The community of the addictions field has long understood that the families where addiction is present tend to live in the extremes of black and white, functioning with few shades of gray to modulate this experience. Broad swings, from one end of the emotional, psychological, and behavioral spectrum to the other, all too often characterize the addicted family system. But why does this happen?

Living with addiction is traumatizing to the body as well as the mind. Living with trauma can lead to the kind emotional dereglation that can make us want to turn to substances to restore the sense of calm and balance that trauma undermines (van der Kolk, 1987).

Our bodies don’t distinguish between physical danger and emotional stress. The natural fear response associated with our fight/flight apparatus will cause the body to react to physical or emotional “crisis,” by pumping out sufficient quantities of “stress” chemicals — such as adrenaline. This gets our hearts pumping, muscles tightening and breath shortening, in preparation for a fast exit, or a fight. But for those where the family itself has become the proverbial “saber-toothed tiger,” for whom escape is not really the issue, these chemicals boil up inside and can cause physical and emotional problems. Family members may find themselves in a confusing and painful bind, and react by wanting to flee from or attack those very people who represent home and hearth.

When the family itself causes the stress, our survival apparatus becomes confused, and we are deregulated. Fear and anxiety build until it is literally overwhelming. The body, mind, and emotions then numb and/or we dissociate. We alternate between these extremes because we live in an environment that does not help us to talk through our intense reactions. Our thinking minds find difficulty regulating our intense emotions such as fear, sadness or anger. The people around us, rather than modeling regulation, often model these swings in temperament and behavior.

Eventually, both the physical and emotional response systems become deregulated. Because the limbic system governs such fundamental functions as mood, emotional tone, appetite, and sleep cycles, when it becomes deregulated it affects us in far-ranging ways. Complicating matters further, the body and mind can enter into a “fear dialogue” that can deepen our sense of losing control. In what becomes a vicious circle, our disequilibrating body or physiological responses increase our fear and anxiety and our expanding sense of fear and anxiety lead to ever more imbalance, and thus more stress chemicals released in the body. We may find ourselves entering a “black hole” that we can’t easily escape. We may quell our ever-increasing sense of feeling out of control.

It is no great wonder that this body/mind dialogue can lead to problems with self-regulation. Problems in regulating our internal states can manifest as an impaired ability to modulate levels of fear, anger, and sadness, and may lead to chronic anxiety or depression. Or, it can emerge as substance or behavioral disorders, for example, problems in regulating alcohol, eating, sexual, or spending habits. The more deregulated the user’s life becomes, the more emotional and psychological pain or trauma they experience. Many increase their substance or behavioral uses and abuses in a misguided attempt to calm their ever increasing inner turbulence. Thus, the relationship between trauma and addiction takes hold. Emotional and psychological trauma leads to self-medication and self-medication or increased use and abuse, leads to emotional and psychological trauma. All of this further deregulates the individual’s limbic system.

All of us arrive as infants needing to learn the skills of emotional regulation and self-soothing. We learn limbic regulation by being in the presence of adequate external regulating relationships, such as parents and siblings. When the family environment does not model good balance and regulation, children can have trouble acquiring this skill. They internalize what surrounds them. Children not only internalize it mentally and emotionally, it becomes part of their neurological wiring (Schore, 2004).

The Model of the Addicted/Traumatized Family System
The Model of the Addicted/Traumatized Family System (see Table 1 below) illustrates the dynamics present in a family that is containing both trauma and addiction in order to help clients gain a sense of the dynamics that they may have internalized as children — dynamics that may be continually impacting their lives today. It describes some specific manifestations of this pattern of cycling between extreme modes of functioning and provides a middle ground. It is for use in the psycho-educational component of any treatment setting for lecture and handouts and/or administered as a “self test.” Its experiential use is described in The Living Stage: A Step by Step Guide to Psychodrama, Sociometry and Experiential Group Therapy (Dayton, 2004).

High Intensity vs. Shutdown/Dissociation
The addicted/traumatized family often cycles between states of emotional constriction and intense outbursts. These swings between high intensity and shutting down or dissociating that characterize the trauma response, become central to the operational style of the family and get internalized by family members.

Emotional modulation is a skill that becomes internalized through regular exposure to modulating relationships such as parents and family members or, in recovery, through therapeutic relationships such as therapists, therapy groups and 12-step programs. It can also be aided through regulating activities like meditation/relaxation, deep breathing and exercise — activities that quiet and soothe the limbic system.

Over-functioning vs. Under-functioning
In a maladaptive attempt to maintain family balance, some family members may eventually over-function or compensate for the under-functioning of others. Some addicts and/or family members may do both, over-functioning to make up for periods of under-functioning.
Over-functioning can manifest in multiple ways: parentified children may try to take care of younger siblings when parents drop the ball or strive to restore order or dignity to a family who is rapidly slipping. Spouses may over-function to maintain order while the addict falls in and out of normal functioning.

Still others in the system may freeze like a deer in the headlights, unable to get their lives together and make useful choices. The learned helplessness associated with the trauma response, in which one comes to feel that nothing they can do will make a difference, can become an operational style that manifests as under-functioning. Unfortunately, a secondary gain of learned help- lessness is that others will generally pick up the slack. This learning is part of what contributes to learned helplessness getting seared into place as a quality of personality. The secondary gain of over-functioning is that it can lead to outward success, even though it may represent an extreme behavior that interferes with other areas of life.

Balanced functioning is the obvious in-between of over- and under-functioning. This state of equilibrium is achieved when we do what is appropriate for the circumstance and when we have conscious choice around the degree to which we function.

Enmeshment vs. Disengagement
Enmeshment or fusion is generally seen as an attempt to ward off unconscious fears of abandonment. It is a relational style in which identities become confused and fused. It lacks healthy boundaries and discourages differences or disagreement, seeing them not as healthy and natural but as disloyal and threatening.

Disengagement is the other or “dark side” of enmeshment. Family members see the solution to keeping pain from their inner worlds from erupting as avoiding subjects, people, places and things that might be triggers. In addition, the mistrust that grows out of this continual relationship discomfort can make family members withdraw into their own emotional worlds, which further isolates them and breeds mistrust.
Balanced relatedness is neither a withdrawal from another person nor a fusion with them. It allows each person a reasonable sense of their own identity in the presence of the family system.

Impulsivity vs. Rigidity
When emotional and psychological pain cannot get talked out, it often instead gets acted out. Impulsive behavior can lead to chaos, wherein a pain-filled inner world is surfacing in action. Painful feelings that individuals find too hard to sit with, explode into the container of the family and get acted out.

Rigidity can be an attempt to manage chaos both inwardly and outwardly. Adults in an addictive/traumatizing family system may tighten up on rules and routines in an attempt to counteract or ward off the feeling of falling apart inwardly or outwardly. And family members may contract in their personal styles, becoming controlled and/or controlling.

Self regulation is a basic developmental accomplishment that allows the growing child and eventually the adult to regulate their thinking, feeling, and behavior. Family members need to find a middle ground where strong feelings can be discussed or even explode momentarily, but then be talked through toward some sort of tolerable resolution.

Grandiosity vs. Low Self Worth
Feelings of low self worth and shame can plague those within the addicted family system. Daily assaults on one’s self esteem along with the lack of comfortable connection with others erode confidence and trust. Not feeling normal, experiencing themselves as different from other families, or hiding the truth of family dysfunction, can all contribute to those in an addicted family system feeling bad about themselves.

Grandiosity is a common defense against feelings of worthlessness. Some family members, to compensate for feeling small on the inside, act big on the outside. Certain members of these systems may not understand how to take regulated, baby steps toward success or getting their lives together. Frustrated and disheartened, they may take refuge in grandiose ideas of themselves and their plans in life, as a way of warding off ever-growing fears that their lives are somewhat unmanageable or they cannot seem to get things to work out for them.
A healthy self image can often tolerate the normal flux in positive and negative feelings about the self without sinking into pervasive feelings of worthlessness or boomeranging into grandiose fantasies.

A healthy self image, or good self esteem is probably one of the most important components of emotional immunity and well being.

Denial vs. Despair
Denial is a dysfunctional attempt to put a good face on a bad situation by denying the ever-mounting despair that is engulfing family members. Reality gets rewritten as family members attempt to bend it toward making it less threatening and more in line with their sense of “normal.” This bending of reality is part of the “crazy-making” world of the addicted/traumatizing family, in which family members lose their grasp on what constitutes normal functioning.

Family members often collude in this denial and anyone who attempts to turn the spotlight onto the harsh reality of addiction or dysfunction, may be perceived as disloyal. They risk being cut off if they get too close to the underlying despair that the family does not want to acknowledge. The family may “kill the messenger” by making them the problem, a phenomenon known as “scapegoating.” Reality orientation, or an ability to live with “life on life’s terms” is an important measurement of recovery.

Abuser vs. Victim
Trauma seems to seek a culprit, someone upon whom to externalize, or take out, painful emotions, i.e., a victim. Abuse may be part of the impulsivity that characterizes families where feelings are acted out rather than talked out. Bouts of rage, physical, and/or emotional abuse are often part of an addicted/traumatized family system. Children who are abused, i.e., victims of abuse, may turn into the school bully or become abusive to younger siblings, acting out their own feelings of humiliation and helplessness by becoming the abuser. This identification flipping can make the dynamic intergenerational. For example, an abused child or the victim of abuse, may “identify with the aggressor” internalizing the role of abuser. Then, when the roles are flipped, that is when the child becomes a parent, they become what they beheld, the abused child becomes the abusing parent.

Both the role of victim and abuser can become personality styles. The perennial bully. The person who shoves other people around physically, emotionally and psychologically. The perennial victim who sees themselves as the one who never gets the “breaks” and slips into a kind of helplessness. These are unregulated life roles. Paradoxically, each extreme covers up a sense of helplessness by behaving in an entitled manner. The bully pushes for what he wants through force and the victim through helplessness.

Clients from these systems need to learn the skills of emotional literacy: understanding that what happened
“wasn’t their fault but it is their responsibility to heal and move on.” This includes:
• Tolerating one’s own painful emotions without acting out.
• Listening to another’s feelings without overreacting.
• Naming and processing feelings, learning to think about what one is ultimately feeling.
• Constructing a balanced life with balanced roles.

Caretaking vs. Neglect
In caretaking we assuage our own anxiety by over responding to another person’s inner or outer needs. We project our own anxious feelings onto someone else and set about fixing in them, what may need fixing inside of us. Caretaking can also be a symptom of unresolved grief, a displacement of painful emotions onto something outside the self.

Neglect can take the form of under-responding to the physical needs of another person or negating their emotional or psychological self. Children who have been neglected can have a hard time in therapy. They have nothing large and obviously abusive to point to as the “problem.” Instead they are often left feeling overly needy, unlikable, or undeserving.

Some parents, both addicts and codependents in addicted/traumatized family systems do both. They have trouble modulating their level of care. They care in a great flurry then collapse in exhaustion and helplessness.

Balanced care of self and others is part of living a healthy life. Balanced, attuned care of children allows them to internalize this skill to be used toward themselves as well as others.

Intergenerational struggle
It is no wonder that families such as these produce a range of symptoms in their members that can lead to problems both in the present and future. Clients who grow up in an alcoholic/traumatizing family system may struggle with trying to paste together some sense of “normal,” while warding off a daily variety of assaults on their self-esteem, peace of mind, and sense of comfort and safety. These people may find themselves moving into adult roles carrying huge burdens that they don’t know exactly what to do with and that get them into trouble in their relationships and/or work lives. It is part of the posttraumatic stress reaction, in which symptoms that have their origin at one point in time manifest at some future point. They may overreact to the vicissitudes of daily living or have trouble hanging onto a sense of self or inner balance while in connection with others.

When this population has families of their own, the feelings of dependency and vulnerability, which are a part of intimacy, may act as a trigger that induces all that they have experienced in the area of close relationships. Their anxiety and hypervigilance in the family situation can lead to problems. They may fear that chaos or out-of-control behavior are looming just around the corner, because this was their early childhood experience. They may unconsciously be so convinced that distress is at hand, that they may experience mistrust and suspicion if problems are solved smoothly. Often they will push a situation in a convoluted self-protective attempt to ferret out potential danger until, through their relentless efforts to avoid it, they actually create it. And so the pattern of strong feeling leading to chaos, rage and tears is once again reinforced and passed along.

Beyond talk: Effective therapies for Adult Children
Some of the tasks of therapy for adult children include helping clients to develop the ability to tolerate strong emotions without acting out. This involves creating enough emotional literacy so that problems can be talked out rather than explode or implode. The thinking part of the brain, the cerebral cortex, “has more inputs from the limbic system than the limbic system has coming from the cortex” (Schore, 2004). Consequently, our emotions highly impact our thinking and choice-making processes (Damasio, 1999). Integrating these emotional messages with our reason is part of how we come to better understand ourselves and develop emotional literacy.

Clients also need to develop new relationships that will teach them the skills of limbic regulation such as those found in therapy, 12-step rooms and healthy lifestyle companions (Lewis, 2000). These healing relationships offer the experience of new, external limbic regulators from which to internalize the skills of limbic regulation. Talk alone does not inscribe new hardwiring into our neural networks. For this to occur, we need to log the necessary hours in the presence of others who are able to experience emotion within a reasonably regulated range — people who are experiencing balance and pleasure in their lives. Adding new healthy relationships as well as nourishing, creative and physically enhancing activities such as hobbies, exercise and relaxation can help to re-regulate a limbic system that talk alone cannot reach. Experiential therapies like psychodrama, allow clients to experience strong, repressed feelings through roleplay and relearn how to express and modulate them in the present moment in more dynamically constructive ways.

Experiencing new insights
Although this Model of the Addicted/Traumatized Family System reflects, as its ideal, an ability to modulate strong affect, it should not be inferred that the goal is a bland response to life. At the core of a lack of regulation is oftentimes emotional constriction or numbness — such as forbidden feeling. When we foreclose on our emotional reactions, when we cannot, for whatever reason, feel what we feel, those emotions do not disappear. They continue to impact the way we think and behave.

Learning to experience these split-off emotions in a relatively safe, clinical situation allows us a second chance to make sense of them and integrate them with new insight and meaning. Regulation allows us to meet the challenges of life with appropriateness and spontaneity.

It leads to a confident, enhanced sense of aliveness and an increased feeling of comfort — both within the self and relationships.

Tian Dayton, PhD, TEP, holds a doctorate in clinical psychology. She is currently the Director of The New York Psychodrama Training Institute. She is a national speaker, media expert, and author of fourteen books. To
contact her, visit www.tiandayton.com.

References
Damasio A.R. (1999). The feeling of what happens: Body and emotion in the making of consciousness. New York, NY: Harcourt.
Dayton, T. (2004). The living stage: A step-by-step guide to psychodrama, sociometry and experiential group therapy. Deerfield Beach, FL: Health Communications, Inc.
Lewis. (2000).
Schore, A.N. (2004). The right brain, the right mind, and psychoanalysis. Retrieved November 29, 2004, from the World Wide Web: http://www.neuro-psa.com/schore.htm.
Thomas, L., Amini, F., & Lannon, R. (2000). A general theory of love. New York, NY: Vintage.
van der Kolk, B. (1987). Psychological trauma. Washington, D.C.: American Psychiatric Press, Inc.

This article is published in Counselor,The Magazine for Addiction Professionals, February 2005, v.6, n.1, pp.12-17

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