FADAA and FCCMH Presents Relationship Detox: Helping Chemically Dependent Clients Develop Healthy Relationships In Recovery Presenter Mark Sanders, LCSW, CADC

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In the Realm of the Hungry Ghost by Gabor Mate, M.D. Drugs don’t cause addiction any more than a deck of cards causes compulsive gambling There needs to be a pre-existing vulnerability For some people, the seeds of addiction is planted years before they use

In the Realm of the Hungry Ghost by Gabor Mate, M.D. Drugs don’t cause addiction any more than a deck of cards causes compulsive gambling There needs to be a pre-existing vulnerability For some people, the seeds of addiction is planted years before they use

Michael Jackson

Iceberg Model Addiction Co-dependence Toxic Shame Abandonment/Trauma John Freil

Guilt Shame Behavior Your being “I’ve done wrong” “There is something wrong with me” “I’ve done bad” “I am bad” “I made a mistake” “I am a mistake” Guilt vs. Shame “

Shame The belief that I am unlovable and unworthly of belonging. Brene Brown, Ph. D.

Iceberg Model Addiction Co-dependence Toxic Shame Abandonment/Trauma John Freil

Co-dependence An over involvement with things outside of us and an underinvolvement with things inside of us. Left untreated codependence can lead to addiction. John Friel

Marilyn Monroe

Billie Holiday

Iceberg Model Addiction Co-dependence Toxic Shame Abandonment/Trauma John Freil

Texas Behavioral Health Institute Presents Relationship Detox: Helping Chemically Dependent Clients Develop Healthy Relationships In Recovery Presenter Mark Sanders, LCSW, CADC

Addictive Relationship Styles Lots of drama Smothering

1 ∕ ∕ 2 = 2 ∕ 4 = 1 ∕ 2

Addictive Relationship Styles Continued Extreme jealousy Lots of arguments followed by sex Lots of break-ups followed by sex Abuse You abandon relatives and friends whenever you are in a relationship

Addictive Relationship Styles Continued You experience withdrawal symptoms when alone You tend to leave one addictive relationship and enter another You tend to stay in these relationships despite adverse consequences

Characteristics of Healthy Relationships Both partners are whole Each is growing and encouraging the other to grow Each has a separate life outside of the relationship Each is able to spend time alone Minimal jealousy No abuse Ability to argue in the present

Adult Children of Alcoholics We tend to fear people in authority We tend to lie when it’s easier to tell the truth We are approval seekers We have a tendency toward perfection

Adult Children of Alcoholics Continued We are extremely loyal, even when there is evidence that the loyalty is undeserved We either marry alcoholics, become one, or choose some other compulsive personality We tend to put the needs of others ahead of our own needs We are addicted to excitement We tend to fear abandonment

The Therapeutic Relationship As A Model For Helping Clients Develop Healthy Relationships In Recovery

The Engagement Phase Punctuality Joining—small talk Making sure the client has a voice The use of humor

Counseling Phase Experiencing a new way of relating o Listening o Inviting solutions from the client Modeling healthy boundaries

Types of Boundaries Loose – no one is aware of what’s going on with anyone else in the family Enmeshed – family members are too involved in each other’s lives Healthy, clear – the necessary distinction between the various subsystems are present; members are allowed the 5 freedoms

The goal is to help clients differentiate

Emotional cutoff – Creating distance in relationships by fleeing A.Homelessness B.Psychosis C.Prison D.Drug use E. F.Joining the military G.Joining a gang, cult or addictive relationship H.Suicide

Helping clients recover from negative core beliefs

Negative Core Beliefs – Stage Two Recovery “I will never get my needs met if I have to depend upon other people.” “What other people think of me is more important that what I feel.” “God is going to get me.” “I have to be perfect.”

Negative Core Beliefs Continued “ I am ugly.” “There’s only one right way to do things –my way.” “You should never do anything for yourself; if you do, you’re selfish.” “I am unworthy of love.” (Some clients in Stage Two Recovery report that they are able to find their “soul”)

Termination Phase A.Denial Bring up termination Expect and explain regression If the client disappears, reach out

B.Anger Allow open expression of anger Try not to personalize the client’s anger

C.Sadness Allow open expression of sadness Express feelings of your own

D.Release Discuss client accomplishments Discuss work that is yet to be done Discuss your relationship Express confidence in the client