Attachment and Substance Abuse: Changing the Substance Abuse Treatment Paradigm
“They don’t care what you know till they know that you care”
Treating addiction is a complicated process requiring an in-depth journey from childhood to the present. Individuals suffering from addiction have long-standing issues prior to abusing drugs or other addictive behavior. Additionally, absent a glimpse into why an addict eventually turned to substances or addictive behavior to avoid emotional pain, the likelihood of wellness is substantially impeded. It is imperative to uncover what destructive patterns exist today as a direct result of past trauma and abuse; thus, the need to avoid emotional pain through addictive substances and behavior.
Abigail, a 47-year-old Caucasian teacher had been married to Bill, 60, for 8 years. Both of them were sober and had been previously married without children.
Abigail sought treatment at an outpatient clinic for an addiction to Xanax. She had previously beensober for 10 ½ months, went to Alcoholics Anonymous meetings daily, had an AA sponsor, read the Big Book, worked through the steps of AA with her sponsor, did service work and prayed. By most definitions of Addiction Treatment, she should have remained sober. Both Abigail and Bill were long-time members of AA, well respected in the community and from the outside their life seemed “perfect”.
Immediately the clarity that merely the cessation of drugs and alcohol has not been enough is clear. Additionally, it becomes clear that the prototypical treatment paradigm of don’t drink, go to meetings, get a sponsor, work steps and help others may not be enough.
Abigail reported that she had three older sisters and her mother and father had been married for 60 years prior to her father’s death three years ago. She expressed, “I was my dad’s favorite, we would go places together, play together and I idolized him.” What is more, her dad was a well-respected and wealthy surgeon and her mother came from a very wealthy family. Although to the outside world all appeared posh, dad was an abusive alcoholic who drank at home and blacked out daily. He would fall asleep in the living room watching porn and Abigail was responsible for turning off the porn and helping her dad to bed, beginning at age 7 or 8. Additionally, he was physically abusive to Abigail’s mother in the presence of the children. Nevertheless, the family would wake up the next day and mom was “cheery” and “acted as if the night before never existed.”
When Abigail presented for treatment for Xanax addiction, it quickly became apparent that there was a direct link between her early childhood and her drug usage before and after sobriety. Furthermore, it was evident her cycle in relationships throughout her life became a replica of her childhood dynamics in her mother and father’s marriage.
“I grew up where dad was the King of the castle and it was critical to make sure he was protected and maintained respectability,” she said, adding, “I thought it was normal to fantasize, lie to the point of believing the lie (“I had to do this to protect the family”) and protect the white picket fence.”