related patterns (codependencies) Depression, dysthymia Compulsive worrying, anxiety Troubled relationships Chronic low self-esteem Lack of identity Lack of boundaries

4. Primary Addictions Ingestive substances Activities & processes Interpersonal relationships Thoughts & feelings

5. Categories of Clean Addictions Activities: work, exercise, shopping, gambling, dangerous or exciting hobbies and sports, caretaking, procrastination, talkaholism, jokeaholism, electronic addictions Interpersonal relationships: sex, romance, and relationship addictions; rescuing and repairing people; and family enmeshment Thoughts & feelings: mindsets like pessimism, negaholism; fixating on “causes” or belief systems; emotional states like rage, chronic misery, anxiety and mild chronic depression Any action for distraction Using people to give you meaning, identity, and value Getting hooked on thought patterns, political of religious belief systems, or mood statesAny action for distraction Using people to give you meaning, identity, and value Getting hooked on thought patterns, political of religious belief systems, or mood states

7. Religious addiction can be defined as a psychological dependence on religious beliefs and practices to repair one’s damaged ego and integrity—escaping to God. While here on earth, Jesus gave no indication that his bosom was fair game for the terminally anxious looking for a way to ride out the storm. Addiction-prone people expect religion to do what booze does—make them feel better fast. The religious practices of churchaholics are an exercise in drivenness rather than an expression of devotion. Religion addicts use God like a giant aspirin. They get high on religion like some people get high on romance. What’s wrong with using religion like a narcotic? Using religion to medicate our emotional pain without dealing with the underlying issues of immaturity and addressing repressed emotions therapeutically is like slapping a bandaid on a de-hissed wound, Religious addiction can be defined as a psychological dependence on religious beliefs and practices to repair one’s damaged ego and integrity—escaping to God. While here on earth, Jesus gave no indication that his bosom was fair game for the terminally anxious looking for a way to ride out the storm. Addiction-prone people expect religion to do what booze does—make them feel better fast. The religious practices of churchaholics are an exercise in drivenness rather than an expression of devotion. Religion addicts use God like a giant aspirin. They get high on religion like some people get high on romance. What’s wrong with using religion like a narcotic? Using religion to medicate our emotional pain without dealing with the underlying issues of immaturity and addressing repressed emotions therapeutically is like slapping a bandaid on a de-hissed wound,

9. Relationship Junkies . . . Think they’re nobody unless somebody loves them Make being in a relationship their sole source of meaning, identity, and value Expect partners (and even friends) to devote themselves to them exclusively Think they own their partners— “parent” them Fear nothing worse than abandonment Control partner to avoid rejection, thus creating the very thing they fear most

10. Sexual Addiction Is . . . A pathological relationship with sex, sexual thoughts, or sexual behavior which makes the mood-altering behavior more important than family, friends, work, and values A loss of contact with reality through denial and delusion Loss of control despite serious life consequences Risks include loss of marriage children, career, reputation, and salvation.Risks include loss of marriage children, career, reputation, and salvation.

11. The line between normal behavior and unhealthy dependence is blurred by the fact that seemingly harmless diversions can be damaging when taken to the extreme. In and of themselves, they may be relatively benign but, when done to excess, they are problematic.  The line between normal behavior and unhealthy dependence is blurred by the fact that seemingly harmless diversions can be damaging when taken to the extreme. In and of themselves, they may be relatively benign but, when done to excess, they are problematic.

16. The Transgenerational Cycle The addictions (chemical or clean) of parents lead to The neglect and abuse of children which creates Internalized pain and shame in the child which results in Vulnerability to anything that feels good which leads to Self-medicating to relieve pain & shame

17. Underlying Issues (Symptoms of Codependence]

18. Thus, codependence may be seen as the disease within all addictive diseases!

20. Could this be the elusive “ism”?

21. Codependence in the Twelve & Twelve

22. Twelve & Twelve Descriptions con‘t

23. Twelve & Twelve Descriptions con’t

25. Codependence: growing up depending on someone who’s depending on something that’s not dependable.

26. Codependence: the disease of being an immature child in an adult body!

27. Codependence: two or more sick people getting worse together!

28. Codependence: a pattern of painful dependence on people and on approval for safety, self-worth, and identity.

29. Codependence is the social, emotional, spiritual pathology that occurs when children are reared in an environment characterized by high stress and low nurturance.

30. Codependence is the pain in adulthood that comes from being wounded in childhood and leads to a high probability of relationship problems and addictive or compulsive behavior. It is a combination of imma-ture thinking, feeling, and behaving that generates an aversive relationship with the self (self-loathing), which the codependent person acts out through self-destructive or unduly self-sacrificial behavior.

31. Risk Factors for Codependence Growing up in the midst of addiction and abuse Living with an active alcoholic, workaholic, relationship junkie, sex addict, etc Early trauma and loss—death, deprivation, divorce (experienced as abandonment) Living in an emotionally repressive or oppressive environment Enmeshment (lack of boundaries) within the family or social system Enmeshment is about systems where everyone tries to live everyone else’s lives. This requires excessive caretaking and control.Enmeshment is about systems where everyone tries to live everyone else’s lives. This requires excessive caretaking and control.

32. “Codependent Personality Disorder”in DSM Language Dr. Timmin Cermak places codependence within the framework of mixed personality disorder, a condition which exists when an individual does not qualify for a single personality disorder diagnosis but has marked traits of several of the personality disorders.

33. Since most members of chemically dependent families exhibit a recognizable and predictable pattern of traits, and since this fits our definition of codependence, we can use the following criteria to diagnose the presence of Codependent Personality Disorder:

34. Continued investment of self-esteem in controlling oneself and others in the face of adverse consequences Assumption of responsibility for meeting others’ needs while failing to acknowledge one’s own Anxiety and boundary distortions within relationships Enmeshment with personality disordered, chemically dependent, other codependent, or impulse disordered individuals Three or more of the following: excessive reliance on denial, frozen feelings, depression, hyper-vigilance, compulsions, anxiety, substance abuse, victim/abuser behavior, stress-related medical illness, staying in a pathological relationship for two or more years without seeking help

35. Symptoms to Be Addressed Difficulty experiencing appropriate levels of self-esteem Inability to set functional boundaries and practice healthy self-care Inability to assess others realistically or present oneself authentically in relationships Lack of moderation, tendency to act in the extreme Immaturity—regressing to childish behavior at inopportune times

36. Therapeutic Focus Key “codependency” issues Developmental arrest Repressed emotion, frozen feelings Recovery goals Unloading backlogged pain and shame Learning to experience appropriate levels of self-esteem Learning to set functional boundaries and practice healthy self-care Addressing issues of immaturity, growing up, achieving healthy interdependence Learning to assess others realistically and present oneself authentically in relationships Learning to practice moderation

37. Therapeutic Process Catharsis of repressed emotions to relieve depression, anxiety, and backlogged anger Reduction of shame that sabotages self-esteem and self-care Facing and grieving losses Addressing “attachment” problems—learning to connect with others while maintaining healthy boundaries Gaining mature coping skills through a remedial program of character development called the Twelve Steps Inappropriate caregiving or caretakingInappropriate caregiving or caretaking

38. Issues Being Addressed Backlogged feelings Unrecognized, unrelieved shame Emotional deprivation Insatiable neediness Attachment problems Delayed development Social & emotional immaturity Spontaneous regressions Inappropriate caregiving or caretakingInappropriate caregiving or caretaking

39. What is “Recovery”? Recovery is a maturing process—a remedial program of identity and character development The process begins with abstinence from primary addictions and codependencies, which requires a viable support system The process involves moving through the stages of human development using simple, strategic, spiritual principles (the Twelve Steps)

40. Recommendations Inpatient treatment of primary addiction/s Rigorous aftercare plan and monitoring Assessment and treatment planning for codependency issues and non-chemical dependencies Individual and group therapy or residential care (no less than two weeks), as needed for codependence and clean addictions Appropriate twelve-step support groups Occasional retreats or tune-ups Aftercare counseling appointment set within 7 days after discharge from treatment.Aftercare counseling appointment set within 7 days after discharge from treatment.

42. Addiction and codependence are contagious diseases that don’t go away unless people do something to make them go away. But recovery is possible, and it’s contagious too!