Tag Archives: trauma

Addiction is a Symptom of Untreated Trauma

Posted on October 8, 2015 by Melissa Killeen

“What is addiction, really? It is a sign, a signal, a symptom of distress. It is a language that tells us about a plight that must be understood.” — Alice Miller, author of Breaking down the Wall of Silence

I am a recovery coach. A recovery coach or sober companion is often called in to work with the most difficult addict, the chronic relapser. A chronic relapser is an individual that has been to several rehabs, often 7, 8 or 9 visits in less than five years. Who has not been able to put together 90 sober days, except in treatment. Whose family, spouse or children have given up on them. In reality, a chronic relapser is an addict that is acting out in their addiction. Their addiction is just a symptom of untreated trauma.

Often, calling a recovery coach is the last resort.

My first job, of course, is to make sure this person doesn’t drink, use or act out. And to find some redeeming qualities of this addicted person so I can approach healing the behaviors driving the addiction. This is the key point that brought me to the understanding that many of my clients have experienced some form of trauma, early in their childhood or adolescent lives.

I always ask the client for their story. I provide all of my clients the ACE study questions. ACE means Adverse Childhood Experiences. The ACE study is an ongoing collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente’s Health Appraisal Clinic in San Diego. It started in 1976 with the purpose of finding more about childhood trauma, and the later-life health and well-being of participants. (For more information on ACE, see my blog post dated August 20, 2015). The ACE study poses such questions as: Did you move a lot? Did you ever go hungry? Did you experience a childhood that was less than nurturing? Did you ever have a moment that overwhelmed you? Did you live through an ordeal that changed how you think about people, places or things? The results of the ACE questions, and the addict’s story that comes after it, always profoundly moves me. I get a much more honest story than most clinicians, mainly because of these questions.

The reason it’s significant for me to identify and acknowledge trauma, is because research proves that trauma can activate behaviors that lead to addiction. My clients are using a drug or alcohol as a way of self-protection, of calming down, as life preservation. Everyone in the rooms (AA, NA meetings) knows addicts “use” in order to “numb out.” Well, let’s rethink that, turning it a bit to say: victims of trauma are really using a drug or drink to:

Stay safe: After trauma the addict’s own mind can feel like a danger zone, which makes being “out of it” feel safer than being in it.
Escape memories: Unwanted and unresolved memories have a way of popping up incessantly after trauma; addictions offer the mind a different area of, or reduced capacity for focus that helps suppress reminiscing.
Soothe pain: Substances or the adrenalin rush of self-destructive behaviors change the addict’s body chemistry, releasing endorphins and other mood enhancers that reduce discomfort.
Be in control: Sometimes, engaging in addictive behaviors can lead an addict to feel strong, resilient and courageous, an experience that is tremendously alluring when trauma from the past intrudes on the present.
Create a world the addict can tolerate: The intense feelings brought on by fear, memories and anxiety can make any moment seem overwhelming. The release of tension brought on by addiction-oriented behavior helps facilitate a manageable experience.
Treat yourself the way you feel you deserve: Trauma can leave an addict feeling less-than, worthless, hopeless, and damaged. The more self-destructive the addict behaves, the more it can feel like he or she is living in alignment with who they truly are. While this is false, it can help reduce feelings of otherness and disconnection.
Redefine who the addict really is: Trauma changes an addict’s identity all the way down to the core of their beliefs and self-definition. It can seem as if no one understands them. Engaging in addictions can help create a sense of community by connecting the addict to others who feel, see, think and behave as they do. Addictions can help the addict revise their self-perception by allowing them to engage in and act out behaviors that allow them to feel stronger, more courageous, capable, etc., than trauma has left them feeling.[1]

This puts the addiction-trauma link into perfect perspective for me, and I hope it opens some eyes for other addicts, alcoholics, and clinicians that are reading this post. Next week’s post will go on to explain the scientific research that backs up this discovery that addiction is just a symptom of untreated trauma.

Research used in this blog:

Centers for Disease Control and Prevention, http://www.cdc.gov/violenceprevention/acestudy/about.html

Adverse Childhood Experiences Study, Posted on August 20, 2015 by Melissa Killeen, https://www.mkrecoverycoaching.com

[1] Trauma and Addiction: 7 Reasons Your Habit Makes Perfect Sense, by Michele Rosenthal. Published on March 30, 2015 in Behavioral Health, Living in Recovery, Living with Addiction and at http://www.recovery.org

Please feel free to leave a comment:

Posted in Addiction, Addiction Recovery Posts, alcohol, Alcoholism, Drug Abuse, Family Dynamics, Gambling, Health, mental health, Parents, Recovery Coaching, Relapse, Research, Sex Addiction | Tagged ACE Study, addiction, Adverse Childhood Experiences, Center for Disease Control and Prevention, dr. gabor mate, Kaiser Permanente Health Appraisal Clinic, Michelle Rosenfield, San Diego, the effects of trauma causes addiction, trauma | Comments Off

What is sex addiction?

Posted on December 26, 2014 by Melissa Killeen

Melissa Killeen

What is sex addiction?

As a recovery coach it is important that I am familiar with every addiction. Growing up during the sexual revolution of the 1960s and 70s, I was amazed when I learned about sex as being addictive. That’s what we were supposed to be doing in college—exploring sex, right? Well, not to the extent that some of us were exploring sex, that’s for sure. Sexual addiction (identified in the DSM-5 as hyper sexuality) is a very real addiction with very real consequences that are every bit as devastating as heroin, cocaine or alcohol addiction. Some recovering addicts call sex addiction their core addiction.

Of course, the definition of sex addiction varies from person to person, based on an individual’s life circumstances (married/single, gay/straight, religious background, community standards, etc.). Sexual addiction is best described as a progressive intimacy disorder characterized by compulsive sexual thoughts and acts.

For some, sex addiction, or the behavior described as “acting out,” can be a solitary activity, such as compulsive masturbation, the extensive use of pornography or sexual fantasy. Some compulsive activities include participating in phone sex or video sex services. For others, sexual addiction can involve illegal activities such as exhibitionism, voyeurism, obscene phone calls, child molestation or rape. Many of the sex addicts that sit in the rooms of twelve-step programs like Sex and Love Addicts Anonymous, Sex Addicts Anonymous or Sexaholics Anonymous, speak about their addiction as having repeated sexual encounters with others, lacking any connection, intimacy, or relationship commitment, and often without even knowing their partner’s last name (this is called anonymous sex). And many times obtaining these sexual services through escort services, massage parlors, strip clubs or prostitutes.

The nature of this illness causes individuals a lot of shame and guilt, and they hide the problem from others because they think they can control their behavior to minimize the damage to their wife, job or community status. This includes being deceptive with their physicians because of their immense shame. If they hold any type of leadership position (e.g., church, business, community, or politics), the fact that they feel they have to be models of moral behavior compounds the problem, adding to their shame and guilt. This addiction also involves the abuse of power, including that which is held over minors, congregants, employees, patients, or other persons under the authority of the sex addict. Any exploitation of power, or complaint of exploitation, can mean removal from duties, furthering the cycle of fear. The following examples illustrate the diversity and complexity of this addiction:

Tiger Woods received sex-addiction treatment after he admitted to a number of infidelities; at least a dozen women came forward to claim they’d had sex with him. In 2008, actor David Duchovny announced that he had checked himself into a rehabilitation facility for treating sex addiction. Charlie Sheen recently sought help in controlling a variety of runaway appetites, including a fondness for the company of porn actresses. Republican Congressmen Christopher Lee resigned after he was caught e-mailing a shirtless photo of himself, hoping to entice a woman he met on Craigslist. Joining the stupid-photo-society was Andrew Weiner, former member of the United States House of Representatives from New York City, caught sending explicit sexual material by cell phone, better known as sexting. Let’s not forget Mark Sanford, the Governor of South Carolina, who told his wife and staff he was hiking the Appalachian Mountain Trail while he actually traveled to Argentina to visit his mistress. The sexual exploits of the rich, and powerful are not limited to the U.S. Remember Silvio Berlusconi, the uninhibited Prime Minister of Italy, who was accused of having paid an underage girl to have sex with him? Dominique Strauss Kahn, International Monetary Fund chief, was forced to resign following a series of allegations made against him. The former French President, François Mitterand, was found to have been living a double life throughout his presidency with a long-term mistress, fathering two children with her. All these cases differ in scope, but a central question remains: Why would these men risk everything to satisfy their sexual urges?

It is important to note that women can suffer from sexual addiction, too. Recently, a New Jersey teacher was convicted of child sexual abuse, and had the child of the young male victim. Last year, I posted the story about a 40-year-old female entitled, “Soccer Mom—Sex Addict,” a suburban housewife and soccer mom who had sex with over 140 men. Jennifer Lopez admitted this winter, that she was a love addict (more on love addiction later in this blog series). In fact, for every three men with sexual compulsivity, there is one woman with the disorder. This ratio parallels the gender ratios of compulsive gambling and alcoholism. The belief of many that women (especially moral or religious women) do not have this problem, helps keep it secret. Yet a female suffers the shame and guilt of having a sexual disorder and the shame and guilt from being a woman who has found herself victimized, as well.

Is it possible I am a sex addict?

There are many assessments available for people who may have questions about their sexual behavior. SLAA has the 40 Questions assessment and Dr. Patrick Carnes provides several assessments on his web site sexhelp.com. Maybe the following descriptions or characterizations based on research completed by Patrick Carnes can help you identify if you might be a sex addict.

Most sex addicts grow up in dysfunctional families, surrounded by parents, siblings or caregivers who display addictive and compulsive behaviors with a lack of intimacy, as a result of these behaviors. Research has found that more than 87 percent of sex addicts come from a detached, uninvolved, or emotionally-absent family. Compulsive sexual behavior is a sign of a significant intimacy disorder and the inability to meet one’s emotional needs.

Children who grow up in these dysfunctional families have ways of keeping themselves safe, these ways continue into adulthood and are extremely self-limiting. Children from these families limit their own growth by their thoughts. Such amindset shapes how children view the world, leading them to believe that what’s happening to them is outside their control and is everyone else’s fault.

Sometimes there is a conflict with authority. For kids growing up in an alcoholic household, complying with authority means an essential loss of self. So as adults, they become comfortable hiding things from those in authority and resistant to accountability for their actions.

A sexually compulsive person may have a history of sexual, physical, and emotional abuse. Starting at a very young age, addictions may have served as a defense mechanism and a way to manage stress during their abusive childhood, oftentimes through compulsive masturbation or the use of a sexual fantasies. One of the effects of abusive families and childhood sexual abuse is as adults, survivors sexualize all interactions. Telling dirty jokes in the break room, commenting on how a complete stranger was ready to marry them after hearing one compliment, fantasizing about movie or rock stars or falling in love with their doctors, are typical examples.

Shame also comes from an upbringing in a dysfunctional home. The child never had the positive reinforcement necessary for developing a sense of self, and truly believed they were “no good.” The old tapes of a parent chastising them were never erased. The constant failure to stop the compulsive masturbation or use of pornography reinforces those old tapes, supporting the belief that the child was fundamentally flawed and unlovable.

Occasionally, times are so bad that an abused child will dissociate or compartmentalize, which is a survival mechanism that allows the child to avoid the reality of the abuse. Dissociation is moving from reality into a dreamlike state during an abusive situation. Dissociative disorders prevail with adults, and can be called daydreaming or diagnosed as adult ADD. For adults, compartmentalization means dividing up life into small boxes or compartments and dealing with each box separately. For example: this box is my family, this box is my secret sexual life, and this box is work. Everyone tries to place work into a box, so they don’t take work home and start talking to their spouse like she was an employee. This is not a healthy form of relating to a loved one. By compartmentalizing, a person puts their sexual behaviors in a box and places it so far back on the top shelf in a closet that they really believe no none will discover their sexual behavior box. They can then lie to others without distress, because it is not present in their reality right at that moment.

I am sure you have heard about binge drinking or binge eating. Sex addicts will also binge. In fact 72% of them binge. They stay up all night or all weekend watching porn, they visit a park and have sex with several anonymous partners or go to a swingers’ club. There is also a form of purging associated with sexual binging behavior. I am sure you have heard of a clergyman who opposes same-sex marriage and is publicly anti-homosexual. Every Sunday, he rants against homosexuality from the pulpit, writes anti-same-sex marriage editorials, and participates in protests. This is the clergyman purging, because later he is discovered meeting men for sexual encounters in a public restroom.

Sex addicts are totally oblivious to the consequences of their behavior when engaged in their addiction. Frequently, addicts reported knowing their behavior would be disastrous, but engaged in it anyway. High-risk behaviors, which result in severe consequences, such as loss of career or arrest, add to the stimulation of the sexual acts or behaviors. This is because when as children they are abused sexually, their young minds blend fear and being aroused by a sexual act, together. For adults that have survived sexual trauma, sex will contain either a fear component or power component, which results in risk-seeking sex.

Sometimes, a sex addict has another addiction or a mental health diagnosis. When this occurs it is called a co-occurring disorder. For example, 41% of sex addicts have problems with alcohol or drugs, and 38% have an eating disorder. Other problems include depression, obsessive compulsions, compulsive gambling, compulsive spending, and nicotine addiction. Usually, compulsive sexual behavior is part of an intricate web of behaviors used to manage internal distress. Many studies have proven that addicts will switch or replace one form of acting out with another addictive and compulsive disorder.

As with all addictive and compulsive disorders, when acute depression is present it is constantly intensified by the failure to control one’s behavior. Other co-occurring issues include mood disorders, anxiety disorders, and abnormal personality traits which could be presented as an individual feeling anxious, fearful, dramatic, distrustful, or exhibiting bizarre or eccentric behaviors.

So, after you read this post and review the assessments, you might ask “Am I a sex addict?” This is a question best discussed between you and a therapist. I highly suggest you speak to a therapist that is a Certified Sex Addiction Counselor or a member of SASH, the Society for the Advancement of Sexual Health. Once you feel comfortable disclosing your thoughts and/or behavior, you and your therapist can discuss the issues of family, control, dysfunction, and abuse. A Certified Sex Addiction Counselor (CSAT) can assist you in finding tools for managing stress, shame reduction, and relapse prevention. Understanding what is normal sexual behavior and what is compulsive sexual behavior is critical to this therapeutic discussion.

I strongly suggest to you that sex addiction is not an addiction that anyone can self-manage, and the next series of posts will help further define all of the intricate ways sex addiction can present itself. I invite you to read next week’s post, and if you like, share this blog post with a friend.

Resources used in this blog:

Time Magazine, John Cloud (2.28. 2011) Sex Addiction: A Disease or a Convenient Excuse? Is it a real disease or an excuse for men to cheat and spend hours on porn sites? The inside story on uncontrollable desire. © 2014 Time Inc
http://content.time.com/time/magazine/article/0,9171,2050027,00.html

Huffington Post, Robert Weiss LCSW, CSAT-S, What the Heck Is Sex and Relationship Rehab? (10.5.1) © Huffington Post 2014 http://www.huffingtonpost.com/news/politicians-sex-addiction/

Patrick J. Carnes, PhD, (10.2000), Sexual addiction and compulsion: recognition, treatment & recovery. CNS Spectrums,Task-Centered Competency-Based Approach to Treatment Volume 5 – Number 10 ● October 2000 ©1998
CNS Spectrums 2000; 5(10): 63-72
http://www.iitap.com/documents/ARTICLE_
SexualAddictionAndCompulsion_PCarnes.pdf

Psychology Today, Neel Burton, MD, (5.9.12) The 10 Personality Disorders: A short, sharp look into the 10 personality disorders.
http://www.psychologytoday.com/blog/hide-and-seek/201205/the-10-personality-disorders

Posted in Recovery Coaching, Sex Addiction | Tagged child sexual abuse, hypersexual disorder, Sex Addiction, trauma | Comments Off

Angry Birds—the conflict between a young adult and her mother in recovery

Posted on August 10, 2014 by Melissa Killeen

Melissa Killeen

Most people have been exposed to the difficulty young adults encounter when trying to separate from their parents, as enacted in the 2006 American romantic comedy film, Failure to Launch, starring Matthew McConaughey. The film highlights a young man’s struggle to detach himself from his parents coupled with the desire to remain a child, and the anger that results from the failure or success of doing either. The anger, however, is not just the property of the young adult; it is also owned by the parent(s) who want the same things for their child; to separate successfully while also wanting them to remain the elementary school child, fully dependent and unconditionally loving them. Things can get complicated.

Psychologist Jeffrey Arnett suggests that there is a new age classification, labeled emerging adults, which bridges the gap between adolescence and adulthood. According to Arnett’s theory, people in their 20’s go through a time of development that’s distinct from other stages of adulthood. Ronald Cohen, a Bowen Family Systems trained psychiatrist from Great Neck, NY, cites that “becoming an adult, leaving home and staying connected is the first stage in Carter and McGoldrick’s formulation of The Expanded Family Life Cycle. This Family Life Cycle transition can be described as beginning with the adolescent’s ‘identity crisis’. It continues through the transition to college and into young adulthood. Some young adults end up never leaving home. Others end up cutting off and becoming estranged and distant from their family. Both of these responses are sub-optimal solutions to the struggles of the launching phase.”

A emerging adult’s tasks in this transitional launching phase are primarily focused on the development of autonomy and healthy interdependence. Interdependence is defined as the mutual dependence between people, places and things, such as how a bee needs to pollenate flowers or when an emerging adult needs to borrow Mom’s car and will agree to take it for an oil change. The goal is to develop differentiation, for the emerging adult to become emotionally and financially accountable to one’s self, while at the same time maintaining connections with their family, without taking on their ‘stuff’.

Case in point, is the situation of my client, a 45-year-old alcoholic in recovery and her 21 year old daughter. The ‘stuff’ is this client’s addiction, the years of enmeshment and the trauma to which her daughter was exposed. My client and her not so perfect sobriety time, which includes two DUIs, an attempted suicide and three stints in a residential treatment center since 2011, is attempting to make amends. The daughter, who is attending college, living with a boyfriend on the other side of the country, is attempting to launch. On the surface, this relationship is like kerosene and water.

Ronald Cohen states “The way to develop differentiation is not to cut off, but to see other family members for who they are and stay connected with them despite their shortcomings.” Sometimes, it is so difficult to stay connected that the emerging adult just wants to run away and not fight this particular battle.

These two were supposed to have some family time together in Philadelphia over the Fourth of July holiday. Let’s just say this, the fireworks were not only in the air over Philadelphia this holiday weekend, but also in this suburban home with explosive interactions including threats, four letter words, the use of all capital letters in texts, and the triangulation of other family members. It was my role to shed some light on the right way to develop differentiation, which is not to cut off all relations to the family, but to see other family members for who they are and stay connected with them, despite their shortcomings.

Many times these shortcomings have caused this young woman significant trauma. How do you cope with a young adult that is very angry that their mother (or father) was a hopeless drunk during their upbringing or has a mental health diagnosis? What happens when recovery changes that parent? Maybe the emerging adult wants the ‘good old times’ to return. How does the young adult grapple with their perceived image of a perfect mother or a placid family life that rivals a TV sit-com? Add to that the difficult reality they are experiencing in their own life, perhaps they are considering a relationship with a partner or developing their own perceived image of themselves as a successful person. Where does the enmeshment stop and autonomy begin? How does this recovering parent deal with the anger and frustration that plays out during these episodes or the grief over the loss of their child if there should be a period of separation? How can any parent predict a ‘successful launch’ ? Can a child perceive what ‘recovery’ is for a parent?

Sounds like there will be some very interesting reading in the next few weeks. Stay tuned!

Posted in Addiction, Alcoholism, Family Dynamics, Recovery Coaching | Tagged alcoholism, conflict, differentiation, family issues, recovery coaching, sobriety, trauma | Comments Off