The Meadows Blog

The following in an excerpt from Mirror of Intimacy by Gentle Path at The Meadows Senior Fellow Alexandra Katehakis. It is available on You can also learn more about her and her work on the Center for Healthy Sex website.

Published in Relationships

By: Joyce Willis, MC, LPC

Up to this point, we have discussed the history of The Model of Developmental Immaturity and how The Model is incorporated into treatment at The Meadows. We learned the definition of codependency and the five primary symptoms of codependency. We have identified the Five Core Issues: Self-Esteem, Boundaries, Reality, Dependency and Moderation. We discussed how living in extremes in the Core Issues leads to immaturity issues. We will now explore the Secondary Symptoms resulting from living in the extremes in the Core Issues. This is where The Model of Developmental Immaturity gets interesting. Columns I (The Nature of the Child) and II (The Core Issues) are tracked straight across. Once we enter Column III (Secondary Symptoms), the chart can spider-web and does not necessarily continue tracking straight across. For instance, with self-esteem issues, we can travel down to addiction issues and mood disorders or we can experience spirituality issues or any of the other Secondary Symptoms. This is the case with all The Core Issues. Being in the extreme in any Core Issue can lead to any or all of the Secondary Symptoms. The Secondary Symptoms describe the unmanageability in our life due to trauma and immaturity. We will explore each of the Secondary Symptoms.

Negative Control Issues

Negative control issues have to do with being controlling of other people. This comes from a lack of respect for the right of other people to be who they are. Negative control issues can lead us to use manipulation and sarcasm to control other people. Negative control happens when we believe we have the right to determine what another person looks like, thinks, feels and does or does not do. On the other hand, negative control can be allowing someone else to control us. Allowing someone else to control how we look, think, feel and act is a part of negative control. How does negative control affect The Core Issues? Negative control can lead to:

  • Self-esteem – If we are struggling with esteeming ourselves and someone has an opinion about us that we do not like, we will try to control what they think in order to feel good about ourselves. This may take the form of arguing, sarcasm, or rationalizing.
  • Boundaries – If we are struggling with functional boundaries, we have difficulty separating our own reality from someone else’s reality about us. If our external boundary is dysfunctional, we often give ourselves permission to do what we want do, when we want to. We give ourselves permission to touch or keep our distance without considering the comfort level of others. Our boundaries can also be impaired by not setting boundaries with how close people get to us and not stopping people from touching us. Negative control occurs in boundaries when we either determine what we can do with someone physically without permission or we give too much permission, when it is not in our best interest.
  • Reality – If we struggle with knowing who we are, we try to control what others think to fulfill someone else’s expectations. We often do this without being aware we are doing this. We try to convince others of who we are, so that they believe in this “made-up” person we present ourselves as.
  • Dependency (needs and wants) – If we have trouble taking care of our needs and wants, we try to control others’ behaviors so that they take care of our needs or wants. We then can become angry when someone cannot read our minds and take care of these needs and wants.

Resentment Issues

Resentment issues have to do with being unable to let go of resentments after being victimized by another person. The “victim” stays in resentment by trying to get the offender to admit the violation, to express regret and/or to right the wrong. It is a possibility that the offender might never do any of these things. Thus, instead of focusing on protection and good self-care to overcome past violations, the victim remains a victim and continues to build resentment. Resentment can take the form of running old tapes in our head and replaying these tapes to try to get revenge. Resentment, in the most extreme form, is like taking poison and waiting for someone else to die. Trying to get revenge leads to the opposite of what we want. Continuing to hold onto resentment can lead to further isolation, increased shame, pain and anger.

How does resentment affect The Core Issues? Much like negative control, resentment can lead to:

  • Self-esteem – If we think that someone has offended us, our self-esteem lowers and we feel shame. We may feel a need to punish the person in order to redeem our value. We resort to getting even in order to restore our own self-esteem. Self-esteem is affected by the better than position, also. If we believe we are better than, we give ourselves the right to react in anger and offend the other person.
  • Boundaries – Often, with resentment, we have no boundaries, thus we offend and can be powerless to stop offending. The resentment we hold onto brings a need to get even.
  • Reality – By holding onto resentment, we are likely to misinterpret situations that happen and think we have been wronged when we have not been. This can lead to hostility and offensive behavior toward the perceived offender.

Spirituality Issues

Spirituality issues have to do with having no connection to a higher power. Having no connection to a higher power can result from having problems facing who we are or being unwilling to see others as they are. Spirituality issues include making others or our addictions our higher power or trying to be the higher power. Neither of these is about living in truth; which is the basis of spirituality.

How do spirituality issues affect The Core Issues? Spirituality issues affect two areas in The Core Issues:

  • Self-esteem – If we believe we are worthless, this may lead to not believing we are worthy to relate to a higher power. This can lead to us alienating ourselves from others and from our higher power. If we are trying to be our own higher power due to thinking we are better than, we do not need an external higher power. Either way, we harm our spiritual recovery.
  • Reality – Becoming truly spiritual requires that we admit and share our imperfections and mistakes and that we listen when others share their imperfections and mistakes. Not being able to do this robs us of a nurturing spiritual relationship with our higher power.

Addiction and Mood Disorders

Addiction problems usually manifest to medicate reality or to create intensity. Addictions stem from codependence. Any substance or process that relieves our distress can become an addiction. This includes addictions to substances, such as alcohol and drugs. This also includes addictions to behaviors/processes, such as eating disorders, gambling, and sex addiction. All these substance addictions and behavioral addictions can develop from a want to medicate unwanted reality or a way to relieve pain.

When we are so afraid of the painful reality of our childhood, this can lead to mood disorders, such as depression or anxiety. We can use the depression and anxiety to avoid the pain of dealing with the past or with our present situations. Depression or anxiety can let us continue to keep what happened in the past as non-existent, leading to denial and not moving into recovery.

In this area, it is important to discuss physical illness, as well. The stress of avoiding pain or owning our own reality can lead us to physical illnesses for which there are no true medical reasons. We can often suffer chronic symptoms that persist in our lives. Many of these symptoms may result from not expressing our feelings. Examples of physical symptoms are headaches, high blood pressure, and asthma.

How do Addiction, Mood Disorders and Physical issues affect The Core Issues? When we avoid reality through addictions, mood disorders and/or physical illnesses, we can develop:

  • Self-esteem – Addictions, mood disorders and physical illnesses can lead to us feeling less than other people. We can also use our substance abuse to be arrogant and better than and continue in addiction to avoid loneliness and shame. Whether we believe we are less than or better than, we cannot be in an honest, trustworthy relationship with others.
  • Reality - When we are stuck in addictions, mood disorders and physical illnesses, we often want to avoid feeling emotions. Thus, we medicate our feelings and become removed from our own reality of what is.

Intimacy Issues

Intimacy issues have to do with difficulty in being relational. Intimacy does not just refer to physical or sexual intimacy. Intimacy has to do with being vulnerable enough to let someone know us emotionally, spiritually and intellectually. Intimacy also has to with respectful curiosity to know someone else on an emotional, spiritual and intellectual level. Trauma can lead to difficulty being intimate and being relational.

How do intimacy issues affect The Core Issues? Intimacy issues affect every area of The Core Issues. An impaired ability to sustain functional intimacy can lead to:

  • Self-esteem – If we are in the less than position, we compare ourselves to others and come up short. Thus, we cannot truthfully share in an intimate way, because we fear others will find out how defective we are. If we are in the better than position, we often judge others. This makes it uncomfortable for someone to be around us.
  • Boundaries – Intimacy is blocked when we are in the victim or the offender role. We cannot get to know others or share who we are if we do not have a functional internal boundary.
  • Reality – If we struggle with knowing who we are, we cannot share ourselves with others. If we are looking for someone else to define who we are, then we may try to change how we think, feel and act. This can lead to dishonest and manipulative behavior that does not allow for intimacy.
  • Dependency (needs and wants) - If we are too dependent on others to meet our needs and wants, we risk becoming the child in a relationship, rather than an equal adult in the relationship. If we are stubborn about our independence and do not ask for help, intimacy is blocked because we stop sharing our needs and wants. If we deny our needs our wants completely, then we are out of touch with our own humanity and are, in essence, not operating as a real person in a way to be intimate with others.
  • Moderation/Containment– If we behave in a way that shows no containment, (angry outbursts, threatening behaviors, extreme intensity), there is no intimacy. If we share who we are in an intense and frightening manner, we are blocking true intimacy. The other side of this is shutting down our emotions and shutting others out. This leads to intimacy dying. True adult to adult intimacy is about being able to be spontaneous and fun while being responsible and respectful.

We have now explored the first 3 columns of The Model of Developmental Immaturity Issues. Childhood Trauma causes Immaturity in The Core Issues. Trauma and Immaturity drive the Secondary Symptoms leading to unmanageability in our lives. Trauma, immaturity and unmanageability create Relational Problems. We will explore Relational Problems in Part IV of Breaking Down The Model.

Resource: Mellody P. (1989). Facing Codependence. New York: HaperCollins.

Joyce Willis is a Licensed Professional Counselor and is currently a therapist at The Meadows. She earned her Bachelor of Education degree from the University of Akron. After teaching for several years, Joyce earned a Master’s degree in counseling from the University of Phoenix. She has been in the counseling profession since 1996 and in that time has worked extensively in the addictions field. Her specialties include treatment for addictions, bereavement, trauma, depression and anxiety. Joyce has a special interest in mindfulness and helping people connect their emotional, spiritual, mindful and physiological selves with compassion and respect.

Published in Blog

Phoenix Free Lecture Series July 25, 2011 7:00-8:30pm
Chaparral Christian Church
6451 East Shea Blvd.
Scottsdale, Arizona 85254

Relational Intimacy: Common Problems and Impasses in Couple and Family Relationships

Kristen Smith, LMFT, LISAC

For more information, call The Meadows 800-632-3697

Published in Blog

Note: This article was originally published in the Spring 2005 issue of MeadowLark, the magazine for alumni of The Meadows.

The Co-Addicted Tango: Pia Mellody's Theory of Love Addiction and Love Avoidance

By Lawrence S. Freundlich

When Ms. "Crazy for Love" meets Mr. "Give Me Some Room to Breathe," the stage is set for what Pia Mellody calls "The Co-Addicted Tango." Ms. "Crazy for Love" is in Mellody's clinical terms, "The Love Addict," and Mr. "Give Me Some Room to Breathe," is "The Love Avoidant." They will each find something attractive about one another and inevitably something that will detract from one another, making their dysfunctional relationship as painful as it is frenetic and a back-and-forth "Co-Addictive Tango."

The Love Addict, to whom I have just referred to as "Crazy for Love," I identify as a woman, and the Love Avoidant, to whom I have just referred to as "Give me Some Room to Breathe," I identify as a man. Is this gender typing accurate? After all, men can be Love Addicts and women can be Love Avoidants? In fact there are powerful forces at work in American culture that distribute Love Addiction to women with significantly greater frequency than to men, and Love Avoidance to men with significantly greater frequency than to women. The most powerful generator of this disproportion is revealed when we understand the psychological concepts of "disempowerment" and "false empowerment."

Trauma results from either disempowering abuse or "falsely empowering" abuse, which, because of its falseness, disempowers as well. Abusive parents either shame the children into silence as a way of diminishing their own external stress, thereby disempowering the children, or assigning the children roles for which the parents should be responsible, thereby falsely empowering the children.

In our culture, young girls are trained to believe that men are the source of value, power and abundance; it is the female whose prevailing dysfunction is the outcome of "disempowering abuse." Her need to be taken care of by a man greater than herself is consistent with Love Addiction. The main conscious fear in relationships from which Love Addicts suffer is fear of neglect and abandonment. In childhood their parents have shamed them into thinking of themselves as unworthy. Without the help of an outside agency, like a husband, for example, they do not feel they have what it takes to be whole.

On the other hand, young males in our culture are raised to believe that it is their job to control and dominate- to be the source of value, power and abundance. They are trained to care "for the little woman," because she can't care for herself. It is the male whose prevailing dysfunction is the outcome of falsely empowering abuse. His need to caretake the needy female is consistent with Love Avoidance. The primary conscious fear of the Love Avoidant is fear of being drained, suffocated and overwhelmed. In their childhoods, the parents of Love Avoidants have forced on the child the role of caring for the needs of the parents. In this role reversal, the parent is being taken care of by the child. Giving the child the adult role is a form of enmeshment, which causes the love avoidant to think of intimacy as a job. They learn to resent this job as the neediness of the Love Addict becomes overwhelming.

The Love Addict enters into the relationship feeling an unbearable sense of inadequacy. Her relationship with the Love Avoidant is as doomed as it is inevitable. Having been neglected and abandoned by her own parents, she has learned that all attempts at intimacy will be painfully unsuccessful. When she seeks a love mate she will, therefore, find someone familiarly not intimate, but someone who will be good at mimicking intimacy. She deludes herself into believing that the mimicry is the real thing by creating her lover in accordance to a fantasy of her own making. The Love Avoidant becomes her knight in shining armor- "armor" being the operative psychological irony- shiny, but impervious to intimate contact.

The Love Avoidant, on the other hand, enters the relationship not because he is seeking confirmation of his own worth but out of a sense of duty. In his childhood, his parents taught him that it is his job to care for people who cannot care for themselves. As an adult, the Love Avoidant, while feeling superior or pity for the neediness of his Love Addicted partner, thrives on the power it gives him over her. Eventually, he grows resentful of all the work it takes to be a caretaker. He begins to feel suffocated and lifeless.

The suffocating Love Avoidant begins to distance himself from the Love Addict, who after several bouts of hysterically trying to get him back, eventually becomes exhausted with the pursuit of the Love Avoidant and turns to someone else with whom to be helplessly Love Addicted or to some other addiction to cover her pain of inadequacy. The substitute addiction could be food, alcohol, sex, work, spending or exercise- any addictive activity.

At this point in the Co-Addicted Tango, the Love Avoidant, who is no longer the object of the Love Addict's desire, feels the pain of no longer being needed. Without someone whose weakness cries out for his strength, his sense of superiority wavers. What value does he have if he cannot care for the needy? This triggers deep, underlying abandonment fears- sardonically the same kind of abandonment fears that lie at the heart of the Love Addict's emotional dysfunction. Love Addicts, never having been unconditionally loved by their neglectful and/or abandoning parents, look for a knight in shining armor to provide them with the self-esteem with which they never had mirrored for them by their own parents. Love Avoidants, on the other hand, almost never got a chance to feel their inherent worth, because in childhood they were empowered to care for their own parents. While not having received love from the parents, their caretaking gives them a sense of grandiosity, while masking the haunting truth that they have never been intimately loved. This false empowerment very effectively hides the crucial truth that they, like the Love Addict, were starved of intimacy. The contempt they feel for the neediness of the Love Addict, is the masked contempt they feel for themselves at not having been worthy of their parents' love. Contempt is shame turned outward on anyone whose weaknesses reminds us of the intolerable shame of our inadequacy.

Deprived of the caretaking role by the withdrawal of the Love Addict, the Love Avoidant finally feels the jolt of the carried shame of abandonment; and the Love Avoidant, who once feared being smothered by the Love Addict, now turns around to get close to the Love Addict again, using all of his powers of seduction to get back into control of the relationship.

One is running and the other is chasing all the time. When the one who is chasing finally gets close to the one running away, they both erupt into intensity, either a romantic interlude or a terrific fight. As the lyrics to the classic song say, "You Always Hurt the One You Love." This behavior is what most people call "normal"; and if it isn't "normal," it certainly is "familiar."


This attraction to what is familiar, says Pia Mellody, starts in our family of origin. "Familiarity" is the central engine of child hood character formation. In the case of Love Addicts and Love Avoidants, each person is first attracted to the other specifically because of the "familiar" traits that the other exhibits. These traits, although painful, are familiar from childhood and appear a safe way to keep the family system stable.

Both the Love Addict and Love Avoidant are traumatized children who originally adapted in order to survive within the abusive family system. They believed that only by adapting to their parents' expectations of them would they remain protected. Maintaining the status quo, even if it was a dysfunctional status quo, was for these children better than being abandoned or losing their identity (role) within the family.

The abandonment pain felt by Love Addicts in their families of origin teaches them as children to be quiet, alone, needless and wantless so as not to bother the parents. Later, they are unconsciously attracted to people who do not aggressively seek attachment to them. They unconsciously seek to replicate their childhood relationships. A part of self-esteem was wounded in the childhoods of Love Addicts. Abandonment and neglect send the message that they were not worth being with. A large part of their attraction toward Love Avoidants is that Love Addicts find in people who walk away from them an opportunity to heal the wound to their childhood self-esteem. If they can make an adult who withholds intimacy connect and fall in love with them, they can prove that they have inherent worth. Only a child can be abandoned; adults cannot. Healthy, mature adults have it within their capacities to deal satisfactorily with the vagaries of relationships without calling their inherent worth into question.

Love Avoidants are accustomed to needy, dependent, helpless people whom they can rescue, which gives them control and a 7 feeling of safety and power. When they pick up the right signal, Love Avoidants move in seductively and powerfully. People who think for themselves, say directly what they mean, solve their own problems and care adequately for themselves are not interesting to Love Avoidants.

Shame Reduction

The conscious fear of Love Avoidants is the fear of being drained and used. The unconscious fear of Love Avoidants is the conscious fear of Love Addicts, and that is the fear of abandonment. Abandonment is the core issue for both, but getting at the abandonment issue through shame reduction therapy is much more difficult with Love Avoidants than it is with Love Addicts. Disempowering abuse keeps Love Addicts close to their shame core all the time. Love Avoidants are walled off from their shame core by the grandiosity of their childhood false empowerment.

Pia Mellody's elegant charting of the dance of avoidance and pursuit between the Love Addict and the Love Avoidant is a fascinating anthropology of failed relationality, which deserves the name "Co-Addicted Tango." But understanding the various stages through which Love Avoidant/Love Addicted relationships travel is not enough to effect healing from the traumatic wounds that set these relationships in motion. For that healing to hap pen, as with all childhood relational trauma, shame reduction must take place.

The therapeutic contribution of presenting Pia Mellody's modus operandi of the Co-Addicted Tango to the patients is that the compelling accuracy of her models reduces the patients' shame by exposing their delusions to reason. As they come to see the delusions of Addiction and Avoidance in their own emotional lives, they see that they are not alone in the world of relational dysfunction. More importantly, they come to see that the emotions that seize them during relational trauma are not their fault, that they are not worthless. Undoing the automatic descent into shame and worthless ness during relational stress takes more than intellectual understanding.

Love Addicts and Love Avoidants must revisit the scenes of their childhood wounding by going back in time with the help of a therapist to confront their childhood abusers with their honest testimony of how their parents' abuse caused shame, pain and bewilderment. There comes a moment in this process of shame reduction when patients are able to rid themselves of carried shame. This emotional "detoxification" is at the center of recovery. The traumatic inheritance of abandonment has poisoned both Love Addict and Love Avoidant with shame of being who they are- better than or less when, disempowered or falsely empowered- it hardly makes a difference. Shame will run and ruin their relation ships unless they heal.

Published in Blog

Newsweek Magazine, July 13, 2009, asked individuals some of their favorite books and listed them as,"Best. Books. Ever." (pp.56.) On the top of Dr. Drew Pinsky's list as a "book to save your marriage, The Intimacy Factor, by Pia Mellody and Laurence S. Freulich."

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