CODEPENDENCE

A compilation of Public Domain

Publications about CODEPENCE.

AUTHORS :

Dr. Irene Matiatos Ph.D.

Daniel Ploskin, MD
Royane Real
Melody Beattie
Patty E. Fleener M.S.W.
Wikipedia Encyclopedy
Codependence?
By Dr. Irene Matiatos Ph.D.
Source: http://www.soulselfhelp.on.ca/codependencea.html

Some of the nicest people I know are codependent.

They always smile, never refuse to do a favor. They are happy and
bubbly all the time. They understand others and have the ability to make
people feel good. People like them!

So, what is wrong with this?

Nothing, really, unless the giving is
one-sided and so excessive that it
hurts the giver. Then, the giver is
showing the signs of codependence.

Partners who go out of their way

for each other are interdependent.
Only relatively healthy people are
capable of interdependent
relationships, which involve give and
take. It is not unhealthy to
unilaterally give during a time when
your partner is having difficulty. You
know your partner will reciprocate
should the tables turn.
Interdependency also implies that you
do not have to give until it hurts. By
comparison, in a codependent
relationship, one partner does almost
all the giving, while the other does
almost all the taking, almost all of the
time.

By giving, codependent people avoid the discomfort of entitlement.

Giving allows them to feel useful and justifies their existence. Rather than simply
approving of themselves, codependent people meet their need for self-esteem,
by winning their partner's approval. Also, because they lack self-esteem,
codependent people have great difficulty accepting from others. One must feel
deserving and entitled in order to accept what is offered.

Codependent behavior is not easy. It requires a lot of work.

It hurts. These individuals typically suffer with low self-esteem, depression,
anxiety, and especially guilt, as well as other painful thoughts and feelings. They
judge themselves using far stricter criteria than they use to measure the
performance of others. While they are brutally critical of their own misbehavior,
they are very good at justifying and excusing the misbehavior of others.
Codependent people misplace their anger.
They get angry when they shouldn't, and
don't get angry when they should. They have
little contact with their inner world and thus
very little idea about how they feel. Usually,
they don't want to know because it gives rise
to painful emotions. It is easier to stay on
the surface and pretend things are peachy
keen, rather than deal with the stuff going on
inside.

If they were to look inside, they would

find their emotional starvation.
They are busy taking care of others. Yet,
they do not meet their own needs!
They may put up with abusive relationships
or relationships that are not fulfilling because
any warm body beats (gasp) no warm body.
Being alone is perceived as scary, empty,
depressing, etc. After all, who will deliver
their emotional

supplies? Who will distract them so there is no time to deal with their inner life?
Even an abusive relationship is better than no relationship.

These loving, giving people find interesting ways of explaining their

behavior to themselves.
Loyal to a fault, a codependent individual is likely to rationalize a loved one's
disrespectful behavior by making excuses for them. "He doesn't mean it." "It
was not done with malice." "It is the best he can do." "She had such an awful
childhood." Etc., etc., etc.

The central concept is that the codependent individual "takes it" and
understands," despite feeling hurt.
Waiting for brownie points in heaven, or for a loved one to be magically healed
through their persistent love and care taking, they accept disrespect from others.
It does not occur to the codependent person that it is not OK to "take it" and
"put up" no matter what!

Much of this abuse acceptance occurs without the codependent

individual feeling abused!
More accurately, these individuals do not feel OK enough to expect respectful
treatment at all times, and to notice when it is not forthcoming. Having grown up
in a home where a parent or sibling demanded inordinate attention (due to
addiction, illness, anger, or other problem), the codependent person is trained to
care for others. Having grown up in a difficult environment, a negative emotional
climate is experienced as normal and familiar.

This is why there is often little recognition of disrespect. If their partner is angry
or upset, the codependent individual will implicitly assume that they did
something to cause the anger. It does not occur to them that it is their partner's
responsibility to deal with their problem and to treat others respectfully. It does
not occur to them that it is their responsibility to themselves to stop another
person's demeaning behavior toward them. But, how can stop disrespect when
misbehavior is not perceived as disrespectful or abusive? Disrespect is normal.

An unfortunate side effect of the codependent person's willingness to

ignore, excuse, or otherwise allow the partner's abuse or disrespect,
enables the misbehavior directed at them to continue and intensify.

Implicit or explicit permission to continue misbehaving

is granted since the codependent partner
"understands."
Because codependent individuals are approval-driven,
they cannot stand it when others are angry at or
disappointed with them.

As such, they unwittingly place themselves in a

position to be taken advantage of. The more approval
is needed, the less likely is the individual to realize the
extent of their self-sacrifice in favor of tending to the
needs of the other. This hurts ("Ouchhh!"), and
creates or maintains depression and low self-esteem,
in a vicious, downward spiral.

While abuse, disrespect, or unrequited sacrifice angers them, as it

should, codependent people do not realize how angry they are and at
whom they are angry!
Targeting the appropriate person may jeopardize a source of approval and self-
esteem. To avoid facing reality, they distort it.
Codependent individuals are likely to somehow blame themselves and rationalize
their "over-sensitivity." They justify the other person's behavior by thinking they
must deserve the treatment they are getting. This is preferable to facing the
possibility that an individual who provides a measure of their self-esteem is
hurting them.

"Anger...is a signal that something is wrong and needs attention".

Anger is healthy. It is a signal that something is wrong and needs attention.
However, if the source of anger is not articulated, how can it be fixed?
Codependent people are expert at denying anger and turning it against the self -
into sadness and depression. Instead of asking themselves why are they are
putting up with... (fill in the blank), they ask themselves how they could have
behaved differently - to obtain a more favorable reaction from their partner!

Unarticulated anger is often misdirected and expressed inappropriately.

Anger may be experienced as resentment, expressed as an aggressive blow-up,
or in passive-aggressive acting out. The cognitive and verbal skills to
appropriately assert oneself are lacking.
Since codependent people are experts at controlling other people's
thoughts, feelings, and behavior, they feel hurt that others don't
reciprocate and "know" what they need.
"If they really loved me, they would know." Not so! Since codependents do not
have the self-esteem to ask for what they secretly want, they are unlikely to get
it. If they do make a request, it is often a roundabout hint. If their partner
cannot decipher the request, they feel hurt and unloved. They believe they
conveyed their desires, when, in fact, they have not!

Because most codependent individuals are control-oriented, they are

very responsible.
They are great employees. Tasks are done thoroughly and on time. Even parts of
the job that are not theirs get picked up if coworkers are neglectful or slow. They
try to control outcomes, whether those outcomes are completed job tasks or
reactions from other people. Anything for approval.

However, some codependent individuals are very irresponsible, in select

or diverse life areas.
They don't know how to or don't feel the need to take care of some of their own
basic needs, especially if there is another person to care for instead. Why spend
the time trying to figure out what the self needs, when
the self doesn't really matter anyway? It is far more preferable to be out avoiding
one's own issues: out having fun, hunting for a partner, or self-medicating
feelings.

Codependent people are addiction prone.

They may drink too much, shop too
much, eat too much, etc. Dulling the
senses is a great way to avoid knowing
yourself and dealing with your
feelings.

Intimacy is avoided.
Intimate behavior requires familiarity
and comfort with one's internal world.
Since the codependent person regards
ordinary human needs as shameful,
embarrassing, dangerous, or otherwise
uncomfortable, meeting basic needs
are often dismissed.

Any relationship that ignores the self is superficial.

Unfortunately, superficial relationships are safe...but empty and unfulfilling.

Control is central to the "MO" of the codependent person.

They control their self-esteem by catering to others' needs.
They control by their over-responsible performance, picking up where others
leave off.
They control by avoiding intimacy or by clouding the mind.
They control by advising others on what to do.
These individuals work very hard to control everything and everybody.
Yet, they neglect the one person they do have control over: themselves.
Why Be Codependent?

Why would anybody spend time and energy to control outcomes, while
actively neglecting the inner self? How can they do this and not realize
they are selling themselves short?
The Why: they know no other way;
The How: they received very good training early in life.

Any dysfunction in the family predisposes a child to codependent

behavior.
Children are biologically programmed
to seek love and approval. They have
to be cared for or they will die.
When a parent or family member is
dysfunctional, the child tends to focus
on this person--rather than on
enjoying a carefree and joyful kid
existence. The child has to worry: if
the caretaker does not care take, the
child dies. For example, in an alcoholic
home, little Sally has to worry about
whether she can bring friends home -
because daddy may be in a bad mood
and embarrass her.
Such events are training her in
codependent thinking, the art of
anticipating the other person.

If mom is physically ill, Teddy has to worry about exerting her. Who would care
for him if anything happened to her? If daddy is angry and controlling, Timmy
needs to worry about pleasing him to avoid punishment and humiliation - and to
get his conditional love and approval.

Children are naturally egocentric.

That means that they see the world
revolving around them. If mom and
dad fight, children feel that it is
somehow their fault. Julie may try to
make her parents happy by getting
straight As in school in an attempt to
keep the parental marriage together.
Another child may have an abusive,
or simply overactive older sibling.

Since the parents cannot be there at

all times to police the situation, the
younger sibling may learn to
anticipate the sib's moods and to
behave in ways that might increase
the probability of "safety." Or,
perhaps daddy is depressed. Jennifer
may tiptoe around him wondering if he is unhappy because she is not good
enough. And so on.

In sum, codependent thinking tends to develop any time a child is

growing up in a home where life is not care free.
Often, addiction can be traced in the family tree of these dysfunctional families,
whether there is an active addict in residence, or not. Nevertheless, these kids
have an adult they have to worry about!

The codependent-in-training is taught to walk on eggshells.

To ensure survival, the child learns to be extraordinarily sensitive in reading the
moods and thoughts of others. The child learns very early to pay attention to and
tiptoe around the dysfunctional family members - at the child's expense. These
interactions take place silently, implicitly. The child learns to ignore the self's
inner needs, instead pretending that all is OK.

When I tell my clients that codependent adults were once children who
had an adult to worry about, some sharply disagree.
They tell me about the loving families they came from and insist that their family
members were "wonderful," etc. As denial melts and self-awareness develops,
they begin to recognize the failings in a caregiver that spawned their
selflessness. Sometimes, both parents were codependent, modeling no other
behaviors for the child to learn.

Help! Can I Fix it?

Good news! You certainly can! You can get control over your life!
You can stop trying to control the lives of others and take charge of
yourself!

While children are truly not

responsible for their actions, adults
are.
To experience a more satisfying life, it
becomes incumbent upon the adult to
take control of the unavoidable childhood
or present-day scars they experienced.
Parents don't set out to hurt their
children; neither do abusive partners! We
get hurt and we in turn hurt others
because we are imperfect. We may never
achieve perfection, but we can improve.

It is important to remember that we are

in part a product of our environment.
If we mis-behave, we have learned to do
so. The good news is that what was
learned can be unlearned or modified.
The best news is that, in my experience,
codependency issues are in most cases not particularly difficult
problems to deal with.

I find a blend of cognitive behavior therapy with an emphasis on cognitive and

verbal skills training combined with a 12-Step approach very effective. Many self-
help resources are available from books to support groups, as well as
professional guidance.

"Codependence" is cocktail party talk. Walk into your local book store's self-help
or psychology section and look around. Melodie Beattie and Pia Mellody are two
of my favorite authors in the field. Also, check out some of Albert Ellis' cognitive-
behavioral work that helps in stamping out irrational codependent thinking.
Self-help groups such as ALANON and CODA are 12-Step programs that have
their own formula help change codependent behavior.

So, go to therapy. Read, get to a meeting. Get yourself evaluated for medication
if you are depressed. Do whatever you need to do. As an adult, you have
options. You can take control of your life! You are the only one who can take
control of your life.
 CODEPENCE
by Daniel Ploskin, MD - August 21, 2007 – A.O.

What Is Codependence?
While not recognized as a diagnosable illness in the American Psychiatric Association’s
Diagnostic and Statistical Manual of Psychiatric Disorders (a professional reference used
to make diagnoses), codependence generally refers to the way past events from
childhood “unknowingly affect some of our attitudes, behaviors and feelings in the
present, often with destructive consequences,” according to the National Council on
Codependence. Certain signs can help us identify a tendency toward codependence.

Self-worth comes from external sources

Codependent people need external sources, things or
other people to give them feelings of self-worth.
Often, following destructive parental relationships, an
abusive past and/or self-destructive partners,
codependents learn to react to others, worry about
others and depend on others to help them feel useful
or alive. They put other people’s needs, wants and
experiences above their own.
In fact, codependence is a relationship with one’s self
that is so painful a person no longer trusts his or her
own experiences. It perpetuates a continual cycle of
shame, blame and self-abuse. Codependent people
might feel brutally abused by the mildest criticism or
suicidal when a relationship ends. In his 1999 book,
Codependence: The Dance of Wounded Souls, author
Robert Burney says the battle cry of codependence is:
“I’ll show you! I’ll get me!”

Examples of codependency
Health professionals first identified codependence in the wives of alcoholic men. Through
family treatment, they discovered that spouses and family members were codependent,
or also had addictive tendencies. Co-addiction occurs when more than one person,
usually a couple, has a relationship that is responsible for maintaining addictive behavior
in at least one of the persons.
For example, co-addicted people might believe that, at some level, getting a partner or
family member to become sober or drug-free might seem like the one goal which, if
achieved, would bring them happiness. But on another level, they might realize they are
behaving in a way that enables the addict with whom they live to maintain their
addictions.
For instance, they might never confront the addict about her behavior. Or they might
become her caretaker, spending limitless time worrying about her. They might assume it’s
their responsibility to clean up after and apologize for their loved one’s behavior. They
might even help her continue to use alcohol or drugs by giving her money, food or even
drugs and alcohol, for fear of what would happen to her if they did things differently.
Many codependents come to believe they are so unlovable and unworthy that to stay in a
dysfunctional, destructive relationship is the best and safest way to live.
Codependent people who believe they can’t
survive without their partners do anything they
can to stay in their relationships, however
painful. The fear of losing their partners and
being abandoned overpowers any other feelings
they might have. The thought of trying to
address any of their partner’s dysfunctional
behaviors makes them feel unsafe. Excusing or
denying a problem like addiction means they
avoid rejection by their partners.
Instead, as in the example above, co-addicted
people often will try to adapt themselves and
their lives to their partners’ dysfunction. They
might have abandoned hope that something
better is possible, instead settling for the job of
maintaining the status quo. The thought of
change might cause them great pain and
sadness.
Codependence works the same way, whether
the addiction is drugs, alcohol or something
else, such as sex, gambling, verbal or physical
abuse, work or a hobby. If the addicts’ behavior causes worry, forcing the partners to
adjust to and deny the problem, they are at great risk of becoming codependent. Those
who were abused as children face an even greater risk.

Checklist for family members of

people with Mental Health Disorders
by Patty E. Fleener M.S.W.

I wanted to touch on codependency. It seems like an old subject yet people are hurt by
this "condition" so often and so many of us have these issues and are not aware.

Why do I bring this up in a mental health website? Most person with a mental health
disorder has a family member. If you are the family member, check yourself out for these
behaviors quickly and if you can't relate then move on.

Just because those of us who have mental health disorders may not be a family member
of someone with a mental health disorder, doesn't mean we don't have a problem with
codependency and it is very difficult to work on recovery when our focus is always on
someone else. In fact, downright impossible.

So many family members are focusing completely on the person who has the mental
health disorder that they are not in touch with their own needs at all. This is not only
unhealthy for the family member but for the person with the disorder as well.

You must learn to get your life back and as the author Melodie Beattie says "lovingly
detaching." You are not on this earth to take care of your partner or your daughter or
your cousin, etc. Let me repeat that. You are not on this earth to take care of your
partner or your daughter or your cousin, etc.
That may be a part of your life and a very important part of your life. But that is not the
only reason you are on this earth and that is not the only thing that defines you. You
must find out who you are and become that person once again. You must be that person
you were before you knew "that person" and have that person in your life as well.

What does it feel like if you have been around someone strongly
codependent?

I felt violated. My boundaries were crossed. I felt extremely angry and upset. I felt
manipulated and power was taken away from me that belonged to me.

I had always heard that 50% of chemically dependent people are codependent. My
husband who attends AA says the joke there is that it is 100%. So I do not know what
the exact figures are.

Let's review some basic codependency behaviors.

What do Codependents try to do? Control others or situations.
Do they really think they can control others? Yes.
Can anyone ever control others? No
Do they cross our boundaries? Yes
Do they mind their own business? No
Do they manipulate? Yes
Do they know what is best for you? Yes
What do they say when we get angry with them for crossing our boundaries?
I was only trying to help.
What are some reasons they do this?
To avoid their own issues. To get their mind off of themselves.
What does Al-Anon and CoDa tell them to do?
Butt out! Mind their own business. Get the focus off of them and back on their selves.
What do codependents do when they can't control you? Get angry.
Characteristics of Codependency
1. My good feelings about who I am stem from being liked by you
2. My good feelings about who I am stem from receiving approval from you
3. Your struggle affects my serenity. My mental attention focuses on solving your
problems/relieving your pain
4. My mental attention is focused on you
5. My mental attention is focused on protecting you
6. My mental attention is focused on manipulating you to do it my way
7. My self-esteem is bolstered by solving your problems
8. My self-esteem is bolstered by relieving your pain
9. My own hobbies/interests are put to one side. My time is spent sharing your
hobbies/interests
10. Your clothing and personal appearance are dictated by my desires and I feel you are
a reflection of me
11. Your behavior is dictated by my desires and I feel you are a reflection of me
12. I am not aware of how I feel. I am aware of how you feel.
13. I am not aware of what I want - I ask what you want. I am not aware - I assume
14. The dreams I have for my future are linked to you
15. My fear of rejection determines what I say or do
16. My fear of your anger determines what I say or do
17. I use giving as a way of feeling safe in our relationship
18. My social circle diminishes as I involve myself with you
19. I put my values aside in order to connect with you
20. I value your opinion and way of doing things more than my own
21. The quality of my life is in relation to the quality of yours

Melody Beattie, author of Codependent No More developed this check list:

*********************************************************
Website Links for Codependents: http://alcoholism.about.com/cs/coda/
*********************************************************
Are You Codependent?
By Royane Real - Published: 5/6/2006

Do you feel like you give and give in your relationships but you get very little back? Are you always
trying to save somebody or rescue somebody that doesn’t have their life together? You may be co-
dependent. Take this quiz and find out.

In a relationship between two emotionally

healthy adults, the roles of giving and
receiving help are balanced. Both people offer
help and receive help from each other in
approximately equal amounts.

However, there are some people who always

take on the role of being the helper, no matter
what relationship they are in. These people
give, and give, and they always seem to get
involved with people who have very serious
emotional problems, such as addiction. And
they exhaust themselves trying desperately to
save the other person, even at tremendous
cost to their own health.

These people have friendships that focus

exclusively on trying to solve the problems of
their friends. We sometimes call this quality
"co-dependency", and we may label people
who are obsessed with helping others "co-
dependent".
A person who is co-dependent will tend to have relationships with people who have a lot
of problems – emotional, social, familial and financial. The co-dependent person may
spend much of their own time, money, and energy helping other people who have
problems, while ignoring the problems in their own life.

Why would somebody be co-dependent?

A person who is co-dependent often suffers from a deep sense of worthlessness and
anxiety, and tries to derive a sense of self-worth by helping or rescuing others. A person
who is co-dependent may not know how to relax and feel comfortable in a friendship
where both people are equals and the relationship is based on enjoying each other’s
company.

Co-dependent people may even feel anxious if someone they have been helping gets
their life in order and no longer wants their help. The co-dependent person may
immediately look around for someone else they can "save".

If you frequently take on the role of helping the people who are your friends, how can
you tell if you are acting out of genuine kindness and concern, or whether your behavior
is in fact co-dependency?

When is it healthy to put the needs of other people first, and when is it unhealthy?

There aren’t really any hard and fast lines between the two.
Here are some questions you can ask yourself to see whether your
"helping" behavior may actually be co-dependency:

- Do you have a hard time saying no to others, even when you are very busy, financially
broke, or completely exhausted?
- Are you always sacrificing your own needs for everyone else?
- Do you feel more worthy as a human being because you have taken on a helping role?
- If you stopped helping your friends, would you feel guilty or worthless?
- Would you know how to be in a friendship that doesn’t revolve around you being the
"helper"?
- If your friends eventually didn’t need your help, would you still be friends with them?
Or would you look around for someone else to help?
- Do you feel resentful when others are not grateful enough to you for your efforts at
rescuing them or fixing their lives?
- Do you sometimes feel like more of a social worker than a friend in your relationships?
- Do you feel uncomfortable receiving help from other people? Is the role of helping
others a much more natural role for you to play in your relationships?
- Does it seem as if many of your friends have particularly chaotic lives, with one crisis
after another?
- Did you grow up in a family that had a lot of emotional chaos or addiction problems?
- Are many of your friends addicts, or do they have serious emotional and social
problems?
- As you were growing up, did you think it was up to you to keep the family functioning?
- As an adult, is it important for you to be thought of as the "dependable one"?
- Do you feel responsible for other people--their feelings, thoughts, actions, choices,
wants, needs, well-being and destiny?
- Do you feel compelled to help people solve their problems or by trying to take care of
their feelings?
- Do you find it easier to feel and express anger about injustices done to others than
about injustices done to you?
- Do you feel safest and most comfortable when you are giving to others?
- Do you feel insecure and guilty when someone gives to you?
- Do you feel empty, bored and worthless if you don't have someone else to take care of,
a problem to solve, or a crisis to deal with?
- Are you often unable to stop talking, thinking and worrying about other people and
their problems?
- Do you lose interest in your own life when you are in love?
- Do you stay in relationships that don't work and tolerate abuse in order to keep people
loving you?
- Do you leave bad relationships only to form new ones that don't work, either?

If you answered "yes" to a lot of these questions, you may indeed have a problem with
co-dependency.

This does not mean that you are a flawed person. It means that you are spending a lot of
energy on other people and very little on yourself.

If it seems that a lot of your friendships are based on co-dependent rescuing behaviors,
rather than on mutual liking and respect between equals, you may wish to step back and
rethink your role in relationships.

If you suspect that your helping behavior is a form of co-dependency, a good therapist or
counselor can help you gain perspective on your actions and learn a more balanced way
of relating to others.

What does a healthy friendship look like

compared to a codependent friendship?
I'm just at the beginning stages of discovering what that's like. From what I know so far I
can say that you should not have such high expectations of your friends. You should
value the differences you see in them.

Also, you should not depend on

them. You can depend on them to
a certain extent, but with a
healthy relationship it's not life or
death if you are not with them.

Obviously love is a part of a

friendship, but now I'm learning
to love others by faith
unconditionally. We all fail but you
have to leave room for failure in a
friendship because

we're all human so

disappointment and mistakes are
bound to happen.

I've also discovered

that relationships are not all
about me. It's about how loving
and serving the other person. Also a good friendship is really about how we can build
each other up.

I have learned a lot about forgiveness too. I had to forgive people in my past for what
they did to me. Now I have to forgive myself for what I did to Anna.

Holding onto my past hurts facilitated a lot of my actions. I know that a healthy
friendship brings freedom. I'm so much more relaxed now. I have lots of friends but I
don’t feel as if I really need any friends or one best friend.

How can someone recognize this pattern in their own life?

I think there always has to be a more

dominant person in a codependent
relationship. You could be the dominant one. I
was the dominant one. The dominant one
takes the initiative. The dominant one has all
the expectations of the other person and can
feel like the other person doesn't measure up.

Often as the dominant one I felt sad or lonely.

When I hung out with other people I would
think of her. My heart would not be fully
engaged with other friends. People considered
us to be so close so the thought of even
breaking away from each other was
horrifying. I invested a lot in her. I shared my
emotions with her. I never got close to anyone
as I did with her.

That's another pattern of codependency - only

letting that one person get close and not letting others get close to you.

Even if someone were to show me, I still didn't see at all how I was codependent on
Anna. It is very much a process of discovering on my own the kind of lifestyle I was
living.

I am a stubborn person too. I didn't quite want to give her friendship up, as unhealthy as
it was. I knew I had a problem, but I didn't want to break from this friendship
because I was scared of the unknown.
All I knew was what I was comfortable with and I didn't want to separate myself from
that comfort. I wanted to change my life but it took months and months before I could
take the necessary steps, which made me realize just how unhealthy my relationship had
been.

What are some key questions that would help someone realize if they are in a
codependent relationship?

• How much time am I spending with this friend? That determines a lot right there.
• Am I neglecting other friends?
• Do I think this relationship is healthy? What do others in my life who care about
me think about this relationship?
• Are there questions about the past that I need to answer for myself?
• Have I forgiven people in my past that have hurt me, and moved on?
What addictive behaviour were you struggling with?
A codependent friendship.

How did it start?

Six years ago I met a person I thought would be my best friend for life. I was going
through a huge transition in my life coming home from college and having to start over in
building friendships. Although I graduated, all my friends were still in college and my old
friends from high school had all changed. It was hard for me to identify and connect
again with my old friends.

I connected with a few of my old friends

from high school, and through one of
them I met Anna.

At the beginning of our friendship Anna

and I connected really well and we had a
lot of fun. We spent a lot of time
together right from the
beginning. She too had just come home
from college and didn't know anyone.

We started hanging out 2-3 times a

week, but I started calling her more and
more.

By the second year of our friendship we

hung out every night and were
communicating thoroughly every day.

We became inseparable to the point that people thought we were sisters. Neither of
us had been in an unhealthy friendship before and because we shared a deeper
dimension of life in our friendship (faith and spirituality), we never thought our
attachment to each other was unhealthy.

But, over time, I started becoming more manipulative over her and placed higher
and higher expectations on her. I figured that if she knew me best she should know how
to treat me perfectly.

She was the one that I thought had to give me what I needed and I would get upset if I
didn't get it. I demanded a lot from her and she complied most of the time with
what I needed.

What kinds of needs did you want her to meet?

I was really looking for Anna to meet my emotional needs. I wouldn't go to God first at
all. I thought about praying but the first person I thought of was Anna.

Ultimately, I thought Anna could help me and pray with me. We were there for each
other spiritually, but only in a selfish way.
Why did you feel "addicted" to this relationship?

Because I felt I needed. It seemed to be a safe place to go for refuge. To me, she
seemed like a safe haven.

I tried to find my satisfaction and fulfillment in Anna. But, she could hardly meet a tenth
of what I expected or thought I needed from her.

When did you start to see a problem with your relationship?

Anna's relatives and close friends would say that we hung out too much. But both of us
were too entrenched in our friendship to think anything was really wrong. We were both
needy and we both fulfilled needs in each other. But, at the same time, we weren't
satisfied because there was a void there that we could feel and sense, especially
spiritually. We knew that only God could fill that void and fulfill our needs, but we went
to each other instead of to God.

We began to realize that we were becoming too dependent on each other. At first there
was no way I'd drop her friendship, because she still meant the world to me. But after
spending more time with God and reading bookson friendship and codependence, we
were both seeing just how unhealthy the relationship had become.

Describe what your relationship looked like in its most dependent

stage...

Often Anna would get angry

easily because I was
manipulative and possessive.

I was outgoing and dominant,

and she, being opposite, was a
good follower. Our difference
in personality made it easy for
our friendship to get out of
balance.

Throughout this time I was

blinded to my other friends. I
didn't see how my other
friends were really important
to me. I also neglected to
value my own family. I cared
more about Anna coming over
on a family day more than I
cared about seeing my family.

I wanted to be with her all

the time. I would shower her with cards and gifts. She would do the same for me.

When I was hanging out with Anna I would try to control who she hung out with and
control how deep her friendship with others would get.
I would ask her what she was doing during the week and made sure she spent the most
time with me. I continually re-affirmed in my mind that I was number one in her
life.

Throughout all of this, I didn't realize how manipulative I had become.

Looking back I can see how much of what I did had an ulterior motive. I wanted what
was best for her, but I was the one who determined that. I figured what was best for her
was to build our friendship.

I tended to see myself as a needed person in

her life. If I wasn't in her life I thought she
would be weakened and not grow to her
potential. It was selfish because I
thought I was everything to her.

But often, our friendship was disappointing.

When we spent time together, I would
expect it to look a certain way and would be
angry, sad, or disappointed when it didn't go
the way I expected.

I would analyze our time together and

question if our time together was quality or
deep enough. This wore me out and made
me anxious. It felt like the end of the
world when we couldn't hang out
together. Overall, my self esteem
sucked.

How would you feel if she wanted

to leave you?

We constantly confirmed with each other that we would never be separated. Any time I
would panic she would always affirm that "I'll always be your friend, I'll always be there
for you."

But, you can't make promises like that to a friend because you don't know where you'll
be or how you'll change. We made these promises to each other to give each other a
sense of stability.

What steps did you have to take to get back out of this
codependent relationship?

Through mentorship, reading the Bible and reading books I learned that our friendship
was unhealthy.

About 5 months ago she took an important step and asked to take time away from our
friendship.

Since then, we haven't communicated or talked. God has done so much in both our lives
in the last 5 months. It was the best thing we've ever done.
For me, it is a daily decision to look to God instead looking to others. I've given Anna to
God every single day since our separation. Each day I have to decide that God is the Lord
of my life, not Anna. I made the mistake of considering Anna to be God to me.

It has been a grieving process as well. God's been showing me more and more
what a real friendship, what a God centered friendship, looks like. Now I love God
more than I ever did before.

Did you notice a pattern of control in your past relationships?

Yes, it started immediately after

high school. High school was a
crucial time in my life and I never
felt accepted. I felt rejected
basically for who I was and felt
very alone. I tried really hard,
and was afraid I wouldn't have any
friends. I wanted to ensure that I
had friends so I was always trying
to be in control.

In college I became dependent on

friends. But, this dependency
didn't reach its peak until I met
Anna because at that point I really
wanted a best friend. Anna was so
compliant to go along with all my
suggestions and I was not allowing
God to direct my heart or mind.

There were so many things I

didn't believe about myself so
my mind was really left unaffected
by God. I didn't let him take over my thoughts and this affected my feelings. I loved
others but I loved wrongly. My love was misdirected.

After turning my life back over to God, my mind changed from one that was very selfish
and focused on me, to having God as the center of my thoughts.

Instead of caring mainly about what people think about me, now I think of what pleases
God and how He would want me to love. As I love myself and others the way God wants
me to love, I reflect His image and love.
Helping a Person Who Is Codependent
If someone in your life is codependent -a spouse, parent, child or friend- your support
may be an important part of recovery. Here are some ways you can help.

Spouse
Begin a dialogue about childhood and
messages your spouses might have received
from his parents that could have caused
shame. You might want to share your own
experiences of shame and how they affected
you. If you are recovering from an addiction, it
might be useful to discuss how most spouses
are affected by their partner’s addiction and
what might be helpful to him (Al-Anon
Meetings, Codependence Anonymous
Meetings). Attending therapy with a spouse or
buying a book on codependence and reading it
together are other ways to begin to help.

Friend

You might want to get a friend to open up to you by sharing your own
insights with him. You can offer to go to a Codependents Anonymous
Meeting with him or buy him a book to read about codependence. You
also could offer him a place to stay (if he is living with an addict and
could benefit from time apart) or a referral to a mental health
professional. Sometimes making the first phone call for help can be the
first step toward empowering the person to get well.

Child
Helping a child, unless it’s an adult child, might not be
appropriate since codependency as dysfunctional behavior is hard
to distinguish from normal dependency when a child is still young.
If you are the parent of an adult son or daughter who is now in a
codependent relationship, you could help by telling your child how
much you love her and that getting well is possible. Remind your
child of the strengths and positive qualities that sustained her
through other difficult times. Offer a place to stay or to go to a
12-Step meeting with her.

Parent
Helping a parent often is like helping adult children. Parents may resist taking advice
from their children. But if, together, you can go to a 12-step meeting, go to therapy or
read a book on codependence, you may begin to stir up a desire for recovery.
Co-worker
Helping a coworker might include sharing information over lunch or inviting her over for
coffee after work. If you are aware of a codependence problem with a coworker, chances
are she already has entrusted you with some intimate information. However, work might
not be the best place to discuss a topic as personal as codependence. Often, you can
help just by offering to listen outside work or to be an escort to a 12-step meeting.

Treatment Options for Codependence

If you think you have a problem with codependence, treatment is available and can help
you feel better. Healing takes time and hard work, but talking with other codependents
and seeing a therapist are two of the best ways to start your recovery.

Therapy
Treatment may consist of individual therapy,
group therapy and, eventually, couples and
family therapy. A clinical social worker,
psychologist or psychiatrist with experience
treating codependents and families of addicts
can help you identify and discuss the feelings,
thoughts and behaviors that you and others
find troubling.

Twelve-step groups
Many advocates of the codependency theory view codependency as a type of addiction.
Therefore, they maintain that codependents can overcome their symptoms with a 12-
step process similar to that used by Alcoholics Anonymous.
Twelve-step recovery programs bring codependents together as a group to talk about
their struggles and share hope and experiences. The 12-step recovery process involves
spirituality and is nondenominational. Codependents Anonymous meetings can provide
participants with a great source of emotional and practical support. Program recovery
involves admitting your life has become unmanageable because of your codependence. It
requires expressing your feelings, doing what you can to get better and letting go of
things you can’t control. Familiar 12-step affirmations include “One Day at a Time,” “Easy
Does It,” “Let Go and Let God (a higher power).”
If you are interested in going to a meeting, contact your local mental health center and
ask where you can find a Codependents Anonymous meeting in your area.

Medication
If you are confronting codependence issues as well as mental illness such as a depression
or anxiety disorder [Link to articles on Depression and Anxiety Disorder], you might want
to see your primary care doctor or a psychiatrist. He can determine whether medication
such as an antidepressant might help you. Often those who take medication and attend
 therapy and 12-step sessions find this combination to be the fastest and easiest way to
get well.

Healing shame
The key to healing a “wounded self” is to change the
distorted, negative perspectives and reactions to our
human emotions that result from having grown up in
a dysfunctional, emotionally repressive and spiritually
hostile environment.
Most therapists agree that part of this healing process
must involve grief. Grieving for the pain that caused
the codependence and for the difficulties you suffered
is a difficult but rewarding process. Learning to love
yourself requires acknowledging your shame,
disowning it, grieving the emotional damage you have
sustained and healing the emotional wounds.

http://psychcentral.com/lib/2007/what-is-
codependence/

The Twelve Traditions

The Twelve Steps are accompanied by The Twelve Traditions of group governance
as developed by Alcoholics
Anonymous through its early
formation. Most 12-step fellowships
also adopted these principles as their
structural governance. In AA, the
empathetic desire to save other
drunks resulted in a radical emphasis
on service to other sufferers only.
Thus “the only requirement for AA
membership is the desire to stop
drinking”. Similar membership
guidelines were adopted by other
fellowships, with particular emphasis
on freedom from alcohol because of the formative history of these traditions
(note that alcohol is considered a drug in most substance-related twelve-step
groups).

The Twelve Traditions of Alcoholics Anonymous:

− Our common welfare should come first; personal recovery depends upon
A.A. unity.
− For our group purpose there is but one ultimate authority — a loving God
as He may express Himself in our group conscience. Our leaders are but
trusted servants; they do not govern.
− The only requirement for A.A. membership is a desire to stop drinking.
− Each group should be autonomous except in matters affecting other
groups or A.A. as a whole.
− Each group has but one primary purpose to carry its message to the
alcoholic who still suffers.
− An A.A. group ought never endorse, finance, or lend the A.A. name to any
related facility or outside enterprise, lest problems of money, property,
and prestige divert us from our primary purpose.
− Every A.A. group ought to be fully self-supporting, declining outside
contributions.
− Alcoholics Anonymous should remain forever non-professional, but our
service centers may employ special workers.
− A.A., as such, ought never be organized; but we may create service
boards or committees directly responsible to those they serve.
− Alcoholics Anonymous has no opinion on outside issues; hence the A.A.
name ought never be drawn into public controversy.
− Our public relations policy is based on attraction rather than promotion;
we need always maintain personal anonymity at the level of press, radio,
and films.
− Anonymity is the spiritual foundation of all our traditions, ever reminding
us to place principles before personalities.

Meeting Process
One of the most widely-recognized
characteristics of twelve-step groups is the
requirement that members focus on the
admission that they "have a problem". In this
spirit, many members open their address to
the group along the lines of, "Hi, I'm Pam and
I'm an alcoholic" — a catchphrase now widely
identified with support groups.

Attendees at group meetings share their

experiences, challenges, successes and
failures, and provide peer support for each
other. Many people who have joined these
groups report they found success that
previously eluded them, while others —
including some ex-members — criticize their
efficacy or universal applicability. This varied
success rate, along with the fact that twelve-
step programs have been associated with the
belief in a higher power -- a belief often
associated with religion -- has caused some
controversy.
Twelve Step process
Twelve Step programs
symbolically represent human
structure in three dimensions:
physical, mental, and spiritual.
The disorders and diseases the
groups deal with are
understood to manifest
themselves in each dimension.
For addicts the physical
dimension is best described by
the "allergy-like bodily
reaction" resulting in the
inability to stop using
substances after the initial
use. For groups not related to
substance abuse the physical
manifestation could be much
more varied including, but not
limited too: agoraphobia,
apathy, distractibility,
forgetfulness, hyperactivity, hypomania, insomnia, irritability, lack of motivation,
laziness, mania, panic attacks, poor impulse control, procrastination, self-injury,
suicide attempts, and stress. The illness of the spiritual dimension, in all Twelve
Step groups, is considered to be self-centeredness. This model is not intended to
be a scientific explanation. It is only a model that members of Twelve Step
organizations have found useful.[12][13]

In time, the process is intended to replace self-centeredness with a growing

moral consciousness and a willingness for self-sacrifice and unselfish constructive
action.[13] In Twelve Step groups, this is known as a spiritual awakening or
religious experience.[14] This should not be confused with abreaction, which
generally only results in temporary change.[15] In Twelve Step groups, "spiritual
awakening" is believed to develop, most frequently, slowly over a period of
time.[16]

Sponsorship
In twelve-step programs, a sponsor is a more experienced person in recovery
who guides the less-experienced aspirant ("sponsee") through the process of the
steps as a program of personal recovery. One of the first suggestions newcomers
to 12-step meetings are offered is to secure a relationship with a sponsor[17][18]. A
vast array of publications from various fellowhips emphasize that sponsorship is a
"one on one" relationship of shared experiences focused on working the 12
steps[19][20][21].

Many forms of sponsorship exist. Sponsors and sponsees participate in activities

that lead to spiritual growth as defined by the twelve-step process. These may
include practices such as literature discussion and study, meditation, and writing.
Part of the final of the twelve steps is often interpreted to imply becoming a
sponsor to newcomers in recovery. "Sponsorship, with its continuing interest in
another alcoholic, often develops when the second person is willing to be helped,
admits having a
drinking problem,
and decides to seek
a way out of the
trap. [18]."

"Sponsors share
their experience,
strength, and hope
with their
sponsees... A
sponsor’s role is not
that of a legal
adviser, a banker, a
parent, a marriage
counselor, or a
social worker. Nor
is a sponsor a
therapist offering
some sort of
professional advice. A sponsor is simply another addict in recovery who is willing
to share his or her journey through the Twelve Steps."

– from NA's Sponsorship: Revised[22]

Sponsees typically do their Fifth Step with their sponsor. The Fifth Step, as well
as the Ninth Step, have been compared to confession and penitence. Many, such
as Michel Foucault, noted such practices "produces intrinsic modifications in the
person" and exonerates, redeems, purifies them; it unburdens them of their
wrongs, liberates them and promises their salvation.[23]

The personal nature of the behavioral issues that lead to seeking help in 12-step
fellowships results in a strong relationship between sponsee and sponsor. As the
relationship is based on spiritual principles, it is unique and not generally
characterized as "friendship." Fundamentally, the sponsor has the single purpose
of helping the sponsee recover from the behavioral problem that brought the
sufferer into 12-step work[18], which reflexively helps the sponsor recover.

Acceptance of a Higher Power

A primary tenet of 12-step recovery requires a member to surrender willful self-
reliance (a characteristic of afflicted persons) and adopt a practice of reliance
upon a "Higher Power" of the member's own understanding. Proponents of
twelve-step programs allege that agnostics and even atheists can be helped by
the program, as a member’s concept of a Higher Power may focus on the 12-step
group itself. With time, any other entity, thing(s) or object(s) that aid a member
in accepting their powerlessness over their problem, are claimed to become the
Higher Power that will help them to recover. It is colloquially stated that any
Power perceived as being greater than oneself will do, provided the power is not
any other, single individual, or one's own unaided will.

Literature studied in
most 12-step groups
is limited to their own
publications, as these
groups claim no
outside affiliation. The
members of 12-step
groups make the
distinction that the
groups are spiritual,
and not religious.
Some members of 12-
step groups are also
members of a wide
variety of religious
bodies. Nearly every
meeting begins with
the Serenity Prayer, a prayer addressed to "God." Some critics also question the
idea of giving up on self-reliance, which, they argue, results in a form of idealized
despair. Others acknowledge a debt to the twelve-steps movement but do not
have a culture of belief in God.

Court-mandated Twelve-step attendance

The success of twelve-step programs in aiding the recovery of chemically-
dependent persons is an argument of significance in jurisdictions of some
criminal justice systems. The criminal justice system of the United States has
ordered attendance at 12-step meetings to convicted criminals as well as
inmates as a condition of parole, condition of shortened sentence, or as an
element of a sentence. Four courts have ruled that Alcoholics Anonymous groups
are religious organizations.[24] The New York Court of Appeals ruled in Griffin v.
Coughlin, 88 N.Y.2d 674 (1996) that doing so compromises the Establishment
Clause of the United States Constitution on the grounds that A.A. practices and
doctrine are (in the words of the district court judge who wrote the decision)
"unequivocally religious". The Supreme Court of the United States denied US
Legal Certiorari and allowed the New York court's decision to stand. Such a denial
"imports no expression of opinion upon the merits of the case, as the bar has
been told many times." Missouri v. Jenkins, 515 U.S. 70 (1995). Denial of
certiorari means that no binding precedent is created, and that the lower court
decision is authoritative only within its area of jurisdiction -- in this case the
State of New York. However, the decision does create a persuasive precedent for
other jurisdictions.
These are some versions of the Twelve Steps from different
sources.
The 12 Steps of Alcoholics
Anonymous
1. We admitted we were powerless
over alcohol --- that our lives had
become unmanageable.
2. Came to believe that a Power
greater than ourselves could restore greater than ourselves could restore us
us to sanity.
3. Made a decision to turn our will
and our lives over to the care of God
as we understood Him.
4. Made a searching and fearless
moral inventory of ourselves.
5. Admitted to God, to ourselves,
and to another human being the
exact nature of our wrongs.
6. Were ready to have God remove remove all these defects of character.
all these defects of character.
7. Humbly asked Him to remove
our shortcomings.
8. Made a list of all persons we had
harmed, and became willing to make
amends to them all.
9. Made direct amends to them
wherever possible, except when to
do so would injure them or others.
10. Continued to take personal
inventory and when we were wrong
promptly admitted it.
11. Sought through prayer and
meditation to improve our conscious knowledge of God's will for us and the
contact with God as we understood
Him, praying only for His will for us
and the power to carry that our.
12. Having had a Spiritual
awakening as the result of these
steps, we tried to carry this message principles in all our affairs.
to other alcoholics, and to practice
The 12 Steps of Co-Dependents
Anonymous
1. We admitted we were powerless
over others --- that our lives had
become unmanageable.
2. Came to believe that a Power
to sanity.
3. Made a decision to turn our will and
our lives over to the care of God as we
understood God.
4. Made a searching and fearless moral
inventory of ourselves.
5. Admitted to God, to ourselves, and
to another human being the exact
nature of our wrongs.
6. Were entirely ready to have God
7. Humbly asked God to remove our
shortcomings.
8. Made a list of all persons we had
harmed, and became willing to make
amends to them all.
9. Made direct amends to such people
wherever possible, except when to do so
would injure them or others.
10. Continued to take personal
inventory and when we were wrong
promptly admitted it.
11. Sought through prayer and
meditation to improve our conscious
contact with God, praying only for
power to carry that out.
12. Having had a Spiritual awakening as
the result of these steps, we tried to
carry this message to other co-
dependents, and to practice these
these principles in all our affairs.
 The 12 Steps to Recovery for 16 Steps for Discovery and
Codependents Empowerment
From: Choicemaking by Sharon From: Many Roads, One Journey;
Wegscheider Cruse Moving Beyond the 12 Steps by
Charlotte Kasl Ph.D.
1. We acknowledge and accept that we
are powerless in controlling the lives of 1. We affirm we have the power to take
others, and that trying to control others charge of our lives and stop being
makes our lives unmanageable. dependent on substances or other
people for our self-esteem and security.
2. We have come to believe that a
power greater than ourselves can 2. We come to believe that God /the
restore enough order and hope in our Goddess /Universe /Great Spirit /Higher
lives to move us to a growth framework. Power awakens the healing wisdom
within us when we open ourselves to
that power.
3. We make a decision to turn our lives
over to this power to the best of our 3. We make a decision to become our
ability, and honestly accept that taking authentic Selves and trust in the healing
responsibility for ourselves is the only power of Truth.
way growth is possible.
4. We examine our beliefs, addictions,
4. We make an inventory of ourselves, and dependent behavior in the context
looking for our mental, emotional, of living in a hierarchical, patriarchal
spiritual, physical, volitional, and social culture.
assets and liabilities. We look at what
we have, how we use it, and how we 5. We share with another person and
can acquire what we need. the Universe all those things inside of us
for which we feel shame and guilt.
5. Using this inventory as a guide, we
admit to ourselves, to God as we 6. We affirm and enjoy our strengths,
understood him, and to other caring talents, and creativity, striving not to
persons, the exact nature of what is hide these qualities to protect other's
within that is causing ourselves pain. egos.

6. We give to God as we know him all 7. We become willing to let go of

former pain, hurt, and mistakes,
resentments and bitterness, anger, and
guilt. We trust that we can let go of the
hurt that we cause and receive.
7. We can ask for help, support, and
guidance and be willing to take
responsibility for ourselves and to
others.
shame, guilt, and any behavior that
keeps us from loving ourSelves and
others.
8. We make a list of people we have
harmed and people who have harmed
us, and take steps to clear out negative
energy by making amends and sharing
our grievances in a respectful way.

8. We begin a program of living 9. We express love and gratitude to

responsibly for ourselves, for our own others, and increasingly appreciate, the
feelings, mistakes, and successes. We wonder of life and the blessings we do
become responsible for our part in have.
relationship to others. 10. We continue to trust our reality and
daily affirm that we see what we see, we
9. We make a list of persons to whom know what we know, and we feel what
we want to make amends and we feel.
commence to do so, except where doing
so would cause further pain for others. 11. We promptly acknowledge our
mistakes and make amends when
10. We continue to work our program, appropriate, but we do not say we are
each day checking out our progress and sorry for things we have not done and
asking for feedback from others in our we do not cover up, analyze, or take
attempt to recover and grow. We do responsibility for the shortcomings of
this through support groups. others.

11. We seek through our own power
and a Higher Power, awareness of our
inner selves. We do this through
reading, listening, meditation, sharing,
and other ways of centering and getting
in touch with our inner selves.
12. Having experienced the power of
growing toward wholeness, we find our
bodies, minds, and spirits awakened to
a new sense of physical and emotional
relief which leaves us open to a new
awareness of Spirituality. We seek to
explore our meaning in life by honest
sharing with others, remember that
BECOMING WHO WE ARE is a lifetime
task which must be done one day at a
time.
12. We seek out situations, jobs, and
people that affirm our intelligence,
perceptions, and self-worth and avoid
situations or people who are hurtful,
harmful, or demeaning to us.
13. We take steps to heal our physical
bodies, organize our lives, reduce stress,
and have fun.
14. We seek to find our inward calling,
and develop the will and wisdom to
follow it.
15. We accept the ups and downs of life
as natural events that can be used as
lessons for growth.
16. We grow in awareness that we are
interrelated with all living things, and we
contribute to restoring peace and
balance on the planet.
 12 Steps for Kids
From: Kids' Power: Healing Games for
Children of Alcoholics, by Jerry Moe
1. I am powerless over alcohol, drugs,
and other people's behavior and my life
got real messed up because of it.
2. I need help. I can't do it alone
anymore.
3. I've made a decision to reach out for
a Power greater than me to help out.
4. I wrote down all of the things that
bother me about myself and others, and
the things that I like too.
5. I shared these with someone I trust
because I don't have to keep them a
secret anymore.
6. My Higher Power helps me with this,
too.
7. The more I trust myself and my
Higher Power, the more I learn to trust
others.
8. I made a list of the people I hurt
and the ways I hurt myself. I can now
forgive myself and others.
9. I talked to these people even if I was
scared to because I knew that it would
help me feel better about myself.
10. I keep on discovering more things
about myself each day and if I hurt
someone, I apologize.
11. When I am patient and pray, I get
closer to my Higher Power, and that
helps me know myself better.
12. By using these steps, I've become
a new person. I don't have to feel alone
anymore, and I can help others.
The Twelve Steps of Non-
Recovery
Evidently originally called the Twelve
Steps to Insanity From the March 1990
Issue of the ACA Communicator,
published by the Omaha - Council Bluffs
Area Intergroup.
1. We admitted we were powerless over
nothing, that we would manage our lives
perfectly and those of anyone else who
would allow us to.
2. Came to believe there was no power
greater than ourselves and the rest of
the world was insane.
3. Made a decision to have our loved
ones and friends turn their will and their
lives over to our care, even though they
couldn't understand us.
4 Made a searching moral and immo-
ral inventory of everyone we knew.
5. Admitted to the whole world the
exact nature of everyone else's wrongs.
6. Were entirely ready to make others
straighten up and do right.
7. Demanded others to either shape up
or ship out.
8 Made a list of all persons who had
harmed us and became willing to go to
any length to get even with them all.
9. Got direct revenge on such people
whenever possible, except when to do so
would cost us our lives, or at the very
least a jail sentence.
10. Continued to take inventory of
others, and when they were wrong
promptly and repeatedly told them
about it.
11. Sought through complaining and
nagging to improve our relations with
others as we couldn't understand them,
asking only that they knuckle under and
do it our way.
12. Having had a complete physical,
emotional and spiritual breakdown as a
result of these steps, we tried to blame
it on others and to get sympathy and
pity in all of our affairs.
12 Step Process
THE BIBLE & THE TWELVE STEPS

The 12 Steps, properly understood, are

actually twelve verses of scripture specifically
chosen and simplified for the addicted one.
When properly applied, they have the ability to
walk a man out of bondage, clean him up, teach
him how to live, and equip him to effectively help
others find freedom. A physically sick person
would go to a doctor and get a medicinal
prescript-ion, and if taken as directed, would
hopefully recover. The addicted one on the other
hand has damage in all three areas (body, soul,
and spirit) and is in need of healing in all three
areas. The problems burried deep within the soul
and spirit are spiritual and thus require a spiritual
solution. The only One that can expose and
dispose (surgically remove them) is the Spiritual
Surgeon, Jesus.

The twelve steps, "a spiritual prescription of

scripture" are twelve verses of
scripture simplified for the alcoholic and the
addict to understand, accept, and utilize. This
process, Biblically speaking, is known as
deliverance.

This simple formula has the ability to deliver an abuser from a life of bondage
and insanity, to a place of freedom, peace, and joy. We find in Jesus, what most have
been searching for in the bottle, a needle, and a pipe.

Steps 1 through 3 have the ability to take a person from a state of selfish self-
centeredness, powerless, helpless, and hopeless, to a Christ-centered life, hopeful and
all-powerful in Christ Jesus. At step three, the all-powerful Helper comes to live within.
"Made a decision" has deeper meaning to it. To decide actually means to kill off the
other option or options. In the process of deliverance, this term is called renounce.
When we decide to turn our will and life over to the care of God, we are
actually renouncing the connections we have made with the other gods we were
worshiping such as alcohol, drugs, sex, etc. The Gate Keeper, our Lord Jesus Christ, the
only One with the power to get them out, can and will get them out and will keep them
out but only if He is asked. He is the giver and respecter of free will, leaving it up to us
to choose how we want to live. When a spirit is removed (in the power of Jesus), the
only way that spirit can return is through a conscious or unconscious invite back. God
has given man a free will and He will certainly respect and protect it.

Steps 4 through 9 are house cleaning steps, a time to utilize the Helper (the Holy Spirit
living within) in the cleansing process of inner self. First, immoral behavior (sin) is dealt
with, then the sinful nature (the defective character living within) that leads us to
sin, and finally we face those that we have harmed with our sinful destructive behaviors.
Admitting our wrongs, repenting of that behavior, forgiving one's self, forgiving others,
and receiving God's forgiveness as well as the forgiveness of others is the key to
freedom. What a freeing experience it is to clean up the wreckage of our sinful
destructive behaviors.

Step 10 is the maintenance step, teaching us to evaluate our daily behavior, while
encouraging us to clean up potential problems before they become problems. Diligently
revisiting this step keeps us from building a new inventory of lingering unresolved
immoral issues.

Step 11 encourages continual spiritual growth, continuously improving our personal

relationship with God. It is His desire to have an ongoing personal relationship with each
of us, and healthy relationships require good communication. We communicate with
Him through prayer and meditation. In prayer, we speak to Him, and through
meditation, He speaks to us. Some of our biggest lessons come directly from Him
through prayer and meditation.

Step 12 is all about trying to help those still suffering in bondage to their addiction. We
become living, breathing testimonies of God's transforming power. Carrying the message
of freedom, Biblically speaking, is known as the great commission. Those that have
experienced this new found freedom can't help but want to share it with others.
 Twelve-step program
From Wikipedia, the free encyclopedia

A Twelve-step program is a set of guiding principles for recovery from

addictive, compulsive, or other behavioral problems, originally developed by the
fellowship of Alcoholics Anonymous ("A.A.") to guide recovery from alcoholism.[1]
The twelve steps were first published in the text Alcoholics Anonymous ("The Big
Book").[2] This method has been adapted as the foundation of other twelve-step
programs such as Narcotics Anonymous, Overeaters Anonymous, Marijuana
Anonymous, Crystal Meth Anonymous, Co-Dependents Anonymous and Emotions
Anonymous. Mandated court involvement with 12-step fellowships is a
controversial practice of some governments; as stated in the Twelve Traditions,
Twelve-step fellowships have no opinion as a group on issues other than personal
recovery. As summarized by the American Psychological Association, working the
Twelve Steps involves the following.[1]

• admitting that one cannot control one's addiction or compulsion;

• recognizing a spiritual higher power that can give strength;
• examining past errors with the help of a sponsor (experienced
member);
• making amends for these errors;
• learning to live a new life with a new code of behaviour;
• helping others that suffer from the same addictions or compulsions.

Overview of Twelve-Step Programs

The way of life outlined
in the 12-steps has
been adapted widely.
The effects of A.A.
recovery within the
family unit providing
improved quality of life
resulted in fellowships
like Al-Anon;
substance-dependent
people who did not
relate to the specifics
of alcohol dependency
started meeting
together as Narcotics
Anonymous[3]; similar
groups were formed
for sufferers of cocaine
addiction, crystal meth addiction and many other behavioral problems.
Behavioral issues such as compulsion and/or addiction with sex, food, and
gambling were found to be solved for some people with the daily application of
the 12-steps in such fellowships as Sexual Compulsives Anonymous, Overeaters
Anonymous and Emotions Anonymous. Other groups addressing problems with
certain types of behaviors include Clutterers Anonymous, Debtors Anonymous
and Gamblers Anonymous. Over 50 fellowships composed of millions of recovery
members, all based in the same principles, are found around the world.

"After a while I began to wonder why I was not [happy] ... I decided to strive for
my own spiritual growth. I used the same principles [Bill] did to learn how to
change my attitudes. ... We began to learn that ...the partner of the alcoholic
also needed to live by a spiritual program."

– "Lois's Story" in the Al-Anon "Big Book", a typical story of a sufferer finding
fulfillment through application of the 12 steps[4]

The Twelve Steps

These are the original Twelve Steps as defined by Alcoholics Anonymous:

1. We admitted we were powerless over alcohol—that our lives had

become unmanageable.
2. Came to believe that a Power greater than ourselves could restore
us to sanity.
3. Made a decision to turn our will and our lives over to the care of God
as we understood Him.
4. Made a searching and fearless moral inventory of ourselves.
5. Admitted to God, to ourselves, and to another human being the
exact nature of our wrongs.
6. Were entirely ready to have God remove all these defects of
character.
7. Humbly asked Him to remove our shortcomings.
8. Made a list of all persons we had harmed, and became willing to
make amends to them all.
9. Made direct amends to such people wherever possible, except when
to do so would injure them or others.
10.Continued to take personal inventory
and when we were wrong promptly
admitted it.
11. Sought through prayer and
meditation to improve our conscious
contact with God as we understood
Him, praying only for knowledge of
His Will for us and the power to carry
that out.
12. Having had a spiritual awakening as
the result of these steps, we tried to
carry this message to alcoholics, and
to practice these principles in all our
affairs.
Other twelve-step groups have adapted these steps of Alcoholics Anonymous as
guiding principles for problems other than alcoholism; in some cases the steps
have been altered to emphasize particular principles important to those
fellowships[6][7][8].

History

The first such program was Alcoholics Anonymous (A.A.), which was begun in
1935 by Bill Wilson and Dr. Bob Smith, known to A.A. members as "Bill W." and
"Dr. Bob", in Akron, Ohio. They established the tradition within the "anonymous"
Twelve-step programs of using only first names. The Twelve Steps were originally
written by Wilson and represented Wilson's incorporation of the teachings of Rev.
Sam Shoemaker about the Oxford Group's life-changing program.

As Alcoholics Anonymous was growing in the 1930s and 1940s and definite
guiding principles began to emerge as the 12 traditions, a singleness of purpose
emerged as tradition five: "Each group has but one primary purpose to carry its
message to the alcoholic who still suffers." [9] Consequently, drug addicts who do
not suffer from the specifics of alcoholism involved in Alcoholics Anonymous
hoping for recovery technically are not welcome in 'closed' meetings for
alcoholics only[10]. The reason for such emphasis on alcoholism as the problem is
to overcome denial and distraction[11]. Thus the principles of Alcoholics
Anonymous have been used to form many numbers of other fellowships for those
recovering from various pathologies, each of which in term emphasizes recovery
from the specific malady which brought the sufferer into the fellowship.

Key Recovery Concepts

There are five key recovery concepts that, through her research, Mary
Ellen found to be essential to effective recovery work. They are:

Hope - People who experience mental health difficulties get well, stay well and go on to meet
their life dreams and goals.

Personal Responsibility - It's up to you, with the assistance of others, to take action and do
what needs to be done to keep yourself well.

Education - Learning all you can about what you are experiencing so you can make good
decisions about all aspects of you life.

Self Advocacy -Effectively reaching out to others so that you can get what it is that you need,
want and deserve to support your wellness and recovery.

Support - While working toward your wellness is up to you, receiving support from others, and
giving support to others will help you feel better and enhance the quality of your life.
Recovery Steps
Relief of symptoms is only
the first step in treating
depression or bipolar
disorder. Wellness, or
recovery, is a return to a
life that you care about.
Recovery happens when
your illness stops getting
in the way of your life.

What is Recovery?

SAMSHA (the Substance

Abuse and Mental Health
Services
Administration/Center for
Mental Health Services)
http://www.samhsa.gov/
defines recovery as:

Mental health recovery is a journey of healing and transformation enabling a person with
a mental health problem to live a meaningful life in a community of his or her choice
while striving to achieve his or her full potential.

Next Steps in Recovery

Depression and bipolar disorder are

mood disorders, real physical illnesses
that affect a person’s moods, thoughts,
body, energy and emotions. Both
illnesses, especially bipolar disorder,
tend to follow a cyclical course,
meaning they have ups and downs.

Treatment for these illnesses can also

have ups and downs. As much as we
may want it to, wellness often does not
happen overnight. It is normal to wish
you could feel better faster or to worry
that you will never feel better.
However, know that you can feel better, and that ultimately you are in charge of your
recovery. There are many things you can do to help yourself.

Relief of symptoms is only the first step in treating depression or bipolar disorder.
Wellness, or recovery, is a return to a life that you care about. Recovery happens when
your illness stops getting in the way of your life. You decide what recovery means to you.
You have the right to recover according to your needs and goals. Talk to your health care
provider (HCP) about what you need from treatment to reach your recovery. Your HCP
can provide the treatment(s) and/or
medication(s) that work best for you.
Along the way, you have a right to ask
questions about the treatments you are
getting and choose the treatments you
want.

It can also be helpful to work with a

therapist, family member, friend and peer
supporters to help define your recovery.
Your definition of a meaning life may
change at different times in life. At times,
depression and bipolar disorder might
make it seem difficult to set a goal for
yourself.

Sometimes it might feel almost impossible

to think about the things that you hope for
or care about. But goal setting is an
important part of wellness, no matter
where you are on your path to recovery. Work on what you can when you can.

Setting Goals
Identifying life goals is the heart of the recovery process. When we see a future for
ourselves, we begin to become motivated to do all we can to reach that future. Goals
can be big or small, depending on where you are in your recovery journey.

Ask yourself:
• What motivates me?
• What interests me?
• What would I do more if I could?
• What do I want?
• What do I care about, or what did I care about
before my illness?
• Where do I want my life to go?
• What brings me joy?
• What are my dreams and hopes?

It can help to start small and work up to larger goals. You

might want to begin by setting one small goal for yourself
at the beginning of each day. As you move forward with
your recovery, look at the different areas of your life and
think about your short and long term goals.
Short term goals might include:

• Be out of bed by xx:00 am.

• Finish one household chore.
• Call a DBSA support group.

Long term goals might include:

• Get training or experience for a job.

• Change a living situation, e.g., find an apartment
• Build a relationship with a friend or family member.

Remember break your goals down into small steps at first. Looking at a goal such as
'move to a new city' can be difficult to visualize and plan all at once. Ask yourself what
you need to do first. What can you do now that will help you eventually reach this goal?
Not only will this help move you closer to your goal, but it will also help give you a
positive feeling of accomplishment.

What are some things I can do that might help me feel better?

Know the difference between your

symptoms and your true self. Your
HCPs can help you separate your true
identity from your symptoms by
helping you see how your illness affects
your behavior. Be open about behaviors
you want to change and set goals for
making those changes.

Educate your family and involve

them in treatment when possible.
They can help you spot symptoms,
track behaviors and gain perspective.
They can also give encouraging
feedback and help you make a plan to
cope with any future crises.

Work on healthy lifestyle choices.

Recovery is also about a healthy
lifestyle, which includes regular sleep,
healthy eating, and the avoidance of
alcohol, drugs, and risky behavior.

Find the treatment that works for you. Talk to your HCP about your medications'
effects on you, especially the side effects that bother you. Remember to chart these
effects so that you can discuss them fully with your HCP. You might need to take a lower
dosage, a higher dosage, or a different medication. You might need to switch your
medication time from morning to evening or take medication on a full stomach. There
are many options for you and your HCP to try. Side effects can be reduced or
eliminated. It is very important to talk to your HCP first before you make any changes to
your medication or schedule.
Talk with your HCP first if you feel like changing your dosage or stopping your
medication. Explain what you want to change and why you think it will help you.

Treatments for Depression and Bipolar Disorder

Treatments that work can help you:

• Reach your goals.

• Build on the strengths you have and the things
you can do.
• Plan your health care based on your needs.
• Live your life without the interference of
symptoms.

Treatments can include some or all of these elements:

therapy, medications, peer support, and overall
lifestyle changes.

Medications for Depression and

Bipolar Disorder
Your HCP might prescribe one or more medications to
treat your symptoms. These may include:

■ Mood stabilizers: These medications help balance your highs and lows. Some mood
stabilizer medications are called anticonvulsants, because they are also used to treat
epilepsy.

■ Antidepressants: These medications help lift the symptoms of depression. There are
several different classes (types) of antidepressants.

■ Antipsychotics: These medications are primarily used to treat symptoms of mania. Even
if you are not hallucinating or having delusions, these medications can help slow racing
thoughts to a manageable speed.

Talk Therapy
There are many types of talk therapy that can help you address issues in your life and
learn new ways to cope with your illness. Goal setting is
an important part of talk therapy. Talk therapy can also
help you to:

• Understand your illness

• Overcome fears or insecurities
• Cope with stress
• Make sense of past traumatic experiences
• Separate your true personality from the mood
swings caused by your illness
• Identify triggers that may worsen your symptoms
• Improve relationships with family and friends
• Establish a stable, dependable routine
• Develop a plan for coping with crises
 • Understand why things bother you and what you can do about them
• End destructive habits such as drinking, using drugs, overspending or risky sex
• Address symptoms like changes in eating or sleeping habits, anger, anxiety,
irritability or unpleasant feelings

Peer Support
Support from people who understand is another important
part of recovery. There are many ways to get this
support. DBSA offers a variety of ways to interact with
your peers, such as support groups, discussion forums,
and an interactive chat room.

• Find a support group

• DBSA's discussion board
• Interactive chat room

Lifestyle
A healthy lifestyle is always important. Even if
symptoms of depression or bipolar disorder make
things like physical activity, healthy eating or regular
sleep difficult, you can improve your moods by
improving your health. Take advantage of the good
days you have. On these days, do something healthy
for yourself. It might be as simple as taking a short
walk, eating a fresh vegetable or fruit, or writing in a
journal. A talk about lifestyle changes should be a
part of your goal setting with your HCPs.

You have the power to change. You are the most

important part of your wellness plan. Your treatment
plan will be unique to you. It will follow some basic
principles and paths, but you and your HCPs can adapt
it to fit you. A healthy lifestyle and support from
people who have been there can help you work with
your HCP and find a way to real and lasting wellness.

Family and Friends' Guide to Recovery From

Depression and Bipolar Disorder
When a friend or family member has an episode of depression or bipolar disorder (manic
depression), you might be unsure about what you can do to help. You might wonder how
you should treat the person. You may be hesitant to talk about the person’s illness, or
feel guilty, angry, or confused. All of these things are normal.
There are ways you can help friends or family members throughout their recovery while
empowering them to make their own choices.

The Five Stages of Recovery

It can be helpful to view recovery as a process with five stages. People go through these
stages at different speeds. Recovery from an illness like depression or bipolar disorder,
like the illness itself, has ups and downs. Friends and family who are supportive and
dependable can make a big difference in a person’s ability to cope within each of these
stages.

1. Handling the Impact of the Illness

Being overwhelmed and confused by the illness.

An episode of mania or
depression, especially one
that causes major
problems with
relationships, money,
employment or other
areas of life, can be
devastating for everyone
involved. A person who
needs to be hospitalized
may leave the hospital feeling confused, ashamed, overwhelmed, and unsure about what to do
next.

What friends and family can do:

• Offer emotional support and understanding.
• Help with health care and other responsibilities.
• Offer to help them talk with or find health care providers.
• Keep brief notes of symptoms, treatment, progress, side effects and setbacks in a
journal or personal calendar.
• Be patient and accepting.

Your loved one’s illness is not your fault or theirs. It is a real illness that can be
successfully treated. Resist the urge to try to fix everything all at once. Be supportive,
but know that your loved one is ultimately responsible for his or her own treatment and
lifestyle choices.

2. Feeling Like Life is Limited

Believing life will never be the same.

At this stage, people take a hard look at the ways their illness has affected their lives.
They may not believe their lives can ever change or improve. It is important that friends,
families, and health care providers instill hope and rebuild a positive self-image.

What friends and family can do:

• Believe in the person’s ability

to get well.

• Tell them they have the

ability to get well with time
and patience. Instill hope by
focusing on their strengths.

• Work to separate the

symptoms of the illness from
the person’s true personality.
Help the person rebuild a
positive self-image.

•
Recognize when your loved
one is having symptoms and
realize that communication
may be more difficult during
these times. Know that
symptoms such as social withdrawal come from the illness and are probably not a
reaction to you.
• Do your best not to rush, pressure, hover or nag.

A mood disorder affects a person’s attitude and beliefs. Hopelessness, lack of interest,
anger, anxiety, and impatience can all be symptoms of the illness. Treatment helps
people recognize and work to correct these types of distorted thoughts and feelings.
Your support and acceptance are essential during this stage.
3. Realizing and Believing Change is Possible
Questioning the disabling power of the illness and believing life can be different.

Hope is a powerful motivator in recovery.

Plans, goals, and belief in a better future
can motivate people to work on day-to-day
wellness. At this stage people begin to
believe that life can be better and change is
possible.

What friends and family can do:

•
Empower your loved on to participate
in wellness by taking small steps
toward a healthier lifestyle. This may
include:
• Sticking with the same sleep and
wake times
• Consistently getting good nutrition
• Doing some sort of physical activity
or exercise
• Avoiding alcohol and substances
• Finding a DBSA support group
• Keeping health care appointments and staying with treatment
• Offer reassurance that the future can and will be different and better. Remind
them they have the power to change.
• Help them identify things they want to change and things they want to
accomplish.

Symptoms of depression and bipolar disorder may cause a hopeless, “what’s the point?”
attitude. This is also a symptom of the illness. With treatment, people can and will
improve. To help loved ones move forward in recovery, help them identify negative
things they are dissatisfied with and want to change, or positive things they would like to
do. Help them work toward achieving these things.
4. Commitment to Change
Exploring possibilities and challenging the disabling power of the illness.

Depression and bipolar disorder are powerful illnesses,

but they do not have to keep people from living
fulfilling lives. At this stage, people experience a
change in attitude. They become more aware of the
possibilities in their lives and the choices that are open
to them. They work to avoid feeling held back or
defined by their illness. They actively work on the
strategies they have identified to keep themselves
well. It is helpful to focus on their strengths and the
skills, resources and support they need.

What friends and family can do:

Help people identify:

• Things they enjoy or feel passionate about

• Ways they can bring those things into their
lives
• Things they are dissatisfied with and want to
change
• Ways they can change those things
• Skills, strengths and ideas that can help them reach their goals.
• Resources that can help build additional skills
• Help them figure out what keeps them well.
• Encourage and support their efforts.

The key is to take small steps. Many small steps will add up to big positive changes. Find
small ways for them to get involved in things they care about. These can be activities
they enjoy, or things they want to change, in their own lives or in the world.

5. Actions for Change

Moving beyond the disabling power of the illness.

At this stage, people turn words into actions by

taking steps toward their goals. For some people,
this may mean seeking full-time, part-time or
volunteer work, for others it may mean changing a
living situation or working in mental health
advocacy.

What friends and family can do:

• Help your friends or family members to use

the strengths and skills they have.
• Keep their expectations reachable and
realistic without holding them back.
 • Help them find additional resources and supports to help them reach their goals
step-by-step.
• Continue to support them as they set new goals and focus on life beyond their
illness.
• Help them identify and overcome negative or defeatist thinking.
• Encourage them to take it easy on themselves and enjoy the journey.

People with depression or bipolar disorder have the power to create the lives they want
for themselves. When they look beyond their illness, the possibilities are limitless.

What you can say that helps:

• You are not alone in this. I’m
here for you.

• I understand you have a real

illness and that’s what causes
these thoughts and feelings.
•
You many not believe it now, but
the way you’re feeling will
change.
•
I may not be able to understand
exactly how you feel but I care
about you and want to help.
•
When you want to give up, tell
yourself you will hold of for just
one more day, hour, minute
- whatever you can manage.
•
You are important to me. Your
life is important to me.
•
Tell me what I can do now to
 help you.

• I am here for you. We will get through this together.

Avoid saying:
• It’s all in your head.
• We all go through times like this.
• You’ll be fine. Stop worrying.
• Look on the bright side.
• You have so much to live for why do you want to die?
• I can’t do anything about your situation.
• Just snap out of it.
• Stop acting crazy.
• What’s wrong with you?
• Shouldn’t you be better by now?

What to find out:

Contact information (including emergency numbers) for your loved one’s doctor,
therapist, and psychiatrist, your local hospital, and trusted friends and family members
who can help in a crisis

Whether you have permission to discuss your love one’s treatment with his or her
doctors, and if not, what you need to do to get that permission.

The treatments and medications your loved one is receiving, any special dosage
instructions and any needed changes in diet or activity.

The most likely warning signs of a worsening manic or depressive episode (words and
behaviors) and what you can do to help.

What kind of day-to-day help you can offer, such as doing housework or grocery
shopping.

When talking with your love one’s health care providers, be patient, polite and assertive.
Ask for clarification of things you do not understand. Write things down that you need to
remember.

Helping and getting help

As a friend or family mem-
ber you can provide the
best support when you’re
taking care of yourself. It
helps to talk to people who
know how it feels to be in
your situation. Talk with
understanding friends or
relatives, look for therapy
of your own, or find a
support group.

DBSA support groups are

run by families and friends
affected by depression or
bipolar disorder. They are safe, confidential, free meetings where people can learn more
about these illnesses and how to live with them.

One father of a daughter with bipolar disorder says, “DBSA support groups help take a lot
of stress out of your life. As a family member, you have to be as prepared as possible,
and accept that things will still happen that you aren’t totally prepared for. DO all the
research you can. Build a long list of dependable resources and support people, so when
a situation arises, you know where to turn and how to take the next step. This really
helped my family when we needed it.”

WHAT TO DO WHEN SOMEONE IS IN CRISIS

Sometimes depression and bipolar disorder have symptoms that can best be helped by
inpatient psychiatric treatment. Try to find out what treatment is available to your loved
one, and what steps you can take during a crisis before the crisis occurs, if possible.

People may need to go to the hospital if they:

• Threaten or try to take their lives or

hurt themselves or others
• See or hear things (hallucinations)
• Believe things that aren’t true
(delusions)
• Need special treatments such as
electroconvulsive therapy
• Have problems with alcohol or
substances
• Have not eaten or slept for several
days
• Are unable to care for themselves or
their families, e.g., getting out of
bed, bathing, dressing
• Have tried treatment with therapy,
medication and support and still
have a lot of trouble with symptoms
• Need to make a significant switch in
treatment or medication under the
close supervision of their doctor
• Have any symptom of mania or
depression that significantly
interferes with life

Voluntary hospitalization takes place when a person willingly signs forms agreeing to be
treated in the hospital. A person who signs in voluntarily may also ask to leave. This
request should be made in writing. The hospital must release people who make requests
within a period of time (two to seven days, depending on state laws), unless they are a
danger to themselves or others.

Most psychiatric hospital stays are from five to ten days. There are also longer residential
rehabilitation programs for alcohol or substance abuse, eating disorders or other issues
that require long-term treatment.
Involuntary hospitalization is a last resort when someone’s symptoms have become so
severe that they will not listen to others or accept help. You may need to involve your
loved one’s doctor, the police or lawyers. It is better to talk with your loved one before a
crisis and determine the best treatment options together. Work with your loved one in
advance to write down ways to cope and what to do if symptoms become severe. Having
a plan can ease the stress on you and your loved one, and ensure that the appropriate
care is given.

How can I convince my loved one to check in voluntarily?

• Explain that the person is not going to an institution, asylum or prison.
Hospitalization is treatment, not punishment.
• Reassure your loved one that the hospital is a safe place where a person can
begin to get well. No one outside the family needs to be told about the
hospitalization.
• Tell your loved one that getting help does not mean someone has failed. A mood
disorder is an illness that needs treatment, like diabetes or heart disease.
Hospitalization is nothing to be ashamed of.
• Call the hospital and find out more about admission, treatment and policies.
• Help your loved one pack comfortable clothing and safe items that are reminders
of home.
• Offer the person a chance to make choices (such as what to take to the hospital,
or who to go with), if this is desired.

How should I talk to a person in crisis?

• Stay calm. Talk slowly and use reassuring tones.
• Realize you may have trouble communicating with your loved one. Ask simple
questions. Repeat them if necessary, using the same words each time.
• Don’t take your loved one’s actions or hurtful words personally.
• Say, “I’m here. I care. I want to help. How can I help you?”
• Don’t say, “Snap out of it,” “Get over it,” or “Stop acting crazy.”
• Don’t handle the crisis alone. Call family, friends, neighbors, people from your
place of worship or people from a local support group to help you.
• Don’t threaten to call 911 unless you intend to. When you call 911, police and/or
an ambulance are likely to come to your house. This may make your loved one
more upset, so use 911 only when you or someone else is in immediate danger.

Crisis Planning:
Some people find it helpful to write down mania prevention and suicide prevention plans,
and give copies to trusted friends and relatives. These plans should include:

• A list of symptoms that might be signs the person is becoming manic or suicidal.
• Things you or others can do to help when you see these symptoms.
• A list of helpful phone numbers, including health care providers, family members,
friends and a suicide crisis line such as 1-800-273-TALK.
• A promise from your friend or family member that he or she will call you, other
trusted friends or relatives, one of his or her doctors, a crisis line or a hospital
when manic or depressive symptoms become severe.
• Encouraging words such as “My life is valuable and worthwhile, even if it doesn’t
feel that way right now.” “Reality checks” such as, “I should not make major life
decisions when my thoughts are racing and I’m feeling ‘on top of the world’. I
 need to stop and take time to discuss these things with others before going
through with them.” How can an advance directive or a medical power of attorney
help?

An advance directive and a medical power of attorney are written documents that give
others authority to act on a person’s behalf when that person is ill. Your loved one can
specify what decisions should be made and when. It is best to consult a qualified
attorney to help with an advance directive or a medical power of attorney. These
documents work differently in different states.

Helping Others Throughout Their Lives

What can I do when my child is ill?
Patience and understanding are
especially important when a child is
ill. Children with bipolar disorder
often have different symptoms than
adults do, and are more likely to
switch quickly from manic
symptoms to depressive symptoms.
Make sure you have a doctor who
understands mood disorders in
children, and is able to spend time
discussing your child’s treatment.
Communicate to your child that
there is hope - you and the doctors
are working on a solution that will
help him or her feel better. Explain
your child’s disorder to siblings on a
level they can understand. Suggest
ways they can help. Seek family counseling if necessary. It is also helpful to network with
other parents whose children have a mood disorder.

With the assistance of your child’s mental health care provider, help your child learn
relaxation techniques and use them at home. Teach positive coping strategies to help him
or her feel more prepared for stressful situations. Encourage your child to self-express
through art, music, writing, play, or any other special gifts he or she has. Provide routine
and structure in the home, and freedom within limits. Above all, remember that mood
disorders are not caused by bad parenting, and do not blame yourself for your child’s
illness.

Children with mood disorders do better in a low-stress, quiet home environment, and
with a family communication style that is calm, low-volume, non-critical, and focused on
problem-solving rather than punishment or blaming. Stress reduction at school through
use of an Individual Educational Plan (IEP) is also very important. Request an evaluation
from your child’s school counselor or psychologist to get the process started.

If your child with a mood disorder is an adult, it is important to treat him or her like an
adult, even when he or she is not acting like one. As much as you may want to, you may
not be able to force your adult child to keep doctor’s appointments or take medications.
As with any other family member, keep encouraging treatment and offering your support,
but establish boundaries for yourself too, such as not lending money if your adult child
seems to be having manic or hypomanic symptoms.
What can I do when an older relative is ill?
Mood disorders are not a normal part of aging. You
may face more challenges if an elderly relative is ill
and lives far away from you or in an assisted living
facility. Stay informed about the treatment your loved
one is receiving. Develop a relationship with his or her
doctors and the staff at the facility. Your relative may
need special help remembering to take medications.
Make sure all of his or her doctors communicate if he
or she is being treated for multiple illnesses. This is
extremely important, since some medications for
mood disorders can interact with medications for other
illnesses and cause problems.

It may be helpful for you to spend additional time with

your elderly relative, or, if that is difficult, meet with
other relatives to see if you can take turns visiting or
caring for your loved one.
Self Help Affirmations That Work
Memory Storage:
It used to be thought that information is planted in long term memory through repetition.
Today, we know that information transfers to long term memory through association
between new data and the already stored information.

Affirmations that Don’t Work:

Ever promised yourself, “I’m going to do better, I’m going to do better, I’m not going to
eat so much junk food, I’m going to eat healthier” to find you ate even more? Most try
such affirmations hoping the repetition, earnestness, positive words and thoughts will
transform a habitual negative behavior. Wrong! Truth is, for the most part, just the
opposite transpires. You often end up doing more of what you don’t want and less of
what you do want. Affirmations done in this way just may be a part of the problem, not a
part of the solution.

On a conscious brain and body awareness

level, you made a promise that the
unconscious brain and body did not hear,
understand or agree to. Often times, the
more the incongruent affirmation is
repeated, the further into despair and failure
you can sink. Sometimes the only result is
increased guilt, hopelessness, powerlessness
and self doubt that further sabotage your
positive intention to change. Detrimental
early experiences, generational coding, and
environmental learning drive the
unconscious reactions and are not readily
resolved with traditional affirmations,
medicine, or treatments.
Learning new habits requires unlearning
existing ones. For several reasons, it is
easier to learn something new than to
unlearn something old. First, many factors
influence how information is stored in the
memory. The hippocampus part of the brain
records a lifetime of experiences and
thoughts. One thought connects to another.
Information is retrieved by searching
through the network of interconnections to
the place where it is stored. The more
frequently a path of retrieval is followed, the stronger the path becomes. It took years to
create the negative part in the first place, so how many repetitions would it take to
create a new one in it’s place? You could just try harder, but the latest scientific research
found it takes at least a 1000 repetitions before a habit begins to change on the
unconscious level. Most people are not motivated to commit to such a long term process
of repetions, no matter how much they desire the outcome.
Second, the unconscious does not hear or process negative words. Traditionally,
affirmations state what you don’t want, plus what you do want. For example, you may
say, “I’m not going to eat ice cream every day, because I don’t want to get fat so I’ll
choose more fruits and vegetables.” Your unconscious hears, “I’m going to eat ice cream,
I’m going to get fat, I’m going to choose more fruits and vegetables.” These messages
are usually enhanced mentally with pictures of ice cream and being fat instead of eating
healthy vegetables and a healthy body.

Affirmations That Work!

Most spend far more time thinking what they don’t want than
what they desire. Each time you think about a problem in a
particular habitual way, the mental circuits or pathways get
activated and strengthen with each recall. Through time,
mental ruts form that makes it difficult to reorganize infor-
mation, or see it from a different perspective, much less
choose a different behavior.
Reversal Conflict Tapping Technique uses a combination of
energy modalities including Touch for health, Eye Movement
Desensitization, and the Acupuncture Meridian System. The
goal is to 1) confuse and weaken negative habits and neural
pathways, and 2) replace and strengthen new, positive
patterns of connections between the nerve cells, so
increasing the odds are that you will call up the new memory.
Real change without the struggle can be realized when the
unconscious and conscious brain and body are congruent.
Given the right tools, all parts are willing, ready and able to
change.

Reversal Conflict Tapping Technique:

Goal: Confuse and delete old habits and install a new ones.
1. Pinpoint your underlying negative emotion or state: fear,
stressed, anxious, depressed, failure, angry, overwhelmed,
guilty, sad, jealous, stuck, frustrated, hopeless, powerless
2. The key to choice and change is to make peace with your
conflicting parts that sabotage your intentions and
affirmations. This requires self acceptance and love for
yourself just the way you are presently, even before things change, even if things never
change.
Say: “In spite of this inner conflict, _______ (ie, fear, anxiety,depression, apathy, anger,
failure, conflict, etc.) “ I deeply and profoundly love, accept, and respect myself.”
3. Stimulate both brain hemispheres. Since your brain has 100 billion neurons, each
being a “learning center” capable of storing new information, activate this potential by
tapping.
Do: Tap lightly in a semi-circle on the area one inch above and around the ear.
4. Circular eye movements integrate both brain hemispheres to assist in deleting the
mental ruts and replacing them with new information.
Do: With your head still and facing straight, move your eyes in a large circle, then begin
looking down on the floor, move them to the right as if you are outlining a large circle
with your eye. Follow the imaginary circle up and down the opposite side, and back to the
floor where you started. Repeat the circles for 5-6 times in one direction, then change
directions for 5-6 eye circles.
* Combine A, B, C to delete the old and enhance the new.
5. Exercise your mind to strengthen your desired outcome. Expedite change through the
visual field of your brain. Take advantage of your brain’s inability to know the difference
between the past, the present, and the future. Play the new, more positive movie as if it
already is … in the present.
Do: Put a picture of the affirmation you desire on the movie screen of your mind. See it
clearly, with color, up close, and life size, the way you dream it to be. Play that movie
often.

How long will it take before the person feels better?

Some people are able to stabilize quickly after starting treatment; others take longer and
need to try several treatments, medications or medication combinations before they feel
better. Talk therapy can be helpful for managing symptoms during this time.

If your friend or family member is

facing treatment challenges, the
person needs your support and
patience more than ever. Education
can help you both find out all the
options that are available and
decide whether a second opinion is
needed. Help your loved one to
take medication as prescribed, and
don’t assume the person isn’t
following the treatment plan just
because he or she isn’t feeling
100% better.

There is hope:
As a friend or family member of
someone who is coping with bipolar
disorder or depression, your
support is an important part of
working toward wellness. Don’t give
up hope. Treatment for mood
disorders does work, and the
majority of people with mood
disorders can return to stable and
productive lives. Keep working with
your loved one and his or her
health care providers to find
treatments that work, and keep
reminding your loved one that you
are there for support.