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.