Families and Addictions: Interventions

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1 Families and Addictions: Interventions With Claudia Black Ph.D. NASW WV Chapter April 2010

2 Claudia Black Ph.D. Family Powerlessness / Unmanageability / Enabling Attempts to Control In the long run Did it make a difference? Silent treatment No Yes Lying No Yes Making threats No Yes Accommodating No Yes Canceling plans No Yes Assuming responsibility No Yes Pretending No Yes Lecturing No Yes Avoiding No Yes Relocating No Yes Hiding or dumping No Yes (alcohol/drugs/food/sex paraphernalia/ etc.) Enabling Cover up Lie Make excuses Bribe Maintain Don t Talk Rule Not follow through on consequences Loss of sleep Headaches Unmanageability Stomach problems Destructive eating patterns Inappropriate expression of anger Silent rage Excessive crying Isolation Job impacted Martyrdom Mental impairment Total preoccupation Destructive behavior Alcohol or drug abuse Depression Walking on eggshells Other (name) Other (name) HO/Family Addiction/Powerlessness Unmanageability Enabling

3 ENABLING EXERCISE The addicted person always goes first ADDICTED PERSON (list for each family member) One way that you have enabled me is: That enabling behavior tells me: CO-DEPENDENT One way that I have enabled you is: (directed toward addict) My enabling behavior tells you and me: I commit to: Enabling process is any behavior that supports the addict s delusion that their drug or behavior is not the problem and aids them in avoiding responsibility for their behavior. HO/Family Addiction/Enabling Exercise

4 Family Addiction Addiction: a compulsive behavior with something external to our self and a continuation of that behavior in spite of consequences to our self and/or others. Disease Symptoms Disease Behaviors Feelings Preoccupation Rationalizing Frozen Feelings Increased Tolerance Minimizing Anger Loss of Control Blaming Loneliness Denial Euphoric Recall Sadness Blackouts Sneaking / Lying Disappointment Craving Hiding / Secrets Guilt Self Defeating Behavior Isolation Fear Decreased Tolerance Shame Medical Problems HO/Family Addiction/Family Addiction

5 Sharing the Disease Addict How long have you had the disease of (name the addiction)? How long have you been dealing with addiction generationally? (i.e. father was alcoholic, grandfather was workaholic, etc.) How and in what ways have you seen your addiction progress? What do you think is the biggest consequence that addiction and codependency has had on you and your family? Give two examples of defenses you ve used that have kept you in denial. Share your recovery practice. (i.e. 12 Step involvement, therapy, meditation, etc.) Codependent / Co-addict How long have you been codependent? How long have you been dealing with addiction generationally? (i.e. father was alcoholic, grandmother was compulsive overeater, etc.) How and in what ways have you seen your codependency progress? What do you think is the biggest consequence that addiction and codependency has had on you and your family? Give two examples of defenses you ve used that have kept you in denial. Share your recovery practice. (i.e. 12 Step involvement, therapy, meditation, etc.) HO/Family Addiction/Sharing the Disease

6 ADDICTED SON 18 YRS OLD Addicted to alcohol & crystal meth / Lies & steals Verbally abusive to Mom & sisters Mom Sister 19 yrs old Overworks Parties with him Stays away Angry Avoids issues Overprotects kids Makes excuses Blames her husband Sister 16 yrs old Is also using Doesn t tell the truth IMPAIRED FAMILY Dad Brother 14 yrs old Doesn t listen Silent anger Lectures Hides in his room Doesn t show much interest in kids Minimizes drinking & smoking pot HO/Family Addiction/Impaired Family

7 Claudia Black Ph.D. Feelings Meter On the meters, mark the levels for the feelings listed as you experience them in your family. Fear Meter Loneliness Meter Guilt Meter Sadness Meter Embarrassment Meter Very Fearful Very Lonely Very Guilty Very Sad Very Embarrassed Fearful Lonely Guilty Sad Embarrassed Somewhat Fearful Somewhat Lonely Somewhat Guilty Somewhat Sad Somewhat Embarrassed Rarely Fearful Rarely Lonely Rarely Guilty Rarely Sad Rarely Embarrassed Never Fearful Never Lonely Never Guilty Never Sad Never Embarrassed

8 Family Self Care Recovery Plan Red Light Behaviors Behaviors that need to be stopped. These are behaviors that are destructive to myself and to others. Examples: verbal rage, driving while angry or in tears, waiting up all night for the addicted person to come home. Behaviors I need to change: How I can accomplish this change: What might interfere with changing my red light behaviors? Yellow Light Behaviors Behaviors that require caution. These are behaviors, people, places and/or things that trigger self-destructive or uncaring acts towards myself and that jeopardize recovery. For family members, triggers are behaviors and situations that can easily lead back into enabling or codependent behaviors. Examples: listening to the addicted person explain why you should loan him/her money; being in a social situation with people who have been part of the addicted person s acting out behavior; or while traveling you call home and no one answers. It is important to learn to assess for potential high-risk situations and triggers to unhealthy behavior. Triggers differ for each family member. This means knowing what triggers your yellow light behavior. One particularly strong trigger is euphoric recall. This is when past experiences or situations are romanticized and the negative consequences are forgotten. Social stressors present significant triggers. When you start to feel pressured and uncomfortable, the urge to return to codependent behavior can feel overwhelming. Behaviors and/or situations I need to be cautious of: 1. _ 2. _ 3. _ What I can do to prevent them:

9 What might interfere with my awareness of yellow light behaviors/situations? Who can I talk to if I find myself running a yellow light? Green Light Behaviors Behaviors to take care of myself. These can be spiritual, physical, emotional, intellectual and/or sexual behaviors that characterize and support the recovery process. Examples: spiritual read daily meditations in the morning; physical eat breakfast, take a walk after work; emotional make an emotional check in with self two times a day; intellectual ask a question when it s not clear what someone means; sexual let your partner know when you want to be sexually intimate. One area that you may find particularly difficult is the amount of extra time you have in recovery. Often you spent hours or days each week engaging in preoccupation with the addicted person and his or her behavior. Now in recovery, it feels as though there is a void. It is important to identify and engage in positive activities to account for the extra time. What I need to do to take care of myself: How I can accomplish this: What might interfere with my green light behaviors? On this day (fill in date) I make a commitment to myself to stop my red light behaviors, be cautious and aware of my yellow light behaviors and follow through on my green light behaviors. (signature) Two affirmations I can use daily to support myself and help me maintain this recovery plan are HO/Family Addiction/SelfCarePlan

10 Claudia Black Ph.D. CoDependent Checklist In the past months, if you have identified with any of the following, describe the circumstances and the behavior. I have raged and that led to I have not set limits that I needed to set and that led to I have used spending or other medicators at times of pain, fear or anger and that led to I have been overworking and that led to I have focused on my children s or partner s needs more than my own and that led to I have not been angry when I should have and that led to I have engaged in self-defeating behaviors such as and that led to I have engaged in self-defeating thinking such as and that led to Situations is which I minimized or rationalized are and that led to Times I did not ask for support when I needed it and that led to Recovery Skills In the past months, if you have identified with any of the following, describe the circumstances and the behavior. Stayed out of the Karpman Triangle (victim, offender, martyr) when in the past I would have jumped in and that led to Appropriately expressed my boundaries name examples and that led to Appropriately expressed my anger, fear and sadness and that led to Asked for assistance/support and that led to Owned and took responsibility for coaddict behavior and that led to Consistently engaged in recovery practices and that led to Other and that led to Recovery Questions 1. What does your co-addiction look like presently, and in the past? 2. What does your personal recovery look like? 3. What do you see yourself doing differently? 4. How would someone recognize it? 5. What practices support your recovery? HO/Family Addiction/Codependent Checklist Recovery Skills Recovery Questions

11 Read through all 22 choices below. Now go back and circle three (3) to five (5) statements that best describe what it was like in the family you grew up in. Then go back again and place a check mark next to three to five statements that describe you or your current family. You can use the space between statements to include any explanations you would like to make. In my family drinking (drug use, gambling, etc.) was 1. never mentioned, never discussed 2. fun, the way to celebrate 3. a tense subject with arguments about it 4. forbidden, considered a sin 5. something that made Mom or Dad unhappy 6. simply not done 7. very scary when one of my parents drank 8. done only on special occasions 9. something that was done almost every day 10. heavy at parties, picnics and family get-togethers 11. what I had to look forward to when I came home 12. one parent hiding how much he/she drank 13. an ordinary part of supper 14. the way Mom and Dad relaxed 15. started when Dad got home 16. what every grown person did 17. the sign of a real man 18. what I would never do 19. what took Dad or Mom away from us kids 20. what a proper lady didn t do 21. the cause of broken promises 22. not a cause of any problems or disappointments HO/ACOA/In my family drinking was Claudia Black

12 I FAMILY ROLES n an addictive or depressed family system the disease becomes the organizing principle. The affected person becomes the central figure from which everyone else organizes their behaviors and reactions, usually in what is a slow insidious process. Typically family members do what they can to bring greater consistency, structure and safety into a family system that is becoming unpredictable, chaotic or frightening. To do this they often adopt certain roles or a mixture of roles. Original work regarding family roles was by Virginia Satir, then adapted by Claudia Black and Sharon Wegscheider Cruse to fit the addictive family. Over the course of years the names vary, yet the descriptions fit. You are welcome to rename that which best describes you. STRENGTHS Successful Organized Leadership skills Decisive Initiator Self disciplined Goal oriented FAMILY HERO RESPONSIBLE ONE DEFICITS Perfectionist Difficulty listening Inability to follow Inability to relax Lack of spontaneity Inflexible Unwilling to ask for help High fear of mistakes Inability to play Severe need to be in control STRENGTHS Caring/ compassionate Empathic Good listener Sensitive to others Gives well Nice smile PLACATER PEOPLE PLEASER DEFICITS Inability to receive Denies personal needs High tolerance for inappropriate behavior Strong fear of anger or conflict False guilt Anxious Highly fearful Hypervigilant 1

13 STRENGTHS Creative Less denial, greater honesty Sense of humor Close to own feelings Ability to lead (just leads in wrong direction) SCAPEGOAT ACTING OUT ONE DEFICITS Inappropriate expression of anger Inability to follow direction Self-destructive Intrusive Irresponsible Social problems at young ages (i.e.) truancy, teenage pregnancy, high school dropout, addiction Underachiever Defiant / rebel STRENGTHS Independent Flexible Ability to follow Easy going attitude Quiet LOST CHILD ADJUSTER DEFICITS Unable to initiate Withdraws Fearful of making decisions Lack of direction Ignored, forgotten Follows without questioning Difficulty perceiving choices and options STRENGTHS Sense of humor Flexible Able to relieve stress and pain MASCOT DEFICITS Attention seeker Distracting Immature Difficulty focusing Poor decision making ability 2

14 The following are some examples of beliefs we hold that drive our behavior. Beliefs of the Responsible Child: "If I don't do it, no one will." "If I don't do this, something bad will happen, or things will get worse." Beliefs of the Adjuster Child: "If I don't get emotionally involved, I won't get hurt." "I can't make a difference anyway." "It is best to not draw attention to yourself." Beliefs of the Placater Child: "If I am nice, people will like me." "If I focus on someone else, the focus won't be on me and that is good." "If I take care of you, you won't leave me or reject me." Beliefs of the Mascot Child: "If I make people laugh, there is no pain." Beliefs of the Acting Out Child: "If I scream loudly enough, someone may notice me." "Take what you want. No one is going to give you anything." Here are some examples of responses to feelings as affected by our roles: The Responsible Child: "I must stay in control of my feelings." The Adjuster Child: The Placater Child: The Mascot Child: The Acting Out Child: "Why should I feel? It's better if I don't." "I must take care of others' feelings." "I must take the pain away." "I am angry about it, whatever it is." 3

15 Another way roles restrict our lives is that they dictate the way shame may manifest itself in our adult years. The Responsible Child shows shame with control, perfectionism, and compulsivity. The Adjuster Child shows shame with procrastination, and victimization. The Placater Child shows shame with victimization, depression, and perfection. The Mascot Child shows shame with depression and addiction. The Acting Out Child shows shame with rage, addictions, and procrastination. While the statements above are subjective generalizations, they describe the reality that many people live. HO/Family Addiction/Family Roles 4

16 Self Sabatoge Assessment 1 = Not at all 2 = Moderate 3 = More than I like 4 = Significant 1. Need to be in control Difficulting taking control when needed Difficulty asking questions Difficulty perceiving options Difficulty making decisions Difficulty delegating Unrealistic expectations of coworkers; of students Difficulty setting limits with coworkers; with students Rigid limits Difficulty accepting criticism Difficulty giving criticism Hypersensitivity to mistakes Difficulty feeling good about accomplishments Difficulty applauding accomplishments in others Difficulty initiating projects Difficulty finishing projects Difficulty listening Difficulty following directions Desirous of autonomy Limited empathy skills Overly empathic Difficulty negotiating Difficulty asking for support Difficulty saying No Other HO/Self Care/Self Sabotage Claudia Black Ph.D.

17 RATING YOUR INNER CRITIC To be rated on a point scale of: (1 Point) Rarely (3 Points) About Average (5 Points) Frequently 1) I wake up at night worried about the mistakes that I made the day before. 2) I replay conversations after I've had them to see what I've done wrong. 3) I don't like the way my clothes look on me. 4) When I'm with other people, I wonder if they're critical of me. 5) I'm cautious about trying anything new because I'm afraid of looking foolish. 6) I'm afraid people will laugh at me. 7) I worry about what other people think. 8) I often feel inferior to other people. 9) I wish I had a more attractive body. 10) When I look in the mirror, I check to see what's wrong with me. 11) When I read over something I've just written, I'm not satisfied with it. 12) I'm afraid that there's something basically wrong with me. 13) I wonder what other people would think of me if they really knew what I was like underneath. 14) I compare myself with other people. 15) I seem to attract judgmental people. 16) I question my decisions after I have made them and think that I might have done better. 17) When I say "No" I feel guilty. 18) When I take a test like this, I'm sure that I don't do as well as other people. 19) I avoid taking risks if I can help it. 20) When I think about self-improvement I feel that there is something wrong with me that needs to be fixed. TOTAL POINTS Scores of 1-45 Small Inner Critic Scores of Medium-Sized Critic Scores of Very Strong Inner Critic SOURCE: Embracing Your Inner Critic by Hal Stone and Sidra Stone HO/Inner Critic/Rating Critic

18 I HAVE NEEDS On a scale from 1 to means to do it well and consistently 1 means it is not a part of your life. Indicate, in general, where you are in the scale. If you mark below 8, what's getting in the way? If it has been difficult in your life, at what age did you give it up? Ability or willingness: to play to laugh to relax to be flexible to lead yet feel comfortable when it is time to follow to question to talk honestly to make decisions to attend to my own needs to recognize where my power lies to protect myself to know and accept my feelings to be able to express those feelings to no longer live life in fear to believe in my specialness to ask for help to make time for self to make time for others to experience appropriate touch to be able to set limits to exercise to practice spirituality Other: Other: HO/ACOA/Needs

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