By Dr. Rosemary Brown with Laura MacKay:
It is emotional dependency, the cause—not such symptoms as alcoholism or overeating or workaholism—that I have been treating in private practice and as a sponsor, with good results, for three decades. My method is my own cause-focused modification of the spiritual process that is the 12 steps.
Symptom Substitution, aka Relapse
The fundamental sameness of addictive behaviors is indicated by their interchangeability. A classic example of this symptom substitution, as I call it, is sugar for alcohol. Years ago, while focused on relapse and 12-step treatment as part of pursuing my PhD, I came to recognize the substitution of a different addiction, including a nonchemical for a chemical one, as a form of relapse. The substitution may be less (or more) immediately life-threatening, but logically, any substitution indicates that the underlying problem has not been addressed.
The phenomenon had been all too apparent in my personal experience. Addicted to alcohol for many years, I had joined AA, relapsed, returned, and found long-term abstinence from that drug. But much to my dismay, I continued to feel like an active alcoholic much of the time.
Even as I continued to work the program—which saved my life—I substituted (i.e. relapsed into) sugar, then cigarettes, then yo-yo dieting, followed by exercise, work, sex, relationships and AA itself. In an attempt to deal with each addiction as it surfaced, I found myself going from one 12-step group to another, where I met many others who were doing the same thing. (Imagine what the relapse statistics would look like if substitutions were accounted for.) Finally, after 18 years of this brand of “abstinence,” I found myself checking into a treatment center for the first time—for codependency.
Once I started my private counseling practice, I saw the same phenomenon in my clients.
For example, my client Chris, like me, had a history of alcoholism but really hit bottom with codependency. “I didn’t think I’d have to commit suicide, because I thought my pain would kill me,” he writes in a testimonial. “I was at that point without a job, without a home, without an ounce of hope. Hadn’t I done everything correctly up to then? I had gone to AA meetings, done service, worked the steps, not drank or drugged for 13 years.”
Or take my client Alex: “I had been sober for more than eight years, going to AA meetings and sponsoring as well as having a sponsor. In addition, I had attended Overeaters Anonymous, Debtors Anonymous, Al-Anon, and Codependents Anonymous. All the 12-step programs I experienced never healed me from my using; it was only sublimated. The drink or drug I abstained from, but in its place came overworking, sex, shopping, relationships, and the list goes on.” As long as single-addiction treatment is the norm—whether through the steps or some other method—relapse in both the traditional sense and by substitution will also be the norm. “Relapse is part of recovery” is the institutionalized rationale for this ongoing failure.
