Addictions and Codependency

• Addiction: Basic Definition.
• Alcoholism and Chemical Dependency.
• Sex Addiction.
• Love Addiction.
• Codependency / Co-Addiction.

Addiction: Basic Definition

In simple terms, addiction is "a pathological relationship with a mood-altering experience." If you grew up in challenging circumstances, you may have found it difficult to tolerate uncomfortable emotions, especially if they felt uncontrollable. You may have learned to not trust others or there was no one to go to for comfort. Thus can begin the search for something to trust and rely upon to escape and relieve the discomfort that you feel may never end. Alcohol, drugs, sex, food, gambling, etc. often promise this relief, at least on a temporary basis; but, the promise of this relationship can lead one down the road to a "pathological relationship" with these substances / behaviors.

Scientists have discovered that addiction has a physiological component that affects the brain: if someone is feeling lonely, anxious or depressed, is under stress at work or in their family / relationships, or is worried about money, then mood-altering chemicals or behaviors may help them to feel better, at least temporarily. However, the temporary pleasure that numbs such painful feelings as loneliness, shame, rejection and low-self-esteem is not a solution when it becomes repetitive. The "addiction solution" requires constant stimulation; repetitive use of substances or behaviors is compulsive, and compulsion is the core of the "addictive process." Below are descriptions of various addictions and co-addictions.

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Alcoholism and Chemical Dependency

Some questions to ask yourself if you are concerned about your use of alcohol, drugs or other substances are:

• Am I doing this over and over again, hoping for something different to happen?
• Am I organizing my life around when I can drink or use drugs next?
• What feelings do I want to escape from?
• Am I regulating my mood with alcohol or drugs?

It’s possible you may not know the answers to these questions. Many people struggling with alcohol and / or drugs find it difficult to identify what they are truly feeling. And, some people may feel their alcohol / drug use is not a problem. However there are a number of symptoms that can creep up on you that indicate that your relationship with alcohol and / or drugs may indeed be problematic. Some of these include:

• Loss of control; not being able to have just one drink.
• Mood changes.
• Blackouts.
• Tremors or hallucinations when in withdrawal.
• Drinking or using drugs despite recurring negative consequences, e.g., DUI, inability to concentrate at work because of using drugs or drinking the night before, fights with significant others when high, etc.
• Frequent morning and / or lunchtime drinking or drugging, or disappearing from work to drink or get high.
• Hiding bottles of alcohol or drugs.
• Sneaking drinks before going to a party.

While this is just a sampling of symptoms, you don’t have to be "addicted" to alcohol or drugs to have a problematic relationship with them. You may observe that you are using them with greater frequency than you used to, or you may not like how you feel after using them, despite some perceived benefits. A thorough alcohol and / or drug history, including any information from your family of origin, will be helpful in deciding whether your usage is a problem and what treatment approach is most appropriate to take. Some possible treatment recommendations may include:

• Detoxification.
• In-Patient Rehabilitation.
• Intensive Outpatient Program.
• Outpatient Alcohol and or Drug Counseling / Psychotherapy.
• Group Therapy.
• Twelve Step Programs, such as Alcoholics Anonymous (AA), Narcotics Anonymous (NA), Cocaine Anonymous (CA) or Crystal Meth Anonymous (CMA).

It’s not easy to come to terms with an alcohol or drug problem on your own. As your therapist, I would partner with you to strategize the right treatment plan to get your life back on track. During therapy, I am especially interested in figuring out what thoughts and feelings you are having, and assessing what "triggers," meaning what specific people, places and experiences (things), make you vulnerable to alcohol and / or drug use. In addition, it would be important to incorporate some "healthy" behaviors (things you like to do or might be curious to try) that can be put into place to fill the gap that alcohol and / or drug use occupied. Putting these structures into place can make working on the puzzle of life easier. And, you will likely feel more supported in the event that unsettling thoughts and feelings emerge, or if you feel the temptation to take a drink and / or use drugs.

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Sex Addiction

Contrary to what some believe, Sex Addiction is a real problem. Unfortunately it often doesn’t get the same attention as alcohol or drug addiction, but it can be just as dangerous. Sex is meant to be pleasurable, but just like alcohol and drug use, it can get out of control and take over your life. And, a cold shower is not an effective remedy to stop. Unlike alcohol and drugs, which we can live without, we are meant to be sexual beings. So, defining what is healthy sexual behavior is not only complex and confusing, but it varies from person to person.

That being said, Sex Addiction can be defined as any sexual behavior that is secretive, shameful or abusive, which continues despite negative consequences. Some acting-out behaviors include: using prostitutes or getting sexual massages, prolonged use of pornography or on-line hookup websites, persistent pursuit of self-destructive or high-risk sexual behavior (like unprotected sex), chronic masturbation (sometimes to the point of injury), anonymous sex, multiple affairs, etc. And, Sex Addiction can also have, or lead to, a partnership with alcohol and / or drug use. Some people have never had sex without the help of alcohol or drugs, because getting close feels too threatening.

Just like all addictions Sex Addiction is not unique in that the cycle intensifies with each repetition. The following are some steps to the cycle:

• Control: At some point, people struggling with compulsive sexual behavior may try to control or change these behaviors, often with little or no success. Despite the feelings of despair and powerlessness that make these people want to stop, feelings of guilt, shame, despair, anxiety, depression confusion, anger, and / or frustration can be too difficult to tolerate, and the cycle resumes again.
• Fantasy: A person’s fantasy life can be so preoccupying that many report a "trance like" state where they are so engrossed with sexual thoughts that an obsessive search for sexual stimulation ensues.
• Ritualization: Rituals consists of the special routines that act as fuel leading up to the sexual behavior. These rituals intensify the preoccupation which is fueled by arousal and excitement.
• Sexual Acting Out: At this point, the imbalance created by the cycle is far too great, and the Addict is unable to control or stop the acting-out behavior. The ball is rolling down the hill with such momentum that the Addict cannot stop it on their own.
• Release: The release that is felt from acting out, and the numbing of emotions such as underlying depression, anxiety and other strong emotions, temporarily provide an illusion of control until the feelings start to build again.
• Despair: The return of uncomfortable feelings, and often the emergence of hopelessness and shame over one’s behavior and the powerlessness to stop it, result in feelings of despair, which can trigger the cycle to begin all over again.

If you are a Sex Addict and make the decision to stop, you will probably experience some withdrawal symptoms, which can result not only in physiological discomfort but psychological discomfort as well. This will be a tricky time. Some people will relapse, while others will replace the physical and emotional discomfort with other compulsive behaviors such as alcohol / drug use, gambling, shopping, compulsive eating, etc. which, before you realize it, can become addictive as well. This is known as Cross-Addiction. The use of multiple substances or behaviors, like sex combined with drugs and / or alcohol, is referred to as a Co-Occurring Addiction. The decision to stop having sex compulsively can trigger some people to stop sex all together for extended periods of time. This is an illusion of control and is referred to as "Sexual Anorexia," which comes with its own set of problems on the Sex Addiction spectrum.

Effective treatment options can include individual psychotherapy and / or group therapy. For many, the additional support of the Twelve Step community can be very helpful. Twelve Step Programs geared towards Sex Addiction include: Sexual Compulsives Anonymous (SCA), Sexual Recovery Anonymous (SRA), Sex and Love Addicts Anonymous (SLAA), Sexaholics Anonymous (SA) and Sex Addicts Anonymous (SAA). If a person cannot stop their addictive behavior through outpatient forms of treatment, then in some cases, intensive outpatient programs and / or inpatient treatment programs may be indicated as part of a treatment plan. As a therapist who is specifically trained in the area of Sex Addiction, I would partner with you to treat this problem and work towards recovering a healthy sex life.

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Love Addiction

Love Addiction, also know as "romantic obsession" or "obsessive love," can be just as much a problem as other addictions. And it reveals itself in many ways. You may be in a committed relationship with someone, in the beginning stages of dating or you may barely know them. Love Addiction knows no gender boundaries. Some of the signs you may be struggling with a Love Addiction include:

• You have a painful, all-consuming preoccupation with a real or wished-for lover. This can include obsessing in the beginning stages of dating.
• You have an insatiable longing either to possess or to be possessed by the target of your obsession.
• You are feeling emotionally deprived or abandoned because your love interest rejected you or is unavailable in some way, either physically or emotionally, e.g., someone in another relationship, a long distance relationship, etc.
• You behave in self-defeating ways because of your love interest’s unavailability or rejection, such as not leaving an unhealthy relationship even though you are unhappy.

Love Addicts may be completely rational in other areas of their life, or their Love Addiction may be co-occurring with other addictions like alcohol / or drugs, sex, sexual anorexia, gambling, etc. Many people have fallen "head over heels" for someone; popular culture has cultivated a fascination with this "romantic obsession," often convincing us to believe this is the only acceptable goal of romance. Just think about movies, television, advertisements and popular songs: These messages can trick someone into believing that no romance is truly real unless it is intense and all-consuming. This is the only "magic lover" out there for me. I must have them, and I must feel this intense euphoria in order for the person to be a right match. And, this euphoria becomes more important than a truly authentic intimate connection.

Yes, chemistry is important, but when this myth turns into an obsessive, tireless pursuit of someone, it moves into the painful realm of a Love Addiction. And with that can come the sadness, loneliness, anger, confusion, shame, despair and frustration that any addiction can cause. Just like addiction to a substance, there can be a withdrawal from Love Addiction. The craving for emotional connection or painful feelings can drive the Love Addict to relieve feelings of separation anxiety and loneliness in any way possible, which can start the cycle all over again.

What are the origins of Love Addiction? Even if you had "good enough parenting / care-taking" during childhood, the process of separating and becoming your own self-reliant person is filled with pitfalls. An illness in the family, the birth of a sibling, unavoidable caregiver absences due to demanding jobs, divorce, a caregiver’s addiction, depression, or death of a caregiver can contribute to feelings of abandonment and emotional deprivation. Even rejection by peers can trigger these same painful feelings. In addition, growing up in an emotionally or physically abusive family, where the needs for protection, respect and love were not present, can damage one’s ability to separate appropriately, learn self-confidence and continue developing into an independent, healthy adult.

It’s possible to recover from Love Addiction, but it can be hard to do it on your own as it can be ingrained just like any addiction. Withdrawal from a Love Addiction has been said to be worse than withdrawal from a heroin addiction. Your desperation can drive you to do crazy behaviors, like following your partner or going to places where you might run into them, checking the pockets of their clothing, checking their recent call log on their phone or calling unfamiliar numbers, looking at their emails or Internet history on their computer. Some will even hack into the Addict’s computer or pose as another person in a chat room. The list goes on and on. People engage in these behaviors in an effort to bind the feelings of desperation, but none of this will control an uncontrollable situation.

Effective treatments for Love Addiction can include individual psychotherapy, group therapy and involvement in a Twelve Step Program such as Sex and Love Addicts Anonymous (SLAA). In Sexual Compulsives Anonymous (SCA), which is geared for the Sex Addict, there is even a meeting geared towards "romantic obsession." In some cases, the Love Addict may benefit from an intensive retreat that is geared towards Love Addiction and Codependency. As a therapist who is familiar and comfortable working with Love Addiction and familiar with the Twelve Step Programs available, I would partner with you to help you get back on the path to building healthy sexual relationships with appropriate, nurturing and available partners.

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Codependency / Co-Addiction

An irony of addiction is that the Addict always affects those around them. It has a different feel and look for each affected person, related to the context of their connection with the Addict. This complementary component to the system is known as the Co-Addict. They could be the Addict’s partner, brother, sister, mother, father, child, friend or co-worker. What all these people have in common is they are in some form of relationship with the Addict. The partner of a Sex Addict is often referred to as a Co-Sex Addict, or COSA.

The term Codependency became popular at rehabilitation centers treating addicts back in the 1970s. Quite simply, a Codependent person is "one who has let another person’s behavior affect him or her and who is obsessed with controlling that person’s behavior." This is often at the expense of the Codependent person’s own serenity and their focus on developing and thriving in their own life.

It’s important to understand that Addicts can also be Co-Addicts. For example, if the Addict grew up in an alcoholic / substance abusing home or some other kind of dysfunctional environment, they were affected by this experience. Underneath their own addiction lies the pain of the Co-Addiction. Both the Addict and Co-Addict parts need to be treated.

If you are the Co-Addict, you may be experiencing a different kind of out-of-control experience that you need to manage. This role can be maddening, heartbreaking and compulsive too, as you try to manage your own difficult feelings as well as those of the Addict. You may begin to doubt yourself and your perceptions. Am I crazy? Things don’t make sense or add up. Sometimes the Addict will lie to you to keep their addiction going at all costs. Denial is one of the hallmarks of addiction, and this denial can also be present for the Co-Addict who cannot believe what is going on around them. You may search for liquor bottles in the house, check the pockets of the Addict’s clothing, check their recent call log on their phone and call unfamiliar numbers, look at their emails or Internet history on their computer.

Some will even hack into the Addict’s computer or pose as another person in a chat room. You may confront the Addict, be told that nothing is happening and for a moment believe the person, only to find out later they were lying. This is all in an effort to control the uncontrollable. This hyper-vigilance is often referred to as the "Codependent crazies," as the Addict’s web spreads and robs you of your sense of peace and well-being. This situation can leave you feeling anxious, depressed, lonely, sad, unsafe, insecure, suspicious, paranoid and very confused. You must remember that the Addict has the illusion of needing their substance of choice, which can lead them to lie, cheat and steal to maintain it, even if they love you.

For the COSA, your partner’s addiction can have a profound effect on your own heathy sexuality. Your sex life may deteriorate to nothing, you may lose your interest in sex, or you may try to control the situation by becoming what is called "sexually anorexic." Or you may try to appease your partner by having sex whenever they want it, even if you don’t want it. You could also develop a Love Addiction or utilize sex as a way to cope with your own stress, which can push you into your own addictive sexual behavior.

Whether the Addict admits to their problem or not, the COSA is going to need help and support for the pain and suffering and other feelings such as shock, disbelief, anger, sadness and more that can be caused by the trauma of this violation. Left untreated, Codependent people tend to repeat this pattern over and over again unless they get some help in breaking this cycle: Even if you are no longer in a relationship with the Addict, the stage has been set for you to be vulnerable to connect with another Addict. It’s important to remember that you did not cause the problem, you cannot control the problem and you cannot cure the problem, no matter how hard you try. The sooner you begin to get some help for yourself, the sooner you can begin the healing process and break the cycle of your role in the addictive system.

Individual therapy, group therapy and Twelve Step Programs can be useful tools on this journey. It can take a long time to rebuild trust in your relationship or to decide if you want to continue in the relationship at all. Some Twelve Step Program options include Codependents Anonymous (CODA), Al-Anon (relatives / friends affected by someone’s drinking / addiction) and Nar-Anon (relatives / friends affected by someone’s addiction). S-Anon and COSA are for the partners of Sex Addicts. If there are no S-Anon or COSA meetings that feel right to you, there are Al-Anon, CODA and Nar-Anon meetings where a COSA might get help. If the Addict is willing to take responsibility for their addiction, then at some point, couples therapy and / or family therapy would be a useful adjunct to the treatment protocol to further help the couple or family recover. There are also Twelve Step Programs for couples, including Chapter 9 Couples in Recovery Anonymous and Recovering Couples Anonymous (RCA). In addition, Alateen is a program for young people affected by someone’s drinking / addiction and is affiliated with Al-Anon.

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References: Facing the Shadow, Starting Sexual and Relationship Recovery by Patrick Cranes, Ph.D. (2001), Wickenburg, Arizona: Gentle Path Press; Out of the Shadows, Understanding Sexual Addiction by Patrick Cranes, Ph.D. (1992), Center City, Minnesota: Hazelden; Sexual Addiction, An Integrated Approach by Aviel Goodman, M.D. (1998), Madison, Connecticut: International Universities Press, Inc.; Cruise Control, Understanding Sex Addiction in Gay Men by Robert Weiss, MSW, CAS (2005), Los Angeles: Alyson Books; Obsessive Love, When it Hurts Too Much to Let Go by Susan Forward, Ph.D. and Craig Buck (1991), New York: Bantam; Codependent No More, How to Stop Controlling Others and Start Caring for Yourself by Melody Beattie (1987), New York, Center City, Minnesota: Harper, Hazelden.