SASH Annual Conference 2018 Healing Shame through the 12 Steps

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SASH Annual Conference 2018 Healing Shame through the 12 Steps Michael Bohan, M.D. michaelebohan@gmail.com Meridian Psychotherapy Virginia Beach & Amanda Asproni, M.A. amanda@healingaffairscounseling.com

Disclosures and Conflicts of Interest Paid Consulting, Honorariums, or Financial Compensation from: Employment : No for both speakers Pharmaceutical: No for both speakers CSAT Supervisor Compensation / Other Financial Compensation: No for both speakers Speakers Bureau: No for both speakers Shareholder: No for both speakers Grant Funding / Research Compensation: No for both speakers Royalties from Books / Book Chapters Authored: No for both speakers Paid Articles / Paid Blogs: No for both speakers

Healing Shame through the 12 steps Negative Shame comes with all addiction including co-dependency. Shame can be positive when it contributes to modesty. Negative or toxic shame arises from one s shortcomings or improprieties. This presentation refers to negative shame. Shame is hard to self identify because denial is one of its consequences, also it blocks insight and judgement.

Reflection on Shame Share the differences in the shame of the victimizer and the victim. Share about shame and boundaries. Share about shame and dishonesty.

Reflection on Shame Can you identify unhealthy shame in yourself? What were the sources of your shame? Transgenerational?

Transgenerational Shame: Personal Genogram List Grandparents: Paternal Maternal List your parents and their sibling under Paternal/ Maternal columns. Under the names list important shame issues which could include addictions, legal issues, sexual shame, divorce, infidelities, illegitimate children, suicide, family abandonment, criminality, incest, and mental illnesses.

Transgenerational Shame Genogram, M. Bohan Grandparents: maternal GM controlled with fear and ridicule Parents: father addicted to drugs, imperious, dishonest, made children feel inadequate. Mother full of rage Biological aunts and uncles (all maternal, father an only child): three of five addicts, one non-addict married to an addict and the other religious addiction. One addict married an addict, one pregnancy out of wedlock. Consequences: workaholic, intimacy avoidant, obsessive/compulsive thinking, internal shame (low self-worth), perfectionism and others. Gift: ticket to NARANON (spiritual connection/growth: right side of scale)

Transgenerational Shame: Genogram, M Bohan My consequences became character defects (step 4), all based in shame. Not dealing with them allowed to worsen (grow in the dark) and I had to quit work because of obsessions (mental illness). The shame became malignant; freedom came from 12-step groups, working the steps with a sponsor, counseling and replacing religion with spirituality connected to nature and meditation. Stopped working for 4 months and have continued in 12-step program for interpersonal healing and emotional/spiritual growth.

The Spiritual Recovery Scale When clients were asked to comment on their spiritual recovery they would talk about how they were praying or not praying or whether they were attending church or not. I (MB) wanted words to use which related directly to the results of practicing the 12 step program. St. George Lee, MD and I developed the Spiritual Recovery Scale to be used as a tool for clients in 12 step recovery to measure their spiritual recovery progress. Prayer and church might be ways to get there but the words in the Spiritual Recovery Scale reveal the status of recovery. The Scale is not comprehensive but it is substantial and useful and free for anyone to use.

Measuring Spiritual Recovery Control -----------------------> Surrender Self-Blame ---------------------> Self Acceptance Self-Pity/Victim ---------------> Gratitude Loneliness /Isolation --------> Friendship/Solitude Resentment -------------------> Forgiveness The left side is based in fear, shame, lack of trust and thrives on chaos & perpetual crisis. The right side is based on increased emotional/spiritual intimacy, vulnerability, trust and cultivating a state of on-going serenity.

Blame For the codependent clients we add: Blame of others --------------------------Acceptance of others Blame is also addressed in the items: Resentment to Forgiveness and Self Pity to Gratitude.

CONTROL Control for the shame-based person is an illusion. Attempts to control feelings and image with drugs, coercion of others, manipulation, and lying are futile but hard to change. These dysfunctional coping activities provide temporary relief but unless addressed, inhibit long term growth and healing. There is some confusion with using the word control. We think of a sex addict being out of control when arrested, versus the sexual anorexic who is in control because his/her addiction does not show. It is not always what shows it is what is in the head. Sexual anorexia is all about control.

Healing Shame through the 12 Steps Workshop task: The items on the left in the Spiritual Recovery Scale are connected to shame, those on the right are based in the absence of shame, how does practicing the steps bring this about?

Healing Shame through the 12 Steps What does control to surrender mean? Which of the 12 steps apply to the transition? What happens to shame? Talk about insight as it relates to control to surrender.

Healing Shame through the 12 Steps Which steps apply to self blame to self acceptance? What happens to shame in this transition? Comment on blame of others to acceptance of others. Is it ok to judge bigots or your enemies?

Healing Shame through the 12 Steps How does self pity connect to shame? How does gratitude connect to the 12 steps? How are addiction and codependency gifts?

Healing Shame through the 12 Steps How does the 12 step program help with tendency to isolate? What about vulnerability and intimacy and the 12 steps? What does solitude mean and how does it relate to the steps? How does intuition fit into the discussion?

Healing Shame through the 12 Steps. Where does Resentment to Forgiveness fit in to the steps? Who grants forgiveness? Heard at an SAA meeting: I have forgiven my wife when she has not forgiven me. Comment? Indignation is the response when many shame based people are confronted with their behavior, why? ( y all know the answer)

Healing Shame with the 12 Steps Much as addiction and codependency are diseases with progressive and predictable losses, 12 step recovery is also progressive and predictable but in a positive way. Shame is not part of healthy spiritual recovery. 13 stepping is shame connected and represents severe betrayal of 12 step members honestly seeking spiritual enlightenment. Recovery is not sexually transmitted. The honest program promotes healthy respect for self and others. With continued participation there is no end to progress in spiritual growth and in the steady elimination of shame.

Healing Shame through the 12 steps Recovery nuggets: From Naranon: Anybody who gossips surely must be a sick person and desperately needs our help. In support of meditation (MB): He turned off the news so he could hear the news in his head and 12 steps: brains on loan. Much as addiction, untreated, is progressive and predictable (the losses) so is 12 step recovery progressive and predictable (the gains). Addiction is shame rewarded; 12 step recovery is shame defeated.

References Conquering Shame and Codependency. Darlene Lancer. Hazelden Publishing. 2014 Healing Shame that Binds You. Johan Bradshaw. Health Communications. 1988 Letting Go of Shame. Ronald and Patricia Potter-Efron. Hazelden Publishing. 1989 Most 12 step programs have 12 step work books but the next two 12 step workbooks are not published by 12 step programs but are valuable A Gentle Path through the 12 Steps. Patrick Carnes. Hazelden Publishing 1993 The 12 Steps a Way Out. Friends in Recovery. RPI Publishing 2012