Chapter #8 How Can I Begin To Take Care of Myself

 

         This chapter begins by addressing classic modes of self blame which could be the sticking point for many partners.  "Is this problem my fault?" She uses nice insights like “listen to your gut” somewhat hidden in the scientific research she quotes.  Then she goes into a list of all the possible types of therapy one could pursue, almost an encyclopedic list.  But then she has some really good insights about finding yourself and making the most of your life.  I found many nice insights in this chapter hidden among the quoted research and the lists as boring as a grocery list.

Chapter #7 What Can The 12 Steps Do For Me? By Mavis Humes Baird, BFA, CSAT

            At first I found this chapter a bit dry and “objective.”  I realized I am more accustomed to listening to those who appreciate the “miracle” which they have experienced.  The founders of Alcoholics Anonymous stumbled on a process, which has had more success than any other in treating addiction.  But this chapter is a pretty complete explanation of how the 12 step process works.   I would substitute “living in the moment” or “mindfulness” for the concept of “detachment.”  Under stress many addicts have used the concept of staying sober one day at a time to living one moment at a time.  

Powerlessness must be a difficult concept for partners, co-addicts.  The alcoholic is powerless over alcohol.  After one drink the alcoholic feels compelled to have another and another and continues to drink.  The first drink is the problem because the door is open and the alcoholic can’t stop.  How does that principle apply to the partner who did not compulsively seek some kind of sexual gratification?  After all it was the addict who caused the betrayal and chaos.

Yet many find it difficult to give up the “Oh my God” chaos.  The excitement and the self-affirming nature of the ruminations has its own attraction.   What’s more the partner’s involvement in the relationship was often based on a “happily ever after” expectation.  To give up that hope, wish and expectation is to say the “I was a fool” and then to face the shame and then the grief of that loss.  Also it would be nicer to be able to avoid facing the questions about your own sexuality that Omar Minwalla so graphically described.  The partner is confronted with what must seem to be overwhelming hurt and vulnerability.

Yet control does not seem very possible or fruitful.  Life has become unmanageable. The management she employed to make up for a partner’s lapses or the cover over problems didn’t work. The partner doesn’t have the control she once believed she had.  She can’t control what others think or do. She can’t turn back the clock and change missing a bus, for example.  But she can be in control of attitudes and/or negativity.  Giving up control and assuming an attitude of humility can maximize healing and learning, but it is terrifying.  The 12 step programs recommend turning to the higher power of your choosing for support and comfort.  The group effort to challenge the demon of addiction can be reassuring.  Others are going through what you are feeling.  Others have had some success.  The group wisdom and faith that the process works can provide hope in a time of chaos and overwhelm.  In battle what often inspires soldiers to bravery is the loyalty to each other.  Members of a 12 step program have a similar loyalty as they fight the enemy they have in common, addiction. 

Chapter #6 What About My Sexuality by Omar Minwalla, PhD, CSAT

            Omar  Minwalla took on a highly sensitive topic in this chapter.  The discovery that a partner is a sex addict can be a traumatic event for the partner.  Sometimes the reactions apparently can parallel those of someone who has been brutally raped. At the very least any self-doubt, particularly about one’s sexuality, becomes a primary concern.

I was wondering how to address such a sensitive topic and it came to me during a meditation. My best ideas often do when I am trying not to get caught up in my thinking during meditation.  Probably the ideas occur because I have suspended my self-criticism

At first Omar Minwalla’s examples of the effect on a partner’s sexuality of acknowledging the sex addict’s behavior seemed to be “over the top”. But what he did was articulate many of the reactions the partners of sex addicts have. Making these reactions so explicit must make these issues more “normal’ for the partner.  Therefore, the awareness of issues can contribute to the work of healing.

One of the keys to any intimate relationship is trust.  Each partner makes him or herself vulnerable by acknowledging the other person’s importance.  Healing enough to tolerate and risk the possibility of the other person's rejection or betrayal is no easy task in the context of one partner’s sexual addiction and/or the other person's rage at the betrayal.

Boundaries –Chapter #5: Cara Tripodi “How Do I Set Boundaries And Keep Myself Safe?”

I like Cara Tripodi’s approach in this chapter.  Apparently her appoach uses a philosophy of “mindfulness.” She recommends developing an “observer” position in which the person steps back and looks at things as an observer would.  Developing a practice of mindful meditation would probably help. Try to disengage for a moment from the passion of feelings and the rush of thoughts.  Try to take a more objective look at what’s taking place.  Then vengeance or the desire to change or control the addict may be less urgent.  The priority of doing what is best for you is more possible.

 She emphasizes the partner taking a path of discovery.  Don’t expect to be able to know how to take care of yourself immediately.  Remember that your first priority is to protect yourself, to be safe and to enable your own healing.  Commit to establishing the necessary boundaries on a “trial and error basis.” 

This approach of staying in the moment and restraining self-criticism would seem to be the logical approach in this type of crisis.  But as she points out, it wouldn’t be easy.

Family Values

       “Family values” is a term which is bandied about in political discussions, but I have musing about Patrick Carnes’s “tests of a partnership.”  That presented "family values" in a different light.  I like the sense of personal responsibility imbued in that description.  But ultimately it is the balance of having the courage to allow oneself to be vulnerable to the other and maintaining the highest level of respect for the other and yourself.  Each partner gives the other partner's life real meaning. To me this is a ideal goal of personal conduct.  I do need a sense of spirituality to pursue this standard of behavior.  This is the “nitty and gritty” of a spiritual “family value” to live and to teach children no matter what kind of relationship a person has with their God.

Further Responses To Patrick Carnes’s writings in Chapter 3

I liked Patrick Carnes's reminder of the tests of the strength of a partnership in which a person feels accepted and affirmed “warts and all.” The person asks himself, “Can I be most myself in your presence? Can I be creative, funny, vulnerable, flamboyant, shy or even smart?  Can I couple any of those words with sex and romance?  Can I be tough, forgiving, generous, spiritual, intuitive, graceful, clumsy, lazy, self-indulgent, and disciplined?  Do I feel equal, successful, attractive, encouraged, trusted and believed?  Can I be fully as competent as I can be and have my partner disappear?  Do I feel challenged?  Can I be accountable and hold my partner accountable? Is it ok to make a mistake?  Does our time together really seem to matter?”

Another test is “Can you share the darkest part of yourself?"  “Can you hear about the dark side of your partner?”  Relationships are “challenging and to find meaning a person needs a “witness.”

I find this material very substantial for any couple whether addiction is involved or not. 

However, the “mismatched stages” concept doesn’t resonate with my own experience in working with couples and families.  It seems too complicated to be a useful concept.  I confess I am a firm believer in the KISS principle. Matched stages seem unlikely.  Murray Bowen talked about working with one individual in a family to improve that person’s boundaries and that improved the boundaries and sense of self for all of the members. Couples and family therapy facilitates that process by enhancing the encounters between or among family members. Boundaries, feelings and beliefs become more explicit for all.  The impact of one person on another is also made more explicit. The members grow through encountering each other.

Chapter # 4 by Patrick J. Carnes, Ph. D Should I Stay Or Should I Go?

            This chapter is a remarkable statement of the universal need to take life as series of learning experiences.  His belief in the possibility of personal growth was a refreshing reminder of what keeps therapy exciting for me. 

            Carnes's  position does expect that the co-addict needs to take personal responsibility for choices made and that being a co-addict is a mental health problem.  That would seem to be a common sense idea, but the “aggrieved party” can be expected to resist it.

            More to follow on this topic.

Further Reflections on Chapter #3 “Is This Going To Get Better” by Stephanie Carnes, Ph.D. and Cara Tripodi, LICSW

           Initially I was awed by the profound analysis of the co-addict’s change process.  Certainly it was more thorough than my initial musings about the change process. I was reminded of the Prochaska and DiClemente “Stages Of Change”, Elisabeth Kubler-Ross and the stages of grief, Maslow’s Hierarchy Of Needs and the basic 12 step AA and Alanon process. Knowing about these theories made this chapter much more understandable, but I don’t want to be dismissive of this work.

            The authors made a detailed analysis of the avalanche of possible behaviors and emotional states and made sense out it.  No matter how much they drew on existing thinking that was a substantial achievement.  Both a therapist and a partner can use the clarity they brought to understanding the process.  In my experience the mind is a very flexible and adaptable being. Although the neurological pathways of the brain may be mapped, the responses and adaptations of an individual are not so easily predicted.  Scientists are just beginning to appreciate the extent of the mind’s capacities.  Those of who have had the privilege of observing the considerable positive healing and changes some people experience are deeply affected by that.  That experience has enhanced my sense of spirituality.

            No explanation can capture all of the complexity.  But the detail of description serves to make the natural chaos of the process intellectually manageable.   Carnes and Tripodi express a consistent message of encouragement.  They presented how it works.  That is possible to come to terms with these issues.  They present a rational reason to believe the partner can heal, grow and be more mature and strong.  The trauma can be an opportunity to grow and mature.

Further thoughts

A reflection:

       Healing requires nurture, self-nurture and caring from others.  To heal a person has to do the work.  Many have to take steps, such as, acknowledging the feelings, experiencing them, putting the experience in perspective, accepting that the injury occurred, acknowledging helplessness to reverse the event or condition and adjusting.

            Two strategies which impede healing are seeking revenge or engaging in self-indulgence.  To seek revenge requires holding the bitter anger and hurt tightly to prevent the memory from fading or the feelings diminishing.  If the feelings are allowed to ‘slip away” the “abuser wins” or the wrong is condoned. Holding the hurt and anger tightly prevents the individual from letting go and moving on.  Self-indulgence in guilty pleasure hinders to the person’s ability to maintain, regain or establish self-respect.  That keeps the “victim” “off-balance” and hinders healing, which requires courage.

       i wrote this down thinking it was profound.  Then I started to read Chapter #3 and my musings seemed so superficial by comparison, another "lesson in humility." 

Chapter #2 Stephanie Schnieder. MD

       In this chapter Dr. Schneider lays out the initial steps for the partner.  She provides important guidelines for beginning to deal with the problem in a way that sets the groundwork for long term healing and possible reconciliation. At the time of “discovery” the partner is likely to be in crisis.  Having such clear guidelines and the reasons for taking these steps must be extremely helpful for person desperately seeking direction.  “What do I do now?!!”

            From a therapist’s point of view this conjoint counseling would be a delicate balance between listening to each person’s pain and fear and maintaining a focus on the steps forward.  The partner may be all over the place emotionally with hurt and rage from betrayal at one moment to self blame the next moment.  The addict may be trying to defend, blaming the victim, trying to negotiate continuing the addiction behavior and /or trying to rationalize it or brimming over with emotional guilt and shame.  An inexperienced therapist unready to cope with such turmoil and unready to be directive could find the session spiraling out of control, helpful to no one.  These guidelines can be very helpful for the therapist to use to keep the process on track.

Chapter #1, by Stephanie Carnes, Ph.D.

        Carnes presented a very inclusive outline of the addiction and co-addiction pattern.  The intellectual framework explains the pattern, but her emphasis on the development of insight and awareness is probably too overemphasized to be effective in treatment.  Probably the nuances of treatment will be described in later chapters.  Yet the thoroughness of the explication of the many forms of projection and denial is awesome. Rationalizing and/or keeping busy by following the famous Sachel Paige dictum, “Don’t look back. They’re gaining on you.” are only two behaviors on the long list of avoidance techniques.  Whatever the behavior it serves the person’s fear and helps avoid whatever awful feelings might be lurking.

The co-dependent partner has so much to fear.  The addict is not alone in fearing withdrawl.  Carne’s description of the parallel cycles of sex addiction and co-sex addiction fully depicts the similarities. To let go of the rumination, the obsessive rituals, the paranoid concerns, etc. the co-dependent would be forced to experience the fierce pain and rage of betrayal, rejection and the emptiness of existential angst. “ Where’s the meaning in this life?”  “What can justify the endless anxiety?” “I feel empty and worthless.”

In a crisis or in the depths of despair the co-dependent person has to stop and take a different course of action despite “the stinking thinking.”  Insight is over rated.  Alone intellectual insight seldom is enough to enable the person to break free of the pattern of self-destructive behavior.  Knowing you are on a “wrong track” doesn’t get you off it.  Attempts to think your way out of the morass often leads back to the starting point.  Hope, determination to break away from the misery, and an, most importantly, an alternative action are probably going to be more effective than understanding. Until the behavior pattern changes the person is doing the same thing, but expecting different outcomes. Insight is more likely to develop as new behavior changes outcomes.  Mustering the courage to try to begin to act differently and actually trying to do something different is the beginning of the development of a new self-esteem.  Knowing that others have been in the same predicament, are also trying to change themselves and have begun to have some success can also be very helpful.  Finding even one other person who believes in the person can make all the all the difference.  Trusting another while despairing is not easy, but trying to do it alone is the most difficult path.

Purpose & Disclosure:

            I thought it would be good for the RI Chapter of NASW’s Addiction Committee and for me to write a series of blogs about my reactions to each chapter of Mending A Shattered Heart, edited by Stephanie Carnes, Ph.D.  Cara Tripodi, LICSW, wrote the chapter on boundaries. She presented our seminar on sexual addiction last spring and will be presenting a follow up seminar on March 30^th, entitled "Partners Caught in the Crossfire: Sex Addictions' Impact on Loved Ones"

            I’ve had considerable experience doing therapy, but not with the treatment of co-dependent partners and families.  Therefore, I can approach this blog as a learner sharing my experience and I am hoping this will develop into a dialogue. Reading each chapter and writing a response at least will deepen my understanding.  Hopefully that will generate greater interest in the seminar and greater interest in this issue within the professional community in Southeastern New England. Sexual addiction has not been a common topic for professional seminars in this area.  In her introduction Stephanie Carnes cited an estimate of 1 to 3% incidence in the general population of this form of addiction.

            Of course commenting on this book is not proving to be the simple process I expected.  Although the book was intended to be a guide for the partner who discovers his/her partner is a sex addict, it provides a detailed description of the dynamics involved as well as a procedural guide. Sometimes I find my commentary is getting ahead of the book and sometimes I find myself skipping by important dynamics.  In short this project is a more ambitious endeavor than i was prepared for and another life lesson in humility.  I welcome any assistance offered.