A Wound By Any Other Name…(pt2/6)
Hurts all the same
Previously on “What is Love….Addiction?”…
According to DSM 5-TR Love Addiction is not a mental health diagnosis. I’m in agreement with Dr. Alexis Briggie and Dr. Clifford Briggie in their determination that “ Romantic Relationship Addiction” (RRA) is a more fitting name for the pursuit and symptoms “Love Addicts” (LA) experience (Ascher et al., 2015). However, I’ll be using the abbreviations LA and RRM interchangeably throughout this blog.
Please note: I credited the “Love Addiction” chapter in The Behavioral Addictions to Dr. Michael S. Ascher, M.D. and Dr. Petros Levounis , M.D., M.A in my previous blog error. Words matter and in the world of mental health terms have real life implications. This post is going to have a lot…. like a lot of words. But bear with me. I’m trying to set up a foundation for understanding why LA doesn’t get the attention it deserves and why those of us who struggle can find ourselves in self sabotaging relationship patterns. So, hang in there with me as I lay firm foundation in which to pursue healing and empowerment with our relationships with ourselves and others.
Another term for that’s use interchangebley with what we’re exploring as Love Addiction (LA) is Pathological Love.
“…Pathological love (PL) is characterized by the repetitive and uncontrolled behavior of providing care and attention to the partner with feelings of freedom loss.The behavior becomes a priority to the individual to the detriment of other interests that were previously valued.”
(Sophia et al., 2009)Whether we call it LA/ PL/ RRA, it’s a pattern of relational behaviors that tend to result in debilitating cycles psychological and emotional pain. Fragile self - esteem can be shattered and a disempowering sense of self can cause individuals to tolerate hurtful and even abusive behavior. The long and short of it is people are suffering and more could be done to support people, if LA is taken seriously.
Some scholars, don’t believe LA should be its own diagnosis, because it’s symptoms over lap with existing disorders. If LA was a diagnosis the following would likely be differential diagnosis.
“Differential diagnosis is a process wherein a doctor differentiates between two or more conditions that could be behind a person’s symptoms.”
(Klein, 2020)Disclaimer: Before we go forward, we must take a pause for the cause…..(1, 2, 3, ). Do not… don’t you dare, use this post and particularly the following as a means of personal / self diagnosis. The information provided in this and all posts on www.nuancedhealing.com is for information and educational purposes. See full disclaimer below… after the works cited.
Dependent Personality Disorder-
The DSM - 5 criteria for DPD:
A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of contexts, as indicated by 5 or more of the following:
Has difficulty making everyday decisions without an excessive amount of advice and reassurance from others
Needs others to assume responsibility for most major areas of his or her life
Has difficulty expressing disagreement with others because of fear of loss of support or approval (Note: Do not include realistic fears of retribution.)
Has difficulty initiating projects or doing things on his or her own (because of a lack of self-confidence in judgment or abilities rather than a lack of motivation or energy)
Goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant
Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself
Urgently seeks another relationship as a source of care and support when a close relationship ends
Is unrealistically preoccupied with fears of being left to take care of himself or herself
Borderline Personality Disorder-
The DSM-5 criteria for BPD:
A pervasive pattern of instability in interpersonal relationships, self-image and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by 5 or more of the following:
Fear of abandonment
Unstable and or frequent changing relationships
Unstable self-image, including struggles with sense of self and identity
Stress-related paranoia
Anger regulation problems, including frequent loss of temper or physical fights
Consistent and constant feelings of sadness or worthlessness
Self-injury, suicidal ideation, or suicidal behavior
Frequent and sudden mood swings
Impulsive behaviors such as unsafe sex, reckless driving, binge eating, substance abuse, or excessive spending
Co-Dependent/ Codependency
When the topic of RRA/ LA arises, I almost always hear the term, “co-dependent”. While the colloquial use of codependency seems to make sense in this context, its origins and actual meaning don’t necessarily apply. Like LA, codependency is not mental health diagnosis. The term originates from enabling role some partners and family members played in the lives of individuals who experience alcohol abuse and or dependency (those once known as alcoholics).
Learn more about Codependency here: https://www.mhanational.org/co-dependency
The Impact of Bias and The Medical Model
Stigma around mental and behavioral health can be further exasperated when symptoms are deemed feminine in nature. When we think of behaviors as “dramatic” etc. we tend to minimize their impact and subsequently well rounded and comprehensive treatment. Now DO NOT get me wrong… I continue to have a complicated relationship with most “mainstream” diagnostic tools and the DSM-5-TR is no different. Even the existing diagnosisis are often steeped in gender (Skodol & Bender, 2003) and racial bias. Our current medical model is a double edge sword. A given diagnosis can have all type of stigma and social assumptions BUT the vast majority of insurance providers require a mental health diagnosis from the good old DSM-5-TR to pay for mental and behavioral health treatment.
So, let’s review the symptoms and cycles of Love Addiction/ Romantic Relationship Addiction include:
Love Addiction/ Romantic Relationship Addiction Symptoms
An Overwhelming and at times incapacitating fear of being alone.
Excessive Preoccupation/ Obsession with maintaining or acquiring a romantic relationship .
Exalting “romantic love” above all other forms of love even to the detriment and neglect of other healthy existing relationships.*
Cravings for partner/ object of attraction to the point of distraction.
Pattern of unstable and tumulotuous relationships marked by pursuing unavailable and or uninterested partners.
Intense infatuation early in the relationship that’s ultimately unsustainable.
Cat and Mouse style relationship
Impulsive* attempts to gain the attention of and interaction with partner/ object of attraction.
Extreme shifts in emotional states when there is a threat of (real or perceived) abandonment.
Inability to leave relationship (object of attraction) even when remaining has become unhealthy and even harmful.
Repeated attempts remain connected to relationship (object of attraction) in even the face of humiliation, shame, and or abject rejection.*
Withdrawal symptoms (These can be physical, emotional, and or psychological)
Love Addiction/ Romantic Relationship Addiction Cycles
brought to us by pop music through the decades
Weird Science
There’s almost always “chemistry”. You feel like you’ve known them forever…. You two just “click”. The attraction is almost “unreal” .
Everything is Awesome
Everything is cool when you’re living the “dream”. They are perfect!. You feel great! Y’all can’t get enough of each other….
Hot and Cold
There’s a shift …but it usually doesn’t settle. The relationship take on a cat and and mouse dynamic. Despite all evidence to the regarding the instability of the relationship … you try to hold on.
Bleeding Love
Loved ones and on lookers may try to encourage you to leave..But you see what others can’t. No matter the pain and harm, you remain.
Un-Break My Heart…..but….You Oughta Know
They have left… or they keep you at arms’ length and are only available based on what benefits them. Your response may be anywhere from, desperation and attempts at negotiating their return or aggressively acting out, protesting the ultimate reality.
Although I attempt to bring levity the realities of LA, these pathological patterns result in pain. There is a through line of *Self Abandonment that results in a disconnection from one’s truest self. Self Abandonment requires us to silence our own healthy needs and desires in an attempt to win the validation and acceptance of another (or others). Somewhere along the way we internalized a message that if we can convince “them”/ “him”/”her” that we are valuable and worthy, they won’t leave. If we are good enough, they will stay. We won’t have to be alone with just ourselves…this stranger we have become and definitely don’t trust.
But our frantic efforts at connection result in damage. Damage to others, to our self image, and our personal potential and progress.
We are social creatures who deserve healthy and worthwhile relationships.. starting with ourselves. I do not subscribe to notion that a person has to be completely “whole” and healed to have healthy relationships. (Like what does perfectly whole even look like). Inner awareness, emotional regulation, healthy boundaries, compassionate self acceptance and awareness are foundational for balanced and relationships.
We can develop the skills and courage to reconnect with ourselves. It will require time, patience, and compassion. We’ll have to figure out what happened along the way. We’ll have to explore where and why we abandoned ourselves and how we can learn to like and love ourselves.
On our next post we’ll the origins of Love Addiction….
Works Cited
Ascher, M. S., Levounis, P., Briggie , A., & Briggie, C. (2015). Love Addiction: What's Love Got To Do With It? In The behavioral addictions (pp. 153–173). essay, American Psychiatric Publishing.
Co-dependency. Mental Health America. (n.d.). Retrieved March 26, 2023, from https://www.mhanational.org/co-dependency
Earp, B. D., Wudarczyk, O. A., Foddy, B., & Savulescu, J. (2017, March). Addicted to love: What is love addiction and when should it be treated? Philosophy, psychiatry, & psychology : PPP. Retrieved March 26, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5378292/
Klein, J. (2020). Differential diagnosis: Definition, examples, and more. Medical News Today. Retrieved March 26, 2023, from https://www.medicalnewstoday.com/articles/differential-diagnosis
Sanches, M., & John, V. P. (2019, January 1). Treatment of love addiction: Current status and Perspectives. European Journal of Psychiatry. Retrieved March 26, 2023, from https://www.elsevier.es/en-revista-european-journal-psychiatry-431-articulo-treatment-love-addiction-current-status-S0213616318300120
Skodol, A. E., & Bender, D. S. (2003). Why are women diagnosed borderline more than men? The Psychiatric quarterly. Retrieved March 26, 2023, from https://pubmed.ncbi.nlm.nih.gov/14686459/
Sophia, E., Tavares, H., Berti, M., Pereira, A. P., Lorena , A., Mello, C., Gorenstein , C., & Zilberman, M. (2009). Pathological love: Impulsivity, personality, and romantic relationship. Researchgate.net. Retrieved March 26, 2023, from https://www.researchgate.net/publication/24394649_Pathological_Love_Impulsivity_Personality_and_Romantic_Relationship
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