Addictive Personality: Stages, Recovery and Ethical Considerations

Dr. Rosalee Martin, LPC, LMSW, LCDC

(Assistance from student Erica Ojeda)

12th Central TX African American Family Support Conference February 16, 2012 4-5:30

Content
Addiction defined Addictive Process Addictive personality Stages of Addiction Recovery Ethical Considerations Bibliography

Addiction defined
A state of physiological or psychological dependence on an object or event that is liable to have a damaging effect; an abnormal relationship with the object

Evidence of Addictions
Cant predict whether or not you will use drugs or

alcohol; or will engage in sexual activities or overeat, etc

Need the addictive object in order to have fun Need more and more of the addictive object in

order to get the same high as for previous highs

Drink or drug alone or with those who also drink

or drug

Evidence of Addictions (cont)

In the case of gambling, gambles days at a time

without eating, sleepingchasing the big win

Cans remember past activitiesblackouts Lack of emotional bonding with others: miss

appointments, lie
Maintain an illusion of intimacy with individuals

Types of addictions
Drugs/Prescription

drugs

Pornography Gambling Eating disorder Internet Sex

Addiction as a Process
All addicts aimlessly seek

wholeness, happiness and peace through a relationship with the addictive object, ie drugs, sex, Internet, etc. can help identify the specific process addiction

Preoccupation with an activity

Addiction as a process (cont)

An addict

experiences a mood change when they engage in a relationship with an object or event in order to produce a desired mood change. (Nakken, 4)

Addiction as a process (cont)

Acting out acting out and uncontrollable behavior provides information as to the extent of the power of the addictive object over the individual.
Ex. Sex addicts searching for their next partner in locations know for prostitution

Addiction as a Process (cont)

Nurturing through avoidance, not relationships Immediate relief from engaging in the addictive event Instant gratification Cause = Effect A depressed alcoholic drinks to feel happy

Addict vs. Self

The addict gets stronger and more powerful

than the self (the non-addictive self) as the addiction progresses even when self knows better

The addict is manipulative for own good Addict wants to be alone; the Self does not

understands the importance of relationships

Addicts are ambivalent: when people try to leave they become very upset: You cant leave me! Youre all I have!

Process--Stages of Addiction
Stage One: Internal Change Stage Two: Lifestyle change Stage Three: Life Breakdown

Stage One: Internal Change

Natural support system is no longer satisfying; internal /external issues are difficult to deal with.

Stage One
Healthy

development of the four natural relationships is important Without them people will turn to other means of relationships

Emergence of the Addictive Personality

Natural supports cease to offer emotional support Addicts abandon oneself in favor of the addictive high Addiction grows stronger I dont need anyone. Reaffirmation of their addictive lifestyle Personality starts to change

Shame

Pain

Feelings of shame intensify with addiction Addiction intensifies feelings of shame Addictive personality emerges when the pain

begins
Addict falls deeper into the addiction to mask

the pain

Triggers
Negative emotions

and/or events trigger the circular effect of addiction

Food addict is feeling

depressed. The body interprets that as hunger. The addict then binges to take the depression away.

Addicts Delusional System acts like a wall

Keeps the addict

within itself
Keeps people out

who may threaten the addictive personality

Stage Two: Lifestyle Change

The addiction begins Addict withdraws to his

to encompass the persons lifestyle

Behavior changes Withdraws Lies Blame others

secret life of indulge

i.e., sex addict starts

going to prostitutes Food addict starts hiding food Drug addict steal to buy drugs

Addict Rituals
Choices:
Addictive personality at odds with the Self To buy or not to buy that beer on the way home

Community:
Addict may drink with drinking friends or alone

Commitment:
Rituals do not change

Labeling by Self and Others

Labeling signals the beginning of recognition

of the addiction by others

He drinks a little too much. She likes food.

Labeling also gives the addict

permission to act out his label; shame and guilt is generally absent

Enabling the Addict

Acceptance of the

new person by family and friends by giving them an out and excuses

Love/hate towards the

addict

Family/friends are

emotionally drained

Stage Three: Life Breakdown

Addictive Personality in total control Pain Fear Loneliness Anger

Emotional logic starts to collapse

On the way down down

Acting out becomes

extreme

Only deal with those

who support addiction

People left are those

who feel pity; love ones avoid them

Behavior Breakdown
Break downs include: Inability to cope Become emotionally devastated Engage in uncontrollable rage

Physical Breakdowns
Stress takes a toll on the body Damage to the brain, pancreas, kidney,

High blood pressure, heart attacks, liver disorder, ulcers, etc Impotency, birth defects, premature aging Suicide is contemplated as the pain is too hard to bear

Acceptance
Acknowledgement

of the addictive personality allows the person to open the door in creating healthy relationships, thus recovery begins

Core Areas in Recovery

Self-esteem issues Work on improving self-worth Set boundaries for self and other Issues around personal control and other control Own your own reality Reduce denial Assume responsibility Focus on self-care Mental, physical, spiritual, emotional

Recovery Journal
Writing is therapeutic A place to be honest A place to discover yourself A place for a chronology of the recovery journey A place to describe feelings, experiences and thoughts A place to examine the transition from being actively addicted to sobriety A place to examine changes in values

Recovery
Creating New Values: Values
Nurturing the self-- Big self, little addict Respect for the addiction Monitoring the addict within Learning to love the Self Listening to the Self Reintegration as we Development of positive and healthy rituals

Recovery
Get treatment either in-patient or out patient Admit your problem to family and friends;

seek to make amends Connect with a recovery group such as AA, NA, GA, Al-Non Take one day at a time Do not switch one addiction for another

Treatment Agencies
Mental Health and Substance Abuse Div

Department of State Health Services P. O. Box 149347 Austin TX 78714-9347 Phone: 512-206-5000 Fax: 512-206-5718 Austin Recovery Pathway to Recovery 8402 Cross Park Drive 2119 Oak St La Marque, Texas 77568 Austin, Texas 76754 Phone: (409) 933-4366 Fax: (409) 933-4367

Ethical Considerations
Privacy and Confidentiality Informed consent The duty to care Respecting client self-determination Credentialing mechanisms Do no harmoverarching responsibility Cultural competence and social justice Access to records Payment for services

Ethical Considerations
Avoid: conflict of interest engaging in sexual relationship with clients harmful physical contact sexual harassment derogatory language Dual Relationships

Ethical Considerations
Respect the rights, views, and clinical

practices of other professionals Hold colleagues accountable for ethical practices Continue to grow professionally Get clinical supervision, and Adhere to all state and federal laws that govern client care and the profession

Bibliography
Hazelden, A Recovery Journal: For Exploring Who I Am,

1993. McGuire, Sheila. 1996. Subtle boundary dilemmas. Hazeldon: Center City, Minn. Nakken, Craig. The Addictive Personality: Roots, Rituals, Recovery. Hazelden, 2001 NASW, Code of Ethics, http://www.socialworkers.org/pubs/code/code.asp NIAA Module 9 Legal and Ethical Issues in Treatment of Alcohol Use Disorder. http://pubs.niaaa.nih.gov/publications/Social/Module 9Legal&EthicalIssues/Module9.html

Bibliography
Overeaters anonymous www.therecoverygroup.org/

http://www.gamblersanonymous.org
Sheafor, Bradford. 2012. Techniques and Guidelines for Social Work

Practice. 9th edition. Allyn and Bacon:Boston, Mass.

Tom E. Slocum MA, LCDC, Ethics for LCDCs PART #2 Texas State Board of Social Worker Examiners,

http://www.dshs.state.tx.us/socialwork