The Meadows Blog

The Meadows will offer Healing Intimate Treason: For Partners of Sex Addiction workshop the week of June 17 from 8:30 a.m. to 4:30 p.m. Monday through Friday at The Meadows' campus.

This workshop was developed in collaboration with Meadows' Senior Fellow, Dr. Claudia Black, with a core foundation from her latest book Intimate Treason: Healing the Trauma for Partners Confronting Sex Addiction. Working from a clinical model based on addiction and trauma, participants will learn about the biology and the behavior of sex and love addiction and will explore their own relational templates.

The Partners of Sex Addiction workshop is an experientially-based workshop that will assist partners to move through their grief and loss, break free from the attachment to fantasy, and enhance emotional self-regulation. Developing both internal and external and sexual boundaries, participants will learn how to move from a position of victimization to personal empowerment.

"I am so pleased to collaborate with Dr. Claudia Black on this intensive new workshop," said Jean Collins, Director of Workshops at The Meadows. "It is very exciting that workshop participants are now getting the benefits of Dr. Black's return to The Meadows, as well as inpatients and their families."

To learn more about the Healing Intimate Treason: For Partners of Sex Addiction workshop, visit

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.

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 Sub-Acute Agency that is accredited by the Joint Commission.

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The Meadows will offer a Grief Workshop the week of May 27 from 8:30 a.m. to 4:30 p.m. Monday through Friday at The Meadows' campus. This five-day workshop teaches participants how to deal with the pain they feel after a loss.

The Meadows' Grief Workshop is designed to assist participants in addressing and resolving the issues surrounding loss, whether from death of a loved one, end of a relationship, or a major change in social or economic status. Participants in the Grief Workshop learn how to face life's hurdles and triumph over pain by using the grieving process to take control of feelings about their losses.

Throughout the week, patients explore thinking processes and the patterns of destructive behavior that follow trauma and other loss. Issues pertaining to relational problems are also addressed, with emphasis on recognizing emotional reactions to loss, trauma and broken dreams.

Participants leave the Grief Workshop able to realize the negative, self-destructive behaviors that have impacted those around them, and able to enjoy the freedom of self-expression that comes with learning to evaluate and properly address feelings.

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' Grief Workshop and other workshops offered by The Meadows, please 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 Sub-Acute Agency that is accredited by the Joint Commission.

Published in Blog

By: Joyce Willis, MC, LPC

In Part III, we discussed The Secondary symptoms that are caused by immaturity in The Core Issues. Trauma in Column I, (The Nature of the Child), leads to immaturity in The Core Issues. Trauma and immaturity leads to The Secondary Symptoms, as discussed in Part III. All three; trauma issues, immaturity and secondary symptoms lead to Relational Problems.

Model of Immaturity

In this last installment of Breaking Down The Model, we will explore Relational problems that have been caused by trauma, immaturity and secondary symptoms. Relational problems can stem from any extreme in any of The Core Issues, as well as from the secondary symptoms. In other words, due to trauma, immaturity and the secondary symptoms, we can develop relational problems. Let's explore each of the relational problems.

Relational Esteem

Relational esteem can be a problem in one of two ways. We may overvalue our partner or the relationship when we believe we are less than. We may overvalue ourselves and undervalue our partner when we believe we are better than.

Enmeshment and Avoidance Issues

Enmeshment and avoidance have to do with boundary issues. When a person has no boundaries, he may try to enmesh or use the partner in some way. When a person puts up walls, he will avoid intimacy. This can lead to relationships that are either stuck in love addiction or stuck in love avoidance.


The simple truth of relational problems when it comes to dishonesty is that we are living in a lie when we believe we are better than or less than someone else. In other words, when a person cannot be real because he believes he is worthless, he will not be truthful with his partner. When a person believes he is one up or better than, he may believe he is a god and, therefore, distorts the truth of who he is.

Problems with Interdependence

Interdependence has to do with allowing yourself to self-care first before taking care of someone else. When you cannot care for yourself in a proper and functional manner, you cannot be functionally interdependent, Self-care creates the necessary energy to ask for help and give help appropriately.

Intensity Issues

When a person has no boundaries or is walled off, he is draining the relationship. This can create either chaos or a sense of deadness in the relationship. Chaos in a relationship is created when the person is out of control or not containing his spontaneity as a functional adult. Deadness in a relationship is created when the person is controlling.

Now that you have learned about The Model of Developmental Immaturity, let's consider what recovery looks like. As Pia Mellody says, "There is no recovery without Core Recovery." Characteristics of a healthy person begin to emerge as a person gets into recovery.   These characteristics are:

  • Having a sense of self-worth based on the concept of inherent worth.  This means believing you are of equal value to others in your strengths and in your weaknesses. Being in recovery means esteeming yourself from within and realizing your humanity.

  • Setting and maintaining functional boundaries.  This means allowing yourself to be vulnerable, yet not too vulnerable. Being in recovery allows you to be intimate and vulnerable, with protection.

  • Trusting yourself by owning your own reality and being true to yourself. This incorporates expressing yourself in a diplomatic manner. Being in recovery means being able to be real and accountable for your imperfections and being willing to look for a higher power for help with imperfections.

  • Taking care of yourself and attending to your needs and wants, while being able to ask for help when needed. This involves being able to hear "no" to a request for help without taking it personally. This, also, involves being able to say "no" to a request for help when this request will enable the other person or when you think complying to the request will lead to resentment. Being in recovery means being responsible for your own self-care and being interdependent.

  • Having the ability to contain yourself, with functional spontaneity and having an attitude of moderation in all areas of life. Being in recovery means being able to experience your life moderately and maintaining a sense of functional spontaneity.

Finally, let's take a look at things you can do to support your recovery. These are suggestions for you to consider:

  • Attend Twelve Step Meetings - This allows you the opportunity to be with people who are talking about their illness and how it operates in their own lives. Twelve Step meetings are an opportunity to talk about all experiences; negative and positive that you are having throughout recovery. Twelve Step meetings can help you focus on your own progress and improvement and allow you to give hope to others.

  • Do a Written Step One – This helps you see the disease in action in your own life. When you can be honest about the unmanageability in your life, you can stop sabotaging your life. Writing helps you to see the patterns of codependency and addiction in your life. Pia Mellody's book, Breaking Free: A Recovery Workbook for Facing Codependence is a great resource in how to write out all the steps.

  • Get a sponsor - Choosing a sponsor who has time in recovery and who demonstrates functional adult behavior will help keep you on the path of recovery. Choose someone who is honest and willing to be confrontational in a nurturing manner.

  • If needed, consider the option of seeking out more intensive therapy, such as an intensive outpatient program or inpatient treatment.

  • Keep confronting the core issues and growing - We cannot be functional in the core issues all the time. This is humanly impossible. We can continue to work on our self-esteem, boundaries, own our reality, meet our needs and wants and operate in moderation.

Life is continuous practice in all core issues. Recovery is about getting to the center in each of the core issues, as much as humanly possible on any given day. We can live our lives with hope and happiness!

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

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By: Jon G. Caldwell, D.O.

During my first meeting with Rebecca (as I will call her), I asked about her family history of mental and emotional difficulties, which can tell me something about her genetic susceptibilities, and about her early life experience with caregivers. These two elements of the evaluation often provide critical information about the unique way in which nature and nurture contribute to human development (see my previous article on this topic).

When I asked Rebecca these questions, an unforgettable look flashed across her face that was part shame and part longing as she explained to me that she was adopted and had no “valuable information” to offer on these topics. All she knew was that she had been adopted by an American family from a Romanian orphanage at the age of two. In fact, to her surprise, this little bit of information proved to be extremely valuable as we tried to better understand how her challenges in adulthood were related to her early childhood experiences.

In the last several decades, as geographic and political borders began to break down, the deplorable conditions of many orphanages around the world came to light, including those in Romania. In some cases this exposure led to policy changes, gradual improvements in orphanage conditions and a wave of adoptions by people from other countries. It also offered scientists a rare opportunity to study children who had experienced early deprivation and adversity and to follow these children as their environmental conditions changed after adoption.

Research of this kind has confirmed that early social experience plays a critically important role in human development. Indeed, we come into the world with a brain that has evolved to capitalize on the social environment, which under favorable conditions is full of rich opportunities for learning and completely embedded in a milieu of meaningful social relationships. Unfortunately, this doesn’t describe many orphanages around the world, where children are kept in cribs or cots for long periods with little access to toys or books and caregiver-to-child ratios can be as high as one caregiver for twenty children. This issue is terribly important because, for better or for worse, the early social environment appears to lay the foundation for cognitive, emotional and social development.

In fact, there appears to be sensitive periods early in life, during which time the brain has an overabundance of neurons that are just waiting to capture information from the outside world. During these sensitive periods, certain brain circuits are more easily shaped by environmental input and may also be more susceptible to environmental insult. After the sensitive period has ended, the brain actually “prunes” or cuts back those neural connections that aren’t necessary for success in the environment of upbringing.

However, as you might expect, children raised in deprived circumstances may not receive adequate brain stimulation during sensitive periods of development, and this is bound to negatively affect the neural pruning process as well. Fortunately, the brain’s mechanisms of neural pruning are balanced with its incredible capacity for “neural plasticity” – which is the brain’s ability to continually change in response to environmental demands. Thus, even when environmental conditions are suboptimal during a particular sensitive period, it doesn't mean that development can't or won't take place, but it can mean that development might proceed along a somewhat atypical trajectory, bringing with it some challenges for the child and the child's caregivers.

Early social experiences with caregivers and family members are important for the development of adaptive emotional and behavioral regulation (i.e., self-regulation). Children everywhere encounter stressful situations on a daily basis and typically they must rely on caregivers to help them resolve these situations and to aide them in regulating their nervous system so that the toxic effects of stress are ameliorated in a timely fashion. In typical rearing environments, children experience repeated cycles of nervous system activation and caregiver-facilitated deactivation and these cycles get written into the child’s neurobiology until it becomes a natural, self-regulatory response pattern for the developing child.

Individuals like Rebecca who were raised in adverse environments often do not receive the short- and long-term benefits that come with this kind of nervous system regulation and organization. Often, these children are forced into a sort of social hibernation where they must shut-down their natural impulses to seek closeness and security from caregivers. Some of these children will learn to sooth themselves, but these make-shift measures are by no means optimal and it is likely that many of these children do not experience the much-needed social-emotional brain development that comes through interacting with sensitive and responsive caregivers.

Despite these concerns, the research on Romanian orphans illustrates the power of neural plasticity and provides some degree of hope because many of these orphans show significant developmental gains in certain areas after they are adopted. The first area of development to show progress after adoption is often physical health; these children can rather quickly experience improvements in weight, height and fine and gross motor skills. In fact, many these children may not be physically different from their peers by the time they start school.

Somewhat surprisingly, these children often make gains in the cognitive domain too – they seem to catch up in terms of reading and writing, and general intelligence is often similar to their school-aged peers. Yet, a proportion of children who were in an orphanage have some lasting problems with attention, concentration, focus, distractibility, impulsivity, and poor organizational skills. It seems as though the neural circuits involved in “executive function” (i.e., attention, cognitive flexibility, planning, goal-directed behavior, etc.) are very sensitive to suboptimal rearing environments.

Of interest, the areas that seem to be most affected by early deprivation are the social and emotional domains. Children raised in orphanages frequently have challenges in terms of regulating their emotions, calming themselves, coping with difficulties, initiating and maintaining friendships, and negotiating close relationships. Because these children often make noticeable physical and cognitive gains after adoption, the lingering social-emotional issues can be confusing to the child and caregivers. Of course, these social-emotional issues can be compounded if the adoptive home environment is less-than-nurturing or if the child encounters any form of trauma later in childhood.

Even after leaving the orphanage, some of these children have difficulty learning to trust caregivers and to make their attachment needs known in adaptive ways. There can be a tendency on the part of these children to avoid showing vulnerable emotions and outward displays of affection and they may seem indifferent to, or afraid of, intimacy and closeness. On the other hand, some of these children may show signs of heightened separation anxiety, clingy and anxious behavior, and they might have strong fears of abandonment. Some children display signs of both of these extremes in their relationships with caregivers – the so-called “push-pull” pattern where they desperately want companionship but at the same time seem to fear closeness or fear that it won’t last. This sort of picture is sometimes referred to as “reactive attachment”.

That being said, it is important to stress that a warm and nurturing home environment will go a long way to buffering many of the social-emotional difficulties associated with early adversity. Over time, sensitive and responsive parenting practices, coupled with consistent and caring limit-setting, can gradually establish a sense of trust and security. Within the safety and security of the caregiver-child attachment relationship, the child’s nervous system can be re-organized in a way that supports greater self-regulation. This socially enriched environment can stimulate new brain pathways in the adopted child that will eventually underpin a greater capacity to regulate emotions and maintain close relationships.

Like Rebecca, some individuals who have experienced early social deprivation require additional support and treatment later in life. This may come as a result of ongoing issues from early childhood that were never quite resolved or previously resolved issues that resurface due to subsequent experiences of loss/death, abandonment, betrayal or traumatic experiences. While the resurfaced issues can usually be handled by traditional treatment methods, it can be very helpful if the treatment providers also have an understanding of how early social deprivation and trauma can influence social-emotional functioning late in life.

The Meadows treatment model is designed to specifically address the core developmental issues related to early childhood neglect and abuse. Treatment at The Meadow also helps individuals to understand how these core developmental issues are related to secondary symptoms, like shame, anger, low self-esteem, co-dependency, love addiction/avoidance, anxiety, depression and addictive behaviors of all kinds. Through various forms of expertly delivered treatment, individuals at The Meadows build on these insights by gaining actual experience in learning to esteem themselves from within and regulate their own nervous systems more effectively. Gradually, as individuals at The Meadows feel more comfortable with themselves, they are aided in forming safe and meaningful relationships with family members and significant others.

For many individuals who come to The Meadows, the experience of early social adversity starts to become a vital part of a broader life story that no longer carries with it the pain of the past, but instead offers the promise of a brighter future.

Jon G. Caldwell, D.O., is a board certified psychiatrist who specializes in the treatment of adults with relational trauma histories and addictive behaviors. Dr. Caldwell currently works full-time as a psychiatrist at The Meadows treatment center in Wickenburg, Arizona. For many years he has been teaching students, interns, residents, and professionals in medicine and mental health about how childhood adversity influences health and wellbeing. His theoretical perspective is heavily influenced by his PhD graduate work at the University of California at Davis where he has been researching how early childhood maltreatment and insecure attachment relationships affect cognitive, emotional, and social functioning later in life. Dr. Caldwell’s clinical approach has become increasingly flavored by the timeless teachings of the contemplative traditions and the practice of mindfulness meditation.

Published in Blog
Wednesday, 20 February 2013 19:00

Breaking Down the Model: Part II - Core Issues

By: Joyce Willis, MC, LPC

In Part I of "Breaking Down the Model, the Nature of the Child” column was discussed. To review Part I: We 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. Now, it is time to get into the core of the model; the Core Issues. The five core issues are:

  • Self-Esteem
  • Boundaries
  • Reality
  • Dependency
  • Moderation/Containment.

As stated in Part I, the Core Issues are caused by childhood trauma, in the form of anything that was less than nurturing in childhood. Less than nurturing behavior comes in the form of enmeshment, neglect, abandonment or abuse. The Core Issues (Column II of the Developmental Immaturity Issues) have to do with how we operate in extremes. These extremes were set up in childhood.

Let’s compare the connection of Column I (Nature of the Child) to Column II (Core Issues) before exploring each of the Core Issues. As stated previously, core issues emerge due to less than nurturing events in childhood.

The nature of a child is to feel valuable just as he/she is. If a caregiver falsely empowers a child, the child will feel better than in Core Issue #1 (Self-Esteem). A parent (caregiver) can falsely empower a child by enmeshing with the child, telling the child that they are the hero, the best, or that they are always right. A parent can falsely empower a child by not allowing the child to take responsibility for mistakes the child has made. If a parent disempowers a child, the child will feel less than in Core Issue #1. A parent can disempower the child by neglecting the child, abandoning the child, putting the child down, calling the child names and such.

The nature of a child is to be vulnerable and to accept protection when needed. If a child is parented without boundaries or with using walls, the child will be too vulnerable or invulnerable in Core Issue #2 (Boundaries).

The nature of the child is to be imperfect and human. This is about Core Issue #3 (Reality). If a caregiver identifies a child’s humanity as “good or bad,” the child will be rebellious or perfectionist. This happens when a parent attacks or over-praises the child’s humanity, rather than looking at the child’s behavior. An example of this is a mother slapping her young daughter’s hand for spilling milk and saying, “bad girl,” instead of mom letting her daughter know that she made a mistake, like all humans do. If mom continues to parent by saying “bad girl” instead of looking at the humanity of mistakes, young daughter will grow up believing she is bad and will be rebellious as a child and into adulthood.

The nature of the child is to be dependent on other people for wants and needs that the child cannot provide for himself. This refers to Core issue #4 (Dependency). If a parent shames a child’s wants or needs, the child will be needless/wantless as an adult. If a parent is needy towards a child, the child will be anti-dependent as an adult. If a parent neglects a child’s needs or wants, the child will be too dependent as an adult.

The nature of the child is to be spontaneous and open. This has to do with Core Issue #5 (Moderation/Containment). If a parent fails to set limits on the child, the child will grow up to be in control of being out of control. If the parent focuses on the child being good and perfect, the child will grow up to be too contained and controlling of others.

Let’s examine each of the Core Issues a bit more, starting with the Core Issue of Self-Esteem. Self-Esteem is a knowing that you are valuable and have worth. Self-Esteem is about being able to say, “I have inherent worth” and believing this statement. There are two big lies we tell ourselves:

  1. I am better than.
  2. I am less than.

When we tell ourselves we are better than, we have been falsely empowered as a child. When we tell ourselves we are less than, we have been disempowered and undervalued as a child. Our strengths do not make us better than and our weaknesses do not make us less than. We are all valuable and precious. Recovery is about appreciating our strengths and learning from our weaknesses in the interest of being relational.

The second Core Issue is Boundaries. Boundaries have to do with protection and containment. In the extremes, we are either inadequately protected or being overprotected in any or all boundary areas; physical, sexual or internal.

Physical boundaries let you know that you have the right to determine how close another person gets to you and whether another person can touch you or your personal property. When we use containment, we are containing how close we get to another person and not touching the person or their property without permission.

Sexual boundaries let you know you have the right to determine with whom, when, where and how you are going to be sexual. When we use containment with our sexual boundary, we are respecting another person’s sexual rights.

Internal boundaries allow us to contain and protect our thinking, feelings and behavior when we are talking to or listening to others. We demonstrate use of the talking boundary by talking to someone with respect and without blaming, controlling or manipulating. We demonstrate use of the listening boundary by listening to someone with respect and curiosity.

When we protect ourselves, we keep ourselves from being victims. When we contain ourselves, we keep ourselves from being offensive. Boundaries help us mitigate our relationships. Recovery is about protecting and containing ourselves in a functional manner; not being too vulnerable and not putting up walls.

The third Core Issue is Reality. Reality has to do with self-identity. Reality asks the question: “Who Am I in this moment?” Reality issues are the hub of the wheel of the core issues. If a person struggles with reality, he/she is allergic to the self. When a child is not allowed to be himself/herself, the child will see self as bad or good. As mentioned previously, a parent defining a child as bad or good sets up rebelliousness or perfectionism. Recovery comes when we can see and accept ourselves as human in all areas of our life; our physical self, our thinking, our emotions and our behavior.

The fourth Core Issue is Dependency. Dependency has to do with self-care around our needs and wants. What is the difference between needs and wants? Needs are basic to survival. Needs keep our body, mind and soul in balance. Wants are not necessary for survival, yet they are important to our sense of abundance. Our wants bring us joy.

Being too dependent comes from not having needs and wants met as a child. The adult will have expectations that others will take care of needs and wants that he/she can take care of on their own. Being needless/wantless comes from being neglected or being shamed for having needs and wants as child. The adult will be detached from their needs or wants. Being anti-dependent comes from having a sense of our needs and wants, yet refusing to ask for them or refusing to acknowledge those needs and wants. Recovery is about being interdependent.

How can you be interdependent? There are three rules to being interdependent:

  1. Being able to ask for help when you truly need it.
  2. Being willing to help someone when they make a reasonable request.
  3. Being able to say “No” for self-care. This keeps you from stretching yourself into resentment.

The fifth core issue is Moderation/Containment. Moderation and containment have to do with living in moderation and containing spontaneity. When a child gets shamed or traumatized around being spontaneous or a child is told they are not spontaneous enough, (a shy child being told to go out and do something), issues are set up around moderation and containment.

The “out of control” person will do what he/she is going to do when he/she wants to, thus controlling with chaos. The “controlling” person will try to control others by trying to be good and perfect. This kind of behavior shuts down relationships. Recovery is about learning to use your personal boundaries to contain yourself so that you are containing spontaneity in a functional adult manner. This leads to being relational without being abusive.

When we are at the extremes in the Core Issues, we are living in immaturity in the Core Issues. Recovery happens when we have recovery in all core issues. There is no recovery without core recovery. Recovery is about living in truth and love. We do this by coming close to the center in each of the core issues.

In Part III of Breaking Down the Model, we will explore secondary symptoms which are driven by immaturity in the Core Issues.

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.

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