Avoidance

The Recovery of Craig K.

Posted on by Christy Weeks
“First responders are usually the first on the scene to face challenging, dangerous, and draining situations,” explains a Supplemental Research Bulletin by the federal Substance Abuse and Mental Health Services Administration (SAMHSA). “They are also the first to reach out to disaster survivors and provide emotional and physical support to them. These duties, although essential to the entire community, are strenuous to first responders and with time put them at an increased risk of trauma.”
According to the SAMHSA Bulletin, “It is estimated that 30 percent of first responders develop behavioral health conditions including, but not limited to, depression and posttraumatic stress disorder (PTSD), as compared with 20 percent in the general population (Abbot et al., 2015). In a study about suicidality, firefighters were reported to have higher attempt and ideation rates than the general population (Stanley et al., 2016). In law enforcement, the estimates suggest between 125 and 300 police officers commit suicide every year (Badge of Life, 2016).”
Experiencing severe trauma is strongly correlated with substance use disorder (SUD). In a study investigating alcohol use in police officers following Hurricane Katrina, there was a significant association between involvement in the hurricane relief efforts and hazardous alcohol drinking (Heavey et al., 2015). In another study, the average number of alcoholic drinks after Hurricane Katrina increased from 2 to 7 drinks per day (McCanlies et al., 2014).
Many traumatized first responders attempt to alleviate their mental health symptoms with drugs and alcohol. Former police officer Craig K. was one of them. As a young man, the Harmony alumnus entered a work environment where you “push horrible calls to the back of the head,” downplay the horror, and move on. The traditional macho culture prevalent among first responders taught him how to “party like a cop” to release the stress.
When traumatic episodes start to show an impact you still don’t think you have a problem: “They tell you about the stress but they don’t build in a mechanism to deal with it.” One time, Craig was called to the scene of a helicopter crash. The smell of the jet fumes connected with the carnage he was forced to witness is etched into his memory. Craig refers to these traumatic events in his career as demons.
One of his main demons is the Columbine high school shooting. “To this day I can’t hear fire alarms,” he says. “I freak out when I hear fire alarms.” More than twenty years later, Craig is still angry with the teenage perpetrators.
In the aftermath of Columbine, his drinking “took another level” and he could not stop watching the news about the shooting on TV. Like many of his colleagues he was traumatized and felt the police were unjustly blamed for not doing enough to stop the massacre. Craig took it personally.
Family hardships followed: his son was born without an immune system and “everything was thrown out of kilter,” including his marriage. All the while his alcohol use disorder (AUD) became steadily worse. “We started going to therapy” but talking about the health problems of my son was just “an easy way to avoid talking about my problems,” Craig remembers. The inevitable negative consequences started to pile up, he left the police force and got a divorce.
The AUD kept destroying his life, “everything after 2011 is really cloudy.” At the end of last year, Craig finally realized that something was wrong. On New Year’s Eve, he was hospitalized for four days. “I still didn’t realize why I was shaking so much.” After his discharge, he started drinking again and by February he was back in the hospital. On that occasion, “the ER doctor tells me ‘if you keep this up, you’re going to die in three months.’”
By this time, however, Craig was firmly in the grip of active addiction, so he kept on drinking. After getting fired from his job, he saw his pastor who told him about Harmony Foundation. Craig was finally ready to change.
Traumatic life experiences are extremely common among patients with substance use disorder. Because of this strong correlation, trauma-informed care is an important part of addiction treatment at Harmony. All staff have been trained in trauma-informed care. When SUD patients arrive for treatment, they often have few coping skills to deal with their traumatic memories and emotional pain. They have to learn to manage emotions and situations without drugs and alcohol.
Craig finally realized that “ego was not his amigo.” Your ego “makes you cocky and doesn’t allow you to see your real self,” he says. “I rode the ego train 24/7.”
Things are much better now for Craig. “I don’t want to be that person anymore. I’m really excited that I am getting clear and more focused. I’m starting to understand things that I read in the Big Book, that we talk about in meetings, that I’m witnessing.”
At Harmony, he began to learn how to process his trauma, acquiring important coping skills. After his discharge, he connected with a sponsor within a week and—thanks to Zoom—was able to attend several meetings a day. The Daily Reflections and two other AA books go with him everywhere he goes.
“I have to work at this every day. It’s like a diet or going to the gym – you have to put in the work.” If you don’t work on your recovery every single day, you’re cheating yourself.
Recovery is always possible. If you or a loved one is struggling with substance use disorder, or you have questions about our programs, call Harmony today at (970) 432-8075 to get the help needed as soon as possible.

Are You in a Codependent, Avoidant, or Securely Attached Relationship?

Posted on by Christy Weeks
codependency

by Lana Isaacson, LCSW, CAC III, Certificate in Marriage and Family Therapy, PACT Level I

Codependency is one of the most confused and contested words in the couples therapy field today. There could even be a debate between couples therapists and addiction counselors on whether or not codependency (and even the cartoon above!) is healthy or unhealthy.

Addiction counselors would likely say that codependency originates in childhood and manifests as an unhealthy relationship with oneself and a dysfunctional interpersonal pattern in adulthood between the codependent and his/her partner, children, and others that involves controlling, excessive caretaking, and enmeshment. Codependency and enabling are often used synonymously to refer to the dynamic between a partner with an addiction and the codependent who “loves him/her to death” through enabling. Addiction counselors might also contend that any level of dependency or too much “connection” to one’s intimate partner is unhealthy and recommend that individuals in recovery wait at least one year before beginning an intimate relationship.

On the other hand, couples therapists are more likely to conclude that codependency stems from the couples’ current dynamic, which includes one partner displaying an avoidant attachment style, which influences the other partner to feel tremendous anxiety and want to cling to her/his partner, and appear as codependent. These therapists might also underscore how partner’s emotional dependence on one another is a normal human need, and therefore should not be shamed. Or, couples therapists might elevate a codependent relationship as the ideal because they attest that partners are more resilient when they have a “secure base” or emotional anchor and will possibly point to the 2006 MRI study by Dr. James Coan that demonstrated how partners can regulate each other’s psychological and emotional well-being. Finally, some couples therapists, especially those who subscribe to attachment theory, might deny that codependency exists as in Amir Levine, MD and Rachel Heller’s well-respected book, Attached, in which they assert that “codependency is a myth”.

As with couples in therapy, often the truth lies somewhere in the middle. Because I am both an addictions counselor and couples and family therapist, it seems to me that this argument is a semantic one and that codependency means very different things to both professionals. In order to best serve our clients, it is important to distinguish the difference between codependency and interdependency or a secure attachment.

First, what is codependency?

This answer can greatly differ based on the source. I will share a definition by marriage and family therapist, Beverly Berg, PhD who wrote Loving someone in recovery; The answers you need when your partner is recovering from addiction.

“Codependency is an emotional and psychological state in which one is excessively preoccupied with taking care of or controlling another person at the expense of one’s own needs… The codependent’s excessive focus on caretaking does not only occur with his or her primary partner; it can also apply to work relationships, friendships, and relationships with extended family. People with codependency have a hard time leaving relationships that are abusive or depriving, tend to stay in jobs that are stressful, and are prone to ignoring their medical needs. Because of their high tolerance for denying their own needs, codependents tend to wait until they have experienced serious consequences before seeking a path of recovery” (2014).

Internally, codependents tend to struggle with thoughts of not feeling good enough, excessive worry about what other people think of them, and constant waiting for disaster or the other shoe to drop. They may perceive neutral or even positive situations as negative. I know some very “high functioning” codependent people who (similar to some addicts prior to recovery) may look great on the outside, but are internally suffering. Fortunately, treatment/help for codependency addresses both one’s internal and external world.

Lastly, codependency affects people from all walks of life- both men and women, addicts and non-addicts, and should not be assigned to every partner of an addict. To see if you or someone else meets the criteria for codependency, one assessment can be found on The Bridge to Recovery’s website (an outstanding treatment program for codependency)

Second, how does codependency develop & manifest in adult relationships?


Stan Tatkin, PsyD, creator of PACT (Psychobiological Approach to Couples Therapy), which incorporates attachment theory, neuroscience/arousal regulation, and experiential therapy, explains the origins of codependency in the foreword for Berg’s book. Tatkin’s former supervisor was John Bradshaw (the latter was a leader in the addiction and codependency treatment field).

“[…] Codependent men and women tend to bond in love relationships in a way that makes them both angry and resistant…because during their childhood, at least one of their important caregivers was preoccupied as a result of feeling overwhelmed, unsupported, and unloved by his or her own parents” [or spouse]. Preoccupied caregivers tend to alternately reward their children for depending on and supporting them, and rejecting, punishing, or abandoning them. This inconsistency tends to make the children angry as well as suspicious of and resistant to affectionate approaches from the caregiver [and later spouse] (2014)”.

“[…] Fast forward to adult relationships with a partner preoccupied with addiction [a mental health condition, or something/someone else] and you find a familiar situation. Your partner knows how to feel good without you [or is unaware of your needs], but you need your partner to be present, loving, and caring to feel good. Even though you feel ignored, abandoned, and alone, you STAY in the situation. Why? Because you are insecure and fear abandonment” (2014). And of course, many partners would also say, “because I LOVE him/her.”

Third, what do different attachment styles look like in children and adults?

Tatkin’s (2016) work draws from researchers who discovered that children and adults typically have one of three distinct attachment styles: secure, avoidant, or anxious (codependent). There is also a small portion of adults who have a disorganized attachment style due to severe unresolved trauma. Adult’s attachment (or “relationship”) styles are primarily influenced by the attachment relationship they had with their primary caregivers when they were children and secondarily by one’s intimate relationship history.
In a nutshell:
Children who felt their parents would respond consistently and appropriately when they called out for help or reached out for emotional comfort tended to develop a secure attachment style as adults. As adults, these securely attached folks find it relatively easy to get close to an intimate partner and are comfortable depending on their partner and having the partner depend on them. These relationships are mutually reciprocal. These partners have each others’ backs!
Children who felt their parents minimized, scolded or ignored their emotional needs or did not know how to appropriately emotionally comfort them tended to develop an insecure/avoidant attachment style as adults. As adults, they have disowned their emotional needs and thus struggle to identify what they need from their partner or over rely on themselves for comfort, and do not know how to adequately meet their partner’s emotional intimacy needs.
Children who felt their parents inconsistently responded (sometimes expert soothers and very loving and other times overwhelmed and either ignored the child, got angry, or guilt-tripped the child) when they called out for help or comfort tended to develop an insecure/anxious (codependent) style as adults. As adults, they worry that their partner does not really love them, won’t want to stay with them, or cannot meet their emotional intimacy needs.

The GOAL- A Secure Attachment Style!

Tatkin’s (2013) description of a “secure functioning relationship” is his unique terminology for a secure attachment:
“We have each other’s backs. We soothe each other’s distress and amplify each other’s joy. We protect each other in public and in private. We have each other’s “owner’s manual” and thus are experts on one another. We are as good at our partner as we are at our job! Our relationship is based on true mutuality.” We work on our own recovery and support each other’s recovery.

Fourth, how does an avoidant attachment style affect partners?

Although avoidantly attached partners and relationships are not nearly as vilified as codependents, they are of equal concern because they evoke in their partner a deep loneliness, often feelings of betrayal (when they seem preoccupied with their work, their family of origin, or other people or activities, including their alone time) and emotional deprivation. Perhaps the lack of widespread concern about avoidance is that our American culture places independence and stoicism above collaboration and vulnerability as well.

Yet, what I see as a couples therapist is as many or more relationships suffering when partners balk at mutually making it their sacred responsibility to put their partner’s emotional well-being first. Although this blog focuses more on codependency in intimate relationships, I have included resources at the end that can help folks interested in healing from and transforming their avoidant attachment style into a secure style.

Fifth, how can we integrate the wisdom from the Couples Therapy and Addiction Counseling fields on the topic of codependency?

The couples therapy field, especially attachment theorists, offer us a unique perspective on codependency that doesn’t blame or shame the partner being labeled codependent by explaining that the codependent is behaving in a normal way to an abnormal situation, which is his/her partner disconnecting from the relationship to connect with something else, ex. an addictive substance or behavior. This distancing from the codependent’s partner will likely propel the codependent to take extreme measures in an attempt to reconnect with his/her loved one because it has been found in research that adults, similar to children, experience “primal panic” when they cannot emotionally reach their loved one and/or their loved one stops emotionally responding to them.

Attachment couples therapists also normalize our biological need to attach and bond to others and to be emotionally dependent on significant others from the cradle to the grave. Couples with a secure attachment style and/or an interdependent dynamic have been found to feel the most loved, safe, and secure with their partner, have the happiest and longest relationships, and are more successful in the world because they are launching and landing each day with a partner who serves as their “secure base” or emotional anchor.

Addiction counselors provide a different type of expertise and often more personal and professional experience with codependency, which can bring a level of wisdom that is invaluable. Addiction counselors tend to better understand the gravity of codependency, ex. being the spouse or child of a codependent can be extremely challenging because the codependent limits others’ growth and unconsciously disables them. These counselors are also often aware of the internal pain that codependents experience and feel compassion for the codependent’s inability to stop (cold turkey) his or her codependent behaviors, thoughts, and feelings. Some codependents describe their experience of enabling or helping (anyone with anything) as a “HIGH”, refer to themselves as “self-sacrificing martyrs” or “rescue warriors”, yet by the end of an enabling spree, they need to crash from emotional and physical exhaustion, and later they feel intense hurt and/or resentment from having given too much and sacrificed themselves for others who continually neglect their needs. This cycle repeats until help is attained by a professional who can provide appropriate treatment.

Thus, by acknowledging that codependency is a REAL condition and explaining the research-based recommendations for treatment, addiction counselors can offer validation, empathy, and hope to their clients who previously felt hopeless about their internal suffering and compulsive behaviors. These counselors also go far beyond normalizing the couple’s dynamic to helping the couple navigate out of an insure attachment style into a secure one.

Finally, Moving Forward~ Recovery from Codependency or Avoidance to a Secure Attachment Style and Relationship

​Tip #1 Strengthen your individual recovery program (if applicable, ex. CoDA, Al-Anon, AA/NA &/or individual therapy, meditation, etc.) and your ability to know your autonomous self (the ability to be emotionally close to someone while at the same time, not lose yourself). One outstanding book to guide you is Loving someone in recovery by Beverly Berg, PhD, which explains the stages of recovery from codependency, emotional relapse indicators, and teaches missing interpersonal skills. (in addition to a comprehensive overview of how couples in recovery can change a dysfunctional dynamic into a securely attached relationship.)

Tip #2 Learn how to develop a secure attachment with your partner that addresses how to transform both insecure styles (codependent and avoidant) into a “secure functioning” relationship. Three outstanding books to guide you are Wired for love by Stan Tatkin, PsyD, MFT, Attached by Amir Levine, MD and Rachel Heller, MA. & Berg’s book mentioned in Tip #1.

Tip #3 Seek couples therapy, with a counselor who has training in helping couples develop a secure attachment and recovery from addiction and codependency if applicable. And, if you are a couple in recovery, develop a couple recovery program, ex. participate in RCA- Recovering Couples Anonymous and AA/Al-Anon/CoDA speaker meetings).
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If you would like help navigating out of an insecure attachment style into a securely attached relationship, Contact Lana Isaacson, LCSW, CAC III, Certificate in Marriage and Family Therapy, PACT Level I Therapist, at 720.432.5262 to schedule your appointment today.

www.lanaisaacson.com

 

 

 

 

 

 

 

 

 

Avoidance and Attendance: Advocating for Yourself

Posted on by Christy Weeks
Attendance

by Khara Brindle

It’s that time of year. The time where you might feel the urge to disengage from therapy in response to the season, holidays, or stress. The time when you may need an appointment the most in order to support you through trauma, family conflict, isolation, and loneliness. For some, the crises seem to intensify during the holidays. Perhaps you are experiencing depression symptoms due to the winter weather or maybe you are battling loneliness in spending the holidays away from your loved ones. Perhaps you are attempting to navigate the unwanted memories of trauma during your family’s holiday dinner or are experiencing high anxiety because of money stress and holiday shopping. You on your journey to sobriety and anticipate having to navigate holiday parties around family and friends where temptation may lead to relapse. Combine these stressful situations with your ability to cope and you may feel you can engage in therapy fully to receive support, or in some cases, desire to disengage in response to the overwhelming feeling of all that is weighing you down. It can feel like a balancing act to engage your supports when feeling stressed, but rest assured, it can be an empowering experience to engage in through the holiday season in support of your personal and relationship goals.

Avoiding Appointments
The more easily measured type of avoidance when overwhelmed is a change in attendance in your scheduled sessions. Perhaps you find yourself canceling sessions when in the past, you’ve been consistent in attending each week. Or maybe you find yourself cancelling last minute due to feeling like you need to use that time or money for another task? How do you explore your needs when you haven’t been able to justify spending the time or money on your own mental health? Depending on how your therapist structures sessions, you may want to consider advocating for yourself in exploring the following:
• Completing a phone call with your therapist to communicate what is going on in your world and attempt to re-engage in sessions to support managing your stress.
• Engaging in a phone session instead of a face-to-face to explore and address present stressors if you are unable to attend in person.
• Identifying a different appointment time that encourages attendance such as an early morning before work or later evening if appropriate and depending on if your therapist has openings at
those times.
• Identifying biweekly or monthly sessions for the holiday season to account for financial constraints and time management.
• Reviewing your attendance contract with your therapist to explore opportunities and restrictions, such as possibly placing scheduled appointments on hold and resuming at a later time if
appropriate.

Emotionally checking out
The hope is that with ongoing rapport, the conversations with your therapist above can support you with healthy communication and accountability when experiencing increased distress. Your relationship with your therapist, or rapport, becomes even more important when you find yourself engaged by your therapist around a lack of emotional participation in session. Perhaps you begin to notice that you struggle to arrive on time to your scheduled appointments, jumping into sessions with details unrelated to yourself or changing subjects rapidly throughout the scheduled time. Or maybe you remain surface-level in your processing, not dropping down into emotions and deeper meaning in session because you are avoiding the stress or have worries that it will become unbearable when talking about it. With healthy communication, you can name what’s going on for you and process the outcomes with your therapist. Here are some examples of how you might start the conversation:
• In response to running late: “I’m struggling to get here on time and it feels rushed lately, like we have to fit it all in. Can I talk to you more about what that’s like for me?”
• In response to staying surface-level: “I have to admit, it’s easier to talk about the lighter things than the deeper, more stressful stuff. I think I’m worried that if we talk about it, it will just make
me feel worse.”
• To encourage connection: “I feel very disconnected from my body, like my head is fuzzy and floating and I just want to be numb rather than this stressed all the time. Can you help me feel
more like myself?”
• To encourage feedback: “I’m needing something different in our sessions to help me. Can I talk to you more about that?”
• To name fears: “I’m afraid that if we talk about these things, I won’t be able to function or get things done afterwards,” or “I’m reluctant to talk about this now because we won’t have our next
appointment until after the holiday.”

Any of these statements can lead to a supportive conversation with your therapist to further identify and explore your needs. These sessions can prove to be some of the most impactful and fruitful in not only holding space for emotion and processing of stress, but also supporting vulnerability and self-advocacy in exploring how you can engage all of your supports in ways that feel beneficial to you.

Hear me
Vulnerability is hard. Yet for many of us, the power of being seen, heard, and understood makes engaging in vulnerability worthwhile. Your therapist, engaging you from a place of compassion and empathy, can better understand your needs when you speak of them. Your therapist can offer a neutral curiosity with ongoing optimism conveys the message that, together, you can find relief. Whether it be concrete tools for coping or holding space for your emotions, your therapist can create a safety net to address any fear, guilt, or shame you may be harboring in these moments of distress. Engaging in holiday travel, consider your therapy sessions a roadmap to relief! With direction and insight, you can address avoidance and attendance from an authentic, supportive place to best serve you during the hustle and bustle of the holiday season.

“You are as amazing as you let yourself be. Let me repeat that, you are as amazing as you let yourself be.” Elizabeth Alraune

Khara Croswaite Brindle, MA, LPC, ACS, is a Licensed Professional Counselor in the Lowry Neighborhood of Denver, Colorado. She received her Masters Degree in Counseling Psychology from the University of Denver with a focus on community based mental health. Khara has experience working with at-risk youth and families, including collaboration with detention, probation, and the Department of Human Services. Khara enjoys working with young adults experiencing anxiety, depression, trauma, relational conflict, self-esteem challenges, and life transitions.