The Meadows Blog

Tuesday, 28 June 2016 00:00

Facing Codependence and Depression

Codependency is an emotional disorder that causes people to ignore their own needs while constantly fulfilling the needs of others. Someone struggling with codependence may forfeit his or her own well-being and values in the pursuit of assisting someone else. It’s not surprising that this disorder would often coexist alongside depression, which is often characterized by a persistent sense of hopelessness and low self-worth.

When you’re struggling with depression and codependence it can feel like nothing is ever going to change. But, once you learn how to accept yourself and be fully present in your day-to-day life amazing transformations can, and do, happen.

Watch the video to learn how one person’s transformation happened during treatment at The Meadows.

Published in Depression & Anxiety

The Meadows Proudly Participates in UKESAD 2011 - London, England

What a tremendous experience we had in London! The Meadows Senior Staff spent the week of May 16th at the 8th Annual UK/EUROPEAN SYMPOSIUM ON ADDICTIVE DISORDERS - better known as the UKESAD 2011 Conference. The conference brought together some of the top minds in the world of addiction treatment and provided an opportunity to network and exchange national and international knowledge with more than 500 attendees.

On Friday, May 20, 2011 Meadows Senior Fellows; Pia Mellody, RN and Shelley Uram, MD co-presented the Plenary Session. The presentation titled "FACING CODEPENDENCE: WHAT IT IS, WHERE IT COMES FROM AND HOW IT SABOTAGES OUR LIVES" addressed the effects of childhood boundary violations on adult behaviors, including codependent adults lacking skills to mature or enjoy healthy relationships - personal or professional. Dr. Uram discussed the effects of Childhood Trauma on the Brain and further how those early traumas are stored to negatively affect our developmental maturity leading to co-dependent behaviors and addictions.

In addition to our Senior Fellows, our CEO, Jim Dredge, was on hand to meet and greet attendees throughout the conference. People lined up to a book signing by Pia Mellody of her best selling work. Dr. Shelley Uram hosted an Alumni Lecture titled: Understanding Trauma and the Brain, which attracted a standing only crowd! Another very popular event was The Meadows Raffle; to which a lucky winner - Alistar Richardson of London - received an I Pad Generation 2 with 32G.

There were some newsworthy issues addressed, including a review of the "Payment by Results" plan proposed by the British Government. This plan would overhaul the reimbursement to alcohol and drug programs by basing reimbursement on treatment effectiveness. This is an issue the U.S. is also debating right now so the U.K outcomes will be interesting to watch.

The experience we had at UKESAD was stimulating and thought provoking. We are already looking forward to next years’ conference.

Published in Blog

The Meadows is proud to present its 2010 Annual Symposium from Wednesday, October 13 through Friday, October 15 at Hoffman Estate, Illinois. The Symposium will include presentations by Pia Mellody, Maureen Canning, MA, LMFT, John Bradshaw, MA, Bessel A. van der Kolk, MD, and Jerry A. Boriskin, PhD, CAS.

This dynamic event will feature the insights of the speakers as they share their philosophies, treatment techniques, and skills regarding such issues as trauma, addictions, relationships, healthy sexuality, codependence, spirituality, and family systems.

Interested persons can sign up for the entire event or may choose to attend the Wednesday evening lecture only. More information about the Symposium, including program session descriptions, a detailed schedule, and information about Continuing Education credits, is available at the Symposium page on The Meadows web site.

Published in Blog

Note: This article was originally published in the Spring 2004 edition of MeadowLark, the magazine for alumni of The Meadows.

Rigorous Honesty: From False Pride to Authentic Self-Respect
By Kingsley Gallup

While in our disease, we may have prided ourselves on many things - perhaps even our "honesty." In recovery, however, we come to see the truth about ourselves - namely, that when we pride ourselves on something, it is likely something for which we wish we could take credit, something we wish we could claim as our own... but something that is not truly us. We discover in our lives the toxic presence of false pride. In our adapted ego state (the modified ego state in which our addictions flourish), we prided ourselves on being everything to everyone... all the time. This was our badge of honor. We were chameleons, forever flexible. At all times adaptable. And we believed it is precisely this malleability that makes us good people - people who deserve to be proud.

In recovery, we discover just the opposite to be true. While in our addictions, we had been indubitably dishonest. Our malleability had been intrinsically deceitful. (Would it seem logical to pride ourselves on that?)

We now find that our pride had been nothing but a mask... a false front. It was simply another brand of denial. It was a facade of self respect. Pride was our pretense. It hid our shame.

Now, this is not to say we were in no ways honest while in our disease. But let's face it: When it came to the critical points, the truly consequential details of our lives - like who we were and what we wanted and needed - the inherent dishonesty of our disease reared its head. And we paid the dearest price. Simply stated:

  • Every time we said "yes" when we meant "no"... we were being dishonest
  • Every time we failed to assert a boundary... we were being dishonest
  • Every time we opted to continue in an unhealthy relationship, a relationship with no prospect of a healthy future... we were being dishonest
  • Every time we stood by as unkindnesses were being perpetrated, saying nothing in disagreement so as not to rock the boat... we were being dishonest
  • Every time we allowed another person to direct our actions... we were being dishonest
  • Every time we permitted resentments to fester in our hearts, rather than risk speaking up and stating our truth... we were being dishonest
  • Every time we said we were okay - to ourselves or to others - when in reality we were anything but... we were being dishonest.

The deceitfulness of our codependence - and our resulting addictions - may indeed bring us embarrassment and shame. Even so, we must not allow ourselves to remain stuck in this place of indignity and dishonor. (We have been there far too long!) In order to heal, let us instead find in this shame a motivation to change.

As we learn in recovery, much of the shame we have been carrying around is not our own shame. It belongs to others. At the same time, however, we learn that some shame is healthy shame. It is our conscience speaking, motivating us to grow and to change. Responding to this personal shame, while at the same time releasing the carried shame that has been nothing but an albatross around our necks, is the hallmark of the functional adult. It is about taking responsibility for our choices. It is about owning our dishonesty. It is about getting honest with ourselves and others - and choosing to do things differently as we move forward.

Rigorous honesty is nothing short of hard work. It takes courage, after all, to speak our truth. It takes strength to be vulnerable, readily admit wrongs, stay current with the people in our lives and acknowledge the truth of who we are. Disciplining ourselves to share our realities and to attend to what we want and need - when we want and need it - is the liberating work of our recovery.

Interestingly, maintaining our dishonesty had been hard work as well. After all, keeping up appearances was exhausting! Keeping all those balls in the air all the time was arduous and draining. The feeling of wanting desperately to flee (and from a situation, no less, that we perpetuated through our deceitfulness), and yet remaining amid all the craziness, certainly felt like hard work. But doesn't hard work usually pay? Were there any payoffs from our dishonesty? Or were there simply trade-offs?

Our disease has robbed us of our integrity for long enough. No longer must we live in that proverbial "pressure-cooker" of codependency - namely, that adapted condition in which the pressure of external demands and the pain of our own dishonesty inhibit our ability to truly thrive. In recovery, we learn to consistently release "steam" from that pressure-cooker by speaking our truth. No longer must we operate in crisis mode. No longer must we seek simply to survive in an environment from which we want to run. We come to embrace life, rather than flee from it! Getting honest involves acceptance and vindication. We acknowledge that our addictions served a purpose in our lives. They helped us to survive in less-than-nurturing environments. Next, we accept where our addictions took us by confronting the dishonest patterns of our disease. The addicted life, after all, is inherently dishonest. (This by no means implies that addiction is a moral issue, but maintaining the addicted life demands a degree of deception.)

One of the greatest - if not the greatest - fruits of recovery is intimacy, the path to which is self-knowledge. To achieve true intimacy in our lives, we must challenge each and every message that has led us astray, that has taken us away from ourselves. In doing so, we come to know ourselves... perhaps for the very first time.

We need no longer cling to false pride. Rather, we now love ourselves justifiably as we nobly strive for rigorous honesty. We learn to love ourselves, if only for the effort we make, as true valor is found in progress, not perfection. We love ourselves for being honest about our fallibility and our weaknesses. We love ourselves as we walk down the perfectly imperfect path of recovery... two steps forward, one back... two steps forward, one back...

Honesty is nothing short of an act of love - for ourselves, for others and for our higher power. It is in this place of honesty that we truly connect. It is here that we genuinely feel a part of the human family. It is here that we not only survive, but thrive. Simply stated, the language of recovery is truth. May we speak it now with honor, dignity and love.

Published in Blog
Wednesday, 03 June 2009 20:00

The Therapeutic Genius of Pia Mellody

Note: This article was originally published in the Spring 2007 edition of Cutting Edge, the online newsletter of The Meadows.
The Therapeutic Genius of Pia Mellody
By John Bradshaw, MA
Pia Mellody joins the company of those who have created highly effective therapeutic models and who can put their theories into practice with unusual skill. Pia's approach is phenomenological, resulting from her own painful struggle with codependency, as well as from thousands of hours spent interviewing and working out healing strategies with patients at The Meadows.
Pia began her unique journey as the head of nursing at The Meadows. In her early days, she suffered from low self-esteem, unhealthy shame, and a hyper-vigilance that accompanied her need to be perfect in every aspect of her work and life. She lived in that lonely place of non-intimacy, polarization and silent anger that most codependents experience.
Pia decided to get some help for her problems at another treatment facility, where she found the experience not only frustrating, but ineffective. Her problems did not seem to fit into any consistent category of the Diagnostic Manual. When she completed treatment, she continued to try to make sense of her raw pain and confusion, reaching out to others to try to get assistance in alleviating the distress. She was grappling with an inner distress exacerbated by a sense of defectiveness, the inability to engage in really good self-care, and living in reaction to other people. Thanks greatly to her, this condition is now called "codependence." At that time, there was no coherent theory or therapy for the problem.

Early Roots of Codependency
Prior to Pia's work, some relevant work had been done concerning the reality of codependence. Ludwig von Bertalanffy's work titled General Systems Theory had filtered its way into several arenas of psychotherapy, notably Ronald Laing, Virginia Satir, and The Palo Alto Group (Gregory Bateson, Don Jackson, Paul Watzlawick and John Weakland).
In 1957 in Ipswich, England, John Howell concluded that the entire family itself was the problem, rather than just the symptom-bearing individuals. Dr. Murray Bowen developed "The Bowen System" of family therapy. He clearly posited the whole family as the problem, maintaining that the most distressed and under-functioning person in the family triggered the rest of the family into over-functioning behaviors. The more the family members over-functioned, the more the distressed person under-functioned. Thus, the more the family tried to change, the more it stayed the same. Bowen was convinced that the whole family was in need of therapy. Bowen did not use the word "codependency," but he emphasized that, like a mobile, every member of a diseased family was dependent on his or her other family members.
Dr. Claudia Black, currently a Senior Fellow at The Meadows, wrote a now classic book called It Will Never Happen To Me. In it, she described the symptoms she carried as an adult that stemmed from living with an alcoholic father and a co-alcoholic mother. Dr. Black made it clear that her whole alcoholic family was diseased, and that each member was codependent on the alcoholic father.
Soon hands-on clinicians like Dr. Bob Akerman and Sharon Wegscheider Cruse (a protégée of Virginia Satir) were describing the symptoms of the adult children of alcoholic families as "codependent," although no one knows who first used the term "codependency."
I did a 10-part series on PBS in April 1985 that met with a huge public response. In it, I used a mobile to describe the family system, moving it energetically to show how the whole family is affected in dysfunction, and allowing the mobile a lightly moving homeostasis to show its functional state. I devoted two parts of this TV series to issues I called "codependency," although my grasp of the concept was still vague and lacked a consistent theory of explanation.
Outside the recovery field, which deals with addictions of all kinds, was the work of Karen Horney and Theodore Millon. Horney's Neurosis and Human Growth presented many descriptions of a dependent personality. Horney's description touched upon many of the primary symptoms of codependency, which Pia Mellody later organized into a coherent theory. According to Horney, those lacking healthy adult autonomy and interconnectedness sought their fulfillment and a sense of self from other people. For these people, relating to other people became compulsive and took the form of blind dependency. Horney used the phrase "morbid dependency."
In the International Encyclopedia of Psychiatry, Psychology and Neurology, John Masters wrote: "I think that mainline academic psychology has not done enough extensive work on dependency as it relates to codependency as an identifiable personality disorder. Codependency is now seen by many to constitute a painful problem for certain clusters in our society. We are on a primitive frontier with regard to understanding codependence."
Psychiatrist Dr. Timmon Cermak, in Diagnosing and Treating Codependence, argued that codependency was on par with other personality disorders. "To be useful though," wrote Cermak, "codependency needs to be unified and described with consistency. It needs a substantive framework and, until this is done, the psychological community will not recognize codependence as a disease."
Enter Pia Mellody
It was at this point that a young nurse stepped onto the arena of modern psychology and made an extraordinary contribution.
One day, Pia Mellody walked around the corner of a building and had a moment of clarity. She thought of AA and how alcoholics start recovery by simply telling the stories of their troubled drinking. They share their experiences and strength in embracing their shame and their first glimmers of hope.
Pia realized that hundreds of people had passed through her office at The Meadows with stories very similar to her own. For one thing, a large majority had been abandoned, abused and neglected as children. Pia had long suspected that her own symptoms stemmed from her traumatic childhood and severely dysfunctional family system.
At this point, Pia began interviewing the many people who came to The Meadows with stories of abandonment, neglect, abuse of all kinds, and enmeshment with a parent, the parent's marriage or the whole family system.
As Pia interviewed person after person, a unique and clear pattern emerged. All had five similar symptoms:
They had little to no self-esteem, often manifested in the carried shame of their primary caregivers;
They had severe boundary issues;
They were unsure of their own reality;
They were unable to identify their needs and wants;
They had difficulty with moderation.
These symptoms together marked an extreme level of immaturity and a level of moral and spiritual emptiness or bankruptcy. Patients shared their sense of relief in just being able to identify and talk about the distress they were in.
With an interviewing approach fueled by her intuition, Pia Mellody had discovered what she called "codependency." She had come to understand the word "abuse" in a much broader context than clinicians had previously understood it. Pia also showed how codependents carry their abusive caretakers' feelings. Our natural feelings can never hurt or overwhelm us; their purpose is to aid our wholeness. Our anger is our strength, a boundary that guards us. Our fear is our discernment, warning us of real danger. Our interest pushes us to expand and grow; our sadness helps us complete things (life is a profound farewell). Our shame lets us know the limits of our curiosity and pleasure; it becomes the core of modesty and humility. And our joy is the marker of fulfillment and celebration. "Carried" feelings lead to rage, panic, unboundaried curiosity, dire depression, shame as worthlessness or shamelessness, and joy as irresponsible childishness.
Pia later saw the five core symptoms as leading to secondary symptoms: negative control, resentment, impaired spirituality, addictions, mental or physical illness, and difficulty with intimacy.
Pia believed that alcohol and drug addiction, sex addiction, gambling addiction and eating disorders must be treated before the core underlying codependency can be treated.
Understanding that addiction is rooted in codependence is another contribution that Pia helped to clarify. Years ago, Dr. Tibot, an expert on alcoholism, saw that there was an emotional core to alcoholism that he called the "disease of the disease." Pia's work has certainly corroborated that intuitive insight.
Pia Mellody's most important contribution may be how she and her groups of suffering codependents worked out strategies of healing. They did this through trial and error. The results were so striking that The Meadows encouraged Pia to develop a workshop titled "Permission to be Precious." It was an instant success, and Pia began to take it to different cities around the U.S. Soon she wrote a book, Facing Codependence, with Andrea Wells Miller and J. Keith Miller. Later she developed a powerful approach to treating love addicts and their counterparts' avoidant addictions. Her most recent book, The Intimacy Factor, is the only relationship book that treats the core "grief feeling work" around early abuse, neglect and abandonment. I believe that other self-help relationship books fail because they do not address these fundamental issues. "Feeling work" involves exposure, vulnerability and what Carl Jung called "legitimate suffering." Pia has done her share of that and has the know-how to gently nurture others through this work.
Pia's work has become the core model in treating addictions of all kinds and the core of codependence they rest upon. She has personally led hundreds, probably thousands, of people suffering from codependency into recovery and wholeness.
Pia answered Dr. Timmon Cermak's challenge to do the work that established codependency as a treatment issue. She not only found a consistent way to conceptualize this source of suffering, but she found the know-how to address it.
The time has come for a broader recognition of Pia's art and genius.

Published in Blog
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