The Meadows Blog

The Fall/Winter 2009 edition of MeadowLark, the magazine for alumni of The Meadows, has just been published. This issue contains several feature articles:

  • The Intimacy Factor by Pia Mellody and Lawrence Freundlich
  • Recess Revisited: A Recovery Behavior by Diane Detwiler-Zapp
  • Perceptions Create Realities by Charles Atkinson

Also included this issue in are staff spotlights, alumni contributions, a featured workshop (Sexual Recovery), free lectures, and other educational opportunities. MeadowLark is available in both HTML and PDF formats.

Published in Blog
Wednesday, 14 October 2009 20:00

Marriage in a Changing Society

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

Marriage in a Changing Society
Pat Mellody

When I write about marriage, I am concerned that my views will appear negative and be viewed as relationship 'bashing.' I believe that we suffer from our own hedonism and lack of personal discipline. I am deeply saddened by the apparent attitude that what we have, as a culture, is somehow permanent and that we will always be free. However, freedom is a two-edged sword: it gives us the right to think and act as we choose and to not have overt negative consequences as long as we stay within legal bounds. It is then the individual's responsibility to behave in a way that is personally productive while maintaining the discipline to not jeopardize the society in which we choose to live.

I have been thinking about the how's and why's of marriage and I keep trying to understand what has happened in my lifetime that has caused so many changes. I want to believe that there is an answer that will allow couples to court, marry and live happily ever after. This final phrase from many fairytales may now be more of a fantasy than it ever was.

The basic biological purpose of marriage is to provide for the preservation of the species by producing survivable offspring at a rate that at least replaces those that die. Looking at world population it is apparent that we have more than met this goal. There does not seem to be an 'off' switch on the reproductive imperative. There does seem to be a temporary accelerator that increases the birthrate after major stressors like war, pestilence and famine strike.

The attitude toward maintaining an integral family with the traditional couple staying married (until death do us part) has greatly diminished. In our culture, for many, marriage is a temporary arrangement. In other cultures, staying together and producing children, still holds a strong influence. Some religions make the goal of a large family a basis for pride and status. In the third world, where child mortality is high, the original imperative still makes sense. Some cultures have adopted our attitude and now find them below the population replacement rate. Sub cultures within a country now are out-reproducing what had been the dominant group.

Is this bad? I doubt that there is intrinsic good or bad in the shift to a new dominant group. In any case, it seems to be where we are and there is little evidence we can or will make changes to preserve what some believe should be our norm. Change would require discipline and/or oppression. Most of us lack the former, and the latter is against everything for what we believe and stand. Xenophobia explains our fears. For many, our values are being challenged; and we each believe that the values we hold are correct, moral and in the best interest of all. Accepting that others have as much right to their beliefs as we do is a difficult journey.

I still believe we are capable of entering and maintaining a comfortable, stable relationship. It will not be the marriage of our fantasies. It will be a union that requires hard work, acceptance of one another, dedication to being a couple and the realization that although it takes two to make it work it only takes one to destroy it. We cannot expect much in the way of support from a society that seeks instant gratification and demands that the fantasy becomes real. The fantasy comes out of initial, often sexual attraction; the intensity of which blinds us to reality. We desperately want to believe that love conquers all and that areas of incompatibility will resolve themselves. Johnny Cash's song "Jackson" says, "We got married in a fever. . .we've been talking about Jackson ever since the fire went out." In order to have a lasting relationship we must be able to stick to a commitment long after the initial flush of excitement has waned.

The journey is not for everyone. It does not seem like there are many who are willing to discipline themselves to adhere to the promises they have made. Having had three marriages myself, I certainly cannot say, "do as I have done." There are couples that seem to make it in long-term marriages. It is sad to me that the number is small and the trend is downward. It is similar to recovery in that the opportunity is there for all, but those who succeed are among the fortunate few.

Published in Blog
Wednesday, 19 August 2009 20:00

Child Abuse, Neglect, and Character Defects

Note: This article was originally published in the Spring 2004 edition of Cutting Edge, the online newsletter of The Meadows.

Child Abuse, Neglect, and Character Defects
by John Bradshaw

One of the most insidious effects of child abuse and neglect is their impact on "character" foundation.

Addiction (any form of obsessive/compulsive behavior) and the codependency that fuels it can be understood as being rooted in a complex of "character defects." We now have good evidence of a chemical imbalance that predisposes certain persons to addiction. (AA has, since its inception, pointed to a chemical imbalance in alcoholics.) Current research points to missing strands of DNA in the neurotransmitter dopamine. But missing DNA strands of dopamine do not mean that a person will necessarily become codependent or develop an addiction.

I do not hold the opinion that addiction and codependency are diseases in the medical sense of the word. They are certainly diseases in the psychological sense. They wreak havoc in a person's life and lead to moral and spiritual bankruptcy. Moral bankruptcy is my focus in this article.

Not all character defects come from child abuse and neglect. In the world of human freedom, anyone can choose to act in an immoral way. My concern in this article is to understand the role of child abuse and neglect in the formation of character defects.

Codependency is a disease of the developing self that is fully manifested in adult relationships. The primary symptoms of codependency, in relation to moral character, are:

  • A lack of a solid sense of self-identity, which is rooted in toxic shame ("carried shame," as described by Pia Mellody).
  • A shame-based identity that manifests itself in polarized extremes, either as a character-disordered "more-than-human" (inhuman) personality exhibiting grandiosity, perfectionism and blame; or a neurotic "less-than-human" (dehumanized) personality exhibiting a sense of worthlessness. A person can be stuck in either polarized extreme or may switch back and forth, as in the more-than-human anorexic eating disorder that is transferred to the less-than-human bulimic eating disorder. Pia Mellody has suggested that these polarizations are the product of two types of abuse: a falsely empowering abuse and a disempowering abuse. Both types are rooted in toxic (i.e. carried) shame.
  • Distorted ego boundaries, both external and internal. This character disorder tends to set up walled boundaries, and the neurotic personality tends to have weak and broken boundaries.
  • Emotional illiteracy, which is characterized by extremes of rigid emotional numbness or the inability to regulate the intensity of one's feelings.
  • Difficulty in recognizing what one wants and needs.

These behavioral symptoms make up the essential "character defects" of codependency, which I refer to as "disabled will" in my book, Bradshaw: On the Family. Codependents do not choose well and seldom make virtuous choices. Virtue has to do with choosing the appropriate mean between two extremes. Codependents and addicts choose in ways that are all or nothing, black or white.

Moral action is concerned with choosing well in the ever-changing singular circumstances that make up our lives. Necessary to a strong ethical character is a specific virtue called prudence - the refined ability to "know how" to choose well in the changing circumstances of one’s life.

The disabled will is the reason codependency has been described as the disease of addiction. Addicts of any kind have serious defects when it comes to choosing well. I chose to drink as a solution to the problems caused by my drinking. I chose to act out sexually and commit adultery to assuage the guilt I felt for repeatedly betraying my wife by committing adultery. Words like "adultery" have a sting that is worse than simply saying "acting out sexually."

The will depends on reason, conscience, and that which the ancient philosophers Aristotle and Thomas Aquinas called a habituated or "right appetite." The will, they believed, has to be educated in such a way that a person experiences and tastes goodness. Aristotle believed we become brave by being brave, just by being just. The more we experience virtuous behavior, the more we learn how to choose to be virtuous. Aristotle and Aquinas referred to this knowledge to choose expertly as the virtue of prudence. Their formal definition of prudence involved right practical reasoning, which is based on right desire and a passion for goodness.

When we examine the symptoms of codependency, we find that they are the results of developmental dependency deficits, which are the consequences of abuse and neglect.

Developmental deficits refer to unmet developmental dependency needs. These needs must be met in order for a person to develop a solid sense of self and emotional literacy; these needs depend on source figures for their fulfillment. A child's needs cannot be met without reliance on a functional adult. Solid selfhood and emotional literacy are two essential foundations for the development of moral intelligence and ethical character. Psychologist Erich Fromm defines ethical character as "the relatively permanent form in which our moral energy is channeled in the developmental stages of our life.... Our ethical character is who we are as expressed in our actions, how consistently we live, what we believe in and how we actualize those beliefs." People often say that a certain behavior is "true to character" or "out of character." Codependent and addictive behaviors are "out of character" for any healthy adult human being. Toxic shame creates inhuman and dehumanized behavior.

Solid selfhood and emotional literacy are the fruits of an educated will. With a solid sense of self, a person has good boundaries and will power. Emotional literacy is characterized by the ability to think about and contain feelings, using them for self-soothing and expressing them with appropriate intensity.

The primary pillars of solid self-hood and emotional literacy are:

a) The development of one's own innate healthy or natural shame.
b) The achievement of "empathic mutuality" through the actualizing of the innate need for secure attachment.

Let me briefly discuss both of these pillars, and how child abuse and neglect damages them.

Healthy or natural shame is an innate human effect. It marks our natural human boundary and is a root of the natural moral law. Someone once described healthy shame as "the permission to be human." Natural shame is an auxiliary feeling that signals limits and monitors our pleasure, excitement and interest. Natural shame lets us know we are limited and imperfect beings. As such, it gives us permission to make mistakes and ask for help when we need it. Natural shame grounds us in our finitude and lets us know that there is a higher power. This is why the philosopher Nietzsche called shame "the source of spirituality." Natural shame is absolutely essential to the development of a moral life. When natural shame is nurtured in a healthy way, it develops into guilt (i.e., moral shame). Guilt is the guardian of conscience.

Natural shame becomes toxic when children interact with source figures who are immature (developmentally arrested) and morally shameless. The caretaker's shamelessness may take the form of the more-than-human, character-disordered control freak or perfectionist who chronically judges, blames, criticizes, beats, punishes or sexually uses his or her children. Or it may come from the neurotic character type who feels worthless and less-than-human, who treats his or her child as superior or worthless. In either polarized character form, the caretaker acts shamelessly and immorally.

Shameless caretakers were themselves the recipients of falsely empowering or disempowering abuse. Their grandiosity or worthlessness is a defense against their own toxic shame. Shameless caretakers also use a primitive unconscious defense mechanism called "projective identification." In projective identification, the projector, by means of interaction with the recipient (i.e. through acts of neglect or abuse), unconsciously induces feeling states in the recipient that are congruent with the projector's own rejected feelings (in this case, his or her own carried shame). A shameless caregiver's defensive projective identification causes those in his or her care to feel the shame being rejected.

Pia Mellody has described the dynamics of the transfer of shame as "carried or induced" shame. Carried or induced shame is toxic shame. Toxic shame results in the breaking of the interpersonal bridge between the child and his or her caretaking source figure. This has disastrous moral consequences, as the empathic mutuality between mothering source figure and child result from their secure bonding or attachment. Erik Erikson has repeatedly shown this secure attachment (along with natural shame) to be the earliest and primal root of moral life. The golden rule is embodied in empathic mutuality.

Years ago, pioneering psychologist John Bowlby stated that attachment behavior is "vital to the survival of the species." The earliest years of life are the most significant for attaining secure attachment. Secure attachment can be defined as the biological synchronicity between organisms. Secure attachment is the dyadic (interactive) regulation of emotion and has its foundations in the right hemisphere of the brain (or the nondominant, if you are left-handed). The known functions of the right brain, or right hemisphere, (RH) are:

  • It is crucial to our sense of bodily and emotional self.
  • It recalls autobiographical information.
  • It relates the self to the environment and to social groups.
  • It maintains a coherent, continuous and unified sense of self.
  • It is the source of resiliency and manages stress.

Secure attachment is a form of resonance, which can be defined as a shared feeling or sense. Emotional information is intensified in resonant contexts. Secure attachments allow a child to develop resilience in the face of stress. Resilience is an ultimate indicator of attachment capacity and an infant's mental health.
The key to secure attachment is the source figure’s capacity to monitor and regulate his or her own emotions, especially negative ones. This kind of regulation is one of the fruits of emotional literacy.

In infancy, the relationship between the mothering source figure and the infant exhibits the most intense emotions. Communication is right brain to right brain. It will take some three and a half years for the left brain (the seat of verbal language and logical thinking) to emerge. In the beginning, the interaction takes place within a context of facial expressions, posture, tone of voice, tempo of movement and incipient action. The infant's emotions are initially regulated by the mothering source. When this interaction is sufficient, the infant toddler is able to increasingly self-regulate and cope with stress. Our earliest emotional experience directly influences the maturation of the right brain's early regulator system.

Emotional dysregulation and the disorders of the self are the effects of early relational trauma, abuse and neglect, and are imprinted on the amygdala of the right brain (the nonverbal unconscious). As leading neuroscientist Dr. Allan N. Schore writes, "Emotional dysregulation is a fundamental mechanism of all psychotic disorders."

Most abused and neglected children were poorly attached as infants for the simple reason that most abusing and neglecting source figures were shameless, immature and dysfunctional. It is illogical to assume that they were mature during their children's infancy and became immature later on.
Because the achievement of secure attachment establishes empathic mutuality, trust and hope, most codependents and addicts began their lives without a moral foundation. Abuse and neglect continue unless source figure caretakers get help and begin their own recovery processes. This is happening more and more as we grasp the dynamics of this whole sordid mess.

While I do not like the connotation of words such as "pride," "gluttony" and "adultery," I have to face the fact that my alcoholic addiction and sexual compulsiveness resulted in immoral behaviors.

I have had to confront my "better-than" belief in my own specialness and face up to making amends, owning my healthy shame and accepting responsibility for my moral life. Steps 4 through 10 of the 12-Step Program are crucial for rebuilding character, establishing a platform for virtue and deepening spirituality. I know these are suggested steps, but I see them as an essential bridge to repairing character defects. If you do not choose to do these steps, you will need to do the recommended work in some other therapeutic context.

Therapists have wisely shied away from moralistic rhetoric, but I see no way to mollify my character defects, other than to see them as immoral behaviors.
We are essentially moral beings. Our innate shame and innate need for attachment are the developmental roots of the natural law. Attachment and shame are the developmental motors of moral development and the virtuous life.

Aristotle believed that human happiness is synonymous with living a virtuous life. Happiness and virtue go hand-in-hand. Those who have walked a long way down the road to recovery know this. The tenets of AA promise it.

The cores of virtue are balance, polarity and moderation. Thomas Aquinas, the Medieval philosopher and theologian, believed that virtue is arduous, that it takes time and hard work to develop. He believed that virtue is a habitus of soul. A habitus is more than a habit. It is an integral quality of a person's inner life, something that has been so internalized that it is a part of the person's very being. When a person has such a quality, he or she does not have to think about things very deeply; he or she simply does good, because good is good to do. Not bribed by heaven or threatened by hell, this person does good because he or she has tasted it and wants it. It is good will.

Character defects are like holes in the conscience that distort our ability to make sound judgments. This is why recovering addicts and codependents are urged to get sponsors or to consult with therapists. It is why addicts and codependents in early recovery are urged to avoid making any major decisions for an extended period of time. The disabled will is as severe a moral problem as a person can have without being psychopathic.

I know of no better ideal or better gauge of a person's recovery than the degree to which he or she lives a balanced and moderate life and makes sound and virtuous choices.

About the Author
John Bradshaw, MA, has, for the past four decades, combined his exceptional skills as counselor, author, theologian and public speaker, to become a world renowned figure in the fields of addictions, recovery, family systems and the concept of toxic shame. Mr. Bradshaw has written three New York Times best-selling books: Homecoming: Reclaiming and Championing Your Inner Child, Creating Love, and Healing the Shame That Binds You.

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."

Published in Blog
Wednesday, 03 June 2009 20:00

The Therapeutic Genius of Pia Mellody

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

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

Published in Blog

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