The Drama of the Gifted Child gone Hyper-Achiever, Hero &/or Rescuer

Responding to a Redditor who wrote, "I only 'love' myself when I achieve things that people admire me for," I wrote...

IME with many young adults who were precocious intellectual children (see Claudia Jankech's groundbreaking article for sure, for sure), the fast-processing but highly sensitive child in distressing circumstances often becomes the family's "duty rescuer," "golden child" or "responsible hero."

In serious, truly "committed & active" recovery since 2003, and with a lot of schooling and research, I've been able to see that Richard Schwartz's Internal Family Systems Model makes total sense, at least for me.

My mind was conditioned, in-doctrine-ated, instructed, socialized, habituated, normalized and neurally “hard-wired” to Learned Helplessness, Dread & the Victim Identity very early on, beginning to develop a case of compensatory narcissism at about 15. My brain's default mode network became so infested with that stuff that pretty much any other way of perceiving, believing and acting accordingly was blown out save for periods of extreme (often totally debilitating) anxiety and depression. But after those periods, the compensatory narcissism would reassert itself even more densely.

After plowing through about 90% of what's in this earlier post from 1984 to 2013, I stumbled onto this stuff and this concept and began to understand what Schwartz was really talking about: My crushed ego had gone severely codependent and created a "protector" scheme I not only used on that ego, I used it as did so many others in the "helping professions" to put others on Karpman Drama Triangles so that my ego could "rescue" them and feel good about itself.

In time I was able to begin to Dis-I-dentify with Learned Helplessness & the Victim I-dentity (see also not-moses's answers to a replier's questions there) and have made a lot of progress into being able to use an "observing self" to spot the addiction (because, neurobiologically, it is that), get immediately into "de-shaming" via 10 StEPs of Emotion Processing, and yank myself out of that I-dentity at least some of the time, more or less in the fashion described by addiction whizbang Gabor Mate in his book, In the Realm of Hungry Ghosts. The yanking does not produce a permanent exit from LH&VI, but can be used as often as necessary to do so.

Over time, the general urge to rescue to be significant and admired in that default mode network is increasingly -- albeit slowly -- diminished via neuroplastic reconstruction, and far more quickly quashed when it is noticed, recognized, acknowledged, accepted, owned and appreciated. But, as they say in AA, it's been a case of "progress, not perfection" and "God is faithful, but He's slow."

John Bradshaw's, Merle Fossum's, June Tangney's, and (especially) Gershen Kaufman's books on the treatment of shame were helpful, along with so many others in A CPTSD Library. Alice Miller's The Drama of the Gifted Child may also be worth a look.

Connecting more Dots: "Lack of power was my dilemma."

It's a grind one hears over and over again in AA meetings.

I was shown by so many around me that one should be frustrated, resentful, angry and rageful when life didn't go the way the way they had been conditioned, in-doctrine-ated, instructed, socialized, habituated, normalized and neurally “hard-wired” to believe it should. I didn't get the toy or the Levis or the place on the team or the girl or the job or the car or the home or the respect from others I had been taught to believe I should get.

Others got righteous. They ranted and railed in their frustration, resentment and anger. They raged. Why shouldn't I?

So I did.

Others drank and used drugs and drove too fast and got in fights and wrecked relationships and lost jobs and got divorced and wound up on the streets or in the joint or psych hospital and became pariahs to their friends and families. They raged. Why shouldn't I?

So I did.

Others "caught" nasty cases of mania, depression and anxiety causing them to suffer with all kinds of physical aches and pains the pshrinques of a generation ago called "factitious," "psychosomatic" and "conversion" disorders. Why should't I?

And I did.

Others came down with Complex Post-Traumatic Stress Disorder from decades of battering their brains and bodies with the untreated results of having been trained to believe that reactive rage was the best way to deal with life's injustice. They got stuck in the "justice fallacy." Why shouldn't I?

And I did.

Others wound up with "issues" like sleep disorders, tinnitus, irritable bowel syndrome, gastric ulcers, peripheral neuropathy, vaginismus, prostate swelling and forms of cancer rarely seen until reactive self-stress began to be an epidemic about 75 years ago. Why shouldn't I?

And I did.

Others did the time for someone else's crimes. Why shouldn't I?

And I did.

For decades. Until I learned finally learned that "lack of power was my dilemma" and that righteous rage is a luxury I just can't afford anymore.

I hope it's not too late.

Resources (Just read the titles? Couldn't hurt.)

Agarwal, N.: fMRI Shows Trauma Affects Neural Circuitry, in Clinical Psychiatry News, Vol. 37, No. 3, March 2009.

Andersen, S.; Teicher, M.: Desperately Driven and No Brakes: Developmental Stress Exposure and Subsequent Risk for Substance Abuse, in Neuroscience of Behavior Review, Vol. 33, No. 4, April 2009.

Antoniak, S.: Inmates with PTSD have higher scores for mood, anxiety, somatoform, substance use, psychotic, eating, conduct, and adjustment disorders, in Clinical Psychiatry News, Vol. 38, No. 1, January 2010.

Arsenault, L.; et al: Being Bullied as an Environmentally Mediated Contributing Factor to Children’s Internalizing Problems…, in in Archives of Pediatrics & Adolescent Medicine, Vol. 162, February, 2008.

Bandura, A.: Self-Efficacy: The Exercise of Control, San Francisco: W. H. Freeman, 1997.

Beck, A.: Prisoners Of Hate: The Cognitive Basis of Anger, Hostility, and Violence, New York: Harper-Collins, 1999.

Benson, H.: The Relaxation Response, New York: Morrow, 1975.

Berger, P.; Luckman, T.: The Social Construction of Reality: A Treatise in the Sociology of Knowledge, New York: Doubleday, 1966.

Brach, T.: Radical Acceptance: Embracing Your Life with the Heart of a Buddha, New York: Random House / Bantam, 2004.

Brown, B.: I Thought It Was Just Me: Telling the Truth About Perfectionism, Inadeqacy and Power, New York: Gotham Books, 2007.

Burgo, J.: Why Do I Do That?: Psychological Defense Mechanisms and the Hidden Ways they Shape our Lives, Chapel Hill, NC: New Rise Press, 2012.

Burrow, T.: The Social Basis of Consciousness, New York: Harcourt, Brace, 1927.

Carter, S.: The Tell-Tale Signs of Burnout: Do You Have Them?, in Psychology Today online, November 2013.

Centers for Disease Control and Prevention: The Effects of Childhood Stress Across the Lifespan, Atlanta, GA: CDC, 2008.

Chodron, P.: Taking the Leap: Freeing Ourselves from Old Habits and Fears, Boston: Shambala, 2010.

Courtois, C.: It's Not You: It's What Happened to You: Complex Trauma and Treatment, Dublin, OH: Telemachus Press, 2014.

Damasio, A.: The Feeling of What Happens: Body and Emotion in the Making of Consciousness, New York: Harcourt, 1999.

Deikman, A.: Personal Freedom: On Finding Your Way to the Real World, New York: Bantam, 1976.

Deikman, A.: The Observing Self: Mysticism and Psychotherapy, Boston: Beacon Press, 1982.

Dyer, W.: Your Erroneous Zones, New York: Avon Books, 1977, 1993.

Earley, J.: Self-Therapy: A Guide to Using IFS, 2nd. Ed., Larkspur, CA: Pattrern System Books, 2009.

Ellis, A.: Overcoming Destructive Beliefs, Feelings, and Behaviors: New Directions for Rational Emotive Behavior Therapy, New York: Promethius Books, 2001.

Engel, B.: The Emotionally Abusive Relationship: How to Stop Being Abused and How to Stop Abusing, Hoboken, NJ: John Wiley & Sons, 2002.

Fink, P.; Luk, J. et al: Positive association between victimization by bullies and substance abuse, in Clinical Psychiatry News, Vol. 38, No. 6, Jun. 2010.

Freud, A.: The Ego and the Mechanisms of Defense, London: Hogarth Press and Institute of Psycho-Analysis, 1937.

Goffman, E.: The Presentation of Self in Everyday Life, New York: Doubleday-Anchor, 1959.

Goleman, D.: Emotional Intelligence, New York: Bantam, 1980. mindfulness

Goleman, D.: Vital Lies, Simple Truths: The Psychology of Self-Deception, New York: Simon & Schuster, 1985.

Herten, J.: An Uncommon Drunk: Revelations of a High-Functioning Alcoholic, New York: iUniverse Inc., 2006.

Herten, J.: The Sobering Truth: What You Don’t Know Can Kill You, San Luis Obispo, CA: Sobering Truth Press, 2010.

McEwen, B.; Seeman, T.: Protective and damaging effects of mediators of stress: Elaborating and testing the concepts of allostasis and allostatic load, in Annals of the New York Academy of Sciences, Vol. 896, 1999.

McEwen, B: Mood Disorders and Allostatic Load, in Journal of Biological Psychiatry, Vol. 54, 2003.

McEwen, B.; Lasley, E. N.: The End of Stress as We Know It, Washington, DC: The Dana Press, 2003.

Sapolsky, R.: Why Zebras Don't Get Ulcers: The Acclaimed Guide to Stress, Stress-Related Diseases and Coping, 3rd Ed., New York: Holt, 2004.

Selye, H.: Stress Without Distress, Philadelphia: J. B. Lippencott, 1974.

Wilson, B.: Alcoholics Anonymous, New York, A. A. World Services, 1939, 1955, 1976, 2001.

Wilson, B.: Twelve Steps and Twelve Traditions, New York: A. A. World Services, 1951.

Wilson, B.: The Best of Bill: Reflections on Faith, Fear, Honesty, Humility and Love, New York: A. A. Grapevine, 1986.

Wolpe, J.: Psychotherapy by Reciprocal Inhibition, Palo Alto, CA: Stanford University Press, 1958.

Wolpe, J.; Wolpe, D.: Life Without Fear: Anxiety and Its Cure, Boston: Houghton Mifflin, 1981, and Oakland, CA: New Harbinger, 1987.

Workbooks Specifically on Anger Processing

Abramowitz, J.: the stress less workbook: Simple Strategies to Relieve Pressure, Manage Commitments and Minimize Conflicts; New York: The Guilford Press, 2012.

Block, S.; Block, C.: Mind-Body Workbook for Stress: Effective Tools for Lifelong Stress Reduction & Crisis Management, Oakland, CA: New Harbinger, 2012.

Block, S.; Block, C.: Mind-Body Workbook for Anger: Effective Tools for Anger Management & Conflict Resolution, Oakland, CA: New Harbinger, 2013.

Chapman, A.; Gratz, K.: The Dialectical Behavior Therapy Skills Workbook for Anger, Oakland, CA: New Harbinger, 2015.

Eifert, G.; McKay, M.; Forsyth, J.: ACT on life not anger: The New Acceptance & Commitment Therapy Guide to Problem Anger, Oakland, CA: New Harbinger, 2006.

McKay, M.; Rogers, P.: The Anger Control Workbook: Simple, innovative techniques for managing anger and developing healthier ways of relating; Oakland, CA: New Harbinger, 2000.

McKay, M.; Rogers, P.; McKay, J.: When Anger Hurts: Quieting the Storm Within, 2nd Ed., Oakland, CA: New Harbinger, 2003.

McKay, M.; Fanning, P.; Ona, P. Z.: Mind and Emotions: A Universal Treatment for Emotional Disorders, Oakland, CA: New Harbinger, 2011.

Simpkins, C. A.; Simpkins, A. M.: The Tao of Bipolar: Using Meditation & Mindfulness to Find Balance & Peace, Oakland, CA: New Harbinger, 2013.

Stahl, B.; Goldstein, E.: A Mindfulness-Based Stress Reduction Workbook, Oakland CA: New Harbinger, 2010.

Van Dijk, S.: The Dialectical Behavior Therapy Skills Workbook for Bipolar Disorder: Using DBT to Regain Control of Your Emotions and Your Life, Oakland, CA: New Harbinger, 2009.

Van Dijk, S.: Calming the Emotional Storm, Oakland, CA: New Harbinger, 2012.

When the Memories & Affects Start to Break Through

While I do want to tread cautiously for those who are still "tender & triggerable," the memories of the traumatic event and the affects (roughly "sensations and emotions") attached thereto will start trying to "break through" into consciousness. Which is what tends to happen in the second of the five stages of therapeutic recovery after the various defense mechanisms like manic rat racing, repression or even dissociation begin to sort of "wear out" the autonomic nervous system through prolonged overuse of the Fight / Flight / Freeze / Faint / Feign (or Fawn) Responses.

If I had had a better understanding of all that and the exposure therapies -- as well as how to tolerate them -- back in the '90s when I was doing everything I could to "outrun" the memories and affects the best way I knew how, I'd have dived far more deeply into that sort of thing then and there. But a) I didn't at the time, and b) it was probably just as well, even if it was very costly.

The post-millennial advances in both the techniques of exposure and the techniques of preparing patients to tolerate the temporary increases in anxiety that can occur in exposure therapy since then are considerable. Of the therapies listed in section 7c of this earlier Reddit post (skip all the borderline personality disorder stuff unless it seems relevant), DBT was the first to formalize such preparation (via "grounding" more or less this way) by using the methods developed in the therapies listed in section 7b of that same earlier post. Since then, SEPt and SP4T (for my money, the best deal out there because it is the most firmly rooted in autonomic physiology, but "results may vary," of course) have come along, and EMDR has added a pre-exposure grounding protocol.

One can be assisted by adroit use of the therapies in sections 7a and 7b to get firmly into the third of those five stages. From which, of course, stage four is then pretty much fully accessible. The end of section seven, btw, gets into how to locate therapists who are familiar with the people listed in the very first paragraph of that same earlier post, which, IMO, is really a necessity for trauma survivors.

For a sort of "review" of all this, see A Recovery Program for Someone with Untreated Childhood Trauma and How Self-Awareness Works to "Digest" Emotional Pain.

Additionally useful, from a personal body of experience: The 10 StEPs + SP4T.

References & Resources (see the continuously updated list in A CPTSD Library)

Will the Addict Ever Stop Using Something if He or She remains Depressed, Anxious & Belief-Bound?

"Alcohol and drugs can modify troubled feelings without influencing their cause, augment confidence by blurring reality and reducing sensitivity, and silence the inner voice of self-contempt, or at least make it nearly inaudible." -- Sharon Eklberry 

I've been at this for a while. C&S since 1984, I went back to school again and again to dig into the title question. (Ten years worth, actually.) A modified point of view is always a possibility, of course. But at this point, my answer is, "It doesn't look that way." And here's why:

Exogenous neurostimulants and neurodepressants elevate limbic emotion regulation system dopamine levels in different ways that effect cascades of other chemical flow and interaction -- and vice-versa -- causing either atypically (like "un-usual-ly") intense relaxation, intense analgesia, intense dissociation, intense euphoria and/or intense motivation, all of which are experienced as "rewarding." (See Edward Khantzian below.)

So. When those who are depressed, anxious and/or belief-bound seem to remain stuck in their unprocessed, undigested and undischarged neuroemotional energy needing some way to get off the not-so-merry-go-round the pros call the cycle of addiction. Take away drugs. Take away alcohol. Take away food (or lack thereof). Take away risk. Take away sex & romance. Take away codependent relationship. Take away workaholism. Take away excessive exercise. Take away almost everything that can be used to temporarily masque off the icky sensations of Learned Helplessness, Dread & the Victim Identity, and one has just that: Untreated Learned Helplessness & the Victim Identity. (If interested, look up Martin Seligman, Edward Khantzian (and his self-medication hypothesis), George Koob, Harold Shaffer and Gabor Mate on how LH & VI drive addiction; or see the References below.)

A regular in AA and NA since 1983... and at least a semi-regular in Al-anon and Nar-anon since 1986, in CoDA and ACA since 1990, in SLAA since 1991, in EA since 2006, et al, et al, et al, as well as from a perch in several treatment facilities, I have been able to observe thousands of addicts in the long as well as short term. Along with the people named above, as well as those named or referred to below, I am fully convinced that addiction of one sort or another -- even if it is to "righteous victimhood" in the manner described by Richard Schwartz's "obsessive protector" (see the Internal Family Systems Model) -- remains the number one go-to for those who haven't digested and discharged something 80 percent of their reactive rage, existential fear, shame, guilt, worry, remorse, regret, morbid reflection. (Bill Wilson's articles in the AA Grapevine in the 1960s -- including those reprinted in the little book, The Best of Bill -- seem to me, at least, to strongly support this assertion.)

The millennial-era study of the neurobiology, neurochemistry and neurophysiology of depression and anxiety utilizing computer-aided tomography (CAT), magnetic resonance imaging (MRI) and small-particle (SPECT) imaging have conclusively demonstrated that a) depression and anxiety have clearly identifiable "images" in the brain's limbic (emotion processing) system, as well as the HPA Axis and its connections to the body's autonomic nervous system. Anyone who understands all that and the operation of the Fight / Flight / Freeze / Faint / Feign (or Fawn) Responses that can lead to Fry and then Freak, can see the relevance to addictive "defenses" in a hot second.

As a result, addiction professionals at such renowned, "Class A" clinics as Hazelden, Betty Ford, The Meadows and Sierra Tucson began to move recovering substance and behavior abusers into examining the causes of their addictions about 25 years ago. And began to bring on board people like those listed in the first paragraph of this Reddit post. (Skip all the borderline personality disorder stuff unless it seems relevant, which, btw, it is for many substance and behavior abusers).

Make no mistake: AA, NA, MA and all those other A's are still viable. In fact, the vast majority of addiction treatment professionals see them as crucial to recovery because they help to keep the as-yet-unfinished product of the complete recovery process away from the worst of his or her temporary, but ultimately worse than merely ineffective, emotional fixes.

But, in 2019, it looks like the limbic->-HPA axis->-autonomic "gas bag" has to be punctured and emptied to put the nails in addiction's coffin. To that end -- and for those who remain interested after all this admittedly challenging edification -- may I offer sections 7a, 7b and 7c of that same Reddit post? Because section seven rolls out a list of the most widely used and accepted methods to puncture that gas bag, including Choiceless Awareness for Emotion Processing.

My Personal Experience 

Clean & dry from 1984 to 1997. But without my "medications" (see Khantsian's "self-medication hypothesis" below), and as the direct result of addiction switching to sex, romance and other forms of distracting over-stimulation -- and not dealing with the causes of my need to use -- my PTSD symptoms became intolerable, went to SUDS level 9 24/7, and I ate the medicine cabinet in 1997.

I thought Alcoholics and Narcotics Anonymous would be sufficient to get the job done on that until I did it again in 2002. Never drank. Never used a drug to get high. Did take a bunch of them (mostly stolen benzos and pain killers) one night to try to get OUT of relentless anxiety hell. Permanently. Woke up two days later (like the first time) in an ICU. Feh.

Returned to psych school in 2004. Found several versions of The Grail and haven't really looked back since 2009.

Added 01-10-2020: Hadn't yet seen this journal article or this medical media piece about it when I drafted this tirade a few weeks ago. But they do seem to lend credence to it, don't they?

Added 08-21-2020: Further "testimony." 

References

Afuseh, E.; Pike, C.; Oruche, U.: Individualized approach to primary prevention of substance use disorder: age-related risks, in Substance Abuse Treatment, Prevention, and Policy, Vol. 15, No. 1, August 2020. DOI: 10.1186/s13011-020-00300-7

Bozarth, M.: Drug addiction as a psychobiological process, in Warburton, D. (ed.): Addiction Controversies, London: Harwood Academic Publishers, 1990.

Bozarth, M.: Pleasure systems in the brain, in Warburton, D. (ed.), Pleasure: The politics and the reality, New York: John Wiley & Sons, 1994.

DiClemente, C.; Addiction & Change: How Addictions Develop and Addicted People Recover, New York: Guilford Press, 2006.

Dodes, L.: The Heart of Addiction: A New Approach to Understanding and Managing Alcoholism and Other Addictive Behaviors, New York: Harper & Rowe, 2002.

Dorison, C.; Wang, K.; et al: Sadness, but not all negatiuve emotions, heightens addictive substance use, in Proceedings of the National Academy of Sciences, Nov. 2019, DOI: 10.1073/PNAS.1909888116.

Ekleberry, S.: Seminar on Substance Abuse and Axis II Personality Disorders, San Francisco: Arcturus (online), 2000. 

Ekleberry, S.: Integrated Treatment of Co-Occurring Disorders: Personality Disorders and Addiction, London: Routledge, 2009. 

Hamilton, L.; Timmons, C. R.: Principles of Behavioral Pharmacology, Englewood Cliffs, NJ: Prentice-Hall, 1990. 

Kannon, J.; et al: Narcotics Anonymous, North Hollywood, CA: Narcotics Anonymous World Services, 1983.

Khantzian, E. J., Mack, J.F.; Schatzberg, A.F.: Heroin use as an attempt to cope: Clinical observations, in American Journal of Psychiatry, Vol. 131, 1974.

Khantzian, E. J.: The self-medication hypothesis of addictive disorders: Focus on heroin and cocaine dependence, in American Journal of Psychiatry, Vol. 142, 1985.

Khantzian, E.J.: The self medication hypothesis of substance use disorders: a reconsideration and recent applications, in Harvard Review of Psychiatry, Vol. 4, No. 5, Jan-Feb 1997.

Koob, G.; Le Moal, M.: Drug addiction, dysregulation of reward, and allostasis, in Neuropsychopharmacology, Vol. 24, 2001.

Koob, G.: Allostatic view of motivation: implications for psychopathology, in Motivational Factors in the Etiology of Drug Abuse, at the Nebraska Symposium on Motivation, Vol. 50, edited by Bevins, R.; Bardo, M.; Lincoln NE: University of Nebraska Press, 2004.

Koob, G., Le Moal, M.: Plasticity of reward neurocircuitry and the ‘dark side’ of drug addiction, in National Neuroscientist, Vol. 8, 2005, doi:10.1038/nn1105-1442.

Koob, G.: A Role for Brain Stress Systems in Addiction, in Neuron, Vol. 59, No. 1, July 2008.

Koob, G.: Neurobiology of Addiction, in Focus, Vol. 9, December 2011. 

Mate, G.: In the Realm of Hungry Ghosts, Berkeley, CA: North Atlantic Books, 2010.

Seligman, M.: Learned Optimism: How to Change Your Mind and Your Life, New York: Knopf, 1990. 

Shaffer, H.; LaPlante, D., La Brie, R.; et al: Toward a Syndrome Model of Addiction: Multiple Expressions, Common Etiology; in Harvard Review of Psychiatry, Vol. 12, 2004.

Wilson, B.: The Best of Bill, New York: AA Grapevine, 1955.