Oct 26

Almost everyone has seen it or even have personal experiences with what is commonly called ‘addictive relationships’. These are the forms of relationships where everyone around a particular couple might raise their hands in disbelief over why both partners are still together.

There might be a strong and obvious imbalance between both of them, sometimes aggressiveness or jealousy of one partner towards the other or blackmailing, but still, for some reason, the ‘addicted’ partner can’t find a way to ultimately break up or might even excuse their loved one’s behavior. Others are highly indifferent to the unhealthy aspects of their relationship as they are hard to see, especially if one is in the middle of it.

I have helped numerous clients get rid of their addictions over the years, and in working with couples (another major field of my work), I couldn’t help but notice certain patterns in chronically difficult relationships that resemble problems of addicts that their partners or family members have to fight with.

An addictive relationship thus is unthinkable without one partner who is emotionally unstable and would in most cases require professional support to successfully deal with their problems for one. This person might also be very self-centered and look very independent and self-confident – or very needy on the other hand. But this since they are not ready to do that or because they are delusional, it needs someone who is ready to ‘support’, or in better words: invest their time, energy and often enough money to take the edge off the other’s imminent issues and to keep not only themselves, but also the relationship going, hoping for things to get better in the near future.
But often enough, it just keeps a vicious circle going – a circle the partner might actually already have experienced during their entire life, sometimes extreme behavior endured by helpful souls who took care for them along the way.

7 Signs of Addictive Relationships:

  • Dishonesty. Both partners don’t communicate openly about their real intentions, needs or worries.
  • Unrealistic expectations. Both partners hope for the other one to ‘fix’ their problems, be it their self-esteem, body image, family, or existential problems. They believe the ‘right relationship’ will make everything better. Yet, they’re in a disastrous addictive relationship.
  • Instant gratification. One of both expects the other one to be there for him whenever he needs her; he’s using her to make him feel good, and isn’t relating to her as a partner – well, because she’s like a drug.
  • Compulsive control. Imminent threats of one partner to leave if the other one doesn’t behave a certain way, and anxious worries of the other one if this idea comes up. Both might feel ‘stuck’ together – for good or for evil.
  • Lack of trust. Neither partner is 100% certain about being ‘truly’ loved by the other one as sometimes they can sense the feelings of hate or desperation their partner is experiencing.
  • Social isolation. Nobody else is invited into their relationship – not friends, family, or work acquaintances. People in addictive relationships want to be left alone and can react harshly if someone is asking about the status of their relationship.
  • Cycle of pain. Often, couples living in a relationship determined by addictive patterns regularly experience cycles of pleasure, pain, disillusionment, blaming, and (often emotionally or sexually  loaded) reconnection. The cycle repeats itself until both partners seek professional help or one partner breaks free of the addictive relationship.

Unfortunately, there is no simple ‘recipe’ on how to help such partners effectively, as the one who suffers most is often very resistant to all efforts aimed at helping them get back on their feet again. Often, someone with a neutral viewpoint as a counselor can help, but if both partners feel determined enough, have strong self-control and are able to accept mutual accountability they might also find back to a fulfilling, balanced relationship.

Strategies for Overcoming Addictive Relationships:

  • Make your ‘recovery’ the first priority in your life.
  • Courageously face your own problems and shortcomings.
  • Cultivate whatever needs to be developed in yourself, i.e., fill in gaps that have made you feel undeserving or bad about yourself and/or get rid of the problems that turned you into an addict in the first place.
  • Learn to stop managing and controlling others; focus more on your own needs for a while and improve your self-esteem to become more independent
  • Find out what brings you peace and serenity and commit some time to that endeavor on a daily basis.
  • Learn not to get ‘hooked’ into the games of relationships; avoid dangerous roles you tend to fall into, e.g., ‘rescuer’ (helper), ‘persecutor’ (blamer), ‘victim’ (helpless one).
  • Find a support group of friends who understand and share your experiences.
  • Consider getting professional help to speed up the recovery process.

Many of you will know firsthand how many times friends or acquaintances entangled in an addictive relationship end up emotionally damaged, financially weakened or even physically injured. What you as a fellow friend can do is to avoid getting sucked into the ‘black hole’ of such an relationship yourself and to push both of them to seek professional advice.

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2011; Image source: bhaskar.com; Laurie Pawlik-Kienlen, Counselor; Hints on how to overcome AR based on Robin Norwood’s book ‘Women Who Love Too Much‘)

Nov 29

Posttraumatic Stress Disorders (PTSD) was very much one of the centers of attention during the last years of psychological research. Posttraumatic stress disorders may develop when  people are exposed to life-threatening situations – such as natural disasters, assassinations, sexual abuse or war events. It is estimated that up to 50% of all U.S. soldiers returning from war zones are affected by forms of post-traumatic stress disorder. But PTSD is difficult to treat and usually requires a lengthy therapy, even though various pharmacological approaches using the stress hormone cortisol, beta-blockers include Propranolo [1] and psychotherapy (the special trauma therapy methods based on hypnotherapy like EMDR, or combined approaches such as the one by Luise Reddemann) brought significant progress.

New hope now comes from a totally unexpected direction: in a study done together with graduate student E. Ganon-Elazar and published in the Journal of Neuroscience [2] it was shown that the activation of cannabinoid receptors in the basolateral nuclear complex of the amygdala (BLA) compensates the  effect of stress during conditioning. Many years ago, the pharmacist at the Jerusalem University, Rafael Meshulam, already published similar positive effects when he administered traumatized mice, now his results could be confirmed in trials with rats. Following a decision of the Supreme Court of Croatia in an appeal against a man who had fought in the war in Yugoslavia and was since then suffering from PTSD, war veterans suffering from post traumatic stress disorder may now even now grow marijuana for self-treatment. [3]

(Sources: [1] Andrea Naica-Loebell: “Die Pille für das Vergessen” in: telepolis Online-Magazin, 08/2005; [2] Ganon-Elazar, E. & Akirav, I. (2009), Cannabinoid receptor activation in the basolateral amygdala blocks the effects of stress on the conditioning and extinction of inhibitory avoidance. Journal of Neuroscience, 29(36):11078-11088; [3] Der Standard 04.06.2009; Image credit: Cannabisculture.com)

Aug 10

Antidepressants are now the best-selling drugs in the USA – and their consumption has doubled in the last 10 years.

This was established by a meta-analysis of studies from 1996 to 2005 among 50,000 children and adults and published in the Archives of General Psychiatry. Currently 10 percent of Americans – about 27 million people – are taking antidepressants, approximately twice as many as in 1996.

Only half of these people, however, are actually treated solely for depression, the rest are taking the drug because of back pain, fatigue, insomnia and other problems. So the increased consumption doesn’t necessarily mean that more people are depressed, but that the drugs are used to manage or facilitate everyday life, and probably also as mood enhancers.

This also fits the other findings, namely that the proportion of people who take antidepressants and who are undergoing psychotherapy at the same time dropped from 31 to 20 percent. Presumably many feel insecure about dealing with the reasons for their psychological problems or are uncertain about whether psychotherapy could really help – while the belief in the effectiveness of drugs is increasing. Also, ‘dropping a pill’ is simple and costs less money – at least in the short run, especially since many American insurance companies don’t pay for psychotherapy, and doctors prefer prescribing drugs over dealing with their patients thourougly as this saves valuable time for other patients waiting in the queues.

The study’s authors argue that an essential factor for these changes may represent the enormous dedication of funds for advertising: for advertisements aiming at end users (patients), 32 million USD were used in 1996, but already 122 million USD in 2005. Only 14% of the proceeds from sales had been reinvested in research and production by the industry – the rest goes to marketing and profit distributions 1.

Update:
A reader of this post has sent me a graphic his company, MedicalBillingAndCodingonline.org, has created and released under the Creative Commons License. I think it illustrates the major aspects of the current trends just great. Please click here or on the image at the right or download a large version of the graphcic from the author’s site.

(Sources: New England Jornal of Medicine in an interview by The Nation, 20090809; “National Patterns in Antidepressant Medication Treatment” by Mark Olfson & Steven C. Marcus in: Arch Gen Psychiatry 2009;66(8):848-85)

06.01.16