The Meadows is pleased to announce several informative free lectures that will be presented throughout the coming summer weeks. These free lectures are open to the community and sponsored by The Meadows in various cities throughout the country. The lectures are targeted to graduates of The Meadows but are also open to the recovery community. Speakers include local therapists familiar with The Meadows' model.
In June there are three lectures to come. On June 23, Amanda Gray, MA, FGA will speak in London, U.K. about Trauma and Spirituality. On June 23, Dr. Janice Blair, PhD will deliver a lecture entitled Good Boundaries for Good Recovery Walking the Fine Line Between Caring and Caretaking in Scottsdale AZ. Finally, Dr. Judith Trenkamp, PhD, CSAT will present Co-Dependency: Roadblocks to Optimum Recovery in West Bloomfield, Michigan as the month ends on June 30.
Many more free lectures on other interesting and informative topics are scheduled throughout July and August also, to be presented in London and in various cities in Arizona, California, New York, Texas, and Washington. For more information about the above-noted or upcoming events, please see the Free Lectures Series schedule.
Note: This article was originally published in the Spring 2005 issue of MeadowLark, the magazine for alumni of The Meadows.
The Co-Addicted Tango: Pia Mellody's Theory of Love Addiction and Love Avoidance
By Lawrence S. Freundlich
When Ms. "Crazy for Love" meets Mr. "Give Me Some Room to Breathe," the stage is set for what Pia Mellody calls "The Co-Addicted Tango." Ms. "Crazy for Love" is in Mellody's clinical terms, "The Love Addict," and Mr. "Give Me Some Room to Breathe," is "The Love Avoidant." They will each find something attractive about one another and inevitably something that will detract from one another, making their dysfunctional relationship as painful as it is frenetic and a back-and-forth "Co-Addictive Tango."
The Love Addict, to whom I have just referred to as "Crazy for Love," I identify as a woman, and the Love Avoidant, to whom I have just referred to as "Give me Some Room to Breathe," I identify as a man. Is this gender typing accurate? After all, men can be Love Addicts and women can be Love Avoidants? In fact there are powerful forces at work in American culture that distribute Love Addiction to women with significantly greater frequency than to men, and Love Avoidance to men with significantly greater frequency than to women. The most powerful generator of this disproportion is revealed when we understand the psychological concepts of "disempowerment" and "false empowerment."
Trauma results from either disempowering abuse or "falsely empowering" abuse, which, because of its falseness, disempowers as well. Abusive parents either shame the children into silence as a way of diminishing their own external stress, thereby disempowering the children, or assigning the children roles for which the parents should be responsible, thereby falsely empowering the children.
In our culture, young girls are trained to believe that men are the source of value, power and abundance; it is the female whose prevailing dysfunction is the outcome of "disempowering abuse." Her need to be taken care of by a man greater than herself is consistent with Love Addiction. The main conscious fear in relationships from which Love Addicts suffer is fear of neglect and abandonment. In childhood their parents have shamed them into thinking of themselves as unworthy. Without the help of an outside agency, like a husband, for example, they do not feel they have what it takes to be whole.
On the other hand, young males in our culture are raised to believe that it is their job to control and dominate- to be the source of value, power and abundance. They are trained to care "for the little woman," because she can't care for herself. It is the male whose prevailing dysfunction is the outcome of falsely empowering abuse. His need to caretake the needy female is consistent with Love Avoidance. The primary conscious fear of the Love Avoidant is fear of being drained, suffocated and overwhelmed. In their childhoods, the parents of Love Avoidants have forced on the child the role of caring for the needs of the parents. In this role reversal, the parent is being taken care of by the child. Giving the child the adult role is a form of enmeshment, which causes the love avoidant to think of intimacy as a job. They learn to resent this job as the neediness of the Love Addict becomes overwhelming.
The Love Addict enters into the relationship feeling an unbearable sense of inadequacy. Her relationship with the Love Avoidant is as doomed as it is inevitable. Having been neglected and abandoned by her own parents, she has learned that all attempts at intimacy will be painfully unsuccessful. When she seeks a love mate she will, therefore, find someone familiarly not intimate, but someone who will be good at mimicking intimacy. She deludes herself into believing that the mimicry is the real thing by creating her lover in accordance to a fantasy of her own making. The Love Avoidant becomes her knight in shining armor- "armor" being the operative psychological irony- shiny, but impervious to intimate contact.
The Love Avoidant, on the other hand, enters the relationship not because he is seeking confirmation of his own worth but out of a sense of duty. In his childhood, his parents taught him that it is his job to care for people who cannot care for themselves. As an adult, the Love Avoidant, while feeling superior or pity for the neediness of his Love Addicted partner, thrives on the power it gives him over her. Eventually, he grows resentful of all the work it takes to be a caretaker. He begins to feel suffocated and lifeless.
The suffocating Love Avoidant begins to distance himself from the Love Addict, who after several bouts of hysterically trying to get him back, eventually becomes exhausted with the pursuit of the Love Avoidant and turns to someone else with whom to be helplessly Love Addicted or to some other addiction to cover her pain of inadequacy. The substitute addiction could be food, alcohol, sex, work, spending or exercise- any addictive activity.
At this point in the Co-Addicted Tango, the Love Avoidant, who is no longer the object of the Love Addict's desire, feels the pain of no longer being needed. Without someone whose weakness cries out for his strength, his sense of superiority wavers. What value does he have if he cannot care for the needy? This triggers deep, underlying abandonment fears- sardonically the same kind of abandonment fears that lie at the heart of the Love Addict's emotional dysfunction. Love Addicts, never having been unconditionally loved by their neglectful and/or abandoning parents, look for a knight in shining armor to provide them with the self-esteem with which they never had mirrored for them by their own parents. Love Avoidants, on the other hand, almost never got a chance to feel their inherent worth, because in childhood they were empowered to care for their own parents. While not having received love from the parents, their caretaking gives them a sense of grandiosity, while masking the haunting truth that they have never been intimately loved. This false empowerment very effectively hides the crucial truth that they, like the Love Addict, were starved of intimacy. The contempt they feel for the neediness of the Love Addict, is the masked contempt they feel for themselves at not having been worthy of their parents' love. Contempt is shame turned outward on anyone whose weaknesses reminds us of the intolerable shame of our inadequacy.
Deprived of the caretaking role by the withdrawal of the Love Addict, the Love Avoidant finally feels the jolt of the carried shame of abandonment; and the Love Avoidant, who once feared being smothered by the Love Addict, now turns around to get close to the Love Addict again, using all of his powers of seduction to get back into control of the relationship.
One is running and the other is chasing all the time. When the one who is chasing finally gets close to the one running away, they both erupt into intensity, either a romantic interlude or a terrific fight. As the lyrics to the classic song say, "You Always Hurt the One You Love." This behavior is what most people call "normal"; and if it isn't "normal," it certainly is "familiar."
This attraction to what is familiar, says Pia Mellody, starts in our family of origin. "Familiarity" is the central engine of child hood character formation. In the case of Love Addicts and Love Avoidants, each person is first attracted to the other specifically because of the "familiar" traits that the other exhibits. These traits, although painful, are familiar from childhood and appear a safe way to keep the family system stable.
Both the Love Addict and Love Avoidant are traumatized children who originally adapted in order to survive within the abusive family system. They believed that only by adapting to their parents' expectations of them would they remain protected. Maintaining the status quo, even if it was a dysfunctional status quo, was for these children better than being abandoned or losing their identity (role) within the family.
The abandonment pain felt by Love Addicts in their families of origin teaches them as children to be quiet, alone, needless and wantless so as not to bother the parents. Later, they are unconsciously attracted to people who do not aggressively seek attachment to them. They unconsciously seek to replicate their childhood relationships. A part of self-esteem was wounded in the childhoods of Love Addicts. Abandonment and neglect send the message that they were not worth being with. A large part of their attraction toward Love Avoidants is that Love Addicts find in people who walk away from them an opportunity to heal the wound to their childhood self-esteem. If they can make an adult who withholds intimacy connect and fall in love with them, they can prove that they have inherent worth. Only a child can be abandoned; adults cannot. Healthy, mature adults have it within their capacities to deal satisfactorily with the vagaries of relationships without calling their inherent worth into question.
Love Avoidants are accustomed to needy, dependent, helpless people whom they can rescue, which gives them control and a 7 feeling of safety and power. When they pick up the right signal, Love Avoidants move in seductively and powerfully. People who think for themselves, say directly what they mean, solve their own problems and care adequately for themselves are not interesting to Love Avoidants.
The conscious fear of Love Avoidants is the fear of being drained and used. The unconscious fear of Love Avoidants is the conscious fear of Love Addicts, and that is the fear of abandonment. Abandonment is the core issue for both, but getting at the abandonment issue through shame reduction therapy is much more difficult with Love Avoidants than it is with Love Addicts. Disempowering abuse keeps Love Addicts close to their shame core all the time. Love Avoidants are walled off from their shame core by the grandiosity of their childhood false empowerment.
Pia Mellody's elegant charting of the dance of avoidance and pursuit between the Love Addict and the Love Avoidant is a fascinating anthropology of failed relationality, which deserves the name "Co-Addicted Tango." But understanding the various stages through which Love Avoidant/Love Addicted relationships travel is not enough to effect healing from the traumatic wounds that set these relationships in motion. For that healing to hap pen, as with all childhood relational trauma, shame reduction must take place.
The therapeutic contribution of presenting Pia Mellody's modus operandi of the Co-Addicted Tango to the patients is that the compelling accuracy of her models reduces the patients' shame by exposing their delusions to reason. As they come to see the delusions of Addiction and Avoidance in their own emotional lives, they see that they are not alone in the world of relational dysfunction. More importantly, they come to see that the emotions that seize them during relational trauma are not their fault, that they are not worthless. Undoing the automatic descent into shame and worthless ness during relational stress takes more than intellectual understanding.
Love Addicts and Love Avoidants must revisit the scenes of their childhood wounding by going back in time with the help of a therapist to confront their childhood abusers with their honest testimony of how their parents' abuse caused shame, pain and bewilderment. There comes a moment in this process of shame reduction when patients are able to rid themselves of carried shame. This emotional "detoxification" is at the center of recovery. The traumatic inheritance of abandonment has poisoned both Love Addict and Love Avoidant with shame of being who they are- better than or less when, disempowered or falsely empowered- it hardly makes a difference. Shame will run and ruin their relation ships unless they heal.
Note: This article was originally published in the Summer 2008 issue of MeadowLark, the alumni magazine of The Meadows.
Science and Ancient Wisdom: Treatment Here-and-Now
Before reading further, take 20 to 30 seconds to do this exercise: Let your gaze leave this article and let your eyes look around wherever, and at whatever, they want - just 20 seconds or so. (Really, try it, and then come back to reading.) People in my Somatic Experiencing® (SE) Trauma Treatment courses who try this are surprised that, in a very short time, they feel noticeably more relaxed, peaceful, and in the "here-and-now." Some say they should do this all the time!
Thanks to the forward-thinking people at The Meadows, the connection between trauma and addiction is better understood and more effectively treated. Part of this treatment at The Meadows' extended-care facilities consists of working with the trauma-resolution skills of Peter Levine’s Somatic Experiencing®. The relationship between trauma and the exercise you just tried is that, according to Bessel van der Kolk, post-traumatic stress is fundamentally a disorder in the ability to be in the here-and-now. This means that the state of- the-art in trauma therapy is no longer intense regressive or cathartic therapy. Instead, state-of-the-art therapy is the process of becoming alive to the moment.
For those I train in SE, like those at The Meadows, working in the here-and-now is a cornerstone of clinical theory and practice. When doing his dissertation decades ago, Peter Levine met Stephen Porges and explored his research. Porges' "Polyvagal Theory" (Porges, 2001) shows how one pathway of the nervous system engages freeze and another relates to social engagement. Levine discovered how to work with the transition of the nervous system through these phases (freeze and engagement), as well as the phases of fight and flight. This is SE. This article’s focus is on the engagement phase, which must be integrated into all other nervous system phases.
While Porges' emphasis is based on single linear phase transitions, in SE we work with non-linear and rapid cycling states, for instance, freeze and fight, or flight and orientation. Traumatic symptomology such as intrusion of fight, flight and freeze means that the past has become the present. Flashbacks are the classic example of such disorientation - innocuous cues can trigger an all-out response. In other words, the person temporarily experiences a state that is disconnected from the actual here-and-now environment. One of the antidotes to this traumatic recollection is orientation. I provisionally define orientation as "connecting to the environment through the senses" - in other words, coming back to our senses. This is a broader understanding of engagement than social engagement, per se. For clients whose early life experiences were marked by trauma and abuse, social engagement is actually a trigger for fight, flight and freeze. In this process of orientation, rather than being inundated with a cycle of feelings, thoughts, and sensations associated with unresolved trauma, the client's attention can be directed to the reality of the environment that is available through the senses. Typically we see decreased blood pressure and decreased heart rate, as well as the subjective experience of greater relaxation and interest. In other words, it is the difference between stopping to smell the roses and reliving getting stuck by a thorn!
With many severely disoriented clients, much of the initial therapeutic work (in addition to establishing rapport) consists of the stabilization that comes from establishing better cognitive pathways or habits of here-and-now sensory attention. In attending to the sensory experiences of the external world, physiological mechanisms for assessing safety are allowed to occur without undue influence from traumatic memory. The mechanisms of this assessment are far too important, in a survival sense, for the slow processing of linear thought or conscious effort. Porges aptly names this subconscious process of safety assessment "neuroception" (Porges, 2004). Thus, a natural orientation to the external environment via the senses facilitates the neuroception of safety.
This approach is receiving increasing scientific and popular attention (Time Magazine: Mind & Body Special Issue, January 27, 2007, pp. 55ff). Whether incorporated into CBT, DBT or meditation, the role of the observer is crucial. The process of orientation is fundamental to this cognitive activity. However, many traditions that recommend observation may not adequately reinforce with clients the importance of orientation to the outer versus the inner environment. For those with significant disorientation, it is nearly impossible to track the interior landscape without being involuntarily drawn into what SE terms the "Trauma Vortex." The involuntary and repetitive attraction to this "vortex" is the disruption of the approach-avoidance system, and it is one of the dynamics that underlies addiction and compulsive behaviors in general. Although somatically informed therapists draw from Levine's work, they often make the mistake of inviting clients' attention to the inward sensate experience, without consideration to the vital criteria that indicate whether a client can negotiate such attention without reactivating and reinforcing trauma states. For instance, one of the most common beginner's mistakes is when a therapist asks an anxious client to focus on that sensation in the body. For some clients, this can work well and provide a sense of relief and transition to a more relaxed state; for others, this can lead to further discomfort and other states of disintegration. It is vital for the therapist to immediately and accurately assess the client's capacity in order to determine the appropriate intervention. Without such assessment skill, the safer route is to begin with external orientation, which can stimulate the innate orienting response and build stability.
Once relative stability is attained, a balance of interior and exterior attention can be facilitated. Then a more neutral and practiced observation of the range of experiences can be enjoyed, as the attention can shift naturally between affective experiences, both positive and negative. (This fundamental process at the heart of SE is known as "pendulation," which I discussed briefly in the Summer 2006 edition of The Cutting Edge) This natural swing between polarities is the normal condition of the balanced nervous system. And interestingly, the resulting integration that comes from this innate oscillation is a broader and more nuanced life in the here-and-now. The experience brings awareness, presence, and a greater ability to experience life on its own terms, without undue constriction or elation. Obtained after significant work of attending, this resulting state can yield an expanse of awareness with an increasing ease of relation and a connectedness to everything that is. This state, known among meditative adepts, is simply our human mind freed of its overlay of conditioning hewn by survival networks related to approach-avoidance. Freed from the dominance of an ill-conditioned approachavoidance paradigm, one enjoys engagement with what is now, new and alive. And so, as clinicians, we can orient to the fact that we live in a time of opportunity, when mind and body are becoming reacquainted, and when science can shake hands with ancient wisdom.
Hoskinson, S. (2006) "SE's Systemic View of Functional Reward Systems." The Cutting Edge, Summer 2006. See TheMeadows.org.
Porges S. W. (2001) "The polyvagal theory: phylogenetic substrates of a social nervous system." International Journal of Psychophysiology, 42, 123-146.
Porges, S. (2004) "Neuroception: A subconscious system for detecting threats and safety." Zero to Three [Online] National Center for Infants, Toddlers and Families. No. 5, May. See zerotothree.org.
Stengel, R. (Ed.). (2007). The brain: A user's guide [Mind and body special issue]. TIME, 169 (5).
ABOUT THE AUTHOR
STEVEN HOSKINSON, MA, MAT
Under the auspices of Hoskinson Consulting in Encinitas, California, Steven Hoskinson, MA, MAT, is an international consultant and trainer for clinicians and trauma treatment providers. Steven is a Senior International Instructor for the Foundation for Human Enrichment and has done research in creativity, myth and spirituality. His perspectives include evolutionary, developmental, cognitive-behavioral and systems approaches within a mindfulness framework. Other major influences include personal mentoring with Peter Levine, PhD, more than 20 years of experience in the contemplative arts, and a decade as a practicing aikidoist. www.HoskinsonConsulting.org
Note: This article originally appeared in the Spring/Summer 2009 edition of MeadowLark, the magazine for alumni of The Meadows.
By Judith S. Freilich, MD
I am a psychiatrist thinking about knitting - about dropped stitches, in particular. Knitters know that a dropped stitch weakens the whole cloth, disrupts the garment's integrity and leaves a hole that may not even show until there is a stretch or stress on it. Then, the fabric is likely to begin unraveling from the hole, no matter how carefully the rest is knitted.
I wonder about this in my life. In the fabric of my life, there were many dropped stitches - emotions suppressed, voices blocked, roads not taken, losses not grieved before moving on, trauma endured. Life.
My way was to keep moving forward with determination, compassion and courage. I loved, worked hard, accomplished, learned and helped others along my way. On the surface, my efforts seemed of strong cloth. As time went on, those invisible holes - the dropped stitches - began to show and unravel.
"The body is the mind's subconscious," says respected neuroscientist Candace Pert, PhD. That which our minds can't absorb is held for us in our bodies. Dropped stitches remain in our garment, a part of us. They do not just disappear.
What to do about my dropped stitches? Do I leave the past untouched and continue pressing forward? What would that mean for the whole cloth? Does it end up in the trash that way? Do I choose the difficult task of repairing my garment, so it has more integrity for the future?
When a knitter discovers a dropped stitch, she repairs it. She unknits back to it, picks up the dropped stitch and then knits forward again. Knitters call this "tinking" - &"tink" being "knit" spelled backwards.
I think I will "tink." Many of my dropped stitches are losses not fully grieved. There are trauma-made holes, too. The largest is from when my daughters died in a tragic car accident in 1985. Then, I had no ability to grieve. I might have died or gone crazy had I not become frozen and dissociated.
I did not consciously make a decision to freeze. Perhaps my soul did, in order to preserve my life. And by doing so, the memories and grief were frozen and stored in my body - until the time came to unfreeze and release them. And, yes, it left dropped stitches. I think this was preferable to having no garment at all.
There are many ways to "tink." Each begins with recognizing a hole. We can complete a grief left undone. We may reconnect with an attenuated relationship. There is repair that is spiritual in nature, such as gratitude and forgiveness in their many forms.
There is trauma work. Effective trauma release is "tinking" at its best. Sometimes it involves finding memory pictures, then developing them to bring buried treasure to light or frozen emotions to life. Sometimes, tracking body sensations is the way to find and release them. Or we might return to an old physical environment, restoring an emotional state that was left behind before it was time.
The purpose is to transform trauma. It helps to think about chemistry and alchemy. Like knitting, these are transformational processes. They turn one thing into another. If a single step in the process is missed, the whole thing won't go to completion. It just doesn't work.
Tinking is precise, too. It begins with intention - and some resistance, as undoing is unpleasant. The knitted strand is carefully pulled apart, all the way back to the hole. The yarn is neither lost nor cut. It remains an integral part of the garment. When reknitted forward, it becomes part of a stronger garment.
Knitting creates links. A bridge is a link. To pick up a dropped stitch is to build a new bridge, make a strong link where one was weak or not even there. Building a strong bridge requires first building good foundations at each end of the span.
Not long after my girls died, a friend talked to me of bridges. She said that when your child dies, the foundation of your life collapses. For a while, you must go forward, building a new foundation. At some point, you then can build a bridge back to the past. Healing happens then. Connecting past and future makes a stronger whole.
With thanks to Descartes: "I 'tink,' therefore I am."
- Judith S. Freilich, MD, is a psychiatrist at The Meadows who is board-certified in psychiatry and neurology.
Peter A. Levine, Clinical Consultant for The Meadows, was recently quoted in the Psychology Today blog Let's Connect. In a post entitled "Enjoying Your Emotions", Thomas Scheff explores the psychological aspects of grief and fear, and suggests that too often, we are told to learn to control our emotions, instead of learning to enjoy them. For instance, grief can be a painful emotion to a person who does not feel safe to grieve.
"We have 'good cries' when we are able to rapidly move in and out of the grief. Peter Levine (1997) called it pendulation. Without this movement, we either don't feel at all, repression, or feel so much that we get lost in it (a 'bad cry')."
Scheff concludes that critics of catharsis haven't considered pendulation, but ought to.
For more information on Peter Levine's works, please visit the Meadows Addiction Treatment Center website.