Addictions Curriculum Review

Dr. Rosalee Martin, LPC, LMSW, LCDC(Assistance from student Erica Ojeda)

12th Central TX African American Family Support ConferenceFebruary 16, 2012 4-5:30Addictive Personality: Stages, Recovery and Ethical ConsiderationsContentAddiction definedAddictive ProcessAddictive personalityStages of AddictionRecoveryEthical ConsiderationsBibliography

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

Evidence of AddictionsCant 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 drugEvidence of Addictions (cont)In the case of gambling, gambles days at a time without eating, sleepingchasing the big win

Cans remember past activitiesblackouts

Lack of emotional bonding with others: miss appointments, lie

Maintain an illusion of intimacy with individualsTypes of addictionsDrugs/Prescription drugsPornography

Gambling

Eating disorder

Internet

Sex

Addiction as a ProcessAll 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

Addiction as a process (cont)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)

Addiction as a process (cont)Acting outacting 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 prostitutionAddiction as a Process (cont)Nurturing through avoidance, not relationshipsImmediate relief from engaging in the addictive event Instant gratificationCause = EffectA depressed alcoholic drinks to feel happy

Addict vs. SelfThe 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 notunderstands the importance of relationships

Addicts are ambivalent: when people try to leave they become very upset: You cant leave me! Youre all I have!

Process--Stages of AddictionStage One:Internal Change

Stage Two:Lifestyle change

Stage Three:Life BreakdownStage One: Internal ChangeNatural support system is no longer satisfying; internal /external issues are difficult to deal with.Stage One

Healthy development of the four natural relationships is importantWithout them people will turn to other means of relationships

Emergence of the Addictive PersonalityNatural supports cease to offer emotional support

Addicts abandon oneself in favor of the addictive high

Addiction grows stronger

I dont need anyone.

Reaffirmation of their addictive lifestyle

Personality starts to changeShame PainFeelings 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

TriggersNegative 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.

Addicts Delusional System acts like a wallKeeps the addict within itself

Keeps people out who may threaten the addictive personality

Stage Two: Lifestyle ChangeThe addiction begins to encompass the persons lifestyle

Behavior changesWithdrawsLiesBlame othersAddict withdraws to his secret life of indulge

i.e., sex addict starts going to prostitutesFood addict starts hiding foodDrug addict steal to buy drugs

Addict RitualsChoices: Addictive personality at odds with the Self To buy or not to buy that beer on the way homeCommunity: Addict may drink with drinking friends or aloneCommitment: Rituals do not change

Labeling by Self and OthersLabeling signals the beginning of recognition of the addiction by othersHe 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

Enabling the AddictAcceptance 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

Stage Three: Life Breakdown

Addictive Personality in total control

Pain Fear Loneliness Anger

Emotional logic starts to collapseOn 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

Behavior BreakdownBreak downs include:Inability to cope Become emotionally devastatedEngage in uncontrollable rage

Physical Breakdowns

Stress takes a toll on the bodyDamage to the brain, pancreas, kidney, High blood pressure, heart attacks, liver disorder, ulcers, etcImpotency, birth defects, premature agingSuicide is contemplated as the pain is too hard to bear

AcceptanceAcknowledgement of the addictive personality allows the person to open the door in creating healthy relationships, thus recovery begins

Self-esteem issuesWork on improving self-worthSet boundaries for self and otherIssues around personal control and other control Own your own realityReduce denialAssume responsibilityFocus on self-careMental, physical, spiritual, emotionalCore Areas in RecoveryWriting is therapeutic A place to be honestA place to discover yourselfA place for a chronology of the recovery journeyA place to describe feelings, experiences and thoughtsA place to examine the transition from being actively addicted to sobrietyA place to examine changes in valuesRecovery JournalRecoveryCreating New Values:

Nurturing the self-- Big self, little addictRespect for the addictionMonitoring the addict within Learning to love the Self Listening to the SelfReintegration as weDevelopment of positive and healthy ritualsRecoveryGet treatment either in-patient or out patientAdmit your problem to family and friends; seek to make amendsConnect with a recovery group such as AA, NA, GA, Al-NonTake one day at a timeDo not switch one addiction for anotherMental 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 AgenciesAustin Recovery8402 Cross Park DriveAustin, Texas 76754Privacy and ConfidentialityInformed consentThe duty to careRespecting client self-determinationCredentialing mechanismsDo no harmoverarching responsibilityCultural competence and social justiceAccess to recordsPayment for services

Ethical ConsiderationsAvoid: conflict of interestengaging in sexual relationship with clientsharmful physical contactsexual harassmentderogatory languageDual RelationshipsEthical ConsiderationsRespect the rights, views, and clinical practices of other professionalsHold colleagues accountable for ethical practicesContinue to grow professionallyGet clinical supervision, andAdhere to all state and federal laws that govern client care and the professionEthical ConsiderationsBibliographyHazelden, 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, 2001NASW, Code of Ethics, http://www.socialworkers.org/pubs/code/code.aspNIAA Module 9 Legal and Ethical Issues in Treatment of Alcohol Use Disorder. http://pubs.niaaa.nih.gov/publications/Social/Module9Legal&EthicalIssues/Module9.html

/BibliographyOvereaters anonymous www.therecoverygroup.org/ http://www.gamblersanonymous.org

Sheafor, Bradford. 2012. Techniques and Guidelines for Social Work Practice. 9th edition. 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