The Meadows Blog

Sunday, 05 August 2012 20:00

“Facing the Truth behind the Mask”

"Recovery is about living more in truth than in lies... it's about facing reality and growing up."
- Pia Mellody

Over 2,500 years ago, in Athens Greece, playwrights like Sophocles introduced a form of theatrical art known as the tragedy. Greek tragedies typically dealt with weighty themes such as betrayal, loss, pride, jealousy, rage, love, courage, honor, life and death. Often these dance-dramas also explored man's relationship with God and the existential challenges that are part of the human condition. Actors wore elaborate masks with exaggerated facial expressions so that their character's role, emotional state, and intentions might be accessible to the audience. Commonly, one actor played several characters during the course of the theatrical performance, changing masks for each character and sometimes for each scene.

Fast-forward to our lives today and the Greek tragedy might be used as a metaphor for some of the key aspects of recovery from trauma and addiction. Like an actor in a play, often we are reacting to life's existential challenges according to a script. This script can influence how we move about on the stage of life; it can spell out our roles in relation to others, how we think and feel, and how we act in various situations. From the first moments of conception and throughout development, by way of ongoing interactions between ourselves, others, and the environment, this narrative is written into our psychobiology - it becomes an implicit script in the mind-body system.

Moreover, similar to actors in Greek tragedies, our implicit scripts encourage the use of certain masks or persona's. In many ways, this is completely natural and necessary for a life in which we play many different roles. For most of us, the scenes on life's stage are constantly changing; we may transition from a family mask to a work mask, then to a friend mask, and back to a family mask, all within the course of one day. However, unlike the actors in a Greek tragedy, for us these persona's are not distinct, separate people - they are aspects of a single being, linked together by the person behind the masks.

For some of us, our own life resembles a Greek tragedy, with painful experiences of betrayal, loss, abandonment, and trauma. These experiences are written into the mind-body script that tacitly flavors our thoughts, feelings, and behavior. Some of these life events can be so traumatic that we don't even want to look at the script - we would rather not face the reality of our situation, it's just too painful. Yet, our bodies and minds still play the part, even when we don't pay attention to the script; something happens on the stage of life and we just react according to our past experiences, maybe without even being aware of the script.

Also, when there are painful and traumatic aspects to our life scripts, wearing a mask can become an adaptive way to hide our vulnerabilities from ourselves and others. The various persona's create a sense of security and a safe distance from the troubling realities deep behind the masks. While this strategy is protective, over time it can further obscure the truth of our scripts and disconnect us from what drives our thoughts, feelings, and actions. In fact, under these circumstances, we risk becoming over-identified with the persona's, forgetting who is actually looking through the masks. We become disconnected from the truth of who we really are and we cannot see the truth of others around us.

Moreover, sometimes these protective measures fall short and the truth of our scripts threatens to come bubbling up into awareness. In those moments, the pain, fear and shame can seem overwhelming, leading to desperate attempts to push it all back out of awareness. Compulsive behaviors with drugs, sex, relationships, and food will facilitate temporary relief from the vulnerability and pain of our tragedy scripts. While addiction can force the rawness of our reality out of awareness for a while, it comes with a whole host of complicating problems. In time, addictions only add painful prose to the narrative of our mind-body scripts and further disconnect us from our truth and from people that we love.

For several decades, Pia Mellody has been encouraging people to remember and rediscover the truth behind the masks and to face reality without addiction. For her, what started as a journey to understand the dis-ease of codependence, so that she could better help her clients, turned into an elegant, comprehensive model for addiction recovery. This model continues to be used at The Meadows of Wickenburg, a world-renowned treatment center, and has been a source of healing for many patients and practitioners.

You might ask, "How is codependence related to addiction?" Pia Mellody kept asking herself this same question when she repeatedly encountered the coexistence of these two conditions in her clients. What she and her colleagues came to understand is that codependence and addiction are frequently linked together by a history of childhood abuse and neglect. These traumatic experiences can be overt (i.e., big "T"), as in the case of physical or sexual abuse, or covert (i.e., little "t"), as in the case of emotional abuse, abandonment, enmeshment, and loss/death. Relational trauma of this kind often results in deep wounds, painful paragraphs in our mind-body scripts, which can lead to developmental immaturity and negative consequences for adult functioning.

More specifically, Pia Mellody found that people usually entered recovery treatment because of addiction, mental/emotional symptoms, resentment/anger, negative control of others, intimacy/relationship problems, and impoverished spirituality. However, usually these issues only become "problems" because other people tell the person in treatment that they are indeed problematic! Yet, given an opportunity to step back from the tornado of unmanageability created by these issues, most people in treatment are able to admit that help is necessary.

Pia Mellody came to understand that these presenting problems were only "secondary symptoms" of deeper, core developmental issues that are frequently related to childhood trauma. She surmised that relational trauma causes an individual to become polarized along five core dimensions of development: 1) self esteem (less than versus better than), 2) boundaries (too vulnerable versus invulnerable), 3) reality issues (bad/rebellious versus good/perfect), 4) dependency (too dependent versus needless/wantless), and 5) moderation (too little versus too much self-control). Furthermore, she discovered that when people are able to address their childhood wounds and identify their core issues of developmental immaturity, they discover a measure of reprieve from the secondary symptoms of addiction and relationship turmoil.

Pia Mellody has consistently taught that the recovery process requires that we honestly and courageously face the truth of our past, both what has been done to us and what we have done to others. It is no coincidence that she titled her now-classic book "Facing Codependence" (italics added). As suggested by Pia Mellody, "The recovery process is about living more in truth than lies." Yet, paradoxically, the painful truth of our mind-body scripts is what drove us to hide behind the masks and disconnect through addictive processes. The prospect of facing the reality of our condition doesn't appeal to many people - that is why the bottom can be so low.

So, how do we go about facing the truth of our scripts and reacquaint ourselves with the person behind the masks? Here are a few suggestions:

  • Develop a willingness to surrender. In the recovery process, a willing heart can take us a long way. The path of recovery has many twists and turns and very often we don't know what is around the next bend. Remembering the powerless and unmanageability of our past can invite the willingness we need to surrender to the recovery process.
  • Be willing to accept help. Recovery isn't a solitary affair. Often we need the help of a director or producer when facing the truth of our tragedy scripts. Guidance and support can be found in friends and family, recovery communities, professional treatment, and something or someone wiser and vaster than us (i.e., nature, spirit, higher power, etc).
  • Cultivate self-compassion and patience. Under the gentle, soft stage-lights of self-directed compassion and patience, we can begin to peer into the darkness behind the masks and face the perilous paragraphs of our mind-body scripts. Rugged honesty isn't the same as self-defeating judgment and blame. Let us be kind to ourselves.
  • Some discomfort is inevitable. As we learn to accept and be with the uncomfortable sensations, emotions, and thoughts associated with our implicit scripts, we find that these mind-body states are generally transitory, like storm clouds moving across a desert landscape. Gradually, our recovery can become imbued with a quiet confidence that we can weather life's storms.
  • Recovery is about growing up. If trauma leads to developmental immaturity, as suggested by Pia Mellody, then recovery must be a maturational process. Don't fight it - let go of old ways and exercise a willingness to embrace new, more mature ways of living.
  • Recovery involves grieving. As we more fully inhabit and live from our truth, we can expect to grieve what we didn't ever receive, what we lost along the way, and the gradual disillusion of the fantasies that we created about ourselves and others.
  • It's a process, not a destination. It is tempting to think of recovery as a goal or a to-do item to be checked off. But, in recovery, no one ever truly arrives... each step on the path brings fresh challenges and opportunities. "Life is a mystery to be lived, not a problem to be solved." ~ Søren Kierkegaard.

Perspectives and practices like these support a recovery process where we begin to live more in truth than in lies. The traumatic narratives of our tragedy scripts are not necessarily erased, but they can be rewritten and reinterpreted on the stage of life. Gradually, we become less invested in, and identified with, our various masks – we are able to more comfortably embody the person looking through the masks.

In many ways, the recovery process is about becoming more conscious – more connected with the truth of ourselves and others. Within this field of heightened consciousness there begins to be enough space and security for the emergence of an authentic self. Generally, this kind of conscious presence brings us into contact with our own humanity, our foibles, short-comings, character defects, and our deepest wounds. However, at the same time we are able to make intimate contact with our own immutable and unconditional worth.

In that authentic space of conscious awareness we come back home to ourselves and, if only for a moment, we experience our wholeness. When we are at home with ourselves, we are better able to make meaningful connections with other humans, all creatures, nature, and a higher power. This is the essence of spiritual practice; ultimately, this is the spiritual path. May we all find and inhabit this path of recovery by facing the truth behind our masks.

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By Vicki Tidwell Palmer, LCSW

The following article is based on Pia Mellody's Post Induction Therapy model of treating childhood traumaWhen it comes to dealing with childhood issues, most of us tend to gravitate toward one of the following extremes:

  • It's in the past, so what's the point?
  • It's all my parent's fault I'm the way I am.

Taking the view that our childhood experiences have no influence over the present is at best short-sighted and at worst perilous. Imagine going to a medical doctor and telling him that you don't want to give him a medical history because you don't see the point. Getting a good history is as important to your mental health as it is to your physical health.

At the other extreme, if we blame our parents for everything that’s wrong in our life, we remain victims of the past. We stay stuck because we aren't taking responsibility for our life.

The truth about the impact of childhood experiences lies somewhere closer to the middle. We need to tell the truth about the past and take responsibility for the present.

The Inevitability of Childhood Trauma

Humans have the longest childhood of any species on Earth. We live with our primary caregivers anywhere from 15-18 years and sometimes longer. Not only do we live with our caregivers for a very long time, during the time we live with them our brains are still developing and we lack basic cognitive and emotional skills to process what happens to us.

Children are like sponges and are highly adaptable. They are also naturally egocentric. If their parents get a divorce they may wonder if they are responsible. If one of their parents looks unhappy or angry, they will probably assume it is because of something they did. It is important to remember that children are not "adults in little bodies." They are completely dependent on their caregivers. That is why children are so vulnerable to childhood trauma.

In addition, while all of us are born with certain innate characteristics and tendencies, children are "calibrated" by their family of origin. If their family is chaotic or violent, over time they will adjust to that level of chaos or violence. They have no choice. They become desensitized and habituated. That is why, as adults, we are attracted to what is familiar, even if it is dysfunctional or abusive. We naturally fear what is unfamiliar.

So how do we heal from painful childhood experiences? There are 6 major steps for effective family of origin work:

Identify Significant Childhood Events

We must identify the kinds of abuse we experienced as children. There are 5 kinds of abuse: physical, sexual, intellectual, emotional and spiritual. Abuse can be overt or covert. Beatings or sexual molestation are examples of overt abuse. Abuse can also be covert or hidden. An example of covert abuse is when a 7-year old boy is told as his father leaves for a military tour of duty that he needs to take care of his mother and is now the "little man" of the family. Neglect and abandonment are also forms of abuse. Many times, just the process of identifying these key events will give us insight about our childhood that we did not previously have.

Tell the Truth

After identifying significant childhood events, we need to tell the truth about what happened to us. This is best done in a therapeutic setting, preferably in a group. When we talk about what happened, are witnessed by others and listen to others' stories, we continue to gain insight about our experiences and begin making connections between past events and the current circumstances of our life.

Integration of the Functional Adult

The Functional Adult is an internal part of the self that we all possess. It is the healthy part of the self that knows the next right thing to do. The Functional Adult has the five core issues identified by Pia Mellody (esteem, boundaries, reality, dependency and moderation) in balance. In family of origin work, we consciously integrate this part of the self and learn how to access it, especially when we regress into a child state.

Reintegration of Child States

There are two primary internal child states that have the most impact on us in our adult life - the Wounded Child and the Adapted Adult Child. When the Wounded Child gets activated in adult life, we will feel one-down, overwhelmed, passive or dissociated. This is a younger child state. The Adapted Adult Child is an older internal child state. We experience this part of the self as being one-up and defiant. All addictions are acted out from this internal state. This is the "inner teenager" in us. When working with child states it is helpful to ask yourself, "how old am I feeling?" to help you identify which child state you are in.


The bad news may be that we did not get the parenting we needed, but the good news is that we can learn to re-parent ourselves. The Functional Adult parents the inner child states through affirming, nurturing and setting limits. The Adapted Adult Child parents through attacking/criticizing, neglecting and indulging. The Adapted Adult Child is usually the sense of "adult" that most of us have until we do family of origin work. The key tools for re-parenting are to first notice which child state you are in and then activate the Functional Adult to parent that part of the self.

Ongoing Internal Boundary Work with Major Caregivers

I mentioned before that children absorb everything that happens around them. If their caregivers are irresponsible about how they handle their emotions, the child will absorb the mis-managed emotions of the caregiver. This is enmeshment. The child who has absorbed a caregiver's feelings will literally have too much of that emotion and will carry these excess emotions into adulthood. Shame is the most dominant carried feeling.

One way to discharge carried feelings is to do a process called "feeling reduction." Feeling reduction work is a therapeutic process where the client metaphorically "gives back" the carried feelings to the caregiver. This is a symbolic experience with the caregiver rather than an actual event with the caregiver is present. The work can be done whether the caregiver is still alive or not.

If your recovery or therapy is stalled, or you find yourself in repetitive and destructive patterns or relationships, family of origin issues are likely holding you back. Family of origin work is a fundamental and necessary part of recovery and healing. The skills of re-parenting the self and doing internal boundary work with caregivers is an ongoing, life-long process that can be learned. It is never too late to give yourself the parenting you needed.

Vicki Tidwell Palmer, LCSW, CSAT, CGP is a Licensed Clinical Social Worker and a Certified Sex Addiction Therapist in private practice in Houston, Texas. She offers individual, group and couples' psychotherapy as well as workshops and presentations. Her clinical specialties are sexual addiction recovery, codependency, trauma, and couples' therapy.

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The Meadows Alumni Association is pleased to host monthly alumni workshops in Houston, Texas, for alumni, family and friends. Meadows' trained professionals will lead the meetings May 22 through July 24, 2012, from 7:00 to 8:30pm. It will be held at The Council on Alcohol and Drugs in Houston and no registration is required to attend.

The following is the schedule for the upcoming workshops:

May 22

Doug Sorensen, LCSW, LCDC, CSAT

"Needs and Wants"

June 26

Joni Ogle, LCSW, CSAT and Taruno Steffensen, ICADAC, SEP

"Perfectly Imperfect"

July 24

Cara Weed, LCSW


Additional alumni workshop dates will be announced in the future. For more information, contact Betty Ewing Dicken, LCDC, at 972.612.7443 or or visit

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.

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As part of its ongoing video series, The Meadows presents an 11-part interview with John Bradshaw, world-famous educator, counselor, motivational speaker, author, and leading figure in the fields of addiction and recovery.

In the ninth video of the series, Mr. Bradshaw praises his colleagues at The Meadows - the senior fellows and clinical advisors who have helped make it one of the nation's leading treatment centers for addiction and trauma.

"A treatment center is no better than the people doing the treatment," he says.

Mr. Bradshaw then addresses the important contributions to the treatment of trauma, PTSD, and sex addiction made by people including Pia Mellody, Peter Levine, Bessel van der Kolk, and Maureen Canning.

"We really have some stars, some excellent people," Mr. Bradshaw attests. "It's really a beautiful thing to be part of The Meadows."

He has enjoyed a long and mutually beneficial association with The Meadows, giving insights to staff and patients, speaking at alumni retreats, lecturing to mental health professionals at workshops and seminars, and helping to shape its cutting-edge treatment programs. In recognition of Mr. Bradshaw's contributions to addiction recovery, an on-campus lecture hall has been dedicated in his honor.

Identified as one of the most influential writers on emotional health in the 20th century, Mr. Bradshaw has changed the lives of millions of people around the world through his writings and sold-out workshops and seminars. His New York Times best-selling books include Homecoming: Reclaiming and Championing Your Inner Child, Creating Love, and Healing the Shame That Binds You.

To learn more about The Meadows' senior fellows and clinical staff, see (insert link here).  To view other videos in The Meadows’ series featuring interviews with Dr. Jerry Boriskin and Maureen Canning, visit

For more about The Meadows' innovative treatment program for addiction and trauma, see or call The Meadows at 800-244-4949.

Published in Blog
Friday, 10 June 2011 20:00

Pain: Healing, Growth, and Awareness

Pain: Healing, Growth, and Awareness

Emotional pain often brings people into therapy and/or recovery. This may be the pain of depression, another relationship ending badly, or finally hitting rock bottom. Addiction, in a very real sense, is used to not feel pain. However, in the end, addiction creates more pain than it avoids. Entering therapy or recovery is often seen as a path towards no longer feeling this pain. However, true healing and recovery asks us to feel and accept our pain. It is through the experience of feeling our pain that we receive many of the gifts that support our healing and recovery.

Dave and his experience in healing and recovery is an example of how feeling pain is an important part of the healing journey. Dave sits in my office with tears sliding down his cheeks. We are exploring his childhood experiences and the reality of what growing up in his family was like. Through his quivering lips, he spits out "I've been working on this for so long. You start talking about my family and I'm back here in all this pain again. Why am I stuck?"

Feeling pain, especially pain connected to traumatic events from childhood, is often interpreted as "being stuck." After all, it is easy to believe that "if I was not stuck, I would not be feeling this pain." This is not the case! Pain is a normal and healthy human emotion. Pain is an emotion to be felt and understood. Pain is an emotion that helps to guide us in life. Pain is an emotion that has gifts to offer us: healing, growth, and awareness. Feeling pain does not mean we are stuck. Quite the contrary, it often means we are doing good healing work.

Dave originally came into my office struggling with addiction. He held tightly to his outward persona which he unconsciously used to hide his pain, shame, and core self from the rest of the world. On the surface, Dave's family of origin looked wonderful, nurturing, and loving. Dave believed that whatever struggles he had were surely about him and his own "defectiveness." He projected to the world the image of someone who had moved through life with seeming ease but about every 6 months or so, Dave would be overwhelmed by pain and spend hours crying to himself, unsure of where this pain was coming from. At the same time, his addiction was gaining momentum and the unmanageability of his life was becoming more apparent.

In therapy, we initially addressed Dave's addiction and helped him to create a support community. Then, we dug into Dave's history and the emotional pain that drives his addiction. Seeing his family and childhood experiences in the light of reality was not easy for Dave. Slowly, he started to see his parents as loving but wounded. He began to understand how their wounds impacted him and limited what they were able to offer to him. Dave started to see that he was not "defective" but wounded.

Dave initially dropped into his pain around his father. Over a number of tear-filled sessions, he explored, accepted, confronted, and started holding boundaries around his father's wounds. Dave had finally dropped into his pain and allowed it to guide him into his healing and growth related to his father. Issues related to his father still come up. At times, Dave feels accepting of his past and at others he feels anger. However, the awareness that Dave received by opening up to his pain and accepting the realty of his father set this process in motion and continues to solidify his recovery.

Dave still feels pain but it no longer seeps out every 6 months in overwhelming bursts. His pain, as opposed to signaling he is stuck, is a signal that he is healing. Dave's pain guided him to uncover and recognize the shame he had been carrying from his father. Feeling his pain and allowing it to guide him in his work has allowed Dave to be less reactive to his father as well as accept his father for who he truly is, a wounded man who loves Dave but is often unable or does not know how to show this. When pain comes up for Dave around his father, he is able to embrace whatever new understanding about his father and their relationship is being offered to him. He no longer stuffs his pain and acts out his addiction to avoid it; Dave now feels his pain, observes his reactions, and uses the tools he has learned in recovery to take care of himself.

Pia Mellody talks about the gifts we receive from all emotions, even the uncomfortable ones. Dave is experiencing and taking advantage of the gifts we receive from pain: healing, growth, and awareness. This process started for Dave when he started to FEEL his pain. Previously he had used his addiction to numb his pain, lived in a fantasy to pretend his pain did not exist, and stuffed his pain by putting on a "good face" to show the world. Now that he is in recovery, lives in reality, and allows himself to be known, he is healing, growing, and learning.

Pain guides us in our journey and helps us in our own self care. It gives us information about ourselves, our situation, and the people around us. Pain lets us know where our wounds are, when the wounds of others are being acted out on us, and helps us to slow down and truly understand the situation. When we stuff our pain or pretend it is not there, we unnecessarily handicap ourselves. Stuffing our pain is like walking around in a pitch black room with our arms at our sides. The chances of us walking face first into the wall greatly increase! With our arms out, we are better able to find the walls without hurting ourselves. Successfully finding the walls allows us to get an understanding of the room's dimensions or, in others words, the reality of the room. With our arms out, we can adjust to the situation. The same is true of our pain. As we feel our pain, we get an understanding of the reality of the situation and can adjust to it.

As we feel the wall, we stop walking to save our nose from a damaging encounter. Similarly, feeling our pain allows us to adjust our own interactions and self care. We may put up our boundaries. We may recognize the reality of another person and shift what we share and/or take in from them. We may leave the situation.

With our arms out, we naturally move more cautiously, keeping ourselves more balanced even though we haven't felt anything. As we open ourselves to pain, a similar experience happens. Even when we do not feel pain, we are more aware of how we take care of ourselves. Whether this is meditation, exercise, journaling, phone calls, meetings, therapy, or rigorous honesty, we keep our self care regiment in place more easily when we are open to feeling our pain. And when pain emerges to help us see more clearly ourselves or our situation, we can fall back on this self care regiment and add to it as necessary. There are many gifts we receive when we are willing to feel our pain.

As Dave sits in my office, feeling his pain, and wondering why he is stuck, I look at him with caring and love. With all the compassion I can offer I say, "You are not stuck. You are more open to your feelings, especially pain. And you are taking advantage of the healing, growth, and awareness that pain gives you. You have used all of this in exploring and learning about your relationship with your dad. But today we are exploring the more subtle wounds you have from your mother. You have opened yourself to this process before and you have developed tools to help you to do this type of work. I'll be here with you as your pain allows you to heal, grow, and understand your relationship with your mother. This pain is your guide - embrace it!"

Tim Stein is a Marriage and Family Therapist based in Santa Rosa, CA. His specialties include sex addiction and developmental trauma. Tim works with individuals, couples, families, and groups as well as providing presentations in the areas of sexual addiction, relationships, and developmental trauma.

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