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Category contains 4 blog entries contributed to teamblogs

Posted by on in Co-dependency

 

Increase“Trauma is to mental health as smoking is to cancer.”-Dr. Steven Sharfstein, Past President, American Psychiatric Association

Last week, I posted the first in a series of articles about children of alcoholics who remain trapped in an alcoholic lifestyle as adults. I examined the neurological underpinnings of a compulsive and  “infinite loop” of ongoing and deeply painful  involvements with partners and activities that reproduce the chaos of the addicted family of origin and endanger physical, psychological, and spiritual well-being. But while psychologists are increasingly interested in the neurology of compulsive behavior, we tend to believe that it stems from a variety of causes.  Most  of us look for“biopsychosocial” explanations for behavior, including the  compulsion to repeat.  When treating adult children who are recapitulating a  painful past,   one psychosocial angle we typically want to explore is the quality of parent-child relationships in a patient’s family of origin. The nature of parent-child interactions is important for several reasons.  In this post, I will discuss howrelationships with caregivers either perpetuate an adverse infinite loop, or inoculate a child against an alcoholic lifestyle by shaping self-esteem and expectations of others, and by affecting a child’s ability to regulate intense feelings and to process and heal from difficult events.

Nearly everyone understands that our earliest  relationships affect us all our lives because theyprovide a model for us to follow as we engage with people outside the family. From the first moments of life, we form impressions of the world through interactions with our caregivers. Over time these impressions evolve and  are stored in the mind as mental representations of the self and  the other. Characteristic exchanges between self and others are also stored. When we internalizenurturing figures along with a representation of ourselves as loveable, it gives us a huge head start with respect to healthy adult adjustment.  It stands us in particularly good stead  as we strive to form healthy relationships with people outside our families.  The  support, encouragement and unconditional regard we receive from our parents forms the basis for good self-esteem and instills optimism about the world as a welcoming place.  If our parents cherish and love us, we tend to feel that we should be, and are likely to be valued and loved by others. In addition, our positive mental representations of our parents can be recalled and recruited, when no one else is around, to establish a sense of calm and hopefulness when troubling events occur. The ability to self-soothe is a critical resource in life, and it is a source of protection against the abuse of substances and activities that we might otherwise turn to in order to numb emotional pain. (Please continue reading.)

It is hard for parents who are preoccupied with alcohol and drugs, and stressful conflicts about alcohol and drugs, to be reliable sources of support and love for children.  Children in addicted families are more likely to be abused, exploited and neglected.  As a result, their mental representations of themselves and others, and their expectations about the type of treatment they can expect from others are pessimistic. Even if they can’t quite verbalize this, and don’t consciously think about it, they view others as untrustworthy and potentially dangerous.  And they view themselves as unlovable and unworthy of respect. Children from addicted families are more likely to accept insensitive and abusive treatment from other life partners because this is what they feel they deserve, and because it seems “normal” to them—it fits with the information they’ve stored in their minds about how relationships are supposed to go. If they grew up feeling responsible for their parents’ pain, as so many children in addicted families do, they may also feel compelled to rescue and reform partners who are desperate and even abusive.

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Posted by on in Co-dependency

Increase

 

The term “infinite loop” comes from the field of computer science and refers to a programming error that leads to the perpetual and unsuccessful recapitulation of an algorithm, or problem-solving procedure. In my book Adult Children of Alcoholics: The Struggle for Self and intimacy in Adult Life, I used this concept as a metaphor for the way in which many adult children seem irresistibly drawn to an “alcoholic lifestyle”.  The alcoholic lifestyle can include compulsive drinking and drugging, ongoing destructive involvements with addicted or enabling parents, and the acquisition of new life partners who reprise important psychic themes of the childhood home, including instability, exploitation, dishonesty, and betrayal.

In recent posts, I’ve talked about genetics, trauma,  and substance-related  changes in the brain as the “usual suspects” behind many addictive problems.  They are also frequently the culprits when adult children–even those who avoid substance abuse and dependence–remain ensnared in the destructive and painful relational dynamics they experienced as children. It is well-known that genetics affect temperament as well as risk for mental illness and substance abuse and addiction.  But environmental factors such as stress and trauma are also powerful factors that influence the development and maintenance of an alcoholic lifestyle.  This is the first in a series of posts aimed at helping ACOA’s with an alcoholic lifestyle  to exit their infinite loop, and it explains how trauma-related changes to the brain predispose them to become mired in it.

It is important to know that many adults who grew up with addicted and  codependent parents, whether or not they abuse substances themselves,   manifest brain anomalies that can predispose them to a variety of psychological problems, such as  depression, anxiety, post-traumatic stress and compulsive involvement with substances, activities and destructive partners. These changes occur as a result  of chronic and severe levels of stress that so often occur in families where parents are preoccupied and propelled by the disease of addiction. The neurological impact of  the physical and verbal abuse and neglect that are common in alcoholic families can be seen  when imaging studies of the brain are performed, and they occur in some of the same  areas of the brain that are affected by drug and alcohol abuse.  For a good discussion of how adverse childhood events (ACEs) affect the brain, see this article: /healthland.time.com/2012/02/15/how-child-abuse-primes-the-brain-for-future-mental-illness/

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Posted by on in Co-dependency

Increase

Last week I wrote about the power of one parent who remains emotionally sober to preserve the mental and emotional well-being of children growing up in a family struggling with addiction. A colleague,Glenn Richardson who is a trainer and consultant in Texas, responded to my post noted that 12 step guidance about emotional honesty, openness and willingness points the way for parents who are striving for emotional sobriety. I agree with Glenn that emotional honesty is a crucial pillar of emotional sobriety. But what exactly does emotional honesty in an alcoholic family look like? Two things come immediately to my mind.

First of all, there is the classic matter of acknowledging the elephant in the room. Are you (or the family you’re treating) discussing addiction as a central fact of life (perhaps the central fact of life) in the home? Recovering parents often ask me what…or if…they should speak at all about the problem. In fact, I think they must speak and must offer age-appropriate explanations of the addiction, just as families should openly and honestly discuss any other medical disorder that is affecting a loved one. Children who don’t receive important information about problems that are afflicting their parents are left to their own devices to explain the problem and the troubling events that stem from it. They will invent explanations using their own immature cognitive and emotional resources to do so. Children are “ego-centric” in the sense that, lacking the capacity to see the big picture, they seem themselves as the center of most family events. This leads them to believe that they are responsible for the problems–that the adults they love are experiencing distress and behaving badly because of them. This can cause real damage to the sense of self and self-esteem.

Another important aspect of emotional honesty is a willingess on the part of the adults in the family to express their own feelings about important events in the family–in a contained and proportionate way of course. Sadness and anger are natural things to feel about illness of any kind in a family. Children know when their parents are unhappy and worried, even when parents think they are concealing it well. Parents are often surprised at their childrens’ responses when they finally admit that they are sad/or angry about the circumstances the family’s facing. I remember well what happened when one father, who had been keeping a stiff upper lip about his separation from his drug-addicted wife, finally told his young son how sad he felt that his wife had left the home. His normally reserved son began to sob about his own grief. This dad had always believed that his son was temperamentally quiet and limited in his ability to express feelings. However, now it seemed that what he’d needed all along was his dad’s permission to grieve openly about his mother’s departure.

As I thought more about the importance of emotional honesty, another question came to mind: What are the barriers to emotional honesty in alcoholic homes (or in any home, for that matter)? My colleague’s comment about AA led me to look for what Bill W had to say about emotional sobriety. Pretty interesting things, as so often is the case. In a reflection on the roots of his own depression and the disappointing failure of his 12th step work to provide more relief from it, Bill W. defined emotional sobriety as the development of of “real maturity and balance (which is to say, humility)” and suggested that the things that tend to destabilize people come from (often less than conscious) striving for “approval, perfect security, and perfect romance”. (See http://www.barefootsworld.net/aanextfrontier.html)  That is, people lose their balance when the “(demand) the impossible”. And he observed that such demands usually stem from “false dependencies” on people or circumstances” for “prestige, security and the like”. Bill W concluded that his own demands for “possession and control of the people and the conditions” surrounding him was blocking his own emotional sobriety and also, feeding the depression that frequently plagued him.

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Posted by on in Co-dependency

 

I recently updated Raising Healthy Children in an Alcoholic Home, a book I wrote in 1992 to help parents in recovery from addiction  and co-dependence to heal relationships with their children. As I re-read and edited the book, I reflected on its essential message.  I  was heartened to discover that over 20 additional years of treating addicted  individuals and their families  has only  strengthened my views about the most important things  families in recovery need to know. Moreover,  the central idea  I was trying to convey then still seems to me to be the most important thing for parents in recovery to remember: A child’s chances of remaining healthy when a family plunges into crisis depends, to a great extent, on the ability of at least one parent (or other  adult caretaker) to remain emotionally sober–that is, stable, supportive and capable of holding the child’s most basic needs in mind.

Certainly other factors, like the child’s basic temperament,  influence a child's resilience in the face of extraordinary stress. However, even  sunny, hardy children   experience fear, sadness, anger, and many other kinds of emotional distress when a family is struggling to cope with severe illness. And typically, the younger children are, the less able they are to soothe themselves and maintain a hopeful and confident outlook when frightening things happen. Their cognitive and emotional resources are just too immature to help them assess the situation accurately and  imagine a path forward for themselves and the people they love. So a parent’s ability to maintain his or her own emotional footing, and to  notice and respond appropriately to a child’s pain is critical.  (Please continue reading.)

A parent's  response to a child in crisis does not have to be perfect. In many cases, it is good enough, at least in the short-term, if the parent perceives the child’s distress, conveys that it is normal under the circumstances, and offers assurance that it is okay to talk about feelings that  are bubbling up. Even if a parent has no clear ideas about how  or when the family’s problems will be solved,  it is very reassuring to a child in crisis to be “seen” and to have painful feelings noticed and validated by a person  she counts on. A parent who says, “I see you are scared, I see you are worried and sad”, and adds, “I understand why you feel that way and I want you to know we are working to figure this out and will make sure you are taken care of” makes a child feel safer and calmer.  A good many of the people I see in my clinical practice  grew up with an addicted parent. The ones who had at least one grownup they could trust and rely on during dark periods  are the ones who find it easier, as adults,  to find and form solid relationships with healthy  friends, partners and therapists who can help them construct rewarding lives.

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Posted by on in Co-dependency

For a family member it can be hard to let go of the attachment to a loved one’s recovery.

We want to be in our comfort zone, yet we may not know how to let go of our worry and concern.

If we let go, we could lose control of the one attachment we have to our child. It can be like a balloon that we let float away. We wonder which direction the balloon will take, and if the balloon will ever fully recover and return to us.

Recovery and healing are inside jobs. It helps to have people who care, give you encouragement, support and love. Sometimes the fear is that our family member won’t seek recovery, at least not on our time table and maybe not at all.

For a family member, this fear can take over our life. With time hopefully we are able to let go and see our attachment for what it is. It may be a way of blaming others for our pain, or it may be a way to control those around us.

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Tagged in: addiction recovery
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