by John Friel
Phobias
Phobias are irrational fears that keep us from going about our day-to-day affairs with comfort. Severe phobias can keep us from going about our day-to-day affairs at all. We develop fears of people, of going outside the house, of working or of going to school. While the specific phobia may be attached to a single traumatic event, it is often the rules in our family system that keep us from overcoming the phobia. And those same rules can help the phobia to expand and grow into other irrational fears that paralyze us even further.
Anxiety
Anxiety symptoms include trembling or shaking, dizziness, chest pain or discomfort, faintness, fear of dying or going crazy, hot and cold flashes, tingling in the hands or feet, sweating, heart palpitations, jitteriness, jumpiness, tension, feeling tired and worn out, eyelid twitches, restlessness, cold clammy hands, dry mouth, upset stomach, frequent urination, diarrhea, high resting pulse rate, worry, fear, hyper-attentiveness, distractibility, difficulty in concentrating, irritability and impatience.
That’s a long list of symptoms, and most of them can also be caused by physical problems, which is why it is strongly advised that you get a complete physical exam before assuming that it is anxiety.
On the other hand, we see many people who go from doctor to doctor and one expensive test to another looking for a physical cause of their symptoms, when what is really happening to them is that they have some deep-seated emotional pain that they are not looking at. When they face the pain, the symptoms begin to slowly disappear.
Our general advice on symptoms is to get a complete physical examination first, to help rule out physical causes. Should you seek psychotherapy, we recommend that you tell your therapist that you also want to explore possible family dysfunction causes for your symptoms, in addition to just getting medication or behavior modification treatment.
In our view, symptoms are either biologically caused, or they are there for a protective reason that is most likely due to family dysfunction.
4
Some Hooks:
Addictions in
Particular
Because addictive and compulsive patterns of living are so common among Adult Children of Dysfunctional Families, we would like to take a brief diversion to identify what some of these hooks are.
An estimated 28 million Americans have at least one alcoholic parent.
More than half of all alcoholics have an alcoholic parent.
One in three families report alcohol abuse by a family member. In up to 90% of child abuse cases, alcohol is a significant factor (National Association of Children of Alcoholics Charter statement).
Experts suggest that 80 million Americans are overweight (Turner & Helms, 1987).
One in three adults still smoke cigarettes (1987 Gallup Poll), millions of people drink coffee, many addictively so, and injuries from jogging number in the thousands.
Before their highly addictive nature was recognized by the medical and psychotherapeutic community, prescription tranquilizers, such as Librium and Valium, trapped untold thousands in addiction.
The average child watches six to eight hours of television every day. By the time he graduates from high school, the average child has spent more hours in front of the television set than in school.
It took two years to sell the first 5,000 copies of the A.A. Big Book, the bible of A.A., first printed in 1939. Now it takes two days (A.A. World Services, 1985). This, of course, is an uplifting and joyful statistic because it shows us how many people are now getting help for a disease that was once thought untreatable, but it also shows how hungry we are for help with our addictive processes.
We could compulsively cite statistics for another 20 or 30 pages to make our point, but we won’t. We aren’t here to use scare tactics or to tear down American society. There are plenty of other societies struggling with their own addictive problems. But we do feel that it is necessary to at least frame addictive agents in broad terms.
To begin, we will simply list for you some of the more common agents to which we can become addicted based on our clinical experience, current research and our own personal experience. Feel free to add to our list or take issue with it if you wish.
alcohol jogging
prescription drugs reading
nonprescription drugs speed/danger
illegal drugs nicotine
food caffeine
television relationships
sex power
work sleep
spending gambling
stress cults
The first thing to notice about our list is that with perhaps one or two exceptions, there is not one item on our list that is harmful or dangerous in and of itself. There are plenty of people who go to Lake Tahoe, Las Vegas or Atlantic City for a weekend of gambling and entertainment and never have a problem with it. There are plenty of people who drink alcohol moderately, and for whom alcohol never becomes a problem. Even stress, in and of itself, is not dangerous. In fact, without some stress in our lives, life would become very boring. So it is not the addictive agent itself that is the focus of our message, except that it is very important to realize that addiction can happen to us in more ways than one.
Just because you don’t drink alcohol does not mean that you are free from addiction. You could have all of the traits of an addict—the denial, the discomfort with intimacy, the need for unreasonable power and control, the inability to let go, the inner torment, the insecurity masked by grandiosity and so on—without being an alcoholic.
And before you start pointing fingers at yourself or someone else because of our list, remember that just because you like jogging or sex or television does not mean that you have an unhealthy dependency on them. Also keep in mind that we are each unique in important ways, too. Watching television may be a healthy diversion or form of entertainment for you, but be a demonic trap for your spouse or children. Your boss’s relationships may be healthy, while yours are bordering on being addictive. His work may be challenging and stimulating while his assistant’s work may be addictive and compulsive. The proof is not in the pudding; in this case it’s in the one who is eating the pudding.
Perhaps the following brief descriptions will begin to help shed some light on this distinction.
Jim has one or two drinks after his long workday, then eats dinner with his family. On weekends he and Barbara usually entertain at home or go out with friends, and he finds that a few glasses of wine and some after-dinner drinks help loosen him up to really enjoy the weekend. All of their friends drink, and Jim only gets “drunk” a couple of times a year. He knows that he really doesn’t have a problem anyway, because he tried to stop drinking last year and was able to go two months without a drink. Jim has a successful career, a beautiful wife and two wonderful children. Jim is an alcoholic.
Katherine has one or two drinks after her long workday, then has dinner with her family. On weekends she entertains at home or goes out to dinner with friends. She, too, has a couple of glasses of wine with dinner when she goes out. She has never tried to quit drinking completely because it has never occurred to her to do so. Katherine is not an alcoholic.
Sue has been running 30 miles per week for the past several years. Every couple of years she trains for and runs in a marathon. She is proud of her physical fitness and can’t imagine what it would be like to not be able to run anymore. In fact, her morning run comes before anything else and when her schedule becomes disrupted for some reason, she is irritable and crabby for most of the morning. Sue is a running addict.
Frank runs 40 miles a week, running at least one marathon every year. He, too, is proud of his stamina and conditioning.
When he discovered that he would have to stop running because of a knee injury, he was disappointed and “down” for awhile but he eventually bounced back and is on an even keel again. He has been thinking lately about taking up swimming to get his aerobic exercise each day. Frank is not a running addict.
Bob watches television with his famil
y every night, starting with the evening news and ending with a late night movie.
While Bob is watching, other family members will be watching, too, if they’re interested in the show. But Bob watches no matter what. His wife jokes about being a “television widow,” but she’s not laughing on the inside anymore. Bob is a television addict.
Mary watches television every night or so, depending on what’s on, but it is never a very high priority for her. Even if she’s in the middle of a program and someone calls her up to go out, it doesn’t bother her to turn it off. Sometimes she’ll go for days without watching anything at all. Mary is not a television addict.
As you can see from the above examples, it is not the amount, necessarily, that determines the addiction. In some cases, amount by itself will be a clear diagnostic indicator, but it won’t always. One of the statements that will get an Alcoholics Anonymous group laughing harder than anything else is when a diagnosed alcoholic says, “But I only get drunk a couple of times a year!” This also brings up the important advice that as we think about our own dependencies and possible addictions, we must not compare ourselves to someone else’s patterns of use.
The best way to look at our own patterns of addiction is to look at a typical list of the symptoms and indicators of addiction used by professionals to determine whether we are addicted and how strongly we are addicted. We believe that addiction is on a continuum, and that if you suspect that you or someone close to you is addicted to something, you should seek professional help in determining a diagnosis. The following are some of the major indicators.
1. Preoccupation With The Addictive Agent: Thinking about it, talking about it, looking forward to it, being distracted because of it, not being able to “be” with others because of the preoccupation. It is this aspect of addiction that makes intimacy difficult, if not impossible after awhile, because the addiction becomes our primary relationship. We are more interested in watching TV, having sex, drinking, running, gambling, etc., than we are in being with the people we once loved.
2. Increased Tolerance For The Addictive Agent: We need more and more of the chemical or experience to achieve the desired effect. The more we use it, the less the effect seems to be. There is also increasing frustration with the tolerance build-up, in that the increased usage causes deeper and deeper shame, guilt and remorse.
3. Loss Of Control: We can’t have “just one.” We try to have periods of abstinence; or we have “white-knuckle” abstinence during which times we are irritable, angry, lonely and isolated. We say that this is the last day we’ll act out compulsive sex, or watch TV all day, or drink, or use Valium, but we get up the next day and start all over.
4. Withdrawal: When we stop using whatever it is we’re addicted to, we have symptoms of withdrawal, such as irritability, depression, moodiness, tearfulness, anger, hostility, etc. This goes as well for addictions other than chemical addictions. Families asked not to watch TV for a month often have the same symptoms if they happen to be addicted to it.
5. Sneaking: Hiding bottles, shamefully buying pornography and hiding it in one’s car, under one’s bed. Having a few drinks or pills before going out for the evening to be sure that there’s enough in the bloodstream in case there is no opportunity to have more later.
6. Denial: To be discussed at length in a later chapter. It includes defensiveness about use and one’s symptoms, as well as the consequences of one’s actions for self and others around us; as if the world is crumbling around us and we’re saying, “Problems? What problems? Everything’s fine!” Or we might say, “Addiction? Hell no, I’m not addicted. I’ll be fine after I get done with this big project. It’s just the stress I’m under right now that’s getting to me.”
7. Personality Changes and Mood Swings: Up, down, up, down, up, down. Angry, syrupy-sweet, then angry again. Moody, temperamental, irritable, sad, hyperactive, elated, then back to sad again. In some, these swings are very obvious. In others, they are much subtler.
8. Blaming: It’s everyone else’s fault. The kids are too spoiled. The spouse isn’t attentive enough, or sexy enough, or enough of a hard-worker. The boss is a jerk. The doctor who examined me is incompetent. There is a powerful inability to accept responsibility for one’s own life with this symptom.
9. Blackouts: With chemical addictions, these occur when we can’t remember what we did while we were under the influence—we don’t remember driving home or how we got to bed or what we said to that woman at the party last night. With other addictions we have “dissociative blackouts,” i.e., we dissociate while using or while preoccupied and don’t remember things. We daydream, “space out,” “go into the ozone” for awhile.
10. Physical Symptoms: These will depend upon the addiction. With non-chemical addictions, they are most often the stress disorders, such as headaches, ulcers and the like.
11. Rigid Attitudes: Black-and-white thinking; intolerance of others’ opinions, compulsiveness, all-or-nothing thinking.
12. Loss of Personal Values: We stop caring as our addiction progresses. We don’t take care of ourselves. We hang around with people who are our “inferiors.“ Our boundaries break down and we do things which we would never do prior to the acceleration of our addiction—sexual things, inconsiderate things, hurtful things, illegal things.
13. Disability and/or Death: Death comes either through physical damage due to a drug or chemical, or through stress-related illnesses, such as cancer or heart attack or stroke or through eventual suicide. We suspect that a large number of alcohol-related traffic fatalities are a form of suicide.
In looking at most addictive agents, there are usually two factors involved in the addiction: the biological or physical addiction and the social/emotional addiction.
Most experts will now agree, for example, that many alcoholics have a genetic predisposition to becoming physically addicted to alcohol. The brain and blood chemistry of alcoholics is different than in non-alcoholics, even before they started drinking. There is also pretty strong evidence that alcoholics metabolize alcohol differently than non-alcoholics, producing an opiate-like substance in their brains after consuming alcohol.
In looking at “love addictions,” it is intriguing to consider the recent discovery of a special neurotransmitter in the brain that seems to exist in much higher amounts when we are “falling in love”. It appears that the rush of energy, excitement and feelings of ecstasy and well-being that occur when we fall in love are due in large part to this neurotransmitter substance (neurotransmitters are the chemicals that send the electrical impulse from one nerve to the next in the brain and other nervous system parts). In the case of “falling in love,” the more of this substance present, the stronger the feelings of euphoria and well-being.
As the newness of the relationship wears off, so does the accumulation of this substance, resulting in boredom, sadness or even depression, which of course can be “cured” by falling in love again. Perhaps some people who become addicted to multiple serial relationships, who fall in and out of love all of the time, are actually addicted in part to this neurotransmitter substance.
The social/emotional factors in addiction seem to be common to all addictive agents, regardless of brain chemistry or body physiology, and it is these factors over which we have much more control at the present time, and on which we wish to focus. In almost every case, these factors include:
1. Temporary anxiety reduction.
2. Temporary stress reduction.
3. Temporary feelings of power and well-being.
4. Avoidance of true feelings.
5. Avoidance of crucial life problems and developmental tasks.
6. Avoidance of intimacy.
Because of the very nature of addictive processes, these benefits are not long-lasting. The well-being we feel while drunk wears off, leaving us in worse shape than when we started drinking the day before. We are left with a hangover, tremendous guilt and shame.
The anxiety reduction, or reduction of boredom
and frustration that occurs when we go on a spending binge, goes as quickly as it came, leaving us guilty, nervous, shameful, and anxious about how we will pay our next month’s bills.
We may get a rush of euphoria and happiness as we walk out the door with a date to whom we are addicted, but when that date is over and we find ourselves pining away by the telephone waiting for him or her to call again, whatever sense of false security we may have had will be long gone. In its place will be feelings of worthlessness, anxiety, frustration and despair.
Put simply, these addictive agents serve to fill in developmental gaps in us quickly and temporarily and by using them often, we never get the chance to fill in the gaps permanently.
Multiple Hooks
Sandy was alcoholic and food addicted. Frank was a workaholic, and as it turned out in the course of therapy, he was sexually addicted as well. In our clinical experience, it is rare for someone to have a single addiction.
The reason for this is simple, actually. Addictions are really symptoms of a deeper underlying dependency that evolved out of our family systems during childhood. The more dysfunctional the family, the deeper the underlying dependency problems that exist in us. The deeper the underlying dependency problems, the more they pervade every aspect of our lives, because the pain inside of us is stronger and more frightening, and it takes stronger defenses to deny that pain and try to hide it from others. It is only logical that a combination of alcohol, food, cigarettes and compulsive perfectionism will serve to help us hide our pain more than if we used only food or only alcohol.
