Disturbed Characters and Substance Abuse – Part 2

The use of substances can create problems in the lives of even relatively well-adjusted folks.  In fact, folks whose character was reasonably healthy before they succumbed to a problematic use pattern can change in some horrific ways.  But when someone has a significant character disturbance to start with and abuses substances on top of it all, life can quickly become a living hell.  As I mentioned in last week’s article (see: Disturbed Character and Substance Abuse: A Complex Picture), the interrelationship between substance use and character is often complex and poses many challenges for providing the right kind of help.  And in today’s article I’ll be giving two examples (once again with possibly identifying details altered for the sake of anonymity) that should not only provide the readers circumstances with which they can readily identify but also should help make the distinction between the kinds of problems tied primarily to substance use vs. the problems that can arise when individuals of significantly disturbed character abuse substances.

“Shelley” was always the happy child who seemed to have everything in balance.  She was not only a good student but also had an active social life and many friends.  She had a joy for life that was infectious, and had that proverbial “heart of gold.”  And while no one would understand it for many years, her life changed dramatically the day that heart of hers was so deeply pierced by the stepfather who molested her.  Shelley desperately wanted someone to know, but when she gingerly broached the subject of something not being right in the way her stepfather had been treating her, her mother seemed to brush it off as just another example of her not being able to accept the reality that her biological father, who was the real cad, had abandoned the family, and she was, as always, displacing her anger about that.  There seemed no one to turn to and no one to trust. One day, after a sip of wine after a family dinner, she found the nagging pain within her diminish for awhile and she really liked that feeling.  She felt even better – if only for a short while – when she accepted a “hit” or two on her brother’s marijuana cigarette.  But before long, she was using a lot, using often, and hiding it as best as she could.  One thing she couldn’t hide, however, was the change that had come over her.  She began failing in school, had fights with several of her friends, and seemed to have an uncharacteristic edge to her.  It wasn’t just that she was behaving differently.  She seemed to be a different person.  One day, her best friend let her have it:  “I just don’t know who you are anymore!,” she proclaimed.  “Where in the world did my sweet, dear friend go?  I miss her so much it hurts!”, she lamented, and broke down. That did it.  Shelley couldn’t bear it anymore.  She broke down herself, embraced her friend, and said she really needed help.  She was, as many caught in her trap have said before her, sick and tired of being sick and tired.  Eventually, both she and her family would recognize both the root of her pain and the less than optimal ways she tried to “medicate” it. And after years of therapy, the successful prosecution of her stepfather, and her regular participation in a sobriety maintenance program, the Shelley everyone once knew seemed to come back, only this time in a somewhat better and stronger version.  Trauma and substance abuse are a truly toxic mix.  They can cause a person to change dramatically, which is in large measure what Post-Traumatic Stress Disorder is all about.

“Shelley’s” case differs markedly from “Marty’s”.  Marty had always been somewhat of a “rebel without a cause.” His caring and patient family did all they could help get the youngster through school without strangling him first.  He was also by nature an ambitious sort, so even though he took a pass on college, he entered the sales field with enough drive and moxie to make a fine living for himself.  And even though he married a woman (whom we’ll call “Ellen”) who was the envy of many, and had just about everything a person could ask for, he seemed chronically discontented.  His impatience was legend.  When making telephone sales calls, if he encountered the slightest resistance he’d simply hang up and move on to the next prospect. Why should I waste my precious time?”, was his rationale.  He was tough enough to live with even when he wasn’t drinking.  But things could get ever so much worse when he did drink.  And that was especially true if he was irritated about something. The pattern had become all too familiar: something would happen at work and he would become irked.  Then he’d stop at the bar on the way home “just to chill” a bit but would somehow end up in a brawl.  Strangely, this generally made him feel a little better.  But sometimes this wasn’t enough.  He’d burst through the front door of his home fuming.  Then you could hear the tops of the beer cans popping one by one.  Oh, how Ellen hated that sound!  She regarded it as a signal to stay out of his way.  One day, however, she couldn’t get out of his way fast enough and found herself badly bruised and beaten. A judge gave Marty probation and ordered him into both rehab and “anger management.”  At the end of his stints, things were better for a little while but gradually got worse again, even though Marty was remaining sober.  And although Marty tried to tell the folks at the treatment center and the anger management program that he was a “really decent guy” when he wasn’t drinking, Ellen knew in her heart there was more wrong with him than just his drinking.  She didn’t trust him and was still afraid of him.  When she left him and problems increased at work, he found the motivation to come in for a visit with me.  But he didn’t like what I had to say.  I suggested to him that contrary to his (and his anger management group’s program leader) belief, his anger rarely preceded his aggression but rather his aggressive personality style frequently begat anger.  And he especially didn’t like it when I said that if there were ever to be any meaningful changes in his life, he’d have to come to terms with that aspect of his character and work like hell to change it.  So, I didn’t see him for years, until one day, after having come to some appreciation about the shipwreck character of his life, he came to see me ready to work. And I’m as certain as anything I’ve ever been sure about that the main reason he came to see me out of all the other places and programs to which he could have (and had in the past) gone, was because I dared to call out both the nature and extent of his character disturbance. As I assert many times in Character Disturbance, trust is the undeniable foundation of a sound therapeutic relationship, and for there to be trust, a troubled character must know in their heart that you have his or her number and stand ready to deal with their real issues.

The vignettes presented above illustrate how very different the picture can be when it comes to a person’s substance abuse pattern. The presence and extent of character disturbance, no matter what the other environmental factors might be, always complicates matters and heavily influences both their prognosis and their likely response to various courses of intervention.  Next week I’ll present more scenarios illustrating the interrelationship between character and substance use.  And I’ll be talking about these and related matters on Character Matters this Sunday evening at 7 pm EDT (6 pm Central).

19 thoughts on “Disturbed Characters and Substance Abuse – Part 2

  1. Dr Simon,
    Thank you from the bottom of my heart for this series and for all your resources. I only wish I knew of this paradigm many years ago. I am immersing myself in learning about CD and have a renewed sense of hope in dealing with the CD people in my life.
    I have many observations and questions, but I’m sure they will be addressed as the series progresses.
    I’d like to make a couple of observations from my experience:
    1. There seems to be a difference in how AA steps are processed by neurotics and CD’s.
    2. I was baffled as to why a CD addict, though thoroughly doing the first few steps, ‘stalled out’ on ‘making amends’. I assumed the shame, guilt and knowledge that they had caused so much hurt overwhelmed them. I gave them a ‘pass’ in trying to empathize. As sobriety increased however, I noticed a tendency to only ‘appear’ to make amends, and then rather indifferently. Your information fills in the ‘missing bits’ for me.
    3. One can only imagine that if traditional counsellors in rehabs are not equipped to deal with CD, how manipulated they might be, even though they think they’re not.
    4. I was told by rehabs that an addict cannot make a choice to get treatment due to brain changes and ambivalence. It must be done for them, and in the process of rehab hopefully they will make that choice for themselves. It seemed to me the choice was eventually made “because I guess I have to”….not ‘because I want to”.
    5. I was told that sometimes 4 or 5 rehabs are needed before they finally ‘get it’..after that there is not much hope. The frequency of relapses are never blamed on the approach/program: it is always the failure of the addict to ‘work the steps’. I think that even for a CD person, repeated failures can be devastating. I’ve seen it.
    Again, thank you so much and I appreciate reading any other readers contributions.

  2. Martha, I’m somewhat of an expert when it comes to addiction (been living with one addicted family member or another since I was born).

    Any rehab that would tell you that an addict can’t make a conscious choice to go, or that it could take 4 or 5 times before they “get to them”, is seriously after your money. Addiction doesn’t work like that…it isn’t a chemical imbalance where the victim is incapable of making a rational decision.

    The old saying, “you can lead a horse to water but can’t make him drink” is 100% true where addiction is concerned. Only an addict can decide, and commit, to beating his disease. You can’t will them to it, or send the to enough clinics to make the well. In fact, addicts get clean every day — without rehab at all. But they have to want it.

    I’m not sure what your story is, but will tell you from bitter experience that if you are considering the rehab route FOR somebody, you’d be better off burning it in the fire place.

    1. Einstein, I respectfully disagree with the notion that an ACTIVE addict is always capable of making the choice to quit using. In my opinion, that is why hitting bottom is usually the only inroad to recovery. Often times a lengthy jail sentence is enough time to force enough sobriety to get the brain dried out enough to be able to see more clearly. Actually the brain is imbalanced is a lot of ways during active addiction. I’ve read things about certain parts of the brain being physically damaged by excessive alcohol usage, etc I suppose it all depends on what the substance is and to what degree the addiction has devolved to.
      Yes, some “addicts” do get clean on their own and yes, they have to want it before that is even a possibility but I think the ones who quit and stay quit on their own, without “switching addictions” are few and far between. I know of P L E N T Y of “recovered” heavy duty drinkers who now smoke loads of pot for example.
      I also do think that the odds of someone getting clean/ sober in one attempt is pretty slim. I’ve not known anyone who has done it anyhow and personally it was quite a process for me over a span of about 20+ years. It was interesting though, every failed attempt at sobriety never erased the ground gained in the time away from alcohol. It was almost like I had to keep proving to myself what I had already learned when I was sober. It doesn’t really make sense and I’m not advocating my haphazard method at all. I’m not sure i was really ever an alcoholic in the true sense of the term though. I never suffered withdrawals or anything like someone with a physical dependency would.
      I do agree that wanting rehab for someone else is pretty much a waste though. Personal realization and motivation is the pivotal ingredient to any change a person undertakes. I’m sure there are SOME success stories out there about people who were forced into rehab and had an ah ha moment, actually my cousin is one of them, but they are probably as few and far between as the ones who are able to achieve and maintain sobriety completely on their own.
      I’ve always wondered what the dividing line is between being an alcoholic with an addiction to alcohol and being a problem drinker, etc….I was the type of drinker who could go without it for pretty significant periods of time but when I would drink, Katie bar the door! One was to many and no number was enough. But I took to drinking like a fish to water from a very very early age, probably because I was marinated in it as a fetus.

      1. My point is that an active addict, unless messed up 24/7, is capable of realizing he has a problem. Heck…even messed up, they can recognize they have a problem. I am comparing this to a mentally ill person, where the whole illness is characterized by the inability for rational thought. There is zero cognitive ability.

        I agree that drug and/or alcohol abuse can leave one brain-fried, but then the problem becomes one of mental illness.

        I think on all other points we’re square.

        1. Einstein, I think there are so many potential variables in this whole picture that it’s really hard to make any kind of solid assessment that is very far reaching or all encompassing. At the ripe old age of 54 I’ve seen it all in the “addiction” department including addicts who really weren’t addicts and non addicts who really were only were able to manage it in a way that didn’t bring any serious consequences. I’m never sure where the fuzzy lines are between addiction, dependency, recreational use, etc! I think that the person I’ve known that drank the most, the most frequently (like all the time) might not have even been an alcoholic! I don’t know! I never saw him “drunk”, he never got in trouble, he maintained a job (that allowed him to drink),,,,,,he was the most successful “alcoholic” I’ve ever known! It was the oddest thing! I wonder what ever happened to him……..
          I drank like a fish! But was never the typical addict either. For me is was mostly a social crutch but because of my chemistry and early exposure to alcohol in utero,,,,,,,drinking moderately was never EVER an option. So when I drank,,,,,I DRANK! And couldn’t get enough. It felt like I had an amputated limb reattached and just wanted to run around the block. but, it caused me plenty of problems……I was most definitely an unsuccessful drinker.
          This neuro-scientist I watched on youtube was talking about how things like this leave a footprint in the brain…..and this is why even long after the substance has been purged from the body, you still have cravings. ugh! Just typing the word gives me a craving! It is HARD! Even when you KNOW you don’t want to drink any more it’s hard to not want to drink and when you are still in the throws of it that pattern is pretty well entrenched.
          Wow,,,,,it’s pretty hard for me to believe *right now*, how much of my life was so different then what it is now. it is like fighting a demon,,,,,,I really get that sense.

        2. Yeah, Maybe I’m thinking of it differently…….. I just see how it was for me when I was drinking…… how it just takes on a momentum and builds on itself. It takes SOMEthing to break that momentum, that rut, that cycle. I think that is why hitting bottom or some other significant outside influence is what usually ends up happening. I see a snow ball rolling down a hill getting bigger and bigger and faster and faster to the point that the only way it will be able to stop is if it hits something bigger than itself. So I see choice meant something much different to me then, everything meant something much different to me then so in a way, the capacity for choice is different or the motivation for choice is diminished.
          And my brother……very different. I don’t know that there is ANY consequence great enough to get him to stop, other than his body just giving out. That being said, I spoke with him recently and he does sound “better” . That is very relative though.

  3. Einstein and Puddle,
    Thank you for responding and sharing your thoughts and experiences. I think there is truth in what you each say. Einstein, even if I had your advice on rehabs I am not sure I would have heeded it. I had trenched in for 10 years waiting for that ‘choice’ moment and watching increasing self destruction, brain damage and devastation. After 3 rehab attempts, I totally agree with Puddle: “every failed attempt at sobriety never erased the ground gained in the time away from alcohol.” The experience of being cared for, loved, confronted, given hope and more all became part of my family member’s life. But I believe I know when to draw the line and no more.
    The problem is that the ‘experts’ all disagree re choice. My ‘aha’ moment came when I realised addicts, and CD people can make choices within choices. Dr Simon writes on that as I recall. They may not make the choice to ‘quit alcohol through rehab and 12 steps’ for the very nature of addiction is ambivalence. But they can choose to ask for help; to surrender to someone else’s judgement and advice and so on.
    This is a huge topic but I really just wanted to consider that maybe applying the advice I had been given as if my family member was at the neurotic end of the spectrum was the mistake. Looking back at all I’ve been through (for the sake of privacy I cant give many specifics), it is now so helpful framing it through the CD filter. All addicts are treated the same in programs and labels put on co-existing psychiatric disorders, (eg antisocial) but maybe they need to heed Dr Simon’s research and develop the CD paradigm in treating the addict as an individual.

    1. Martha,

      The stats on addiction are pretty sad. Very few neurotics (good people with a bad problem) ever get clean; for CDs, I’m gonna say zero – unless it severely hampers their ability to be an even crappier person.

      As for who’s a neurotic and who’s a CD….hard to tell the difference…the outward behavior of an addict is the same. I think that if you indulge in your addictions long enough, you’ll be emotionally stunted enough to qualify as CD.

      If you’re curious, is there anything in their pre-addict years that would lead you to a particular conclusion? It’s an interesting twist on addiction…my growing up years told me they are all beautifully flawed people, but my adult experiences have taught me differently. Still….the chicken or the egg theory? You know?

      1. Good question Einstein. It’s one I’ve been asking since reading Dr Simon. I am reticent to answer definitively as I fear imposing my new knowledge on their past behaviour. But family members knew there was something ‘different’ but have been unable to explain it. I still have an open mind keeping in mind it is a continuum.
        It sounds like you’ve been really hurt by the addicts in your life. I know the statistics…ones which the rehabs never own up to! But to give into the statistics, which I have at times, takes one to a dark hole. And the reality is, some do ‘recover’. I admire the courage of ones I know. And their character has been changed in the process.
        Just my thoughts at present as I’m new to this paradigm, but I can’t help but wonder if CD addicts might not be easier to reach than neurotics..or than those who are both. it seems once you ‘get’ the motives of the CD s you can call them out and then their choice to submit or defy are clear.

        1. They Never capitulate!! If they (CD’s) quit doing something its only because it suits their purpose covertly!! Do I sound bitter?? LOL!

    2. “All addicts are treated the same in programs and labels put on co-existing psychiatric disorders, (eg antisocial) but maybe they need to heed Dr Simon’s research and develop the CD paradigm in treating the addict as an individual.”

      From your words, Martha, the last one jumps at me. Carl Rogers, after all, developed person-centred therapy, but he worked within the neurotic paradigm.

      Also, I’m slipping from the context(talking about rehab) a bit to nitpick. Personal responsibility can’t mean we’re guilty of any bad stuff that comes our way by chance, can it? It can’t also be a form of victim blaming when bad stuff happens through no fault of our own. Personal responsibility as a concept makes more sense, if it takes into account how things can happen that aren’t our fault and takes into account that we do want to live well and we do care about being well.

      “Personal realization and motivation is the pivotal ingredient to any change a person undertakes.”

      So is personal responsibility that we do care to make things better without enabling? Refering back to that Beyond Self-awareness: Self-development -article again. Also, Einstein, you brought up an interesting thought about someone being “emotionally stunted enough to qualify as CD”.

    3. Martha, recovery programs are no different than therapy and counseling practitioners. The way Dr. Simon and others have come to understand CD’s is just not widely recognized or accepted. It’s very frustrating and perplexing because people like Dr. Simon and others have been banging this drum for a significant period of time! It’s not “new” information……..it’s just bizarre to me!

  4. Well, I’m feeling out of my depth now as Im new to this. It seems though that in the vignette above, there was hope for “Marty” ..and his family!!! When the character attributes we’re addressed competently. I am exploring that hope..

    1. Martha, these types come in all “shapes and sizes” and as dr. Simon has spelled out, haracter disorders exist on a continuum, so it certainly is not impossible that there are those who might be able to turn their lives around and the love and support of those close to them might help them do that. I can tell you that the one I was entangled with and the one that Tori was unfortunate enough to have in her life are not at the end of the spectrum where any kind of change that will impact those around them in a positive way is possible. Impossible is where i would place my money.
      I hope for you that this person in your life is of a different variety and I certainly would never discourage you from staying hopeful and supportive but I would also suggest that at the same time you remain realistic and continue to educate yourself. Really, all it takes is one serious ultimatum (that you are willing to stand by) and if the person is motivated by the consequences of that ultimatum,,,,,they will find a way to help themselves. My cousin did.

  5. For a good many years in my relationship with my CD, I believed it was his problem with alcohol that caused all the problems. I tried to get him to see that he needed help. It got to the stage I would leave pamphlets on alcohol addiction and help lines around the house, hoping he might say “Yeah I need help.” I was aware an addict had to get help for themselves or it wouldn’t work and that I could not push him into it. Well, all I can say is it must have amused him no end, all these attempts of mine. He never wanted to get help, he liked drinking. In his mind he was fine and if there was a problem I HAD TO HELP HIM MYSELF! I realise now that’s how all his problems had to be dealt with by me and in his CD mind if I couldn’t help him that’s because I had the problem and I didn’t understand him or I wasn’t loving enough, I wasn’t listening to him or I wasn’t whatever… he could relieve himself of all responsibility. I think their addictions are just another weapon in their arsenal, used as an excuse to hide their real intentions.

    1. Hi Tori 🙂 Yep,,,,,,,I agree agree agree. Spathtard sat back while I bought relationship book after relationship book, communication books, sex books, while I praised him about this and that and made the crumbs he dribbled off his plate, onto the floor for me seem like fillet mignon that he had prepared himself, just for me, because I meant so much to him, as IF! Looking back as well,,,,,,,,,to the beginning………he brought me flowers!!!! From his MOTHERS GARDEN! Brought me tasty food treats………LEFT OVER FROM THE MEAL HIS MOTHER HAD COOKED FOR HIM!! And I was gullible enough at the time to not see just how absolutely pathetic that really was!
      Spathtard thought, or wanted me to think, that unconditional love meant that you had to accept everything a person does and not have an issue with it…………you know, like MOMMY does?

  6. Hi Puddle, yes the acceptance thing is big isn’t it…this is the way I am and you should love me anyway. Right now the ex’s life is apparently like the said ship floundering on the rocks…and even that’s not enough to make him see that something obviously isn’t right with the way he is BUT of course it’s all MY fault isn’t it! So there’s his answer to everything. I hope all is coming together in your world Puddle 🙂 and you can be warm this winter?? Are you getting a win with these characters? I know it’s hard, seems their downright refusal to engage just works in their favour all the time.

    1. yeah Tori, all is NOT well in this at all……..so many facets to how this as a negative impact on me, winter prep, winter existence. So many layers. Right now I can’t even get the guy who was going to fix this and get me back on track to do anything. He said he doesn’t feel comfortable getting involved until it’s settled……and my attorney left on vacation for over a week so,,,,,,,,,,,,,, he comes back this Sunday but it’s all in limbo. Very frustrating and I am overflowing with anxiety. In my opinion the guy who won’t work here doesn’t want to get his hands dirty and i don’t have a very high opinion of that either! I thought he was my savior and he can;t be bothered. He said he doesn’t want to be drawn into a legal battle as a witness. Well right is right and wrong is wrong and shouldn’t we as fellow humans be willing to stand up for someone who is getting screwed? Nope,,,,,every man for them self. It’s the biggest mess I’ve ever encountered .
      But, thank goodness I pulled the plug on this before they ripped down my kitchen and destroyed ANY chance of me being able to live here through the winter (too complicated to explain ALL if the details about this).
      So I do have a furnace in this house but wood heat is my primary heat and I can’t even get my firewood till this mess is sorted out……
      (((!!! HUGS TORI !!!))) 🙂
      I hope someone drops a house full of empty beer bottles on your ex and that he suffers a bad case of some kind of rash that keeps him up all night!!!

    2. Tori, this whole situation is absolutely textbook CD behavior. He (they??) is ticking all the boxes and I’m already experiencing the scapegoat aspect. Even the girl who was here helping me during the lead into the project and during the week they actually were here working before I pulled the plug on it, she is just being the naive voice of “reason” in this with her “well maybe’s” and “maybe he just” or some other kind of “look at the bright side” comments. I voiced concerns to her the entire time and every tie she took an opposite stance that gave him the benefit of the doubt. so much of this WILL turn out to be a “he said, she said” thing…… and she is so wishy washy I doubt very seriously I could call on her as a witness. AND I think there are some underlying neurotic dynamics to her even WANTING to excuse his behavior. NOONE can understand how covertly devious these CDs are! They just can’t conceive of what I’m 99% sure this guy had in mind from the get go!

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