by Claudia Black, Ph.D.
It has been known for many years by those professionals Increased Tolerance — the addict needs to engage
working in the addiction field that for every person more frequently in the behavior or the substance to
addicted, it is estimated that approximately another four garner the desired affect, which is usually related to a
people, usually immediate family members are directly neurochemical change.
affected — husbands, wives, committed partners, mothers,
fathers, siblings, young and adult children. Addict: "I used to get drunk on six beers. Now it takes
me a dozen." "I used to be satisfied with pornographic
Given that four people are immediately impacted by magazines, now I need contact with someone on the
As the addict one person's active addiction, how might the impact of Internet who will interact with me."
is deserving addiction be reduced if there were four times the number
of family members in recovery programs? How might Loss of Control — the addict is no longer able to
of his or her the impact be reduced if there were educational and predict engaging or using behavior.
recovery, treatment programs that at least minimally addressed the
confusion, fear and pain suffered by families when the Addict: "I told myself I was only going to spend $50
so are the addicted person enters treatment? How might the lives dollars at the casino and lost my whole paycheck before I
codependent of family members be altered if intervention was directly left." "I told myself I would only have one glass of wine at
with the family? the wedding and I got drunk and passed out."
members. As the addict is deserving of his or her recovery, so are Denial — the addict erects defenses to rationalize and
the codependent family members. When family members minimize; thereby supporting the behavior.
recognize their codependency and its similarities to the
addict's addiction, they can recognize the mutuality of their Addict: "My children have not been affected by my
recovery processes. drinking." "Everybody drinks don't they? It doesn't mean
The following, excerpt from the recently published
Family Strategies: Practical Tools for Professionals Treating Blackouts — The substance addict has a period of
Families Impacted by Addiction, offers therapists working amnesia, usually lasting from hours to days. He/she is
with family members a way to link the addicted person's conscious and interacting, but the memory is not imprinted
behaviors with similar behaviors as experienced by family on the brain, and therefore, it cannot be recalled.
members. This approach will aid the family members in
realizing they also have issues from which to recover. Addict: "I don't know where I was, what I did, or who I
was with last night."
Using the disease symptoms of addiction, the following
gives examples of each symptom as experienced by the Craving — the addict has a severe physical or psychological
addict and the family member (codependent). urge or craving to reengage in the substance or behavior.
Preoccupation — the addict has a repetitive focus on Addict: "I wanted cocaine so bad I could taste it."
behaviors connected to his/her acting out behavior.
Compulsive Behavior — addicts begin engaging in
Addict: "I wonder if there's enough booze at home or if my behavior in a manner that they feel driven, obsessed,
dealer will be home or if I have enough money for my drugs." and they do so repeatedly, which often reduces cravings
"I will need to cover my bases with my family by ...." or preoccupation.
16 Paradigm • Winter 2007
Addict: "When I had a craving, I knew I shouldn't drink, blackout, often referred to as a 'brown-out', is due to
but I found myself in the bar last night anyway." the stress of heightened emotions; there is too much
emotionally charged stimuli for details of what occurred
Decreased Tolerance — progressively the addict to be recorded. It may not be as well-delineated a block
cannot engage or use to the extent he/she once did and of memory as a substance abuse blackout. It is more a
begins to experience negative symptoms more quickly. sense of something occurring without clarity. This could
be referred to as a trance-like or dissociative experience
Addict: "I used to be able to stay out for hours using, and in which the memory may or may not be recorded and
now I am in trouble shortly after I begin." not readily available for conscious memory. The process
addict's, i.e. gambler, sex addict, blackout is more similar to
Medical Problems — In the latter stages of addiction, the codependent's than the substance abuser's.
particularly if the addict is a substance abuser, physical
problems can run the gamut from heart and lung disease, Codependent: "We had a screaming fight the other night.
brain disease, liver damage, throat and mouth diseases, I don't remember exactly what I said."
to diabetes and digestive disorders. Medical problems
may also be related to unsafe sexual practices, accidents, Craving — the codependent experiences a deep obsessive
and injury. psychological urge or longing for the times when things
were better. Frequently craving goes hand-in-hand with
Professionals should walk the family members through euphoric recall (romanticizing the good times).
each of the symptoms again. On the second time, the
symptoms should be related to the family member's Codependent: "I really miss him. When he is gone I
experiences. In doing so you can ask them for examples ache for him."
of how they identify with the symptom and then be
prepared to give examples in areas that are difficult for Compulsive Behavior — codependents may begin
them to recognize. engaging in behaviors such as snooping, spending money,
eating, sex, etc. Codependents' compulsivity may be acted
Preoccupation — the codependent experiences the out in perfectionistic tendencies.
inability to focus on other things without intrusive thoughts
about the addicted person and his or her behaviors. Codependent: "My house is clean with everything in its When family
place. It makes up for how I feel inside."
Codependent: "I wonder where my husband is, who he
is with and what I will say to him when he gets home." Decreased Tolerance — the codependent becomes recognize their
less patient and is less likely to stay in denial and may codependency
Increased Tolerance — the codependent displays a experience an emotional bottom.
willingness to accept inappropriate and or hurtful behavior and its
with lower expectations, which is usually related to a Codependent: "I can't take anymore. Everything he does similarities to
psychological tolerance. irritates me."
Codependent: "He used to be critical of me and I would Medical Problems — codependents are more apt to addiction,
get really upset, now he calls me horrible names and it's experience stress related health problems ranging from
no big deal to me." headaches, stomach or digestive problems, hives, back they can
problems, ulcers, depression and/or anxiety. Many diseases recognize the
Loss of Control — the codependent is also no longer codependents suffer are fueled and complicated by stress,
able to predict his or her own behavior. most specifically autoimmune disorders.
Codependent: "When I know that he is going to be late Continue to talk about disease behaviors such as lying,
for dinner again, my plan is to give him the cold shoulder sneaking, etc and the many feelings related to living with
and go about my business. On occasion I'll snap. Yesterday addiction. By discussing the symptoms to understand the
I planned on ignoring him but I ended up screaming in addict's process and then immediately adding the overlay
front of the kids. I, not my husband, was out of control." of the family having similar experiences, they begin to
readily picture what it means when it is said that they are
Denial — the codependent erects defenses to rationalize in need of recovery as well. As family members share in
and minimize thereby supporting the behavior. the disease, they may now share in the recovery.
Codependent: "There's nothing wrong with me. He has Dr. Claudia Black is a renowned author and trainer internationally
the problem, not me. I don't need to change." "The kids recognized for her pioneering and contemporary work with family
systems and addictive disorders since the 1970s. Claudia has extensive
have not been affected by me or my behavior."
multi-cultural experiences working with agencies and audiences in Japan,
Brazil, Australia, Scotland, Iceland, Germany, England and Canada. Many
Blackouts — The one symptom the addict experiences of her books and videos have been translated and published abroad including
that is not an exact carryover to the codependent is It Will Never Happen To Me (two million copies sold), and her latest
blackouts. The substance addict has a period of amnesia, Family Strategies and Anger Strategies. For additional information visit
usually lasting from hours to days. The codependent's the Web site www.claudiablack.com.
Paradigm • Winter 2007 17