The Disease within all
Addictive Diseases
CAPTASA -- January 25, 2008
By Carol Cannon, M.A., C.A.D.C.
Broad Definition of Addiction
Addiction is anything a person makes highest priority
in his/her life, over and above other priorities, doing it
to his own detriment or the detriment of the people
closest to him and continuing to do it in the face of
obvious negative consequences.
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
Primary Addictions
Ingestive substances
Activities & processes
Interpersonal relationships
Thoughts & feelings
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
Workaholics . . .
 Are harried, hurried
 Live to work rather than work to live
 Get high on multi-tasking
 Operate in hyperdrive
 Routinely over-commit (double book)
 Compete with the clock
 Become irritable when interrupted
 Are addicted to stress and intensity
Religion Addicts . . .
 Seek relief in their beliefs
 Use religion like a narcotic
 Abuse themselves with church doctrines
and standards
 Make being right & righteous their sole
source of meaning, identity, and value
 Have trouble accepting their fallibility
 Beat themselves (and others) up with guilt
Romance Addicts Are . . .
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Addicted to the drug-like high of falling in love
Stimulated by the excitement of the hunt
Hooked on the accoutrements of romance
Likely to move on when the high wears off
Inclined to be involved in serial marriages or
simultaneous affairs
 Uncomfortable unless they have one or more
“candidates” waiting in the wings
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
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
Compulsion
Alcoholism
Drug dependence
Overeating
Anorexia/bulimia
Workaholism
Caregiving
Control
Sex, love, romance
Excitement
Misery (negaholism)
Perfectionism
Religion (legalism)
Obsession
The next drink
The next high
The next meal
Image management
The next project
The next cripple
Power/perfection
The next affair
The adrenaline rush
The next insult
Image management
Being right & righteous
Prevailing Theories
Roommate Theory: a codependent is someone who
has a problem with someone who has a problem
Reaction Theory: a codependent is someone who has
developed discrete symptoms of his/her own as a result
of living with an alcoholic or addict
Historical Theory: a codependent is someone trained in
childhood to cope with dysfunctional people and unconsciously looks for “sick” partners in the present
Developmental Theory: a codependent is someone
whose adverse life experiences blocked optimal
development and made him/her vulnerable to addictive
substances, activities, and people
BIOLOGICAL PREDISPOSITION (Hereditary)
Continued use
of addictive
substance or activity
Increases vulnerability by 4 X
PSYCHO-SOCIAL SET-UP (Environmental)
Increases vulnerability 2-4 X
Transgenerational Cycle of
Addiction & Codependence
X
Xanax
Busy-ness
Food/no-food
Volunteering
School
Perfection
Caretaking
Job - Affair
RELIEF
FIRST OPPORTUNITY
TO “USE”
Symptoms:
1. Arrested development
2. Repressed emotions
Pain
Anger
Hurt
Fear
Shame
Guilt
Good Stuff
Portrait of
Codependence
Nurture Children to High
Children
divert growth
energy into
Self–Worth
& Social
defending
themselves or
Effectiveness
caretaking parents
“STUCK” BETWEEN
AGES 0-12
Immaturity + repressed emotion
spontaneous age regressions =
dysfunctional relationship behavior =
dry drunk syndrome = codependence
“Dry Drunk”
Codependent
Irresponsible
Needy
Irritable
Moody
Critical
Demanding
Controlling
Arbitrary
Insistent
Impatient
Hard-to-please
Tantrum-like
behavior
Boss or colleague?
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
Underlying Issues
(Symptoms of Codependence]
Religion Addiction,
Perfectionism
Eating
Disorders
Excitement, Risktaking (Intensity
Addictions)
Compulsive
Caretaking/Control
Alcoholism/Drug
Addiction
(1) Immaturity
(2) Undue shame
(3) Repressed emotion
(4) Lack of identity
Workaholism
Achievement Addiction
Misery
Addiction
Sex and/or
Relationship
Addiction
Thus, codependence may be
seen as the disease within all
addictive diseases!
Codependence
Relief-seeking
behavior
Primary
addiction
Could this be the elusive “ism”?
Bill W: “I think that many oldsters who have put our AA ‘booze
cure’ to severe but successful tests still find they often lack
emotional sobriety. Perhaps they will be the spearhead for the
next major development in AA—the development of much more
real maturity and balance.”
“The Next Frontier: Emotional Sobriety,” Grapevine, January 1958
Codependence in the Twelve & Twelve
“He [the willing person] made a beginning . . . when he
commenced to rely upon AA for the solution of his alcohol
problem. By now, though, the chances are that he has become
convinced that he has more problems than alcohol, and that
some of these refuse to be solved by all the sheer personal
determination and courage he can muster. They simply will not
budge; they make him desperately unhappy and threaten his
newfound sobriety.” p. 39
Twelve & Twelve Descriptions con‘t
“It is from twisted relations with family, friends, and society at
large that many of us have suffered the most. . . . The primary
fact that we fail to recognize is our total inability to form a true
partnership with another human being. Our egomania digs
two disastrous pitfalls. Either we insist upon dominating the
people we know, or we depend upon them far too much. . . .
Always we tried to struggle to the top of the heap, or to hide
underneath it.” p. 53
Twelve & Twelve Descriptions con’t
“Our demand for emotional security, for our own way, had
constantly thrown us into unworkable relations with other
people. Though we were sometimes quite unconscious of
this, the result always had been the same. Either we had tried
to play God and dominate those about us, or we had insisted
on being overdependent upon them. Where people had
temporarily let us run their lives as though they were still
children, we had felt very happy . . . . When we had taken the
opposite tack and had insisted, like infants ourselves, that
people protect and take of us, . . . then the result had been
equally unfortunate. . . . We had failed to see that though adult
in years we were still behaving childishly.” p. 115
WARNING
Undiagnosed, untreated
codependence may compromise
sobriety, contribute to relapse, or
cause the abstinent
addict/alcoholic to switch from one
addiction to another.
Codependence: growing up depending on
someone who’s depending on something
that’s not dependable.
Codependence: the disease of being an
immature child in an
adult body!
Codependence: two or more sick
people getting worse
together!
Codependence: a pattern of painful dependence
on people and on approval for safety,
self-worth, and identity.
Codependence is the social, emotional, spiritual
pathology that occurs when children are reared
in an environment characterized by high stress
and low nurturance.
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 immature thinking, feeling, and behaving that generates an
aversive relationship with the self (self-loathing),
which the codependent person acts out through selfdestructive or unduly self-sacrificial behavior.
Risk Factors for Codependence
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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
“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.
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:
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
Symptoms to Be Addressed
 Difficulty experiencing appropriate levels of selfesteem
 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
Therapeutic Focus
Key “codependency” issues
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Developmental arrest
Repressed emotion, frozen feelings
Recovery goals
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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
Therapeutic Process
1.
2.
3.
4.
5.
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
Issues Being Addressed
1.
2.
3.
4.
5.
6.
7.
8.
Backlogged feelings
Unrecognized, unrelieved shame
Emotional deprivation
Insatiable neediness
Attachment problems
Delayed development
Social & emotional immaturity
Spontaneous regressions
What is “Recovery”?
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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)
Recommendations
1. Inpatient treatment of primary addiction/s
2. Rigorous aftercare plan and monitoring
3. Assessment and treatment planning for
codependency issues and non-chemical
dependencies
4. Individual and group therapy or residential
care (no less than two weeks), as needed
for codependence and clean addictions
5. Appropriate twelve-step support groups
6. Occasional retreats or tune-ups
Regarding treated alcoholics/addicts who have
trouble staying clean: “To the extent that they
overlook child abuse trauma, the impact (of
treatment) may be transitory—often resulting in
temporary abstinence but typically failing to
resolve the pain that motivated the substance
abuse in the first place. In the absence of trauma
resolution, the survivor may easily return to
familiar tension-reduction or avoidance devices,
including alcohol and/or drugs.”
Dr. John Briere, Child Abuse Trauma, p. 147
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!
Recovery is
possible!
the
BRIDGE
TO R E COVE RY
1745 Logsdon Rd
Bowling Green, KY 42101
Toll-free (877) 866-8661