Operation Daughters Addicted: Positive Strategies to Overcome the Dual Addiction of Eating Disorders and Substance Abuse

Table of Contents

Foreword

Authors’ Note

Acknowledgments

Preface

A Note to the Reader

How to Read This Book

Getting To Know You: The First Step Toward Full Recovery

Cathy

Sandy

Your Personal Story

Preparing for the Big Picture Intake: Your Life in the Mirror

Two Patients and Two Big Pictures

Jesse

April

The Courage to Face the Physical Damage

Praying for your Big Picture

Tapestries of Life: Real Stories from Real People

Three Patients, Three Stories

Kerry

Amanda

Heather

Piecing the Big Picture Together

Fitting Families Into the Big Picture

Cathy’s Story: How I Gave and How It Changed My Life.

Sandy’s Story: How I Found My Calling in Life

Tools for Recovery

HALT

Storytellers

Bibliography

About the Authors

Copyright

Foreword

In recent years, there has been increasing concern among medical professionals about the epidemic problem of eating disorders and chemical dependency, especially as these disorders afflict women. The image of anorexic, stick-thin models and other celebrated figures in the entertainment industries is often blamed for a heightened anxiety and dissatisfaction among young women obsessing daily over their own body image.

The media continues to report on their numerous problems, substance abuse and their trips to rehab and legal problems. The public sees the devastating effects that eating disorders and chemical dependencies may wreak on the very celebrities that have been so idolized. There have been many stories of the terrible toll that these diseases have taken on the careers and, indeed, the lives themselves, of public figures. More and more frequently, people everywhere are realizing that they must seek treatment if they are to become whole and well again.

Unfortunately, with all the best intentions, so many of those who enter into treatment programs, either on their own or with the encouragement of family and friends, are returning to their former lives and resuming the habits that brought them into treatment in the first place. Soon they find themselves back into treatment. The treatment programs them-selves become a swinging door, when the individuals core issues aren’t identified and dealt with.

The fault may lie to some extent with programs which, historically, tend to regard eating disorders and chemical dependencies as separate and distinct problems, to be dealt with individually and with different methods. Cathy Napier and Sandy Mullen, in this book Operation Daughters Addicted, have recognized that these two disorders very often are closely related: Eating disorders, drug and alcohol abuse, Cathy and Sandy demonstrate, have become dual dependencies.

Take for example the case of a woman who seeks treatment for an eating disorder, whether it is over-eating, bulimia, or anorexia. She may have discovered along the way that pills, in the form of amphetamines or opiates such as codeine compounds, or even alcohol, can reduce or almost entirely eliminate her appetite. She loses weight but in the process has acquired a chemical dependency—a hidden addiction.

Or, in another case, a woman with a drug or alcohol dependency may discover that she is losing weight by virtue of her loss of appetite. To maintain what she considers a more attractive figure, she may then begin reducing her intake of food and nutrients to the point that she acquires, in addition to her chemical dependency, a full-blown eating disorder. In both cases, the patient who has been treated for one disorder returns to treatment in the throes of the other disorder.

Cathy and Sandy came upon their unique insight into the little understood phenomenon of dual dependency through years of professional practice and clinical work in their individual specialties: Cathy as a therapist treating chemical dependency and Sandy as an R.N. treating eating disorders. Puzzled by the failures of otherwise excellent programs, the two began comparing notes and observations and discovered that treatment of one addiction, while apparently successful, was in fact feeding the growth of another, hidden addiction.

This collaboration is the result of their discoveries and the joint effort to treat their patients for more than one addiction simultaneously. In these pages, Cathy and Sandy tell the brutally honest personal stories of a number of dually addicted people who they have treated, then take the reader through the processes by which their patients achieved awareness of the presence and dangers of the hidden addiction, and describe paths taken by these people to total recovery.

Operation Daughters Addicted is written as if spoken to the individual reader, in a conversational and non-technical style. The reader is drawn into forging a path to her (or his) own recovery through a series of clearly defined steps leading to increased self-awareness and commitment to succeed. Readers are invited and guided to write their own stories by way of simple exercises offered at the end of each chapter. Additional exercises provide a spiritual component, which, at the reader’s option, provide guidelines to calming prayer or other beneficial meditations.

This is where I brag that Cathy is one of my oldest and dearest friends. She’s been an empathic, smart gal since she was small. Cathy and Sandy describe their own battles with, in one case, alcohol/pills, and in the other, an eating disorder. This book is the result of Cathy’s lifetime commitment to helping others.

Cathy and Sandy acknowledge that addiction is a family disease. I personally was grateful that Cathy and Sandy acknowledged that addiction is a family disease. My own two daughters, Wynonna and Ashley, have sought help. Wynonna battles an eating disorder and Ashley has suffered major depression. The family chapter gives family members practical tools for dealing with resentments and regrets that accompany dependencies and make it clear that family genetic make-up as well as family dynamics become a part of the battle. They illustrate how an entire support system contributes to getting the disease into recovery.

Cathy Napier and Sandy Mullen are to be congratulated for their work in bringing this secret of dual addiction to the forefront. They bravely expose the lethal combination of the two killer diseases and are to be commended for encouraging the treatment community to treat patients for both diseases simultaneously. Operation Daughters Addicted offers entirely new insight into what has been until now a largely unrecognized phenomenon and gives the reader both renewed hope and tools that enable him or her to find the joys of life free of dependencies.

Naomi Judd

Singer, Author and Motivational Speaker 2012

Authors’ Note

This book began in the disappointing experience of seeing our patients leave treatment on the road to recovery, only to witness them returning to treatment a few months later, worse off than when they left. We had become frustrated as professionals by the prevailing protocol by which it was believed that addictions should be treated one at a time. Happily, when the treatment team decided to prescribe chemical dependency treatment along with the eating disorder treatment for patients, we started to see patients getting into full recovery. After many years of keeping track of those we had treated for their addiction to and abuse of chemicals as well as their addiction to food, we began to see and then document successful long-term recoveries. The results that we witnessed, the testimonies of our patients, and the insights we gained, we now pass along to you in this book. Since have had our own battles with addiction, we felt that teaming together would give us more insight to the protocol for life-long recovery for our patients. We both have a desire to see the eating-disorder patient and the chemical dependency/abuse patient achieve a life of quality without bondage. We believe that anyone who suffers from mental illness, whether it is depression, anxiety, or addiction, can benefit from the tools we have provided the reader.

Acknowledgments

In the course of this journey, there have been many fine professionals whose work I, Sandy, am proud to acknowledge. Individuals from whom I have a great sense of support, include the R.N.’s Kathy Aferiat, Nancy Park, Jeri Zenwinski, Cindy Short and Susan Mendoza. The therapists include Kim Rockwell-Evans, Cynthia Hutchinson, Gloria Dean, Jim Harris, and Pam Jenkins. Dietitians include Carla Schattle, Carol Park, and Jean Bivona. Art therapists Teresa Jackson, Betty Keller, Susan Merecle, and Abby Kalish were an amazing group of women to work with, as were psychiatrists Dr. Urusla Kelley, Dr. Yaprac Harrison, and Dr. Margaret Miesch. I send a special thanks to Jim, my husband, who has always encouraged my writing efforts and has been my biggest fan, and I send special love to my three wonderful sons.

Throughout the 34 years that I, Cathy, have worked in the mental health field, I have had the privilege of being associated with many intelligent, gifted, and caring professionals. I would like to acknowledge therapists, physicians, and support staff, who have worked alongside me. Tip Mckay, Mike Gaffney, Dr. Stephanie Darsa and the support of psychiatrists Dr. Laurie Klieman, Dr. Chreyé Callagahan, Dr. John Wilson and the late Dr. Mary Conrady. My co-workers, Amy Pool, George Kane, Jim Kennedy, Joyce Zang, Debra Singer-Hanson, Chuck Hanson, Eugenia Vasquez, Barb Shannon, Rose Whitcomb, Dr. Alice Crawford, Cathleen Weidner, Horace Whitfield, Suellen James, Dennis Reinecker, Dr. Jon Crook, Dr. Sharon Clark, Dr. Michael Jarrard, Bill Holtmeyer, Dr. Quinella Minix. Ron Hesslein and to Susan Winn for their support to the Burlington Northern Santa Fe Railway Employee Assistance Team. Kevin Vaudt, Medical Field Manager with Burlington Northern Santa Fe. Amanda Gambrell and Rick Foley who are dedicated to the cause of helping employees of the Burlington Northern Santa Fe Railroad maintain their physical and behavioral health. I give special thanks to my mentor, Dr. Leslie Secrest the Chair of Psychiatry at Presbyterian Hospital of Dallas. Thank you to my good friend Dina Horneffer who would gently listen to me during the frustrating times. Naomi Judd my loyal friend for 56 years. With thanks too to our editor, Erika Cooper, for her patience with us and her belief in this book. Finally, I reserve my greatest gratitude for my wonderful daughter, Holly, who has always been my motivation in life and to the people of Israel who held me up through the tough times.

Preface

For more than 15 years, I have had the privilege of working with Sandy Mullen, R.N. in an inpatient psychiatric and addiction unit. We groped our way, learning as we went, developing our program and treating our patients.

As the body of knowledge evolved over the past 20 years, it became increasingly clear that it is critical to treat addictions simultaneously and in an integrated way. To be successful, a balanced treatment approach must be comprehensive, through an evaluation (physical and psychiatric) with appropriate treatment plans that include medications, education, a therapeutic milieu and a strong 12-step orientation. A strong family component must also be implemented. Sandy and Cathy have developed a book that describes how the patient and family can achieve wellness through all the above mentioned treatment protocols. I applaud their good work.

R. Lynn Markle, M.D.

Psychiatry

3609 Cedar Springs

Dallas, Texas 75219

When we first began working with eating disorders, little did we know how widespread our knowledge would have to be in order to address this serious life endangering disorder that sounds so benign. We quickly discovered that we needed knowledgeable internists, cardiologists, gynecologists, and endocrinologists at our sides, as well as people who understood addictions. We discovered the need for family therapy and for the need of authenticity. Our patients were coming from families that kept secrets and we recognized the importance of establishing a staff that focused on honesty and openness. These two strong capable women, Sandy and Cathy, with their many years of clinical experience, have been willing to take the time out and put on paper their discoveries about what works and what doesn’t work in the treatment of eating disorders. I am thankful for their generosity in sharing their thoughts and personal experiences in working with this difficult patient population. They have been in the trenches. This book began with their concern for the recidivism of the symptoms and the light came on! This is addiction and, if not addressed, the danger is that the patients will switch to another and then another addiction. The book is filled with such stories. I knew Sandy and Cathy were good listeners.

Sandra Steinbach, M.D., P.A.

Psychiatry

1920 Abrams Parkway #376

Dallas, Texas 75214-3915

A Note to the Reader

It might be that you have found a treatment situation in which you are encouraged to address all of your addictions and the ways that they interact, reinforce, and cover for each other. If that is the case, this book will be an excellent tool in your recovery. It will show you some of the ways that we and our patients have learned to track the connections among the powerful manifestations of the disease. If you are not in a situation in which you will receive simultaneous and integrated treatment, then this book will provide enormous benefit. Eventually, you will have to face up to and deal with the connections between your addictions and behaviors. If not, you may face a lifetime of relapses. Just as you gain traction in one area of your life, we believe that chances are you will slip and fall in another. This book is an invitation to you to start to think about the big picture, to start to think about how different forms of addictions and behaviors are attacking you at once. This book will guide you along the recovery road, physically, emotionally, mentally, socially, and most of all, spiritually.

During treatment, we recommend that patients with identified dual addictions or patients who would benefit from the education about dual addictions attend eating disorder sessions during the day and drug and alcohol sessions in the evening. We recommend the facilitation of weekly multifamily educational groups for parents, family members and others in the patients’ support systems, and these sessions should be well attended by the patient’s loved ones. We suggest that, in family group, the patients share the history, nature and extent of their eating disorders. We also encourage them to examine possible connections between their eating disorders and their histories of drug and alcohol use/abuse. From the moment of the first group meeting, we invite our patients to reflect upon and work toward their full recovery. As you will learn in later chapters, we sustain this integrated attention throughout the course of the patient’s recovery.

We are convinced that addressing your eating disorders and chemical dependencies simultaneously can give you the healing power of full recovery.

How to Read This Book

We suggest that you read in a way that you never have before: read these stories by writing your own. We ask you to purchase a writing notebook in order to journal and to create your story.

Your first step in your journey to recovery is to sign the front of the journal. Once you have done this, you have signed a contract with yourself. Your name is very important. Even if you feel like you don’t know who you are right now, even if you feel that you have lost yourself, even if you hate yourself, or maybe you want to destroy yourself, your name is sacred. Your name is unique. Your name calls you into personhood. Sign this journal and even though you have written nothing else, you have started your journey.

You will write the following on the cover later.

For now, leave the title blank. You will know when you are ready to give your recovery story a title. It might be when you are in the middle of your struggle with addiction that you most need a vision of something to work toward, a life that you want to achieve and accomplish. You might not be ready to title your journal until you have six months or one year to look back and reflect on your journey. You might have one word that sums up your experience and what you have learned. You might have a title that is much longer. You will know what to call your story when the time is right for you. For now, we just ask that you sign your name and that you keep up with the writing suggestions.

As you read, you will find a series of writing exercises that we ask you to complete. Clearly, unless you are reading this book with a treatment team or a therapist, no one is going to check on you and make sure that you are keeping up with your homework. However, you need to realize that to do your job you must write in your journal. Just reading, just waiting for us to fill your head with the knowledge that we have gained through our experience, is not enough. You must transform this knowledge into an awareness of your