Oppression and Privilege: An Excerpt from Trauma and the 12 Steps Revised and Expanded Edition (Dr. Jamie Marich)
In 2016 I had the privilege to give an EMDR therapy overview at a conference for treatment providers of color. We didn’t even get to the content on EMDR. I was not surprised, yet was still amazed at how healing the validation of an experience like racism as traumatic was to my students in attendance. I listened to the attendees’ experience, strength, and hope on the traumatic impact of being a person of color in communities and systems that will likely invalidate their experience. The conference taught me that validating the suffering people experience, especially in contexts when it is likely to be ignored or dismissed, is a vital first step in healing trauma. And healing trauma can be a life or death matter to people seeking recovery from addiction.
Consider the concept of negative cognitions that accompany any traumatic experience. In EMDR therapy and various other modalities, we describe negative cognitions as the messages people receive about themselves (e.g., “I am a failure,” “I am permanently damaged,” “No one will ever love me”) or the world (“No one can be trusted,” “I am in danger”) resulting from a traumatic experience. In the fifth edition updated in 2013, even the DSM added the presence of such cognitions as part of the negative alterations in cognitions and mood criterion under the PTSD diagnosis.
My colleague Rajani Venkatraman Levis and her writing partner Laura Siniego introduced the idea of oppressive cognitions in a 2016 book chapter on cultural diversity in EMDR therapy. This construct takes the idea of negative cognitions a step further by recognizing that some of these messages we internalize are rooted in what we learned from others about our race, ethnicity, gender, or sexual identity. Examples of oppressive cognitions can be very specific (e.g., “Dark-skinned women are not beautiful,” “I am a freak for being this way,” “Real men don’t cry,” “I am trash because of where I come from,” “I am an abomination because Jesus says so”) or more generalized (“The world is not a safe place for people like me”). In the words of Melita Travis Johnson, an African-American woman, longtime social worker, and one of my personal mentors, “Oppression complicates--and aggravates—the recovery process.”
These visceral imprints are very real and can be even more impacting when they fester day in and day out. Although many people who have experienced oppression can pinpoint one or two major events in their lives that might qualify for a PTSD diagnosis, it’s the cumulative impact that can be more damaging. A student of color once described her experience of racism to me as “the trauma of a thousand paper cuts.”
At this point, you may dismiss what I’ve presented thus far as irrelevant because these experiences were not so for you. Or you may fear that drawing attention to the dynamics of oppression plays into the idea of terminal uniqueness, or the inclination many folks in recovery have to prove that they had it worse than others. Remember that a core component of trauma-informed care is honoring that just because something was a certain way for you, doesn’t mean it was that way for everyone else. I am not a politician, pundit, sociologist, or diversity specialist, and it’s well beyond the scope of this book for me to get into any debates on the matter. Consider, if you’re familiar with the Big Book of Alcoholics Anonymous, how we are even encouraged to resign from the debating society in order to get well. So I am no longer a debater.
And yet I am a trauma specialist and can testify to the reality of oppression and the various ways it manifests itself as a legitimate form of wounding that needs to be addressed. My hope is that people in recovery who have not been personally affected by oppressive cognitions in any way can honor the struggle of people who have. Even if you have been impacted by oppressive cognitions based on how you grew up, please don’t transpose this wounding onto others by getting into shouting matches about who had it worse. I’ve seen this happen too often in the rooms of recovery, and that is not how we help each other heal.
Alcoholics Anonymous was founded by two well-educated white men of privilege. If you are a white person reading this you may already be getting nervous at the very mention of the word privilege. Privilege doesn’t mean that you don’t have problems or your life hasn’t been hard. A simple way to look at it is that you have not experienced the extra stress of having to navigate life with the added weight of oppression due to race, ethnicity, gender, class, or sexual orientation. Recognizing your privilege means honoring that you may not have to worry about what others face as a daily struggle. This recognition and the personal work that goes along with it are important if you are going to work with others in recovery who are different from you.
Failure to honor the struggle of an individual seeking help pushes more people away from seeking or retaining help than any other factor I’ve observed in my career. Recognize and acknowledge how others experience life—this is the very definition of empathy. If your biases and misconceptions about how people other than you experience the world is getting in the way of your being empathetic, there is likely more work to be done on yourself if you wish to be of optimal service to others. In the brilliant words of Pastor Nadia Bolz-Weber, herself a person in long-term recovery, “Our drug of choice is knowing who we’re better than.”[ii] This hit me like a ton of bricks when I heard her say it out loud. It felt like the answer to why we can get ourselves into a frantic mess as a society, and why we can alienate people in recovery contexts.
If you feel uncomfortable about anything you have read thus far, or anything you read in the sections that follow, remember that discomfort is required for meaningful change. Hopefully you first picked up this book because you want to do better. The sections that follow will go into more of the specifics on how you can. The quest to do better must always include constant inventory and evaluation of ourselves, our biases, and where our own wounds may need healing.
[i] Jamie Marich, Trauma Made Simple: Competencies in Assessment, Treatment and Working with Survivors (Eau Claire, WI: PESI Publishing & Media, 2014), 61.
[ii] Panel discussion at Wild Goose Festival, Hot Springs, NC, July 12, 2019.
From Trauma and the 12 Steps Revised and Expanded Edition: An Inclusive Guide for Recovery, by Dr. Jamie Marich, Published by North Atlantic Books, copyright 2020. Reprinted by permission of publisher.
Defects of Character or Emotional Parts: Using Structural Dissociation to Reframe Step Six by Michael Gargano, LMHC, CASAC-2
“We were entirely ready to have God remove all these defects of character.”
--Alcoholics Anonymous, Step 6
Treatment centers and 12-step communities need to begin normalizing dissociation within the addicted person’s experience. Trauma and dissociation are often left out of the discussion in addiction treatment and recovery worlds. Survivors of abuse, neglect, abandonment, and other traumatic experiences note with consistency and frequency the value of compartmentalization plays in daily life functioning and avoidance of traumatic memories. As an addiction and trauma specialist, I’ve heard countless clients describe how and why it became necessary to stuff events, emotions, sensations, thoughts, actions, and images deep into the catacombs of the psyche. The self that seeks recovery may sometimes feel like a fraud, fake, or not real, as a result. And this can make the phrase defects of character in Step 6 difficult for addicted survivors of trauma to navigate. Looking at Step 6 through the lens of structural dissociation, may offer the field, recovery communities, and people we serve new insight into both trauma-informing and dissociation-informing the steps. What we commonly call defects of character within 12-Step Literature can be more accurately viewed as dissociative parts of self that impede spiritual progress, acceptance, connectedness, healthy relationships, and recovery
A cursory overview of the Theory of Structural Dissociation is needed to help us understand its theoretical and clinical framework. The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization, a ground-breaking book on trauma and dissociation, written by Onno van der Hart, Ellert R.S. Nijenhus, & Kathy Steele, proposes human beings are not born with an integrated personality. Our early formative life experiences shape our personality, thoughts, feelings, and behaviors. In healthy development our caretakers help us to meaningfully integrate and adapt to our environment. Attachment wounds stemming caretakers who could not meet our essential needs, sooth us, and provide us with restorative experiences sets the stage for fragmentation of the self. The discussion presented in this blog will prepare us to draw connections to how structural dissociation relates to 12 Step work and a trauma-informed approach to embracing our dissociative parts. We challenge the notion of character defects as it is traditionally understood in recovery circles as the term defects of character does not align with a trauma-informed approach. This contention is made with full recognition that the steps can and do work for millions, including me. And it’s also time to have this discussion.
The conception of dissociative parts of the personality is not new. The theory of structural dissociation of the personality is a cogent, comprehensive, and concise description of dissociative parts. The theory holds every person has what is commonly referred to as an Apparently Normal Self/Part (ANP). The ANP is the survivor self or the core persona that is seen by others in public, holds a job, raises a family, forms attachments, and does everything that we often ascribe to the executive functioning in our brains. In response to a traumatic event the ANP fragments with the formation of an Emotional Part (EP). The EPs form to protect the ANP from the wounding that has occurred.
The self as EP displays evolutionary defense mechanisms, emotional reactions, and action systems to protect the core self. Action systems guide us to notice and be drawn to stimuli. They restrict our field of consciousness to relevant stimuli and promote certain action tendencies while inhibiting others. For example, when a fire alarm suddenly goes off, the self as EP may signal “Danger, Danger, Danger!” and the action system related to panic may activate. The action system related to rational thought and decision making may be disinhibited. These mechanisms include responses based on flight, fight, freeze, and submission. If a dissociated part is fixated in a particular action system or subsystem, they may be unable to cope or perceive with their situations because their perceptions are colored by the goals, and a restricted field of consciousness will be restricted to stimuli relevant to that subsystem.
I believe Dr. Bob and Bill W.’s vision of step work helps us to heal our structural dissociation. Step Six invites recovery seekers to dig deeply and invite our EPs into their healing journey. Up to this point in our recovery experience we have accepted the nature of our addiction, we took steps to find a new path, embraced a belief that a power greater than ourselves could restore us to sanity, made a searching and fearless inventory, faced our dissociation, and now we are tasked with integration. Bill W.’s commentary on Step Six hones in on the addicted person’s compulsive tendency for self-destruction and annihilation. We work against our instinct for self-preservation. The commentary goes on to describe structural dissociation like language in discussion of how our drives far exceed their usefulness. The founders of Alcoholics Anonymous understood parts of self. Bill W. writes in 12 Steps and 12 Traditions commentary on Step Six: “When our instincts drive us blindly or willfully demand that they supply us with more satisfaction or pleasure than are possible or due us.” He is talking about an EP. Bill recognized EPs operating within recovery seekers more than 80 years ago.
The goal of Step Six is not to eradicate our EPs. Total integration of all dissociative parts of self will not happen overnight. Some parts of self will mature or extinguish. Others will take a lifetime to heal. Parts work, trauma work, and working the steps are circular pursuits. We may need to go through the Steps several times to gain a new way of relating in the world. The wisdom of this Step is we are cautioned to “be content with patient improvement.” It is important to seek proper therapy with someone skilled in dissociation and parts work who can help you understand the emotional parts of your personality. In our parts work some of our parts may not want to work on the spiritual aspects of the program. Some might attempt to destroy the whole system. We did not will these EPs to exist. Our minds fractured in a beautiful way to keep us safe, secure, and protected. However, the actions, thoughts, and impulses of our EPs caused us insurmountable problems as we sought to change old patterns.
Change is difficult. Sometimes we get into a routine and become complacent with our EPs. Take procrastination, for example. By not completing a task on time, one does not have to risk failure. This EP could be protecting us also from people hurting us by seeing our vulnerability. Turning in assignments late or showing up on time for appointments means our EPs remain in control of who gets to see our vulnerable side. Procrastination, like other destructive tendencies, could be an EP part designed to hide reality from us.
Our EPs have secondary gains which make it difficult to heal them. Skillful work in this area will explore the systems and rules at play. We will not be perfect in this work nor do we need to be. In Step Six we work to renegotiate the boundaries with our EPs and the alliances between them. Our work here is to meet our needs in more adaptive ways so our lives as ANP is fuller, richer, and more meaningful.
In my recovery experience I relied heavily on EMDR therapy, sponsorship, and the 12-step recovery meetings and literature to heal my fragmented self. I believed I could be restored to sanity. I trusted my Higher Power would allow me to get where I needed to go in the often hard and emotional trauma work, I set for to complete. I had a mindfulness and yoga practice that helped me settle inward to listen to my emotional parts. I had faith in my therapist who guided me through parts work and trauma reprocessing. I was able to see for the first time how my EPs impinged on my ability to live unchained. My EPs were my minds grasps of relating to a world which no longer existed. We must face facets of our personality which do not paint us in a good light. The Shadow side of the personality we must not fear. Step 6 and parts work are reparative processes. What I have learned is I do not have to live in survival mode any longer. Because of this work I can meet needs without reliance on old compulsive behaviors. I can risk authenticity and vulnerability without fear of rejection.
Sexual addiction and recovery can be controversial constructs. Unlike addictions to chemicals or substances, sex and sexuality are intrinsic facets of healthy human life and development. The goal of recovery from sexual addiction for most people is not to give up sex or the expression of one’s sexuality in its entirety. Rather, the purpose of recovery is to live a fulfilled life embracing a healthier model of sexual expression. Recovery is about setting boundaries and freeing one’s self of the suffering caused by acting out.
Like eating disorders, shopping addiction, and gambling, sex addiction is a process addiction. Process addictions are generally described as behaviors that are habitual and provide the person with an emotional high. The problematic behavior is often repeated to gain an increased high. A negative feedback loop forms wherein the individual cannot stop the behavior despite negative consequences. The origins of these addictions are rooted in trauma. Most people do not wake up one day and say, “Hey I think I’d like to become a sex addict.” Wounds leave their mark. The pain endured over time often becomes unbearable and prompts a form of escapism we see as addiction.
Shame often keeps people from seeking the help so desperately needed to develop healthier lifestyles in their journey for sexual recovery. Sex Addicts Anonymous (SAA) Green Book reminds recovery seekers:
Sexual addiction is not just a bad habit. Nor is it the result of poor self-control, a lack of morals, or a series of mistakes. If it were something we could stop on our own, the negative consequences would be enough to make us stop. Many of us tried to cure ourselves with religious or spiritual practice, moral discipline, or self-improvement. Despite our sincerity and our best efforts, we continued to act out. Our behavior eluded all rational attempts at explanation or correction. We had to face the fact that we had a disease, and that we could not stop the addictive behavior by ourselves (p. 9).
My name is Michael and I am a recovering sex addict, anorexic, and alcoholic. What follows comes from my lived experience as a person in recovery and as a clinician trained in trauma, addiction, and mental health. I work the twelve steps and traditions of Alcoholics Anonymous (AA) and Sex Addicts Anonymous (SAA). I will forever be indebted Eye Movement Desensitization and Reprocessing Therapy (EMDR) and to 12-step recovery programs for the gift of living free from the bondage of addictions.
The spiritual principles, tools, and suggestions contained within 12-step recovery helped me to find a life that was worth living. I learned that I deserved to be recovered, loved, and that I have worth. Recovery and trauma work helped me to thrive and accept who I am, was, and can be. In an earlier piece I wrote about the Step 1: “We admitted we were powerless over alcohol and sex, and that our lives became unmanageable.” The process to admit that I was powerless and that my life had become unmanageable took what felt like a lifetime to achieve. I bought the SAA Green Book and read through the entire text cover to cover in search for the answer of how to remain in sexual recovery.
The first task of this sexual recovery journey started 90 days of abstinence from all sexual behaviors. Let me tell you that it the most difficult thing I ever had to do in my life. I experienced withdrawal symptoms which included body shakes, anxiety, depression, angst, despair, craving, hypersensitivity, suicidal thoughts, and intense dreams. That list does not do justice to my lived experience during that time. It was a miserable experience, and yet a necessary one for recovery in my eyes.
When I joined SAA, I continued to hear a concept called “3 Circles.” It was all everyone talked about in meetings and in literature. In the Fellowship these three circles are how each member defines what is addictive and healthy sexual behavior for themselves. The program is quick to recognize the personal nature of addiction to sex. Not every human being acts out in the same way. For some their addiction is pornography. And for others it may be masturbation, destructive relationships, power and control, romantic obsession, cruising the streets for sexual partners, cybersex, prostitution, cross-dressing, having affairs, and fantasy. The list is endless.
Understanding what is addictive and is healthy requires distance and reflection. That 90-day embargo on sex and thinking or acting on sexual thoughts/desires were critical. The help of incredible trauma-informed sponsorship and therapy also played a major role in my recovery. I recall early in recovery listening to others share first step presentations about their powerlessness and unmanageability. I got into recovery in a Pre-COVID19 world with no local SAA meetings. My only options were telephone meetings all over the country.
Living with an addiction in isolation often drove me to act out. The beauty of phone and video meetings with others was that I could stay connected. I leaned early on in my process that recovery thrives in connectedness. I made several phone meetings part of my routine schedule. I volunteered on calls to read literature. During meetings I spoke up about my struggles and desires for a life built on a firm bedrock of recovery. It did not matter the time of day or hour of night. I made meetings a priority in my life. I stayed for fellowship hour at the end of each call. I exchanged numbers with other recovering sex addicts, and made phone calls during the week to talk about life, recovery, successes, and struggles.
I already received the gift of desperation. I needed something to give me hope in my life. As I called into these meetings, I heard men and women who shared their experience of what it was like, consequences of their acting out, and steps to stay in recovery. I sat and reflected on my own life after each presentation. I saw patterns of what behaviors I could not control. My first SAA sponsor, Adam, was a man who attended these phone meetings. We exchanged contact information and started to work the steps. I owe him a debt of gratitude for helping me to define what sexual recovery would look like for me. We have never met face to face. We conduct step work via email and phone calls. Sponsorship and meetings are my lifelines for connectedness. These are some of the tools in my recovery toolkit:
The Three Circles (diagrammed below) consist of three concentric circles. Each level represents a layer of addiction and recovery. Inner Circle behaviors are ones that cannot be safely practiced and/or controlled (seeking out emotionally unavailable people, pornography, drug use, alcohol use, disordered eating, etc.). Middle circle behaviors are actions, desires or behaviors that may lead to a slip or are risky (using sex to avoid emotions, lying, hiding, justification, etc.). Outer circle behaviors promote recovery (healthy sex based on choice, mutuality, and respect; meetings, sponsor, therapy, family time, staying connected, hobbies, step work, spiritual community time, dating, writing, dancing, creating music, etc.).
The process was a spiritual awakening. For the first time I could see my addiction; it had a name. It was real. It had a list of behaviors and symptoms. Defining healthy sexuality shifted my understanding. The best advice I received from my sponsor was live in the outer circle. What a jewel that insight was. The way I interacted with people and my surroundings changed. I noticed a shift in mind, body, and spirit. I felt alive again.
As a professional and a person in recovery it was important to define my boundaries especially around addiction. I carried intense shame for my addictions. I often felt that I lived a double life. My recovery work centered around integration of all the parts and pieces of myself. I never could be who I was. All the parts of me were cut off. Sexuality was one piece. Intellectual me was another. Emotional side was another. Creativity was lost in the abyss. I felt if I came out about my addictions or my parts of self, I would be shunned from the profession. My recovery integrated into every domain of my life. I turned a new leaf thanks to the program, recovery support systems, and others who have opened the door that I may walked through.
I am who I am. I will not change this inner-knowing for any person or institution. The process of recovery has instilled within me radical acceptance for who I am. I am not alone. Acceptance, I discovered, was key to healing. Once I made a thorough first step and opened the flood gates of the past, I quickly realized the need for trauma work. I could not stay in recovery from sex addiction without resolving the past that impeded on my present life. Spiritual awakening lead me to start EMDR.
I went to see Tom Buckles, LMHC, a former professor and licensed mental health clinician, who offered EMDR treatment. I quickly learned about my dissociative mind and how my parts of self directly influenced my acting out behaviors. Each of my eleven parts represented a wounded piece of my life. These parts were cut off facets of my life. I recall asking each of the parts to work together to help me heal. I believe because of this dissociative trauma work I was able to heal. At each session we completed between 4-5 trauma memories. I continued to see gains in EMDR. I started running, and I never thought I would be the running type. I restarted playing instruments, painting. My relationships with others took on a deeper meaning. I was free! I could remain present.
I have learned that my circles may change over time. In order to move something out of my inner or middle circle it requires an honest and willing conversation with my sponsor, recovery community and close friends whom I trust. My spirituality also plays a key role in helping to keep me on the road. Throughout this journey I have relied on faith to guide me. I turned over everything to the Higher Power of my understanding. I went back to the Roman Catholic Church, made confession, took spiritual direction, restarted mindfulness and yogic Practices, practiced spiritual principles in all my affairs. I remained open to what the universe, other people both inside and outside the fellowship, and my higher power were teaching me. I was an eager student.
The 3 Circles tool evolves with the person. Recovery is not stagnant. As I grew in healthiness and worked on the traumatic events that feed my addictions, sexuality took on a richer meaning for me. Today I am open to the potential in any situation. SAA and EMDR gave me the gift to live in the moment. Both 12-step programming and EMDR allowed me to face what seemed previously impossible. Today I can live a life that I never dreamed was possible. I realize today that sexuality is creativity and a vital life force. I channel that energy for good.
Today, I am a trained EMDR therapist. I get to help others in their quest to heal.
Recovery made this possible.
Painting by Michael Gargano
To read more about Michael and his work click HERE
Institute for creative mindfulness
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