The Meadows Blog

Dr. Patrick Carnes, the pioneer researcher whose work helped establish the concept of compulsive sexual behavior as an addiction, presented a Research Award to Dr. Bessel van der Kolk at the second annual International Sex & Love Addiction Conference. The three-day conference focused on the changing architecture of addictive desire, trauma, and attachment.

Clinical consultant and Senior Fellow at The Meadows (, Dr. van der Kolk accepted the Research Award from the American Foundation for Addiction Research for his research as a clinical psychiatrist known internationally for his contributions in the areas of post-traumatic stress and related phenomenon since the 1970s. His book Psychological Trauma was the first integrative text on the subject.

Co-sponsored by The Meadows, a Wickenburg, Arizona-based treatment center focusing on trauma and addiction, this key industry event drew more than 300 clinicians and therapists who explored the many facets of Sex & Love Addiction, one of the most pertinent clinical and counseling issues facing addiction and mental health professionals.

Dr. Patrick Carnes was pleased to fill the role of Conference Chair. “All of The Meadows staff who took part in this year’s industry event – from our senior fellows to our chief of psychiatry – continually incorporate the latest research into our incomparable treatment programs that have made us the most trusted name in treating trauma and addiction.”

Prominent speakers included John Bradshaw, Senior Fellow at The Meadows who accepted a Lifetime Achievement Award; Conference Chair Dr. Patrick Carnes, founder of Gentle Path at The Meadows (; and Dr. Claudia Black, renowned addictions, codependency, and family systems expert who is also a Senior Fellow at The Meadows and has spent more than a decade in an advisory role there.

Conference attendee Dr. Jon Caldwell, chief of psychiatry at The Meadows who specializes in the treatment of adults with relational trauma histories and addictive behaviors, found the conference inspiring, enlightening, and meaningful. “This international conference features some of the most knowledgeable and respected thought leaders of our day in the fields of trauma, attachment, and sex/love addiction. Additionally, their experience and wisdom is being augmented by a new generation of passionate leaders and remarkable scientific advances. It has been a historic conference that will have great meaning and utility for the people we serve!”

To learn more about The Meadows’ work with trauma and addiction contact us at (800) 244-4949 or visit our Contact page.

About The American Foundation for Addiction Research: The American Foundation for Addiction Research (AFAR) was founded in 1998 by Dr. Patrick Carnes, a pioneer in sexual addiction who has made innovations in sexual compulsivity, trauma, and outcome measures through scientific research, treatment and education.

Published in Sexual Addiction

The Meadows will be an exhibitor at the Healing Sex and Love Addiction 5th Annual Conference on October 27, 2012, at The Spiritual Life Center in Sacramento, California. The theme of the conference is "Sex Addiction Expanded - Relationship Disturbance & Associated Issues."

This annual conference is organized by the Professional Association for Sexual Addiction Treatment (PASAT), which is an organization of Northern California psychotherapists who specialize in the prevention and treatment of sex and love addiction. PASAT is dedicated to providing training and education on these subjects for clinicians, recovering people and the general public.

The Meadows will be among the exhibitors with staff member Kirk Watson, Business Development Liaison for The Meadows, in attendance.

The Meadows is an industry leader in treating trauma and addiction through its inpatient and workshop programs. To learn more about The Meadows' work with trauma and addiction contact an intake coordinator at (866) 856-1279 or visit

For over 35 years, The Meadows has been a leading trauma and addiction treatment center. In that time, they have helped more than 20,000 patients in one of their three inpatient centers and 25,000 attendees in national workshops. The Meadows world-class team of Senior Fellows, Psychiatrists, Therapists and Counselors treat the symptoms of addiction and the underlying issues that cause lifelong patterns of self-destructive behavior. The Meadows, with 24 hour nursing and on-site physicians and psychiatrists, is a Level 1 psychiatric hospital that is accredited by the Joint Commission.

Published in Blog

Senior Clinical Advisor for The Meadows, Pia Mellody "is the queen of love addiction recovery for me," said Alanis Morisette in her interview with Piers Morgan on September 7, 2012. Seven-time Grammy Award winner, Morisette tells Morgan that she was a love addict. To watch the interview, visit:


Published in Blog
Wednesday, 05 September 2012 20:00

Sex, Love and Longing

(Excerpted from Debra L. Kaplan's book due out in 2013)

I am often asked in therapy (with deep reluctance and trepidation) if it is a pre-requisite of therapy to explore childhood issues. "That depends," I say. "I have no desire to dwell in your past but exploring your past childhood relationships might help us both understand your current relationship style and how you relate in romantic relationships."

When we are no longer able to push away the emptiness in our life that we work so hard to ward off we succumb to either seek therapy and explore that loneliness or continue to disconnect from the world and wallow in distress.

Our current relationships are informed by how we learned to bond with and attach to caregivers and others. These early experiences greatly determine how, or if, we feel safe and secure and therefore lean into connection, or dismiss, and avoid emotional connection all together. In other words the past remains present if we do not heal unresolved early relational disturbance. A trigger in the here and now will only serve as summoner to our buried pain, carrying it forward- front and center- causing us to experience significant internal and relational anguish. The ways in which that relational distress is exhibited depends strongly on the type of relational distress (or outright trauma) we experienced in childhood, the duration of those traumatic relationships, and the family system in which we lived. Of substantial importance to the outcome is our support system, our own character traits, personality, or adaptability.

In the Beginning

Attachment is an emotional bond to another person. Any discussion about attachment and relationship would be incomplete without a explanation of what attachment is and the two names synonymous with having pioneered attachment theory; psychologists, John Bowlby and Mary D. Salter Ainsworth. John Bowlby is a British psychoanalyst and the first individual to develop the theory describing attachment as a lasting psychological connectedness between human beings (Bowlby). As humans we are motivated by a primordial need to seek proximity and comfort from such figures in times of distress. Bowlby postulated that caregivers who were consistently available and responsive during times of distress were fundamental in helping an infant create a safe haven from which s/he could explore the world and begin to safely and securely form attachments beyond infancy. He also believed that four key characteristics of behavior were an infant's natural adaptation to regulate proximity to an attachment figure:

  • Secure Base: A caregiver provides a consistent secure base from which the child can explore the world.
  • Safe Haven: When in distress a child will return to the caregiver for comfort and soothing.
  • Proximity Maintenance: The child attempts to stay near the caregiver, thus assuring safety.
  • Separation Distress: When separated from the caregiver, a child will become upset and distressed.

Mary Ainsworth, (1913 - 1999) an American born psychologist worked with John Bowlby researching maternal-infant attachments. She came to define attachment as "an affectional tie that one person or animal forms between himself and another specific one - a tie that binds them together in space and endures over time." (Ainsworth)

Attachment Gone Awry

If early bonding and attachment is so vital to our later adult relationships, what happens to attachment in the face of not-good-enough parenting? And, how do anxious and avoidant attachment patterns present in romantic relationship? Many individuals come to experience relationships as anxiety provoking and enmeshing and a situation warranting escape; their earlier childhood bonding and attachment to caregivers was, in all likelihood, anything but secure.

Preoccupied Attachment

Where an individual finds him/herself on the anxiety and avoidance axis, will determine the extent to which that individual trusts/distrusts others (exhibits low anxiety or high anxiety) or fears others in relationship (exhibits low avoidance or high avoidance). Likewise, the extent to which an individual finds him/herself on the anxiety scale determines how safe (comfortable) vs. fearful that individual feels about being in relationship. Consider the following:

  • Janet was obsessional about checking her partner's phone and laptop when he was in the shower. Despite the fact that her partner was neither unfaithful nor gave her any reason to question his commitment to her or the relationship, she tended to be possessive. Janet often started arguments just to convince herself that he wasn't going to leave. While Janet wanted his affection she was nonetheless afraid of getting too close. He began to question if staying in the relationship was worth the struggle.
  • Bryan knew that his wife was faithful but couldn't help wonder why as beautiful as she was, she didn't cheat on him. He often found himself thinking "It is only a matter of time that she will ask for a divorce and leave me."
  • Gail has been in several relationships before she met Alex. Unlike her other boyfriends, Alex stated that he would not sleep with another woman. Despite Gail's concerns about Alex's flirtation with women and his online sex chat behavior, she was afraid to leave. Over time Alex's pornography use increased resulting in little to no sexual contact between them. Gail's anxiety increased but she remained staunchly committed to not leaving Alex.

As we read above, Gail's relationship is compromised due to her ever-present distrust of Alex and her fear of abandonment. Despite the sexual avoidance and emotional disconnect in the relationship Gail is unwilling to change the situation. A look back to her childhood reveals that Gail's mother was a doting mom to her three girls in the face of her husband's ongoing infidelity. Gail's father worked long hours to make ends meet and was rarely physically or emotionally present with the family- except on weekends. It was then that Gail would accompany him on his fishing trips or jaunts to the local bar; anything just to be with him. She felt special when she was with him although he spent his time joking with the others at the bar and laughing with the women who surrounded him. It never occurred to her that being with her dad meant doing what he wanted and worse yet, being abandoned to watch the overt betrayal of her and the family. The emptiness she felt growing up was minimally eased by those moments of being in his presence. This early pattern of emotional distance endured into her adulthood even as she longed to connect with men. Her need for love, acceptance and reassurance created a self-deprecating pattern of exploitation in her relationships.

In childhood when caregivers were inconsistent with their responsiveness (here today but not tomorrow) or overly protective and distancing, the child forms an anxious attachment. If the infant turned child is distrustful in knowing that the parent will consistently be there, the child will do anything in its ability to ascertain their survival and lower his/her own anxiety of abandonment. Hence the child remains focused on the caregiver, staying close in proximity (although in an insecure fashion) in an adaptive mode of self-preservation.

These examples all illustrate the anxiety and avoidance that engulf an individual who has one foot in and one foot out in relationship. Preoccupied partners are more likely to focus on the others' behaviors due to an anxiety and obsession about "if" or "how much" their partner cares about them. This is contrasted to the insecurity of "if" the individual will be abandoned. An otherwise secure relationship will come to an abrupt end due to an increasing fear that "this is too good to be true" a fear that becoming too close will increase one's vulnerability to rejection or unsuspecting abandonment- I will leave before you inevitably leave me. The resultant behavior becomes a distancing by partner from the anxious individual further exacerbating the very fear of abandonment that drove the obsessive behavior in the first place. This becomes a worsening and vicious cycle. This preoccupation around the insecurity of a romantic attachment drives a need for intensity; of which the purpose is to mitigate the intra (internal) distress.

Fearful - Avoidant Attachment

  • John had yet to be in a romantic relationship. He is as fearful of women as he is fascinated by them and only wished that he had the nerve to ask one out. He has worked for years in a large corporation silently longing for several female coworkers, yet he goes home at night and fulfills his fantasies and dashed dreams online in chat rooms and on websites for phone sex.
  • Henry: "Being naked in front of my girlfriend is as terrifying as parading around in public with my pants down."
  • David and Ellen met online and were dating for 3 months when Ellen approached David seeking more emotional commitment from him. David became despondent and withdrew from the relationship which became quite distressing for Ellen. After two weeks of no-contact Ellen arrived unannounced at David's apartment to confront him. The only thing David knew to say was, "I'm sorry that I am such a disappointment to you." He proceeded to become aloof and cold giving no explanation for his behavior.
  • Judy spent many years in therapy hoping to heal from the wounds of childhood sexual and physical abuse. "I know that most men are good." Yet, whenever I'm approached by a male who wants to date me, I all but ignore his intentions thinking that he must be as damaged as I am! "Why else would he be interested in me?"

Fearful-Avoidants avoid emotional and sexual intimacy but nonetheless, struggle to connect. The behavioral course of action is to disengage and distance as a result of high anxiety and high avoidance. However, this attempt by the avoidant to deflect or avert deep feelings often backfires. Avoidant people cannot escape thinking about their close relationships no matter how hard they try not to. Scientists refer to this as the "ironic rebound effect," similar to what would happen if someone said, "Don't think of a white horse." Consequently, avoidant individuals tend to seek superficial physical/sexual encounters with others (e.g., anonymous one-night stands, online sexual encounters, pornography) outside the restrains of a rejecting relationship. Fearful-Avoidants experience attachment insecurities and turn to what researchers call "secondary attachment strategies - deactivating or hyper-activating strategies in an effort to cope with threats." (Cassidy and Kobak 1988)

The fearful-avoidant's childhood family system is characterized by hostile and violent abuse that reinforced the child's belief that he or she is defective, worthless and rejected. These individuals may display emotional symptoms of both the avoidant and the pre-occupied attachment styles.

John's upbringing is a perfect example of how terrifying childhood attachment figures, albeit unintentionally, can be. John learned early on that in order to be loved and cared for he would have to endure considerable loneliness. His early neglect and abandonment in childhood came by way of spending many nights alone waiting for his mother to return home from her second job as a janitor. John's overwhelming sense of isolation and fear during those countless nights by himself served to reinforce his belief that to be loved and cared for, "I will be abandoned." While his mother never intended any harm and by today's standards may have constituted child abuse, her single mother status and necessity to support her son conveyed this painful mixed message. As an adult and in the face of a potential emotional and romantic entanglement John experienced such internal distress and shame that he became emotionally walled off preferring instead to remain alone versus being threatened with potential and "inevitable" abandonment.

Dismissing - Avoidant Attachment

  • Allison could barely contain herself when she exclaimed to her friends that she met a new guy online. Allison had always enjoyed her independence so this long distance relationship was just what she wanted. Besides, she acknowledged, "I don't like guys getting too attached. If they do I just move on to the next. I let them know up front so if they have a problem with this it won't matter. It's not like I didn't tell them."
  • Jim was unsympathetic to his girlfriend's attempts to connect with him. "I don't understand why you would be so into me?" she probed, "and now you couldn't be less interested!" In her efforts to be emotionally intimate with Jim she asked that he join her in counseling to discuss how they can resolve this disconnect. "I'll go with you if that's what you really want, but I think it's a waste of your time and money."
  • Michael was enjoying his new found success with his budding yet lucrative investment company when his wife Lia gave birth to their first born child. It was at that time that Lia became overwhelmed and needed his help with their new baby. Michael loved his independence but began irritated as he saw it slip away and as he put it, "fade out of view." It was at this stage in their marriage, that Lia began to see how alone she was as Michael so comfortably escaped into his work commitments.
  • "Relationships!" Brendan blurted out, "Do I really want to get involved with a relationship just to have great sex? I'm not that kind of guy. Give me gorgeous, self-sufficient women who don't need to be rescued, and I'm all in; that is until they want more. Then I'm out of there!"

Allison, Jim, Michael and Brendan are all individuals who are emotionally unavailable and actively disengage from real intimacy. Individuals like them often present with a charming wall of seduction; a seductive come-on that conveys interest, but does not allow for deeper emotional and relational connection. This engaging behavior albeit non-relationally can be irresistibly alluring to the "neediness" of the individual with a pre-occupied attachment style because their need for attention and connection is fulfilled by the seductive nature of the dismissive-avoidant. The seductive "all in" quality of the dismissing-avoidant masks his or her yet-to-be-revealed unwillingness to be relational thereby setting the stage for the preoccupied individual's eventual self-fulfilling relational anxiety and relational demise- here today/ gone tomorrow. The Dismissing-Avoidant eventually becomes uncomfortable with the closeness of the partner and begins to detach from emotional and relational intimacy. In the process the avoidant may engage in addictions (drugs, food, sex, money) or addictive processes (compulsive masturbation, internet porn, anonymous sexual encounters, work addiction) in an attempt to put distance between them and the partner/relationship. Nonetheless, the initial allure that captivated the pre-occupied individual plays into the precarious cycle of anxious and ambivalent connection given the preoccupied individual's tendency toward low avoidance and high anxiety. Since the avoidant's childhood attachments were consistently unavailable or overwhelmingly engulfing their ability to remain relational is slim to none. A child that experienced too little interaction will learn to be self-sufficient and counter-dependent. That same child that may experience an overinvolved and smothering attachment will later in life, make all efforts to attract a partner but not emotionally connect with her or him. For the dismissive-avoidant, sex, for example is a mechanism that expresses connection but not relational intimacy.

Debra L. Kaplan, MA, LAC, LISAC, CMAT, CSAT-S is a licensed therapist in Tucson, Arizona. Ms. Kaplan specializes in the treatment of attachment and intimacy disorders, complex traumatic stress and accompanying dissociative disorders. Debra's area of expertise includes sexual addiction/compulsivity; issues that are often rooted in unresolved childhood trauma. Debra serves as faculty for the International Institute for Trauma and Addiction Professionals (IITAP), founded by Dr. Patrick Carnes and publishes and presents nationally on trauma and sex addiction.

Published in Blog

The Meadows will offer a Love Addiction/Love Avoidance Workshop the week of June 18 from 8:30am to 4:30pm Monday through Friday at The Meadows' campus. This workshop is based on Pia Mellody's groundbreaking work on the compulsive behaviors of love addicts and love avoidants.

During the workshop the characteristic of the love addict and love avoidant are explored. Love addicts experience abandonment and neglect in childhood, causing them to assign too much time, attention and value to another person, while neglecting to care for or value themselves. Focus on the partner is obsessive, and fear of abandonment drives the obsession. Love addicts can be addicted to anyone: lover, spouse, friend, parent or child. By comparison, the love avoidant was smothered or enmeshed in childhood, for example, a parent who was domineering or used the child as a confidante or surrogate spouse.

"Love addicts create fantasies and they live in fantasy rather than reality. They make up a fantasy about who the other person is and have unrealistic expectations about what it means to be relational," said Gail Yaw, Director of Workshops at The Meadows and a Licensed Clinical Social Worker. "The love avoidant's fear is "if I let you get close, you'll take me over."

Attending a Meadows' workshop offers an individual many benefits. A workshop can be a cost-effective alternative when long-term treatment is not an option. Individuals who cannot be away from their work or families for an extended period of time can attend a workshop and work on sensitive issues in a five-day concentrated format. This allows individuals to jump start their personal recovery by gaining insight into patterns and practicing new relational skills within a safe environment.

For more information about The Meadows' Love Addiction/Love Avoidance Workshop and other workshops offered by The Meadows, please contact Heidi Dike-Kingston at (866) 856-1279 or visit

For over 35 years, The Meadows has been a leading trauma and addiction treatment center. In that time, they have helped more than 20,000 patients in one of their three inpatient centers and 25,000 attendees in national workshops. The Meadows world-class team of Senior Fellows, Psychiatrists, Therapists and Counselors treat the symptoms of addiction and the underlying issues that cause lifelong patterns of self-destructive behavior. The Meadows, with 24 hour nursing and on-site physicians and psychiatrists, is a Level 1 psychiatric hospital that is accredited by the Joint Commission.

Published in Blog
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