The Meadows Blog

Maureen Canning, Clinical Consultant for The Meadows Addiction Treatment Center, was interviewed January 6th on Good Morning America. In a story on the death of Johnson & Johnson heiress Casey Johnson, Canning explained the difficulties that high profile families face when their adult children have trouble with substance abuse.

To read more about the story and view the Good Morning America video, visit at

Published in Blog
Wednesday, 08 April 2009 20:00

History & Addiction

Note: This article was originally published in the Spring 2006 edition of Cutting Edge, the online newsletter of The Meadows.

History & Addiction
by Claudia Black, PhD, MSW

Like every aspect of mankind, addiction has its own history. Long before anyone understood the core problems of addiction, people became hooked on substances. The following is adapted from Claudia's videos The History of Addiction and The Legacy of Addiction.

Chemical dependency has plagued humankind since man first crushed grapes. Each millennium has treated the problems that addiction brings with a methodology unique to the times. Historically, society, as a way of treating those addicted, has imprisoned them, banished them, put them in mental institutions, religiously converted them and, in today's world, treated them.

What has not changed is the impact of chemical dependency, particularly on those addicted and their families. Herein lies the story.

The roots of addiction are deep and ancient, and the methods used to deal with addicted persons are historically bizarre. The Egyptians used to flog drunkards; the Romans created Bacchus, a God of wine and revelry; and the Turks "cured" drunkenness by pouring molten lead down the throat of the inebriate, perhaps the first example of aversion conditioning - crude, but effective. The Greeks believed that the use of amethysts, beautiful deep purple stones, would ward off drunkenness. They festooned their cups with amethysts, wore them when drinking, and even ground them up and put them in the wine they drank.

An example of an early addict we might recognize is Alexander the Great, king of Macedonia in 350 B.C. By the age of 31, he had conquered the world and, during all his mighty triumphs, had abstained from intoxicating beverages. However, after his great triumphs, in a short span of two years, Alexander became an alcoholic and ended his career in a series of insane escapades.

He burned cities at the request of a courtesan and killed his best friend, and his demise came in a contest of wine drinking. Alexander the Great was 33 years old when he drank himself to death.

Wine making and its export became the economic basis of the Roman Empire. With the collapse of the empire, religious institutions, particularly the monasteries, became the source of brewing and wine making techniques. It was not until the 19th century that the production of beer, wine and distilled beverages became efficient and cheap enough to supply inexpensive alcohol to the masses.

Throughout the 19th century and into the early 1900s, alcohol and various drugs - notably morphine, cocaine and chloral hydrate - were used in various combinations as medicines. These "patent" medicines were highly addictive; alcohol content was as high as 95 percent. By the mid-1800s, the problem of addiction was major and growing. A physician from Battle Creek, Michigan, traveled extensively and used charts to show the effects of alcohol, drugs and nicotine on the body. Today, you would most likely recognize him as the founder of Corn Flakes. His name was Dr. John Harvey Kellogg.

In the 1840s, the first large temperance group, The Washingtonians, was born. The origin of this movement was a drinking club that met nightly at Chase Tavern in Baltimore, Maryland. One night, 20 chronic drinkers, in a spirit of jest, sent two of the younger members to a temperance lecture. Upon their return, the two men presented a favorable report of the lecture, and an argument concerning abstinence began. This argument would last four days and ended when six of the members announced their decision to support an abstinence society. This became a huge movement, with a membership of almost five million Americans by 1845 -notable because it probably marks the beginning of modern-day addiction recovery.

Like Alcoholics Anonymous, the Washingtonians believed in the substitution of personal experiences for lectures, and they viewed the drunk as a sick person. Perhaps most significant, they also professed a singleness of purpose: to help the drunk. But politics became an issue and would cause the movement's demise.

America's most recognizable temperance leader may be Carrie Nation. In 1888, she began a campaign wherein she and her female followers destroyed kegs of liquor and sometimes entire saloons, using stones and trusty hatchets.

In the late 1880s and early 1900s, some bizarre forms of addiction treatment were practiced. The Keeley Cure began in 1880. Using bichloride of gold, the treatment involved withdrawing the alcohol or narcotic drug and restoring the nerve cells to their original unpoisoned condition, thus removing the craving for liquor. Enemas and laxatives then stimulated the elimination of the accumulated poisonous products. (Incidentally, Bill Wilson, co-founder of Alcoholics Anonymous, was subject to this treatment in 1934.) In 1918, it was stated that more than 400,000 people had been treated by this system at various Keeley Institutes. (NOTE: Bichloride of gold did not exist.)

While not concerned primarily with addiction, the Oxford Group, a popular religious movement in the 1930s, was to play an important role in the future treatment of the disease.

But perhaps the most successful treatment for alcoholism has been Alcoholics Anonymous. Dr. Bob Smith and Bill Wilson founded AA in 1935 in Akron, Ohio. Wilson was a drunk who, after being called on by an old friend and member of the Oxford Group, was admitted for his alcoholism to Towns Hospital in New York City in 1934. He remained sober, and his work took him to Akron, where he felt the need to talk to another alcoholic. He was introduced to Dr. Bob Smith, a prominent and persistent drunk. From this meeting emerged the basic premise of Alcoholics Anonymous: one alcoholic helping another alcoholic. The original meetings of Alcoholics Anonymous were held as adjuncts to the Oxford Group on Wednesday nights at Dr. Bob's house.

Alcoholics Anonymous is a spiritually based program, and its primer is The Big Book. Proposed names for the book were One Hundred Men, Moral Philosophy, The Empty Glass, The Dry Way, and Dry Frontiers. In 1939, 5000 copies were published. Today there are four editions of The Big Book - and millions and millions of copies. Alcoholics Anonymous exists in most countries, with meetings in just about every city in the world.

In 1950, Lois Wilson, wife of Bill Wilson, founded Al-Anon, the 12-Step program for families and friends of alcoholics. Alateen was started in 1957.

In 1951, the "Minnesota Model" was developed. The foundation for treatment from the 1970s to the present, this abstinence model is based on the 12 Steps of Alcoholics Anonymous. It has become the primary protocol for residential and outpatient treatment programs in the United States and in many parts of the world.

In 1952, the American Medical Association defined alcoholism, but it would not be until 1967 that it passed a resolution identifying alcoholism as a complex disease and recognizing that the diagnosis and treatment of alcoholism are medicine's responsibility.

While abstinence-based programs would become widespread throughout the United States, treatment in the late 1970s would focus on all chemicals, not just alcohol. The word "alcoholism" was gradually replaced by "chemical dependency." There would be a resurgence of interest in attending to the family, spouses, partners and children of addicted persons. There also would be heightened interest in both young and adult children of alcoholics.

The role of the private sector in treatment has lessened, with community-based programs taking on more responsibility. Today's recovery programs treat addictive disorders, recognizing cross addictions and the need to abstain from all mind-changing chemicals. In many cases, clients are treated for multiple addictive disorders, such as gambling, chemical dependency, eating and sexual disorders, and dual diagnoses, most commonly PTSD and affective disorders.

Addiction is a complex disease, a devastating disease and a terminal disease - yet today it is a treatable disease. History has left us a long and painful legacy of addiction. Today we are beginning a new legacy: that of the reality of recovery.

Published in Blog
Wednesday, 14 January 2009 19:00

Denial is Not a River in Egypt

Note: This article was originally published in the Summer 2004 edition of Cutting Edge, the online newsletter of The Meadows.

Denial is not a River in Egypt
By Robert Fulton, MA, LISAC, Administrator, The Meadows

One of the wittiest adages we hear in 12-Step recovery is “Denial is not a river in Egypt.” It is so witty, in fact, that many recovering people repeat it without asking themselves the absolutely important question, “If denial isn’t a river in Egypt, what is it?”

The answer seems too obvious for further inspection. Denial is about denying that I had a psychological problem. Most often, I denied that I was an alcoholic or an anorexic or that I was a sex addict. But now that I have admitted to myself and to another person that I am any one of those things, I am no longer in denial. I am back in control.

Sadly, intellectual admission often leaves the deeper denial in place – intact and poisonous. The alcoholic awakens every morning swearing not to have another drink and, by 5 p.m., heads to the bar. The anorexic, who has planned three healthy meals, looks at herself in the mirror, sees a fat woman, and decides not to eat. The sex addict at the SA 12-Step program shares the agony of his addiction and, after the meeting, hits on the attractive newcomer.

In recovery, behavior cannot be the driving force. Intellect and affect are the driving forces that determine my behavior. As an addict, I behaviorally shut off my affect and distort my intellect, so that I maintain the behavior that protects me from the awful confrontation with my childhood shame.

Denial of affect involves disassociating from those feelings that our primary caregivers taught us to regard as shameful. Our caregivers taught us to dishonor our feelings, because to honor them and to communicate was to be punished and to be shamed. We learned to separate self from the emotions generated by the truth of what we witnessed. In order to avoid the worth destroying poison of carried shame, we were forced to deny the feelings we had when we witnessed an emotional event in the family.

In order to medicate the pain of having abandoned our authentic self, we find ways to medicate the dissonance – we deny the truth of what we think; we submerge and camouflage the truth of what we feel. The self that emerges from the pain of denial becomes, in most adults, the only kind of “maturity” to which they have access.

We deny on an intellectual level, and we deny on an affective level. We deny intellectually by telling ourselves that two plus two is five. We were empowered to do that, or conditioned to do that, when we were growing up – and two plus two never added up to four in Mommy and Daddy’s household. Our father was a falling-down alcoholic. We said to Mommy, “Daddy’s drunk out on the lawn. He’s passed out. He looks like he’s dead. I’m scared.” And she said to us, “Don’t worry about it; he’s fine.”

The kid knows that the fear of his father’s drunken abandonment is real, but to have that truth, that reality, denied by his mother is to have his reality denied. The child then wonders what’s wrong with himself. Mind you, he doesn’t ask what’s wrong with his father or his mother. They are the ones acting shamefully, yet it is he who feels ashamed – he is carrying their shame. Because the kid’s real fear of the father’s death is being made illegitimate by the lies of the mother, the child himself is now experiencing a death of self – of his own emotional reality and his access to it. He is not allowed to feel the fear of losing his father.

This is the most damaging kind of shame-based denial, because it attacks the child’s very authenticity. He has learned that to have the terrifying emotions attendant upon Daddy’s drunkenness is not all right. Disassociation from self becomes habitual. Denial of self is honored in the dysfunctional family system.

When the child is older and he witnesses a shameful act, the kind of disassociation he experiences will be covered up with a more sophisticated form of social camouflage than when he was 5. For example, he may think that his father’s shameful drunkenness will disgrace the family in the eyes of the neighbors. The primary lie that Daddy is not drunk is justified by the need to remain socially acceptable. The young adult now needs a defense system that not only deflects his father’s shame, but protects his own social self as well. Such denial is often called loyalty and is praised as being politic. He is often told that his cover-up makes him a good citizen.

The child who has viewed his father’s shameful drunkenness may fear that his father will stop loving him should the father became aware that his son sees him as a failed father. In Michelangelo’s Sistine Chapel fresco The Drunkenness of Noah, Noah’s two sons come into the tent and see him drunk, and they experience intense shame. They identify with their father’s unexpressed shame at having abandoned his children and given up power in regard to his sons. The intended Biblical lesson is that to see someone in his nakedness is to obtain power over them. Rarely has the Bible been so psychologically deluded. It is not the children who have power over the parent; it is the shameless parent who holds power over the children through the mechanism of carried shame, setting off a career of adapted wounded-child codependence.

So denial, better than alcohol, is the best dysfunctional medication for shame. However, denial cannot salve one against that sense of hopelessness and despair that is engendered when one loses connection to self. It is then that we feel the need to buddy up to an addictive process that will give a false sense of power, that will eliminate the fear in a moment, that yields that one-up posturing of denial and grandiosity.

When dealing with these disconnects, one is driven back not only to the newborn-to-age 5 feelings of shame but to the adapted state of ages 5 to 17 as well. The early shame sets the stage for the acting out, through which each individual learns to dramatize brilliantly his dysfunctional avoidance of emotional truth. It is an artistic way of keeping from connecting to oneself and avoiding the agony of re-experiencing the death of our truth.

There is a Catch-22 in this artistic denial, no matter what relief it seems to give us. Even when we manage to get in touch with our honest feelings, if we do not have the tools to survive the encounter, we cycle right back into the wound of abandonment or of shame.

Feelings then seem to us a trigger to an unhealable vulnerability. They become something that we need to stay away from, which is why one of the first things a good clinician does (once a patient is reasonably stable) is to urge the patient to drop into his honest feelings, and to let him know that it is okay, that he is okay. He needs the security to feel that accessing his affect will not kill him.

This is actually what happens in the Survivors Workshop. People begin to express their affective authenticity, and they are not shamed – they are honored. And they begin to honor themselves. I often remember what I always said in group: that we have to learn to honor our feelings, which is to hold them – and ourselves – in high regard. Our feelings are our windows of insight into the depth of who we are. But all of that is for naught under the guise of affective denial when, in a defended posture, we compulsively seek to offset the initial wound of being defective, of being unworthy.

In reactivity to the carried shame of abusive childhoods, there are those who acquiesced and expressed their shame, pain, fear and anger in neurotic, seditious ways. Then there are those who rebelliously fought for some kind of voice, but who lacked the tools for connection. In either case, the trauma disconnects one from oneself.

The aim of treatment is to allow me to reconnect to me for the first time as the beneficent parent, the loving parent who needs to be nurtured for who and what I am. At the same time, I learn to present my authenticity and accept the vulnerability that my truth may meet within the world, even if the world shuns me. You may be sad, but you will have the joy and power and value of not disconnecting from the self. You do not rise above and go one-up; acceptance of one’s imperfect perfection is a soaring disengagement from that which is destructive.

People taking the first steps to deal with the trauma of carried shame will choose submission rather than surrender. This submission is often an intellectual admission that there is a problem. But unless the submission is also a surrender to the will, this apparent surrender of dignity will leave a bad taste; it will feel dissonant. It will be sensed as a false admission, one made to keep the depth of the real problem at a distance. The feeling of true surrender is internal peace. Only I will know. But I know I have surrendered when I feel that peace.

The concept of denial and surrender being in that same crucible is vitally important, because denial is a form of false security through control. If, by admitting we are addicted, we seek clarity for the sake of control, it is only to give ourselves the illusion of safety. We remain terrified of letting go of control, because if we let go of this charade, we are going to be left in the abysmal pit of carried shame. So our whole life has been to orchestrate this nonsense. We know it to be nonsense, but we don’t know anything other, so we medicate the nonsense.

In recovery, however, I am now invited to go to a place of powerlessness, and that is a miraculous paradox, because it is only there that I can be empowered. The first thing that has to happen is for you to acknowledge that change is impossible without help. When I surrender, I learn to trust another to give me that help, to help me get on the path to recovery. The recovering individual, once the path becomes a reality, takes the path and continues to go forward.

When somebody gets into recovery, and they begin to date again, it is like being back at 14 or 15, even though she is 40 or 50, because it is a whole new experience. There is the similar excitement and fear and passion – it is a whole new way of relating. It is not a state of authenticity and acceptance of self within memory. Because it is new, it is innocent. In recovery, we experience “innocence.”

And so the healthy lineage allows for the delight, the life, the joy, the possibility and the joy-pain – ever new, ever going forward. Healthy, functional shame, not the sickness of carried shame, is what fuels the joy and the richness, because it reminds me of my authentic self; it puts me back on the path, back on line. As you move in a new venture, it is all new and, therefore, a delight.

And you may find that you have overstepped and then feel ashamed of a behavior because it was all new, but it is now functional shame that allows you to become more intimate, to feel more deeply. I am imperfect, and I make mistakes. My mistakes may cause me pain, and they will. But they don’t make me bad. They only make me human. And that, I don’t have to deny.

Published in Blog
Sunday, 29 November -0001 18:00

What Do I Do With My Child?

College can be an exciting time for many young adults; it is where they experience many firsts, including a new lifestyle, friends, roommates, exposure to new cultures and a wide-variety of principles and thinking. Unfortunately, when many students are unable to handle these firsts, they’re more likely to struggle. Insecure and unable to manage the new environment or adjustments they can become susceptible to depression and anxiety.
Published in Treatment & Recovery

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