Many recovering alcoholics and addicts discover in recovery that they also have struggles associated with codependency. Historically, the problem known as codependency arose from Alcoholics Anonymous and the realization that the family members of alcoholics had their own unique set of character traits and relationship difficulties, and so the program known as Alanon was born.
However, we know today that dealing with codependency isn’t solely an issue for those in Alanon; it is pervasive among members of A.A. and N.A. as well.
Most alcoholics and addicts come from families with some history of alcoholism or other addictions. Typically adult children of alcoholics (ACOA), or adults that grew up in some other similar dysfunctional family situation, tend to have these codependent traits that cause difficulty in their relationships.
There are 12 step programs that specifically address the issue of codependency such as Alanon, ACOA, and CODA (codependents anonymous). Some treatment centers also offer programs specifically designed to help people address these issues. For example, the renowned Caron Foundation in Pennsylvania not only treats addiction but also offers a personal growth workshop called "Breakthrough" that involves an intensive 5-day program focusing on the root of codependency issues. If you have the ability to attend this popular workshop, it is a great place to start if you are just beginning to recognize codependency issues, at any stage in your sobriety / recovery.
A primary objective of Health In Recovery is to help connect people in recovery to additional resources to augment whatever program of recovery they hopefully already utilize. After all, Bill W. encouraged us to seek “outside help” in addition to A.A. With that in mind, a fantastic simple tool known as Emotional Freedom Technique (EFT) could be the most important “outside” self-help method to have in your toolkit.
The following is a review I wrote after reading the e-book called “EFT For Codependency Recovery” by J.P. Bailey that teaches how to use EFT directly on codependency issues:
Upon learning of J.P. Bailey’s work, I was immediately struck by the crucial need that it addresses by brilliantly blending her experience and research on codependency with the growing research on energy psychology and EFT. What a natural fit and effective solution to share with the world to empower the millions struggling with recovery. Her book is a refreshing straight forward explanation of the many codependency traits common to adult children of dysfunction, followed by a comprehensive step-by-step manual to immediately incorporate the tool of EFT to accelerate codependency recovery. I am constantly reminded of the pervasiveness of codependency amidst the recovery community, and EFT is a phenomenal simple tool to help address this otherwise complex and extremely challenging issue.
J.P. Bailey has shared an important contribution to the recovery field with her book and manual, EFT For Codependency Recovery. I confidently recommend it to all my readers, colleagues, and clients.
If you would like to work one-on-one with an advanced EFT practitioner who specializes in recovery, support is available via phone or webcam sessions.
There is an abundance of literature on the subject of codependency. Explore the help that is available– via 12 step programs, therapists who specialize in codependency, intensive programs such as Breakthrough at Caron Foundation, and self-help manuals such as EFT for codependency recovery, or personalized EFT sessions 1-on-1 with a certified practitioner, to overcome the effects of this pervasive condition among alcoholics and addicts and enjoy healthier relationships, emotional health, and freedom from codependency in sobriety and recovery.
Connection between PTSD and Alcoholics/Addiction
PTSD (Post-Traumatic Stress Disorder) and alcoholism / addiction often go hand in hand. Self-medicating symptoms of anxiety and depression associated with PTSD can lead to substance abuse. Also, active alcoholics or addicts may be more susceptible to experiencing certain types of trauma based on circumstances and potential risky behavior sometimes associated with addiction. Therefore while people who have endured trauma are more likely to have drinking problems, people with drinking problems are also more likely to have experienced psychological trauma of some kind.
What is PTSD
Post Traumatic Stress Syndrome can develop after exposure to an event that causes psychological trauma. The exposure can involve actually experiencing the event or witnessing the trauma. Symptoms of PTSD may include nightmares or flashbacks, sleep disturbances, avoidance or negative responses to associations with the trauma (i.e. people, places, situations), emotional numbing, anger, hypervigilance, or anxiety. The symptoms must be present for more than a month after the event, otherwise it may be “acute stress disorder” which is short-term. Untreated, the symptoms of PTSD can be experienced for years beyond the initial trauma. Finally, for the official diagnosis of PTSD, the set of symptoms must impair normal life functions i.e. in work or relationships. Note: “unmanageability” comes to mind.
People commonly associate PTSD with individuals who have suffered an obvious major trauma such as with combat veterans and abuse or rape survivors… Indeed, there is a prevalence of PTSD in those populations but it is certainly not limited to those.
ACOA and PTSD
PTSD is not always caused by a single traumatic event; it can be from a series of intense or even more subtle traumatic experiences. Adult Children of Alcoholics (ACOA) are an example of a subgroup that may be particularly likely to have endured traumatic events in childhood leading to PTSD as an adult. Abuse, neglect, or other psychological trauma may be experienced as the result of growing up in an alcoholic environment, in which one or more parents or caregivers were untreated alcoholics / addicts.
Many recovering alcoholics and addicts are also ACOA. Adult Children of Alcoholism in particular should consider ruling out PTSD if suffering any of the symptoms associated with post-traumatic stress. While they may not recall one particularly traumatic event, an ACOA may have experienced a series of less intense but traumatic experiences which can lead to PTSD alike.
Which Came 1st: the PTSD or the Addiction?
It’s sort of a “chicken or the egg” situation. Trauma can lead to unhealthy coping mechanisms in an effort to numb the pain, and thus lead to substance dependence. By the same token, when engaging in behaviors that accompany an addictive lifestyle, an alcoholic or addict is more likely to be in a situation where trauma can occur. Or both may be the case; some alcoholics may experience traumatic events prior to active addiction as well as during their active years. Binge drinkers may even not recall exposure to a traumatic event if it occurred during a blackout!
Dealing with PTSD in Sobriety
Regardless of when the trauma occurred - before or during active addiction - untreated PTSD is sure to affect an individual after starting the process of addiction recovery. As most therapists will tell you, you have a much better chance at healing your psychological traumas if you first put down the alcohol and drugs. Once the initial fog lifts and you are sober, it can be your first time really experiencing the effects of PTSD if you have been self-medicating with booze or drugs for years.
In early sobriety, previously numbed anger or anxiety associated with PTSD may surface. The alcohol and drug use could have masked sleep disturbances otherwise present with PTSD, thus resulting in sleep difficulties or insomnia in recovery (see related article on dealing with insomnia in sobriety). Certainly anger, anxiety and sleep problems can only aggravate the daily struggle to stay sober in early recovery. These symptoms alone do not necessarily equate to PTSD but it is a good idea to consider ruling it out.
“You’re as sick as your secrets.” Intrusive thoughts regarding old memories can surprise the newly recovering alcoholic who may have thought he/she had dealt with the memories or left the past in the past. Consider how many people relapse in anticipation of step 4, or when between step 4 and 5. Imagine uncovering memories of old traumas which trigger heavy emotions… leading to the danger of picking up a drink or drug before sharing it all with a sponsor.
Even when the recovering alcoholic with PTSD makes it through the 5th step with a sponsor, he/she may be disheartened by a lack of relief that may have been anticipated based on the experiences shared by others who successfully complete the 5th step who do not suffer from PTSD and thus may find more relief from the steps alone.
Treatment for PTSD in Sobriety
Clearly if there are concerns of potential PTSD in sobriety, it is crucial to seek treatment. The 12 steps are a great tool that will help support the process of addressing the PTSD, but outside help is recommended for recovering alcoholics/addicts who may suffer from post-traumatic stress. Remember, A.A. literature states:
“God has abundantly supplied this world with fine doctors, psychologists, and practitioners of various kinds. Do not hesitate to take your health problems to such persons.”
The ideal treatment for any disorder is one which treats the underlying cause of the disorder. Let’s face it: PTSD is not a deficiency of medication… although sometimes people suffering from PTSD can end up on anti-depressants or anti-anxiety drugs from their primary physician or psychiatrist.
Medication alone is not appropriate treatment for PTSD; the drugs only serve to medicate some of the symptoms in that case. This is why the typical recommendations for treatment of PTSD involve psychotherapy (not psychiatry), typically in the form of a cognitive behavioral therapy.
A particularly effective and clinically supported modality in this field is EMDR (Eye Movement Desensitization and Reprocessing). EMDR has been rated by the APA in the highest category of effectiveness and research support for treating trauma, based on the extensive clinical research performed validating it as a significantly effective treatment modality for PTSD in particular. EMDR can safely accelerate the healthy processing and healing from the traumatic memories underlying PTSD. To learn more about this effective modality, visit the EMDR Institute.
Emotional Freedom Technique (EFT) is another effective method used by therapists as well as coaches and holistic practitioners to help clients deal with the effects of PTSD. Similar to EMDR, EFT utilizes is a mind-body modality but that can be utilized for self-care in addition to guided sessions with certified practitioners. Research on EFT supports it's efficacy in the treatment of PTSD including with combat veterans; and a published review of recent research concluded:
"According to published reports, systematic reviews of the published evidence, a meta-analysis of seven RCTs, and practitioner consensus, most cases of PTSD are remediated in ten EFT sessions or less. As a safe, efficacious, and easily learned self-help method, EFT should be offered to clients as an initial treatment option immediately after diagnosis."
Note: the long term emotional stress of PTSD can contribute to physical stress on the body as well – see related article on nutritional support during stress to address the physical aspect.
In summary, when present PTSD is a crucial component to address in sobriety. Whether newly recovering or sober for a number of years, whenever this becomes evident it is necessary to address. You need not suffer silently with PTSD, and the symptoms can put you at risk for relapse. As with alcoholism, there is a solution! Utilize all the tools and outside resources available to effectively deal with PTSD in sobriety, and subscribe to this blog for more health information pertaining to recovering alcoholics and addicts.
