CNM 022: Adult Children of Alcoholics Trauma Syndrome – with Dr. Tian Dayton

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In this episode I interview Dr. Dayton about her book, The ACOA Trauma Syndrome: The Impact of Childhood Pain on Adult Relationships. We talk about what happens in our central nervous system when we experience trauma and what that does to us. We talk about something called process addictions and why we develop them, why women are naturally wired for codependency moreso than men, ways to heal from trauma, and a slew of other topics.

Dr. Tian Dayton is a nationally renowned speaker, expert, and consultant in psychodrama, trauma and addiction, ACoAs and self help related issues. She’s written fifteen books and has been around since the beginning of the word “codependency”. She’s also in the process of creating an online community and digital resources to help codependents and people recovering from trauma.

Dr. Dayton was extremely warm and knowledgeable, and this was one of my favorite interviews to conduct so far. Here’s my full interview with Dr. Tian Dayton:

Interview with Dr. Tian Dayton

Question: Can you define what you mean by ACoA Trauma Syndrome and tell us why this body of knowledge is significant for codependents?

An ACoA is someone who grew up with alcoholism or some form of addiction in their home, but the effect of the childhood pain or trauma that’s unresolved emerges in adulthood, which makes being an Adult Child of an Alcoholic (or ACoA) a Post Traumatic Stress Syndrome. Unresolved pain from childhood is emerging and being played out in adulthood.

This is relevant to codependents because the movements were overlapped in the 1980’s when both of these categories emerged. Until the 80’s there was really no such thing as an ACoA; it was assumed that if an alcoholic got sober the family would be fine, but over time as the disease pattern became more nuanced and understood by people, they realized that children who grew up with addiction were not fine – they were affected by it. The effects could vary depending on the buffers or a myriad of factors surrounding a child. Codependency came of age right about the same time, and the reason codependency started is because so many people identified with the symptoms associated with ACoA that we in the field just had to keep broadening the category and the word “codependency” is really “co-dependent”; the person in the orbit of the one who’s dependent. That’s where that started.

Question: You mentioned PTSD and I have a question about that. In the book you wrote that it is a very common side effect of being an ACoA. My sister actually experienced PTSD but didn’t realize she was suffering from it until years after it had already started. My question is, if someone  underwent extensive trauma as a child or teen, but they haven’t officially been diagnosed with PTSD, is there some way that people in this case can determine if in fact PTSD is affecting them?

In my book The ACoA Trauma Syndrome, I do have a checklist that helps people identify with the issues that surround PTSD (or tend to emerge later on as a result of early childhood trauma). Think of it as on an arc; you may identify a lot or a little, or a medium amount. Unresolved grief, hypervigilance, relationship issues, anxiety and depression are big ones.

Question: 1 out of 4 children is an ACoA, and I was astounded by that statistic. When I saw that number being so great, I wondered how addiction is classified for that; does this mean the addicted parent is necessarily on drugs or alcohol?

Yes, that statistic relates to drugs and alcohol. If you broaden it out to other addictions like food addiction, sex addiction, or gambling, the number would be higher but there aren’t numbers that I’m aware of on those categories.

Question: You also wrote that one of the effects of intense childhood stress can be “process addictions” like overeating, sex addiction, and other “invisible” addictions. Can you talk more about process addictions and why those happen?

They started emerging, again, as peoples’ understanding of this disease process became more sophisticated. They started honing in on what ways unresolved pain might evolve pathologically in adulthood other than the symptoms we talked about such as hypervigilance and so forth. Many people, when they experience unconscious pain that feels manageable, rather than work it out through going to 12-Step programs, therapy, or doing some reading, they do what we call “self-medicating”. You can self-medicate with food (which is very effective to numb out pain), alcohol, drugs, gambling, sex addiction. If it’s taken to an extreme then it’s seen as a form of self-medication. So it’s really just trying to numb out pain that you don’t know what to do with and don’t want to feel.

Question: If you’re partaking in an activity such as over-eating – if you find yourself overweight and can’t seem to reverse it (even if that’s your intention), could that be a symptom that there’s something inside that you haven’t processed or dealt with yet?

It could be. I have a great example that comes to mind. I was driving with a young woman who is a colleague. She is very overweight and I’ve known her years. She’s never really managed to lose the weight. We were driving through traffic, and she had brought with her a sugary snack, and sugar is something that will release dopamine in the brain very fast. So if you’re feeling upset in any way, you’ll get a dopamine rush from sugar. But every time there was stress (with the traffic, a phone call, or other example), her hand went quietly over to the bag and grabbed a few of those candies and she ate them. It was like a robot response; stress – candy – eat – soothe. I’ll never forget it. Usually you see self-medicating a little more masked than that. If you want to analyze the stress, that was pretty much stress about traffic, but if it’s emotional stress it’s the same dynamic. If it’s depression or anxiety it’s the same. Traffic is not just traffic. People have different responses to being stuck in the car; maybe she’s late and that makes her feel emotional, maybe she’s worried about getting me somewhere on time, there could be a lot of responses.

Question: Chapters 6 and 7 in your book go into great detail on what happens in the body and central nervous system when we experience trauma, and I’m wondering if you could sum up for us what is happening when we experience trauma inside ourselves.

The simplest way of understanding is that the thinking mind shuts down and the feeling, sensing mind goes into high gear. To unpack that a little and describe it further, the pre-frontal cortex is where we do our thinking, long range planning, rational thinking; it’s our filing system, the CEO of the brain. It’s in charge of orering the information taken in by the limbic system. The limbic system processes emotion, experience, all the sensory input. In other words, what we see, smell, taste, hear is all absorbed, recorded and processed by the limbic system along with how we feel about what’s happening. So all of that information we are constantly pulling from our environment, and that’s a limbic process. The thinking mind is ever-making sense of that. “Oh gee that sounds good, maybe I can go home, curl up, have a nice dinner and relax a little bit.” That feels good. Or, “Uh oh, something’s burning, that’s scary. The house could be damaged, I’d better run!” Whatever is going on with our senses is being understood through our thinking mind. Now when we’re in a high fear state; when we’re being terrified or highly stressed, the thinking mind shuts down so that the limbic mind swing into action.

The limbic mind is associated with our fight-flight response, and nature did not want us thinking about whether to run out of the way of oncoming traffic, or of a charging wooly mammoth. Nature wired us so we would just run; the thinking brain would shut down temporarily while the limbic system pumped adrenaline into our system, made our muscles more active with blood flow, and we’d take off. That’s the biology of that fear moment. If all goes according to nature, we shake off the extra adrenaline.

If you look at an animal in the wild, it will shake off the extra adrenaline that got pumped up out of fear. But if you are a child in an alcoholic home being raged at by a drunk parent, they are not going to allow you to shake that off. You’re going to go into a high stress state, and you’ll want to fight or flee but you’re probably not going to be able to do either because if you fight a drunk parent you’ll probably lose, and if you flee where are you going to go? A kid is trapped in a home like that. There aren’t a lot of options. So instead of shaking that trauma off, we go numb and dissociate.

(Brian) In junior high school I had a terrible anxiety problem. I would sit day after day in class sweating bullets. At first I would try to leave the class room and go to the nurse, but after a while I couldn’t any more because teachers would stop letting me and the other kids would know there was something wrong with me. I didn’t realize it at the time, but I think I was experiencing trauma and it had residual effects in me.

You know, I had a similar experience at school. I started to get migraine headaches in about ninth or tenth grade when my dad’s alcoholism was really turning the family inside out. I somatized the feelings which is one of the symptoms of PTSD or trauma. You feel it in your body but not your mind. So I would get these migraines and I must have asked my school nurse to go home on more than one occasion. She looked at me one time, and by then the school was starting to realize that there was something going on in my home. She sat me down and asked if something was wrong at home. I said yes, my parents were getting a divorce, my dad was drunk all the time, and things weren’t good at home. She looked at me and said, “You’re going to hate me now but you’ll thank me later. I’m not going to let you go home.”

The shock of it made me burst out crying. I hadn’t cried in a long time, I had just gone numb. There was no point in crying really. So, in the nurse’s office I remember crying – a lot. She brought me water and blanket, and said I could talk if I wanted to (I don’t think I was capable of it). It completely changed my life. She got me to feel the feelings I wasn’t feeling. And once I cried I grieved; I let it out. I could start to get my life back.

Even as a kid I started to see things differently; my thinking mind stopped just shutting down and somatizing my feelings. I started to feel them and realized how crazy my home was. I made some good choices for myself which led to more and more good choices.

So how those moments are handled by the people surrounding the child are critical in terms of the long trajectory of how much PTSD one might have or how much one might be able to get herself out of a bad situation.

Question: You laid out several spectrums of trauma-engendered family dynamics, and named the extremes. Codependents stereotypically fall to one side of each of these, namely codependents tend to be impulsive, enmeshed, over-functioning, caretaking, have low self-worth, tend to be victims, and tend to have denial. I’m wondering why, in your opinion, codependents fall so starkly to one end of each of these spectrums.

That’s an interesting question which I’ve never been asked before. I think traumatized people go to both ends of the spectrums, but you’re saying that you see codependents as people who are stuck on one side, is that right?

(Brian) The way codependents are stereotypically described, it seems that one end of each of the spectrums would be fairly evident (impulsivity vs. rigidity / control, enmeshment / disengagement / avoidance, overfunctioning vs. underfunctioning, caretaking vs. neglect, low self-worth vs. grandiosity, abuser vs. victim, denial vs. despair). There are several writings out there about codependents and narcissists being polar opposites, and you could almost put them on opposite sides of some of those examples.

Honestly, I get a little worried when we categorize codependents as only clusters of behaviors. Having been around when the movement started, I remember the frantic energy that we all had when we were trying to define codependency. I think the field of trauma has evolved past the field of codependency. I see codependency as a trauma phenomenon associated with this shutting down of the thinking mind because the thinking mind is where we are abstract enough in our thinking to conceive of a sense of self.

The sense of self is a kind of mental construct; it doesn’t really exist, it’s in a constant state of construction. You’re constantly discarding things that don’t fit and adding things that do fit. And it should be under constant construction. One wouldn’t wish for a rigid sense of self; one would wish for some flexible core aspects. So if the thinking mind is shutting down because it’s traumatized, then the focus becomes oriented outside of one’s self. One isn’t conceiving of sense of self; he is hypervigilent, constantly scanning his environment, his parent’s faces and the atmosphere around him for little changes so he can stay safe. Is my parent angry? Do I need to placate them? Do I need to stand up for myself? Do I need to leave their room, argue, comply? There are many ways we try to manage the unmanageable if we’re stuck. They can look like a codependent behavior and become codependent behaviors depending on the extent to which we get stuck in a particular set of them.

But essentially codependency, as I see it, is feeling somebody else’s feelings more than your own, looking towards caretaking in order to stay safe yourself, putting the focus on the environment and keeping the environment happy without a sense of ‘you’ or ‘me’ being a part of the environment. If you’re a mom of young children and you have a husband, basically your life is going into keeping everyone happy. When I was a mom, I eventually realized that the adjustment I needed to make wasn’t to change myself and behavior so much, it was to include myself in the equation. I was erasing myself because raising kids at some level scared me. I adored it, but I had a lot of feelings coming up having been from a trauma-engendering home. So I think codependency is pretty complicated, and I think what you’re saying is actually very interesting and I’ll think more about it and look back at that chart.

I’m also broadening the subject out. I’m not really offering answers because I see this as a snowball rolling down the hill, and I like to present codependency not necessarily as just a cluster of behaviors, but a reaction to being frightened so much of the time that we lose our sense of self, and our focus becomes on the other person. Often times codependents see themselves as self-sacrificing or as caretakers and whatnot. But I think it’s really trauma-based, so it’s a form of caretaking that doesn’t really feel good to the other person.

I’ll use myself as an example; I have children and grandchildren, and I can be very over reactive in terms of hoping they’re all fine. If it’s a beautiful day, I’ll wonder why they’re not here enjoying it. Are they tired? Are they not feeling well? Is my grandson missing us? I’ll go into a sort of spasm-thinking, worried about if everybody else is okay. And on the surface that may look like I’m just a really nice, caring person, but it doesn’t feel good to my kids and probably wouldn’t feel good to my grandson. It’s really based on my own form of insecurity about how people can manage their own lives, and my kids can manage their own lives fine. I think some of it is a natural maternal response, and some of it is my own… you might call it codependency, PTSD, or an overreaction. But in my book, what happened is that my still unresolved pieces of childhood trauma emerged when I had my children and raised them, it emerged when they got married, and it emerged again when I witnessed them starting to raise their own families.

(Brian) This feels like a fresh perspective to me. For folks who are starting to learn about codependency, and are out there Googling everything they can find, there is a lot of information out there about the behavior clusters. But there are lot of people who don’t associate themselves with the stereotypical codependent. It can be broader and can apply to you, but every aspect of the clusters doesn’t have to apply to you in order for you to be codependent.

(Dr. Dayton) You don’t have to adopt these ways of being in order to think of yourself as codependent. You can look into the literature and figure out where it applies to you and where it doesn’t. For the folks in my field, we all want to have an easy answer and we deal with people who are sometimes in a very high needs or disturbed state who want answers. Therefore, it’s very tempting to reduce subjects to something that gives easy answers, and what I’m saying is to search for the answers yourself (whoever’s listening to this), you’re your own best cure. Think with your own mind. Don’t just take it from the so-called “experts”, because we’re not such experts; we’re in learning processes ourselves.

(Brian ) The whole point of this podcast is to get different perspectives from all kinds of people. We want people to listen, and take what works and leave what doesn’t. As people hear about codependency they discover little truths (about the world and about themselves).

Question: You mentioned maternal instincts a minute ago, and I have a question that came up from reading your book. You discuss the neurobiological factors that contribute to codependency, and how codependent behaviors are just natural behaviors bent out of shape. In my research, more than 80% of our audience is made up of females, generally 20 to 60 years old. Are women naturally wired for codependency more than men?

Yes. If you think of the kind of relational skills it takes to inuit what a little baby needs when they can’t tell you, that’s what women are wired to do so that the species will survive. Men are not wired for that to the same extent, although I think the younger generations are changing. They’re not wired quite the way the women are but they’re pretty sensitive.

My daughter had a child recently. He’s growing up and is more and more able to express what he needs, but when he was a baby, she would just look at him and say, “What are you trying to tell me?” And here would be this tiny little baby squiggling around, but she heard him and she would figure out what this baby was trying to tell her, through his eyes, the sound and nature of his cries, the way he moved his body or reached for her, the eye contact he did or didn’t make; she understood his myriad of little signals and responded to them. Today this boy feels very understood, and he is very understanding, even just as a little boy.

But if you think of it as a cold process, it’s not just what a mother is doing for a child; it’s what the child is doing with the mother. It’s a process that goes back and forth a zillion split seconds. So the female’s wiring is attuned to pick up on these constant signals and interpret them in both a female or male child. So yes, female’s are hyper wired for nuanced relating. Having raised a girl and a boy, I have a son who’s thoroughly sensitive, and still as a grown man is very sensitive. But my daughter was much more aware of what we were expecting from her; she cared more about it. My son was aware, but he was more “large motor”. Any mother out there who’s had a daughter and a son knows what I’m talking about. The girls are wired differently, we’re just wired for different tasks.

Question: John Raven is a professional counselor who’s collaborated with us, and he had this question for you. His question is, “I have found a striking similarity between codependency / boundary work and addiction work, in that most people are unaware of how their behavior is affecting them and those around them. I have personally come to understand that the piece of mind I received from doing the difficult internal change work around codependency is much preferable to the pain I was living in. I find myself at times feeling sad and challenged when I see others who are suffering, often unaware of how much pain they are actually in, and how affected their own sense of well-being is. What are some ways that you have learned to help ease people in to a deeper understanding of how poor boundaries or codependency is affecting their lives?

First of all, I agree. It all obviously impacts peoples’ lives and makes them miserable. And that people are unconscious of it is dazzling, and I think this is what John is addressing; that you can work with people and just be dumfounded at just how unaware they are of the impact of their behavior on others (and the impact of others’ behavior on them). It’s very disheartening and disturbing, and it is very tempting to try to catapult into an understanding that they aren’t necessarily ready for, or to let it lie forever and not give them any understanding. It’s very tough as the therapist not to either be overly prescriptive or under-prescriptive, in other words to join them in their desire for easy answers or to just join them in their sort of numb state.

So I have found from myself that psychodrama takes care of a lot of that because patients do their own role-plays and other people in the group witness those stories (Dr. Dayton is primarily a group therapist). If you go onto (one of Dr. Dayton’s websites) and click on streaming videos, you’ll see what I’m talking about. I have videos of a lot of psychodramas that I’ve done. If you watch those you’ll have an emotional reaction. I would tell clients to watch psychodrama, take notes and bring them into therapy, and a counselor will know what to do with all the things that come up.

You need some kind of stimulus for people so that they can start to see themselves in action. It’s very tough when you’re in an office one to one, and someone’s locked in some kind of denial or whatever their particular defense is, and you can’t get through. Let them see a story of somebody else and identify with it. I find that a very helpful way to work. I always work in groups and I always use psychodrama. But if you’re in one to one, you could get people to watch films that are essentially designed for this.

(Brian) We’ve actually invited several recovering codependents onto this podcast to tell their stories, and I’ve been surprised at how many people have sent me messages saying that they never realized their problem until they started hearing what other people were saying.

(Dr. Dayton) I know as a therapist myself, it’s very hard without another vehicle to get this awareness into the client; it’s tough. There are week-long programs for codependency that a lot of therapists use a interventions into this. Clients come back from these programs, and their denial is down and they’re wanting to look at their issues. The complaint on the other side is that they’re too wide open or they opened up too fast. But the good news is that they’re opened up; they’re willing to learn.

I always ask my clients to go to 12-Step programs because it makes my work so much easier. I think that’s the other answer for John. It’s too frustrating to try to do it alone. I know that I need my clients to be getting a lot of other influences, and 12-Step programs help them get motivated, take ownership of the healing process, hear other peoples’ stories, start to see, through identification, themselves. At I’m really trying to create a web community that will also address just this kind of thing.

Question: Towards the end of the book, you discuss ways to heal from ACoA Trauma Syndrome. I specifically recall mobilizing help and support, breaking the generational pattern, integrating the fragmented self, balancing the limbic system, mindfulness, and several other things. Without getting into the specifics to much, what do you think is most important for people to focus on as they heal and recover?

Reach out, reach out, reach out!

Don’t do this alone or just from my book. Although, I do recommend reading my books, reading other people’s books, listening to all your podcasts, going to, going to 12-Step meetings (and going to them a lot). Don’t try to do it alone. I wrote a book called Emotional Sobriety along with an accompanying workbook. People have been forming groups and doing the workbooks together, and I like that especially well because I think they have a lot to gain from talking and doing the exercises together and discussing them. So don’t try to do it alone, take it seriously, and get as much help as you can. I can’t tell you how much help I got to get over a really painful childhood. I got so much help, and after that was done I got some more, and it took that much.

Question: Are there any other final thoughts that you have for the audience, either about the topic of ACoA or in general about codependency and getting better?

Take childhood trauma seriously. If you were an addict you know you have to sober up in order to have the life you want. If you have serious trauma in childhood, you have to sober up emotionally. Get the help you need and do it for a long time; not a year, not 18 months, but years. Invest the time, invest the energy. 12-Step programs are free and glorious. You can pay for therapy or get therapy that’s less expensive. Do the reading, educate yourself, listen to these podcasts, watch the films. Dig in and stay with it, and don’t give up until you’re where you want to be.

We’ll be including links to the resources you’ve mentioned, including your books and Innerlook. Do you want to take a minute and talk about your work and what you offer?

I’m in the process of launching, but if you go there and create a login, you’ll get a daily affirmation in your email every morning that you can share, or go to the Share Board and share with others what feelings come up when you read that affirmation. There’s another part of the site called Emotion Explorer, an online process for processing an emotion, and it really works. If you have a feeling, click “Emotion Explorer” and process the feeling, and you’ll identify it and go through a series of exercises for processing it online; it’s sort of a creative arts online journal. If you click “Streaming Videos”, you’ll be able to watch videos of psychodrama. You can create mood collages. I’ve been working on this for years and years because I wanted people to have a place to go when they’re alone in the dark to process feelings – someplace where there was no barrier to entry. It’s a free resource for people, and all I really want is for people to use it, share it, and tell other people about it; that’s what will help me persist. If enough people use it, maybe some sponsors will come along and it can pay for itself. I just want it to be used.

About Dr. Tian Dayton

Dr. Dayton is the Director of Program Development for Breathe Life Healing Center. She is the author of fifteen books most recently The ACoA Trauma Syndrome, 
Emotional Sobriety,Trauma and Addiction:, Forgiving and Moving On , The Living Stage, and has developed a model for using sociometry and psychodrama to resolve issues related to Relationship Trauma Repair.

Tian Dayton has a masters in educational psychology and a PhD in clinical psychology and is a board certified trainer in psychodrama, sociometry and group psychotherapy. She is a certified Montessori teacher. Dr. Dayton is the director of The New York Psychodrama Training Institute. She is a nationally renowned speaker, expert, and consultant in psychodrama, trauma and addiction, ACoAs and self help related issues. Dr, Dayton was on the faculty at NYU for eight years teaching psychodrama. Dr. Dayton is a fellow of the American Society of Psychodrama, Sociometry and Group Psychotherapy ASGPP, winner of their scholar’s award, editor in chief of the Journal of Psychodrama, Sociometry and Group Psychotherapy and sits on the professional standards committee. She is also the winner of The Mona Mansell Award and The Ackermann Black Awaard. Dr. Dayton has been a guest expert on NBC, CNN, MSNBC, Montel, Rikki Lake, John Walsh, Geraldo. Tian blogs for Counselor Magazine, Recovery View and The Huffington Post.

Dr. Dayton’s Books


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