How We Learn to Self-Medicate

Flickr Commons

It is said that in any AA or NA meeting 60% of its group members will have experienced some form of abuse (physical, emotional or sexual) as a child. Childhood abuse is a good indicator of later substance abuse and addiction. 

Recently I posted about ACE (Adverse Childhood Experiences) Study which showed that early adverse experiences, or traumas, predict adult physical and mental health problems that ultimately lead to early death. Adult substance abuse is one such consequence, in addition to smoking and obesity.

In this context, I've been thinking a lot of about validation. To validate simply means recognizing another person's experience of an emotion and their reaction.

If a friend is crying because his dog recently died, I would validate by saying something like "I see that you are really sad" or "You are really missing Buster." In my wanting to help, I might instinctively want to problem solve or advise him so he feels less hurt. I will get there, but first and foremost I acknowledge that his sadness is real and valid.

Imagine a little girl falls and scrapes her knee, and she cries. Her mother or caretaker hopefully will say something like "Oh, no, you fell. Come and let me look at it" or "Let me see. I think it's going to be okay." Both statements indirectly validate that an accident has happened and that the little girl's reaction is valid. But, another parent might simply order the child to stop crying, or say something like "I told you not to run" or "This is what happens when you misbehave by running." 

In a dysfunctional or abusive family, a child's feelings and reactions are invalidated, as the latter examples illustrate. It doesn't seem so bad when looking at just one example, but when it is long-established pattern, parental invalidation teaches the child that her feelings, especially negative ones, can't and shouldn't be felt or expressed. 

The same girl might grow to ignore, disregard, deny or avoid her feelings, especially uncomfortable ones like sadness, anger, shame, guilt, boredom, loneliness, even though they are part of every person's experience.

Enter alcohol and drugs, which in the short-term help her avoid unpleasant feelings. Repeat this way of coping and a dependence and addiction develops. And a cycle of self-medication begins: Immediate relief from unpleasant feelings followed by intensification of those feelings, and so on...

Peaches Geldof: Eating Disorders and Body Dysmorphic Disorder

Peaches Honeyblossom Geldof March 13, 1989-April 7, 2014

Peaches Geldof died the other day. Autopsy results are still pending, but given her family history, many, including myself, are guessing that it's related to drugs and/or eating disorder. She was just 25. Horrifyingly, next to her body was her 11-month old son. When PG's mother died, her half sister, a baby at the time, was also found next to their mother who had overdosed from heroin.

PG had gone off radar, at least for me, for a few years, during which she seemed to have grown up —she had gotten married and became a young mother two young boys. Before this she was primarily known for being an English party girl famous for her druggy antics and her father.

I couldn't help knowing who she was just as I know Paris, Lindsay and Brittney. I've given up being resentful about celebrity culture and accepted that this is the pop culture we deserve; we celebrate the famous for just being famous.

In PG's case she was the daughter of Sir. Geldof. For anyone who came of age in the 80's, his name is difficult not to remember. Her mother, Paula Yates, died from a heroin overdose three years after the "suicide" of Michael Hutchence, the INXS singer, another difficult name to ignore from the same era. And as mentioned earlier, Yates' body was found in bed with her youngest daughter.

I am not interested in focusing on celebrities, but these occasional tragedies provide access points to discuss finer points about the nature of addiction and different forms it can take. Her mother was also diagnosed with an eating disorder (anorexia, bulimia, or dependence on stimulants to lower appetite or misuse of laxatives?), so the issue of "heritability" of addiction can be discussed, not just addiction to alcohol and drugs, but behavioral addictions. And is there a positive correlation between early trauma and addiction later on? (My answer? Duh.) Here is an ominous last interview she gave to The Independent, an English newspaper.

In my work, mostly I deal with addictions to drugs and alcohol. But over the years, I've encountered a few clients with eating disorders and body dysmorphic disorder (BDD). Always, these food-related, self-image centered issues were just one part of a larger cluster of addictive behaviors to drugs, alcohol, sex and self-defeating relationships (both romantic and social), in addition to poor self-esteem and a history of early loss of a parent, divorce, parental neglect, emotional abuse, and sometimes sexual abuse. Working with these clients (I am not an expert in eating disorders, btw) it felt as if one's body was the easiest, most readily controllable target onto which to transfer unprocessed negative feelings and memories, all of which take time and lots difficult work. Rather than looking inward to dig at the source of pain, eating disorders and BDD forces the body, and ultimately the self, to take all the blame.

History of substance addiction in the Geldof clan is well known, and the experience of losing one's mother at a young age to addiction without the privacy that is afforded to ordinary people, would have made any young woman susceptible and fragile to becoming self-conscious.

Ultimately, I feel PG's addiction to drugs and alcohol was replaced with pathological obsession/addiction to her weight and appearance, and partly at fault is the celebrity industrial complex, whatever that is exactly.

My heart goes out to the two young children who've just lost their mother, as well as rest of Peaches' family and friends.

The Importance of Addiction Counseling in Staying Sober

flickr commons

One of my favorite bloggers writing on the subject of sobriety, the Drunky Drunk Girl, recently posted a piece about why counseling should be part of living sober. She does not downplay the importance of AA and other types of mutual support groups to maintaining sobriety.

But, she says, professionals are needed to help "unravel the core issues" hidden under the addiction.

I've been doing this work for a few years, and I glimpsed some of these core issues. I mean glimpses because even the those in therapy are not completely invested in the process. It could take years of work and courage to digging, and for many this is too daunting.

Whether a client has had the most horrific childhood, suffered abuse and neglect, witnessed addiction and violence, and subjected to immeasurable harms caused by poverty; or the client comes from old money and had access to all the educational and vocational opportunities afforded by money, the underlying issues are very much similar — unresolved, unprocessed emotional pain originating in childhood. It can be parental neglect, enmeshment, a traumatic event, or even a habit (modeling) — if your parents drank fine wines with every meal, it wouldn't seem abnormal that you consume over 5 or 6 drinks during an evening out, which becomes the norm.

My job is to ask question, then listen, ask more questions and listen some more. And what comes to the surface is magical thinking, habitual (mindless) behavior, projection, distorted negative self-image, lack of a support network, anxiety and depression, etc. And they all intersect at one point or another.

It's possible to work through all this. However, you have to be willing to work at it and learn to be okay with the discomfort. There is just no other way.

https://drunkydrunkgirl.wordpress.com/2014/03/30/the-importance-of-professional-counseling/

Fatherless on Father's Day

Fatherless on Father's Day. Some thoughts.

Holidays, even Hallmark holidays like Mother’s Day and Father’s Day, can be difficult for those of us with atypical childhoods. Rather than a celebration these "holidays" can, if not downright depressing, be a reminder that you are missing out on something, that you aren’t quite normal. This is how it feels. However, if you look at statistics, father-absent households in the US are quite common (one in three children). Still, if you have lost your father or never had a father to begin with statistics will not soothe how you feel.

Loss is part of everyone’s experience. At times, especially like today, Father’s Day, your loss can feel significant. You feel life has treated you unjustly. You may even feel resentment towards others who appear to have it all (like a loving, caring and strong father). 

The following are some points to reflect on to gain some perspective.

1. Be grateful for what you have. 

This may be difficult, if you’ve had a very difficult history with your father or with your family. There are many of us who have suffered sexual, emotional or physical abuse by our fathers, and the scars will forever haunt us. But the fact is you have survived it, and there is help to undo some of the damage. Remind yourself that you are not alone, and many of us have overcome our traumatic histories. Also, the miracle of being alive means accepting its unpredictability and our humanity – we are capable of great love, but we also have the potential to cause great pain to others, even our children. 

2. Acknowledge the feelings of loss, sadness, anger and pain.

Emotions, like energy, is in a state of entropy. This means unconsciously we are trying to achieve a state of equilibrium, a state of emotional balance. Physical pain is avoidable and something we can manage. But psychic or emotional pain – a defining feature of human experience and therefore unavoidable – must be felt and accepted. It cannot be stuffed away. This would upset the natural course of emotions. Unprocessed emotions will surface down the road, and often it will be more troublesome.

Practically, it means reaching out to someone on a difficult day (Father’s Day, anniversaries, etc.) and talking about how you feel. You will still feel blue afterwards, but you will find comfort. And if your history contains significant loss or trauma, psychotherapy or talk therapy is something you should seriously consider. Avoidance and denial can contain our pain only to a point. Pain needs to have light shined upon it so that it can’t fester in the darkness of memory.

3. Step back from yourself. 

If you are reading this chances are you live in the “developed” world. When we become absorbed in our pain and confuse it with physical pain, the primacy of our feelings can skew our perspective. The fact that you are reading this on a computer (whether it’s your own or shared) you are part of the fortunate minority. We have in common a standard of life and freedoms that most people in the globe can’t take for granted. We can bitch about our own lives, the politics of our imperfect countries, but the fact is our lives could be intensely more difficult. This does not mean your private sorrows, losses, and painful biographical facts are meaningless. But, it means recognizing that you are not alone in the world who is suffering. Emotional pain is one thing, but consider what it might be like to lack adequate shelter, access to health care and education, and food and water.

Practically, this might mean paying more attention to world affairs, for instance getting a more global perspective from news sources that are more international in scope, reading books on public health,  volunteering, and donating money to organizations.