The Meadows is pleased to announce the launch of our new blog, addictionrecoveryreality.com, featuring articles by some of the most well-respected and innovative experts in the treatment and recovery fields of drug addiction, alcohol addiction, gambling addiction, depression and anxiety, relationships and childhood trauma.
Contributors to the blog include leaders in the treatment of addiction and trauma: Pia Mellody; John Bradshaw, MA; Bessel A. van der Kolk, MD; Peter Levine, PhD; Maureen Canning, MA, LMFT; Jerry Boriskin, PhD; and Shelley Uram, MD. These experts write about a wide range of addiction-related topics.
If you are interested in writing for addictionrecoveryreality.com, please send submissions to firstname.lastname@example.org.
Note: This article originally appeared in the Spring 2004 edition of MeadowLark, the magazine for alumni of The Meadows.
Living Lives of Quiet Desperation
By Ben Barrentine Jr., MA, CAS
I was scared. I was lonely. I was a little boy. My father was a college professor. My mother was college educated. I have two younger brothers and a younger sister. We had plenty of food and clothes. We got birthday presents. Santa Claus came to see us. We were a very distant family, like ships passing in the night. We rarely hugged. We rarely expressed emotion. We rarely talked about what was going with us as individuals or as a family. I was scared. I was lonely.
I remember that, when I reached puberty, a neighbor boy showed me masturbation. I masturbated a lot. Now I wasn't so scared, and I wasn't so lonely. I found a magazine. It was just an ordinary magazine with a picture of a woman in a bikini. It became my first pornography. I wasn't so scared, and I wasn't so lonely. When I was a sophomore in high school, I started drinking and, from the beginning, I drank alcoholically. I wasn't so scared. I wasn't so lonely.
I masturbated a lot, and I found Playboy, Penthouse, and other porn magazines and books. I drank a lot. I started dating. I got into relationships. I wanted the women to make me happy. I looked at the women the way I looked at the women in the porn - as objects. I would fantasize and lust about the women I was dating in the same way I did the women in the porn magazines and books. After awhile. I could run the porn images in my head. and I no longer had to have the porn magazines and books. I drank a lot. I was scared. I was lonely.
I went to treatment for my alcoholism. When the staff discovered that I did cocaine and marijuana, they said I was a drug addict. I stopped drinking alcohol, but for the next two years, I continued to use cocaine and marijuana. I liked doing cocaine and marijuana with sex. It wasn't until many years later that I realized that it was my sex addiction that kept me in my drug addiction for another two years. I was scared. I was lonely.
With no awareness of my sexual addiction, I got into recovery for my drug addiction. I was still using sex-porn, lusting, looking at women as objects, masturbating lustfully. I was scared. I was lonely.
When I went to treatment for my sexual addiction, I began to get into recovery. I began to learn something about intimacy with myself and other people, not just women - men and women. I began to like myself and to discover who I was - my values, my interests. I began to connect with people on a more intimate level. I wasn't so scared. I wasn't so lonely.
As the facilitator of the "Men's Sexual Compulsivity Recovery Workshop," I have firsthand knowledge of recovery. I first developed this workshop some 10 years ago, before Patrick Carnes joined The Meadows. The workshop builds on the groundbreaking work of Patrick Carnes and Pia Mellody in the areas of sexual addiction and codependence, respectively.
Sexually compulsive people are caught up in sexual addiction: thoughts and behaviors, pornography, lusting, leering, fantasizing, anonymous sex, one-night stands, prostitution, affairs, simultaneous relationships, adult bookstores, etc. They are scared. They are lonely. They are in pain. They feel guilt. They feel shame. They are living lives of quiet desperation - empty on the inside, while on the outside, they may have all the trappings of success.
The "Men's Sexual Compulsivity Recovery Workshop" is an educational and experiential workshop. With a limit of six participants, the workshop is designed to promote changes in the lives of those suffering from sexually obsessive thinking and compulsive behaviors.
The workshop explores the cycles of addiction, recovery and relapse.
Individuals have an opportunity to explore their arousal templates - to discover and examine the events and experiences that caused them to act out sexually. They learn how to lead different lives, how to empower themselves in healthy ways. They learn to experience intimacy with the other men in the workshop. They develop a written recovery plan. They are not so scared. They are not so lonely.
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.
Note: This article is an excerpt from Claudia Black's book "Straight Talk". It was originally published in the Fall 2003 edition of Cutting Edge, the online newsletter of The Meadows.
Straight Talk from Claudia Black: What Recovering Parents Should Tell Their Kids About Drugs and Alcohol
Whether you sobered up last year or 15 years ago, you may be wondering what to tell your kids about your past addiction. Dr. Black shows readers five very different families and how these parents have talked to their kids about recovery, relapse, and the children's own vulnerability to using drugs and alcohol in an addictive manner.
Discussion tips and easy-to-understand facts are shared in boxed sections to help parents focus on key issues. Topics include:
The basic healing messages that young children need to hear if parents who have recently become sober are raising them.
How to talk to adolescents, teens and grown children about the basic characteristics of addiction, including denial, preoccupation, loss of control, change in tolerance and withdrawal.
How to discuss genetic and environmental influences that can contribute to becoming chemically dependent, including the latest brain chemistry research.
How parents in early recovery can begin making amends and building sober relationships with their children, whether the children are young or grown.
Age-appropriate strategies to reduce a child's risks for experimenting with drugs and alcohol.
This book is aimed at parents who are recovering from drug and alcohol addiction but is also relevant to non-addicted parents who grew up in addicted families.
The following is an excerpt from chapter one:
On December 31, 1986, the day after I got sober, the last thing I wanted to face was what I had done to my kids. Prior to sobriety, as a father, what I had going for me was the law, the Ten Commandments, and the tradition that adult men protect their kids. So when I became sober, the first thing I wanted to do was quickly reassert their respect for me based upon everything I had going for me. This might have worked when they were small and I had drank only a short period, but, by the time I got sober, nobody could say that I deserved all the respect that the law and the Ten Commandments provided for. I realized I was going to have to get to know the kids and vice versa. For me it meant being friends first. The kids really wanted me to be a parent, and I wanted to regain their respect. Today I have been in recovery for several years and have regained that respect, but not by asserting what I had in the first place but by "letting go" of the outcome of my relationships after I had done all I could to change, trusting that God would then do His thing.
It has always been my belief that parents truly love their children and genuinely want what is best for them, yet that message often becomes convoluted, inconsistent and sometimes nearly non-existent when addiction begins to pervade the family system. As much as parents want to correct this, the focus of early recovery is often on recovery practices, the marriage or partnership, and job or career. This is coupled with parents frequently just not knowing what to say to their children, or how best to interact with them. This confusion can be as true for the adult child as for the adolescent or younger child. In many cases it is easy to ignore the issue of what to say or how to interact with your children if someone else, such as an ex-spouse or grandparents, predominantly raises them, or they are adults living on their own. Children can also impede the process by pretending all is just fine between you and them because you are now clean and sober. And, in fact, for many it is better already. Or they distance themselves from you with aloofness or anger.
The inability to be intimate, to share yourself with your children, to be there for them, is one of the most tragic losses in life. Having worked with thousands of addicted parents, I've seen their eyes shimmer with tears and glow with love when they talk about their children. As I wrote this book, I interviewed a host of parents, and I was inspired by the depth of love and vulnerability shared as they talked about how addiction impacted children, and the hope their recovery would provide them the positive influence and connection that they would like to have with their children.
What Do You Say To Your Children?
In recovery there is a lot of wreckage of the past that needs to be addressed, and there is a lot of moving forward that will happen as well. What your children want most is to know you love them.They want you to be there for them and with them. That can be hard to recognize if your children are angry or distant. It can be hard to do, given the priority needed to learning how to live clean and sober. Creating new relationships or mending old relationships doesn't happen overnight. The most important thing you can do for your children is to stay clean and sober. Yet while you are doing that, there are so many little steps you can take with your children to begin to be the parent they need and the parent you want to be. It is my hope this book will help you in this journey. Thomas, a recovering parent, shared this story with me.
My daughter was grown by the time I got sober. More than anything I loved her and wanted her to know that. I wanted her to know that the parent she saw all of her growing up years wasn't the real me- that there was this whole other me, this place of love that I had for her that I had lost control of due to my drinking and drugging lifestyle. The hardest part was being honest. Then I had to be willing to listen and not argue with her about how she saw me. I know what she saw. She saw the addict. She couldn't see my place of love; it was too well hidden. So I listened and I didn't need to argue, I was now in my place of love. But I really wanted her to know that the things I had said or done was not the real me. Yet it could sound like a cop out. I wasn't trying to cop out. She had her experiences because of how I acted in my disease.
I talked; she listened. She talked; I listened. Together we have healed.
Addiction is a devastating disease. It ravages one's physical, mental, emotional and spiritual being. The greatest pain is that it impacts those we love the most- our children. In recovery we learn that addiction is a disease, that it is not a matter of will power or self-control. We surrender to our powerlessness over alcohol and other mind-altering chemicals. We put one step in front of the other, often following the direction of other recovering alcoholics and addicts before us. We rejoice and celebrate recovery. For the first time in a long time, we begin to like ourselves. We begin to let go of our insecurities, our fears, and our angers. We begin to look beyond ourselves, and when we do, many of us are confronted with the reality that this disease is not just ours alone. Addiction belongs to the family. Confronted with that stark realization, how do we empower ourselves to make a difference in our children's lives so that they do not repeat our history?
Most children raised with addiction vow to themselves and often to others, "It will never happen to me. I will not drink like my father, or use drugs like my mother." They believe they have the will power, the self-control, to do it differently than their parents. After all, they have seen the horrors of addiction, and shouldn't that be enough to ensure that they don't become like their parents?If I were to meet with a group of children under the age of nine who were raised with addiction, and ask them if they were going to drink or use drugs when they were older, it is very likely that nearly 100 percent of them would vehemently shake their heads no. If I were to come back six years later when these children are teenagers, half of them would already be drinking, using drugs or both. The majority of others would begin to drink or use within the next few years.
These children will begin drinking or using out of peer pressure, to be a part of a social group, to have a sense of belonging. Kids often start to experiment just to see what it is like, and many simply like the feeling. Some will find that alcohol and drugs are a wonderful way to anesthetize or medicate the pain of life. Alcohol and drugs momentarily allow their fears, angers, and disappointments to disappear. For some it produces a temporary sense of courage, confidence, and maybe even power. Aside from the emotional attraction that alcohol or drugs may provide, the genetic influence may be such that these children's brain chemistry is triggered within their early drinking or using episodes, and they quickly demonstrate addictive behavior.
As a recovering parent or spouse/partner, what can you do to stop the chain of addiction? What do you say to your children about your addiction? What you say and do depends on your own story.
About the author
Claudia Black, Clinical Consultant for The Meadows, is a world-renowned lecturer, author and trainer internationally recognized for both her pioneering and contemporary work with family systems and addictive disorders. She is also past Chairperson of the National Association for Children of Alcoholics and presently serves on its Advisory Board. Dr. Black has been featured in numerous publications, appeared on many national television shows, and written several well-known books, including It Will Never Happen to Me, Depression Strategies: Practical Tools for Professionals Treating Depression and her latest book, Straight Talk.
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.