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Addictive Personality: Stages, Recovery and Ethical Considerations

Addictive Personality: Stages, Recovery and Ethical Considerations. Dr. Rosalee Martin, LPC, LMSW, LCDC (Assistance from student Erica Ojeda) 12 th Central TX African American Family Support Conference February 16, 2012 4-5:30. Content. Addiction defined Addictive Process

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Addictive Personality: Stages, Recovery and Ethical Considerations

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  1. Addictive Personality: Stages, Recovery and Ethical Considerations Dr. Rosalee Martin, LPC, LMSW, LCDC (Assistance from student Erica Ojeda) 12th Central TX African American Family Support Conference February 16, 2012 4-5:30

  2. Content • Addiction defined • Addictive Process • Addictive personality • Stages of Addiction • Recovery • Ethical Considerations • Bibliography

  3. Addiction defined A state of physiological or psychological dependence on an object or event that is liable to have a damaging effect; an abnormal relationship with the object

  4. Evidence of Addictions • Can’t predict whether or not you will use drugs or alcohol; or will engage in sexual activities or overeat, etc • Need the addictive object in order to have fun • Need more and more of the addictive object in order to get the same high as for previous highs • Drink or drug alone or with those who also drink or drug

  5. Evidence of Addictions (con’t) • In the case of gambling, gambles days at a time without eating, sleeping—chasing the big win • Can’s remember past activities—blackouts • Lack of emotional bonding with others: miss appointments, lie • Maintain an illusion of intimacy with individuals

  6. Types of addictions • Drugs/Prescription drugs • Pornography • Gambling • Eating disorder • Internet • Sex

  7. Addiction as a Process • All addicts aimlessly seek wholeness, happiness and peace through a relationship with the addictive object, ie drugs, sex, Internet, etc. • Preoccupation with an activity can help identify the specific process addiction

  8. Addiction as a process (con’t) • An addict “experiences a mood change when they engage in a relationship with an object or event in order to produce a desired mood change.” (Nakken, 4)

  9. Addiction as a process (con’t) • Acting out • acting out and uncontrollable behavior provides information as to the extent of the power of the addictive object over the individual. • Ex. • Sex addicts searching for their next partner in locations know for prostitution

  10. Addiction as a Process (con’t) • Nurturing through avoidance, not relationships • Immediate relief from engaging in the addictive event • Instant gratification Cause = Effect A depressed alcoholic drinks to feel happy

  11. Addict vs. Self • The addict gets stronger and more powerful than the self (the non-addictive self) as the addiction progresses • The addict is manipulative for own good even when self knows better • Addict wants to be alone; the Self does not—understands the importance of relationships • Addicts are ambivalent: when people try to leave they become very upset: “You can’t leave me! You’re all I have!”

  12. Process--Stages of Addiction • Stage One: • Internal Change • Stage Two: • Lifestyle change • Stage Three: • Life Breakdown

  13. Stage One: Internal Change Natural support system is no longer satisfying; internal /external issues are difficult to deal with.

  14. Stage One • Healthy development of the four natural relationships is important • Without them people will turn to other means of relationships

  15. Emergence of the Addictive Personality • Natural supports cease to offer emotional support • Addicts abandon oneself in favor of the addictive high • Addiction grows stronger • “I don’t need anyone.” • Reaffirmation of their addictive lifestyle • Personality starts to change

  16. ShamePain • Feelings of shame intensify with addiction • Addiction intensifies feelings of shame • Addictive personality emerges when the pain begins • Addict falls deeper into the addiction to mask the pain

  17. Triggers • Negative emotions and/or events trigger the circular effect of addiction • Food addict is feeling depressed. The body interprets that as hunger. The addict then binges to take the depression away.

  18. Addict’s Delusional System acts like a wall • Keeps the addict within itself • Keeps people out who may threaten the addictive personality

  19. Stage Two: Lifestyle Change • The addiction begins to encompass the person’s lifestyle • Behavior changes • Withdraws • Lies • Blame others • Addict withdraws to his secret life of indulge • i.e., sex addict starts going to prostitutes • Food addict starts hiding food • Drug addict steal to buy drugs

  20. Addict Rituals • Choices: • Addictive personality at odds with the Self • To buy or not to buy that beer on the way home… • Community: • Addict may drink with drinking friends or alone • Commitment: • Rituals do not change

  21. Labeling by Self and Others • Labeling signals the beginning of recognition of the addiction by others • “He drinks a little too much.” • “She likes food.” • Labeling also gives the addict permission to act out his label; shame and guilt is generally absent

  22. Enabling the Addict • Acceptance of the ‘new person’ by family and friends by giving them an out and excuses • Love/hate towards the addict • Family/friends are emotionally drained

  23. Addictive Personality in total control Pain Fear Loneliness Anger Emotional logic starts to collapse Stage Three: Life Breakdown

  24. On the way down… • Acting out becomes extreme • Only deal with those who support addiction • People left are those who feel pity; love ones avoid them

  25. Behavior Breakdown Break downs include: • Inability to cope • Become emotionally devastated • Engage in uncontrollable rage

  26. Physical Breakdowns • Stress takes a toll on the body • Damage to the brain, pancreas, kidney, High blood pressure, heart attacks, liver disorder, ulcers, etc • Impotency, birth defects, premature aging • Suicide is contemplated as the pain is too hard to bear

  27. Acceptance • Acknowledgement of the addictive personality allows the person to ‘open the door’ in creating healthy relationships, thus recovery begins

  28. Self-esteem issues • Work on improving self-worth • Set boundaries for self and other • Issues around personal control and other control • Own your own reality • Reduce denial • Assume responsibility • Focus on self-care • Mental, physical, spiritual, emotional Core Areas in Recovery

  29. Writing is therapeutic • A place to be honest • A place to discover yourself • A place for a chronology of the recovery journey • A place to describe feelings, experiences and thoughts • A place to examine the transition from being actively addicted to sobriety • A place to examine changes in values Recovery Journal

  30. Recovery • Creating New Values: • Nurturing the self-- Big self, little addict • Respect for the addiction • Monitoring the addict within • Learning to love the Self Listening to the Self • Reintegration as ‘we’Development of positive and healthy rituals

  31. Recovery • Get treatment either in-patient or out patient • Admit your problem to family and friends; seek to make amends • Connect with a recovery group such as AA, NA, GA, Al-Non • Take one day at a time • Do not switch one addiction for another

  32. Mental Health and Substance Abuse DivDepartment of State Health ServicesP. O. Box 149347 Austin TX 78714-9347Phone: 512-206-5000Fax: 512-206-5718 • Pathway to Recovery 2119 Oak St La Marque, Texas 77568Phone: (409) 933-4366Fax: (409) 933-4367 Treatment Agencies • Austin Recovery • 8402 Cross Park Drive • Austin, Texas 76754

  33. Privacy and Confidentiality • Informed consent • The duty to care • Respecting client self-determination • Credentialing mechanisms • Do no harm—overarching responsibility • Cultural competence and social justice • Access to records • Payment for services Ethical Considerations

  34. Avoid: • conflict of interest • engaging in sexual relationship with clients • harmful physical contact • sexual harassment • derogatory language • Dual Relationships Ethical Considerations

  35. Respect the rights, views, and clinical practices of other professionals • Hold colleagues accountable for ethical practices • Continue to grow professionally • Get clinical supervision, and • Adhere to all state and federal laws that govern client care and the profession Ethical Considerations

  36. Bibliography • Hazelden, A Recovery Journal: For Exploring Who I Am, 1993. • McGuire, Sheila. 1996. Subtle boundary dilemmas. Hazeldon: Center City, Minn. • Nakken, Craig. The Addictive Personality: Roots, Rituals, Recovery. Hazelden, 2001 • NASW, Code of Ethics, http://www.socialworkers.org/pubs/code/code.asp • NIAA Module 9 Legal and Ethical Issues in Treatment of Alcohol Use Disorder. http://pubs.niaaa.nih.gov/publications/Social/Module9Legal&EthicalIssues/Module9.html • /

  37. Bibliography • Overeaters anonymous www.therecoverygroup.org/ http://www.gamblersanonymous.org • Sheafor, Bradford. 2012. Techniques and Guidelines for Social Work Practice. 9thedition. Allyn and Bacon:Boston, Mass. • Tom E. Slocum MA, LCDC, Ethics for LCDCs’ PART #2 • Texas State Board of Social Worker Examiners,http://www.dshs.state.tx.us/socialwork

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