My heart sank. I looked at Sanja, my client, who had struggled for years to gain abstinence from sugar — her key to staying in recovery from food addiction — and knew what would happen next. Her self care would erode. She’d start skipping meals again. She’d get too little sleep. At work she’d have periods of dullness or poor coping, which would result in negative attention from her manager.

What sad timing. She had just been promoted at work. She’d moved into a new, fancy office. She had been touring the city with realtors on the exciting hunt for her first home.
What was the issue here? Was it just too difficult for her to accept a life without her food addiction, or was a larger factor at work?

In my years of counseling Sanja and some other clients too, each set of gains seemed to be followed by a predictable slide back into a pit of defeat and despair. This predictability told me that something more than mere chance or bad luck was at work. As I was thinking about this pattern, an insight burst like sunlight in my mind: Sanja was addicted to misery.

Every time she started to feel better, achieve some success, or make some other gains, she would do something to sabotage her progress. This made it very hard for me to help her — or for her to help herself.

Like turning the focus wheel on a camera, suddenly many disparate events fell into place and I had a key for helping these clients who are so hard to help, who set themselves up over and over again.

Does she want to be miserable?
Do misery addicts such as Sanja deliberately choose misery?

Not really. A more accurate statement would be that misery is a byproduct of the choices Sanja feels compelled to make when things go too well.

It works like this. As things go well, anxiety builds inside Sanja. Eventually, she has to do something to make the anxiety go away. Two options will be most vivid to her: to turn to a mind-altering substance or activity that feels temporarily soothing, or — more likely — to sabotage the flow of good. Either choice reduces the anxiety that positive feelings provoke in her.

However, either one also produces other consequences: movement in a negative direction, loss, isolation, and the return of hopelessness, despair, or misery. As a result, Sanja feels wretched, but she also feels safer.

Misery may not be the state that Sanja consciously sought, but it became the natural consequence of her efforts to reduce her anxiety.

Self-sabotage
Self-sabotage is any action (or lack of action) that naturally leads to a negative consequence. It is the signature behavior of misery addiction.

Edwin was late for everything. Although his friends joked about this, it irritated them and created a subtle friction in his relationships. He was late to work often enough to be censured and to lose a promotion. He was usually late filing his taxes, turning in reports, and renewing his driver’s license.

Viewed from the outside, it seemed willful, at the most, a procrastination problem. From the inside, it was a different story. Edwin was deeply fearful. He expected to be criticized or hurt in every situation, so he had difficulty getting himself going. When offered an opportunity, such as a class or a therapy group, he was so paralyzed by the vision of embarrassing himself or appearing ignorant, he’d fill out the application too late to get accepted. Last year, when he had a sore tooth, he kept putting off dental appointments. By the time he got to the dentist’s office, the tooth was so infected it had to be yanked.

Edwin soothed himself with computer fantasy games; he’d go online and take on the persona of a warrior. His computer gaming then ate up time that he might have used to make a medical appointment or deliver the dry cleaning. As a result, he’d go to work in a suit past its prime, look scruffy, sometimes even smell bad. All of this took him solidly out of the running for promotion and pushed people away.

He was also involved in metal collecting and spent hours on deserted beaches sweeping the sand for coins. He did join a metal collector’s club, but he was, of course, often late to meetings. He went to the club’s social events, but out of fear of doing the wrong thing, he never offered to help or clean up or bring something to eat or drink. He was, at best, tolerated.
Taken together, his activity and his inactivity sabotaged most opportunities for a fuller life. He wasn’t miserable, exactly. His world was rather gray and limited, but it felt safe.

“One way to spot self-sabotage is that the proportions are off between the initiating action (or nonaction) and the consequences. Characteristically, the initiating action (or non-action) is far easier or more bearable than the consequence. A relatively severe, punitive, or time-consuming consequence could have been prevented by a relatively simple, time-efficient measure” (Katherine, 2004, p. 109).

Tool addictions
If I had kept Sanja’s food addiction as my focus, I’d have been looking at her situation from too narrow a perspective. Food addiction, as powerful as it is, was not her biggest issue. Rather, it was a tool.

She had other tools too. She was a caretaker, often focused on the needs of others. She shopped compulsively about once a week. Someone taught her leathercraft and, within a month, she had a closet full of leather and was making leather items non-stop.

Any one of these activities looked innocent enough, but, taken together, they so distracted and depleted her that she had neither the time nor the energy to attend to important life-maintenance activities.

One way to spot a misery addict is this near-constant rotation among mind-altering substances or activities to the point that opportunities are missed or self-care is neglected.

Other symptoms
Self-sabotage and a variety of tool addictions are two telltale symptoms of misery addiction. Another is this: if a medication such as an antidepressant helps, misery addicts are notorious for wanting to stop taking it, or they’ll take less than the dose prescribed so that it isn’t effective. This client, too, will be resistant to taking such medication in the first place. It took years before Sanja was willing to visit a consultant who could prescribe medication.

Others symptoms include patterns of:

• Avoidance and/or resistance
• Leaving or stopping a positive chain of events
• Fear of well-being, success, or happiness
• Not acting when action is required or indicated
• Indecision
• Sacrificing themselves for others
• Longing for a certain experience, but insisting that it take a form that can’t or won’t work
• Wanting something they’ll never get if they keep doing what they’re doing
• Feeling that their life is jinxed
• Feeling unworthy
• Not changing their behavior after it repeatedly causes problems or failure
• Alienating the people who can offer the most help or advancement
• Craving closeness, but evading intimacy
• Feeling that they’ll never fit in or belong
• Being attracted to unavailable people
• Losing relationships with friends or relatives by sabotaging the relationship
• Losing relationships with friends or relatives who can no longer endure their frustration as they watch their loved one place herself or himself on a perpetual collision course
• Being easily triggered into feelings of shame
• Becoming ill frequently, especially to avoid thorny situations or choices
• Being self-critical
• Refusing helpful medications or treatment
• Being slow to seek or use remedies for illness or injury

We all do some of these things from time to time. Even a misery addict won’t do all of them, but a person who is addicted to misery typically is locked into a pattern of many of these actions and attitudes.

What causes misery addiction?
Research into misery addiction is too young to provide a definitive answer.1 However, based on my own clinical work, these are the patterns.

Failure of childhood attachment
Every misery addict I’ve worked with has a childhood history of insecure attachment to their parents or primary caregivers. A secure child is helped to find a balance between contact (intimacy) and exploration (autonomy) (Cassidy & Shaver, 1999). When parents are unable to provide a secure attachment, the child is forced to choose one or the other.

One strategy a child can develop is to become avoidantly attached — to be uninvolved with the parent by being busy or looking or moving away (Main, 2000, p. 418). Another strategy is to hang on to the parent while expressing anger in subtle, indirect ways, called ambivalent, preoccupied, resistant attachment (Ainsworth, Blehar, Waters, & Wall, 1978, pp. 31-44). With the former, the child sacrifices intimacy. In the latter case, the child sacrifices autonomy.

Children with frightening parents aren’t safe with either strategy so they get stuck between impulses toward contact and impulses toward exploration. This is called disorganized and disoriented attachment (Main, 2000, p. 426).

Edwin, clearly, was avoidantly attached. Sanja survived through ambivalent, resistant attachment strategies.

Critical, judgmental, angry, or frightening parents
Sanja and Edwin both were targets, throughout childhood and beyond, of endless criticism from two angry fathers.

Sanja’s mother, Eloise, was frightened, way too intimidated by her husband to intervene on Sanja’s behalf, and too scared of economic insecurity to take the enormous step of leaving him and getting herself and Sanja out of the madness. One way she discharged her fear was to overreact to any aspect of Sanja’s personality that made Sanja stand out.

For example, Sanja loved bright colors, but, perhaps, to Eloise’s mind that made Sanja more of a target. So she’d say, too intensely, something like, “That looks terrible on you!” or “Why would you want to wear something that loud?”

Her motive may have been to encourage camouflage as a safety device around the heat-seeking missile of her husband, but the result was that Sanja had no faith in her own ability to make choices. Since any choice that came from her own inner knowing brought Sanja some sort of criticism or emotional abuse, she learned to choose against her inner knowing. This led to never feeling right about anything.

As an adult, when Sanja preferred something, she automatically walked away from it. Thus she kept ending up with friends, work, or furniture that didn’t speak to her true self.

When she was a child, Sanja’s wiring got crossed. In adulthood, that crossed wiring led to perpetual dilemmas that she solved by soothing herself with sugar and other tool compulsions.

Edwin could do no right in his father’s eyes and his mother, also a target, had given up so long ago Edwin never knew her as anything but a silent, passive shadow who tended to house and kitchen.

We aren’t surprised that an abusive parent causes a child distress. However, it turns out that a frightened parent is also alarming and leaves the child without an effective strategy for living (Main, 2000, p. 426). With both a critical parent and a frightened parent a child is, psychically, on his own.

Protective of one or both parents
One factor kept Sanja from benefiting from therapy for years: She absolutely would not, under any circumstance, no matter what it cost her, let herself be angry at her mother. Between one parent who was incessantly angry, harsh, critical, and mean, and another parent who was frightened, passive, critical, but also caring, she went with the one who expressed love by taking care of her.

Although her mother was, in her own way, abusive to Sanja, Eloise was Sanja’s best option in a home gone awry. Eloise did not protect Sanja, so Sanja protected her. Sanja took care of her, focused on her, gave gifts to her, and stood guard over her. As an adult, Sanja grieved, not for herself, but for her mother. Sanja cried her mother’s tears.

This protectiveness extended to the therapy room. Whenever Sanja would come up against feelings that were on the front porch of anger toward her mom, she sidetracked, sabotaged herself, or sabotaged her therapy. Even through her increasing consciousness that this was her pattern, she still would not allow that anger to emerge. She sacrificed years of her life on behalf of her mother.

To what are they addicted?
With drug, food, or gambling addictions, it’s so clear. The addiction is to the substance or activity (as well as to the state induced by use of the substance or activity). The centerpiece of attention — alcohol, sugar, slot machines — stands as the icon for the problem.

In the case of misery addiction, the nucleus is subtler. The centerpiece for misery addiction is a system.

“Misery addicts have devised a system by which they’ve survived crushing disappointment, devastating abandonment, visitations of despair, ongoing separateness from others, fear, and being misunderstood and misread. Their system has even been powerful enough to withstand the seductive whisperings from their own minds, which tell them that they might as well give up entirely. Misery addicts are addicted to this system because it has saved them from annihilation” (Katherine, 2004, pp. 21-22). Many misery addicts make it through each day despite a longing to quit, a desire to sleep the endless night.

Fortunately a life force continues to beat inside them. They are a courageous people, because they march on despite hearing music of despair.

Misery addicts crave the state that is created by self-sabotage — avoidance. When they turn to a tool addiction, let their self-care slip, or interrupt the flow of good, they put themselves into an avoidant state. They turn down the volume on the world. It’s the equivalent of being drunk or being dazed by whirling cherries in the slot machine.

This is the reason misery addicts are susceptible to multiple addictions, and why they can pick up a new addiction in the blink of an eye. Anything that serves up avoidance can be added to the repertoire. They can go from ignorance of an activity to addictive use of it overnight.

Living in avoidance perpetuates self-sabotage. While they are busily avoiding things, they miss the important announcement; they don’t act in time; they aren’t seeing the subtle signs that someone could be a friend; they wait too long to make the reservation. In this way they fall into an endless self-sustaining loop familiar to other types of addicts: sabotage leads to avoidance leads to sabotage leads to avoidance, much like being drunk leads to guilt leads to drinking leads to being drunk.

Is it properly called an addiction?
I believe that someday soon, when we’ve identified the synapses and neurotransmitters involved in behavior addictions such as compulsive gambling, compulsive spending, compulsive computer gaming, or compulsive cleaning, we’ll also find the particular mental wiring that creates and supports an addiction to misery.

Meanwhile, the same tests that validate other addictions apply here too:2

• Strong, irresistible cravings for the substance or activity.
• Continued use despite predictable negative consequences.
• Increasingly serious losses due to use.
• Withdrawal in response to removal of the substance or activity.
• Cessation of withdrawal when the substance or activity is reintroduced.
• Reoccurrence of withdrawal with repeated removal of substance or activity.

The good news is that the same recovery systems that work for other addictions also work for misery addiction. In fact, this is further evidence that we are dealing here with an addiction — recovery program formats that work for other addictions also work here.

What is abstinence for misery addicts?
It’s abstinence from self-sabotage.

Recovery from alcoholism is by no means easy, but at least it’s clearly defined. Stop drinking and go to meetings. (We in the business know it’s not quite that simple, but at least abstinence is easy to describe.) The primary behavior of misery addiction is self-sabotage. The misery addict is powerless over self-sabotage. This, then, is the focus of abstinence.

Since the state sought through self-sabotage is an avoidance of anxiety, confusion, difficult feelings, or dilemmas that seem unsolvable, the misery addict must also be wary of the seduction of avoidance. His or her recovery program must include ongoing attention to the lure of unconsciousness and enough support so that the problems that cause such desires are made manageable.

Special requirements of recovery from misery addiction
Misery addicts are addicted to a system they devised themselves. Fortunately, recovery is also a system — one that has worked for millions of people and that can replace the old, deleterious one the misery addict has been using.

With misery addiction, the path to sobriety has several branches, all of which must be attended to with reasonable diligence. Omit any branch and the likelihood of recovery is close to zero.

With other addictions, therapy is very helpful, but it is not required. Many people have recovered from their addictions through 12-Step, anonymous programs without any therapy whatsoever.

However, most misery addicts need to be in therapy, unless the addiction is mild. In fact, not until therapy has created a safety zone will some clients even have the ability to walk into a 12-Step meeting.

The first order of business in the therapeutic setting, besides the usual requirements of offering safety, providing a frame, and having respect for the client, is to facilitate a healthy bond. A person addicted to misery is operating with an insecure attachment strategy.

The therapist must stretch to make it possible for the client to have a secure, healthy attachment. By doing so, she or he creates a safe haven and a secure base from which, eventually, the client will become secure enough to explore, come back and get reassurance, and explore again (much like a child in rapprochement), perhaps hundreds of times.

In other words, it is the counselor-client relationship itself that is one of the robust tools for healing. You may be this client’s first truly healthy bond.

Tasks of therapy
As the counselor, you are also in a position to oversee the various paths that must be walked if your client is going to build enough fortification to withstand the beguiling voice of addiction. Here is what you can do:

• Support the client in attending regular 12-Step recovery meetings.
• Facilitate a healthy, secure attachment.3
• Teach the client how to feel feelings, and shepherd the client through that process whenever needed.4
• Promote practices that allow the client’s physical brain to heal.5
• Encourage the client in learning additional tools such as meditation, affirmations, and visualization.6
• Encourage the client to gain relationship skills through group therapy.7

This client needs a healthy support community. Yet she may not have the skills to know how to form community or how to get included into one. Anonymous programs are great for this, like training wheels, but they don’t provide the direct relationship-skill teaching that is offered in group therapy or treatment programs.

This client, used to less, needs more — more bases covered, more factors attended to, more forms of assistance happening at once.

Because you can see the dilemma, can’t you? Recovery helps a person feel better. This client is scared of feeling better. Recovery itself is likely to trigger the misery addict to relapse.

You provide the service of holding the bigger picture, of understanding that with each gain, they will get scared and want to mess things up. You can interpret, remind, predict, and urge protective measures.

You carry the vision, because they will forget it. You remember for them that, with enough footwork, they will walk into the fulfilling future long awaiting them.

Anne Katherine, MA, has a counseling practice in Mukilteo, northwest of Seattle. She has over 32 years of experience and more than 22 years in recovery from food addiction. She is the author of Boundaries, Anatomy of a Food Addiction, Where to Draw the Line, and When Misery is Company. Find her at http://www.annekatherine.com/.

Footnotes
1 Since the brainstorm that, three years ago, offered me an awareness of the existence of misery addiction, I’ve focused my energy and attention toward finding solutions for my clients who’ve suffered so devastatingly from this condition. Perhaps the greatest cost of this addiction is time. My clients had lost so many years to misery addiction that I wanted to salvage for them as much time as I possibly could. Thus, I’ve not done formal studies. The scope for studies is large. Causes, origins, percentage of sufferers, cultural demographics, gender differences, are all ripe for investigation. Feel free to pick up a thread. Please let me know what you discover.

2 The first three on the list are from Father James Royce, “Symposium on Alcoholism,” and the last three are from Dr. Jerome Schnell, “Pharmacology of Alcoholism,” Alcohol Studies Program, Seattle University, Seattle, WA, 1986.

3 Goldberg, Muir, and Kerr, Eds. (2000) and Cassidy (1999), are both excellent resources.

4 For an explanation of this process see Katherine (2004) Chapter 26.

5 See Katherine (2004), Chapter 28.

6 See Katherine (2004), Chapter 27.

7 See Katherine (2004), Chapter 27.

References
Ainsworth, M., Blehar, M. C., Waters, E., & Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation. Hillsdale, NJ: Lawrence Erlbaum Associates.
Cassidy, J., & Shaver, P. (1999). Handbook of attachment: Theory, research and clinical applications. New York: Guilford Press, p. 69.
Goldberg, S., Muir, R. & Kerr, J. (2000). Attachment therapy. Hillsdale, NJ: Analytic Press.
Katherine, A. (2004). When misery is company. Minneapolis, MN: Hazelden Publishing and Educational Services.
Main, M. (2000). Recent studies in attachment. In S. Goldberg, R. Muir, & J. Kerr, (Eds.) Attachment theory. Hillsdale, NJ: Analytic Press.

This article is published in Counselor,The Magazine for Addiction Professionals, June 2004, v.5, n.3, pp. 14-21.

THE MISERY ADDICTION SCALE (MAS)

The Misery Addiction Scale (MAS) is designed primarily for individuals who may have an addiction or psychological or physical dependency on misery (please see the above article “Addicted to Misery: When Being Happy Hurts” by Anne Katherine). The scale is a Likert scale with five (N=5) rating categories, indicating how true each statement is for the client. Note that total scores range from 0 to 120, with higher scores indicating that the client may have a higher propensity to be “addicted to misery.” All 30 MAS items are scaled in the same direction to simplify the client’s ability to rate himself or herself on each statement. The MAS is intended only to provide supplemental information that may be used in practice. No clinical decisions should be made on the basis of the MAS or any other single instrument.

• Never true of me = 0 points
• Rarely true of me = 1 point
• Sometimes true of me = 2 points
• Often true of me = 3 points
• Always true of me = 4 points

1. I have trouble making decisions.

2. I repeatedly make the same mistakes.

3. Whenever I get nervous or upset, I have to do something right away to feel better.

4. I don’t make the right choices for myself.

5. I don’t really deserve better than what I have.

6. I avoid situations rather than confront them head on.

7. I try hard to protect those I love, no matter what it costs me personally.

8. I avoid doing some things because I’m afraid I’ll do them wrong.

9. I miss deadlines.

10. I feel ashamed.

11. Even when I try to do everything right, I don’t get to the things I need to do.

12. I want to be successful, but something always seems to prevent me from achieving what I want in life.

13. I’m afraid to be too happy.

14. I can’t seem to stop doing certain things, even when I know that doing them will cause me problems.

15. When I’ve made a mistake, I can’t forgive myself.

16. Bad luck seems to follow me around.

17. I don’t think anyone can help me with my problems.

18. I have lost friends because I have disappointed or angered them.

19. When things are going well, I just know something bad is going to happen.

20. I tend to sacrifice myself for others, even when they don’t give much to me.

21. I expect things won’t work out for me.

22. People I really want to be close to often don’t provide me with the closeness I crave.

23. Sometimes I know doing a simple little thing will make things go better, but I still don’t do it.

24. My Mom/Dad/both was/were critical, judgmental, or angry.

25. Sometimes I just get angry and push people away who try to help me.

26. I wait too long to act and then I lose out all together.

27. Although I secretly long for intimacy with others, I get scared whenever someone gets too close.

28. At least one of my parents was often afraid and depended on me.

29. I have no control over certain activities (e.g., eating, shopping, etc.).

30. I tend to “check out” when my feelings overwhelm me.

Sylvia Kay Fisher is a program specialist at the Center for Program Planning and Results of the U. S. Department of Labor. She was formerly a therapist and psychological evaluator. Ronnie Fisher is a retired teacher and a former social worker and counselor.

One person has commented on this article.

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Jean Kenly Siimpson, Unregistered

This is one of the best articles I've ever read in Counselor Magazine. I use this material constantly with clients who may not be ready to address other addictions but can readily identify with the symptoms described. This really helps them to begin moving from a precontemplation stage of treatment into contemplation.

 Posted 2007-10-10 19:04:44

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