Joseph Contorer LMFT provides virtual/telehealth therapy sessions. This may include use of programs like Zoom, FaceTime, Skype or telephonic appointments.

For more information and appointment scheduling please contact the office at any time at:

310-486-0087 or you may also email directly:

Chemical Dependency Alcoholism and Drug Addiction 


There are people who use various substances or drink regularly or may sometimes overeat, while others engage in a number of different compulsive behaviors or other closely related activities. When the behavior becomes an abnormal established disruptive regiment it is then thought to be an addiction or alcoholism.

Alcoholic or Substance (drug) addict- is a term used to describe a person struggling with the consequences and conflicts of using substances or drinking or alcohol or other abused substances and behaviors. An addict or alcoholic is an individual who has reached a level where their substance usage is causing measurable interruption, destruction, interference and damage in their lives. Twelve-Step (12-Step) Programs refer to this addictive level as a life that has essentially become  “unmanageable.”)

Alcoholism and substance addiction is a particularly complex condition, with many variables involved. Human Beings love their mood-altering substance such as wine, beer, cocktails, “medical marijuana,” uppers, downers, hallucinogenic drugs, etc. Perhaps half of the country engages in some type of semi-regular drug or alcohol consumption. Maybe close to half of those who drink or use substance fairly regularly have a problem at or near an addictive level.

Millions of Americans are routinely prescribed narcotics for pain (i.e. Percocet or Vicodin) or Benzodiazepine medication (i.e. Xanax/Valium) to help them relax or sleep. These drugs and other certain drugs or substances can be potentially habit-forming. It’s more habit-forming especially for those who have a tendency towards more compulsive or addictive behavior.

USE of drugs or alcohol is a term that implies drinking or using drugs perhaps for recreational usage. So the posing question of “Do you use drugs or do you do drugs?” is somewhat benign, since the concept of the drug use is perceived subjectively.

ABUSE of substance is defined as more of an abnormal usage of drugs, alcohol or other substance that significantly disrupts a basic routine.

DEPENDENCE is defined as abuse plus physical dependence, where serious illness can ensue in the case of immediate termination of using/consuming that substance or alcohol (I.e.: abrupt termination of usage, for example would require medical or hospital management for a safer outcome.)

Causes of Addictions

Alcoholism in particular is generally thought of as a disease. In this model, the explanation suggests that there is biological basis/genetics and hereditary factors involved; it’s almost like an “allergy” to the alcohol. With other substances as well, there is a similar physiological and psychological conflict with the various chemicals and processes (street drugs/prescription drugs, certain foods and even compulsive behaviors, like shopping, gambling and codependent relationships.)

Behavioral factors should be considered as well in addition to physical/organic family history, Growing up in a family where there was at least one member who was alcoholic/chemically dependent creates a profound family dynamic; this is sometimes referred to as an Alcoholic Family System. In this type of family dynamic, there are various roles that each immediate family member is likely to take on which is created as a by-product of responding to/interacting with a sick addict/alcoholic. In addition to the alcoholic family roles, the obvious unfortunate issue is that there is an abnormal version of family modeled to the children growing up in that family. So then it is almost inevitable that the alcoholic behavior sends many confusing, inappropriate messages out to the developing children. The family members from these alcoholic family systems grow up to become adults who are at risk for addictions and other codependent or dysfunctional adult relationships in their own families. The cycle tends to perpetuate, which creates likely cause to seek treatment and intervention, including therapy and or "12-step programs" or similar.

Alcoholic Thinking and Alcoholic Behavior

Quotes: “That is very alcoholic of you…” “There goes your alcoholism again…”

Many Alcoholics typically lack a sense of general humility, because their thought processes have been taken over by an egotistical distorted sense of self and reality.  Often times, the self-medicating effects of substance abuse can lead addicts/alcoholics to have a grandiose sense of self importance or synthetically inflated pseudo-confidence while in that mode/under the influence.

An Untreated Addict describes a person who is still actively using/drinking with little or no recovery/treatment/sobriety. Sometimes the untreated addict or alcoholic may have been involved in some recovery or is actually making attempts to abstain/become sober and achieve a more solid recovery. However, along the way of their journey, some of those in this predicament could very likely be demonstrating signs of being an untreated addict, struggling to quite drinking or using. Some who quit the drinking or using may still struggle to truly be a sober individual, because it may be even harder to address the underlying drives, cues, issues and triggers. The term "Dry Drunk" or Dry Sober refers to an addict or alcoholic who has stopped drinking or using the substance, but is still acting like an addict or alcoholic in their behavior.

Many Untreated Addicts and alcoholics and those struggling with various levels of conflicts with substance and addictions to drug and alcohol will display what is sometimes referred to as Alcoholic Thinking or Alcoholic Behavior. In mental health, the term “alcoholic” is used in conjunction with thoughts, behavior or even a certain mentality. So, for example, in this case, alcoholic thinking would be a general term that would reference the ways and dynamics that an untreated alcoholic or addict interacts with others, operates, thinks or behaves.

Now, for those who really understand what “Alcoholic Thinking” is, they will know that some folks exhibit this behavior who have never literally had anything to do with drinking or substance abuse, but their behavior patterns “acts-out” in a similar way to that of an (un-treated/un-recovered) alcoholic or addict.

Are YOU an Alcoholic or Addict?

Fortunately, the majority of people who drink alcohol are probably not alcoholics and hopefully most of those who are prescribed pain or anxiety medications are not living with a disrupted life because they are addicted to those drugs. What is both remarkable and also puzzling to some who may be less aware, is that “Alcoholic Behavior” doesn’t solely apply to those who are actually actively drinking/using.’’ Hence the term “Dry Drunk,” which refers to a person who is acting out like an Alcoholic, but does not or has not been drinking or using.

It is important to understand the mentality and behavior of addicts to be able to empathize and either initiate your own recovery if it is you who is actively using or drinking problematically or if you are a friend or loved one of a person who is afflicted with this hideous complex disease.

It is mainly those who have struggled with substance abuse and who have experienced some recovery and exposure to recovery/recovery programs/ “rehab” or whom are actively sober who will understand and identify when the behavior and traits of addicts are presented. A person may be exhibiting “Alcoholic Behavior,” but have no idea what that term refers to. Similarly, unless you are aware of what alcoholic behavior looks like or unless you’ve been there yourself, you probably aren’t going to isolate what’s going on either.

“Am I an Alcoholic Self-Test” Click on this link for further details on this quick free self-test to assess possible presence of alcoholism.

The 12-Steps

There are various approaches for treatment of addictions, however most are based on the “Twelve Step Model” (12-Step.) Commonly known examples are Alcoholics Anonymous (AA) and numerous other programs, like Narcotics Anonymous  (NA), Crystal Meth Anonymous (CMA), Codependent Anonymous (CODA) and Sex and Love Addicts Anonymous (SLAA) etc.. Of course there is controversy about treatment for substance abuse and dependence mainly surrounding how the condition is perceived in the first place. In general, most approaches in mental health, medical health and recovery communities treat addiction like a disease.

Why are Addictions So Hard to Quit/Control?

  • Denial: There may be total minimization and lack of accountability or responsibility of the problem
  • Desire to change not there: there may not be any or enough desire to want to stop. The addict simply does not want to stop urgently enough; the incentive isn’t convincing enough.
  • Difficult: challenging involved undertaking; change of this magnitude is not an easy undertaking. Addictions are comprised of a complex compounded set of problems.       Stopping using is not a pleasant process, similar to any behavior change.
  • Inability to change: Inherent inability to change; some just really cannot functionally stop; they are profoundly maladaptive or the genetic, physiological factors are too overpowering.
  • Refusal: They absolutely decline to seek necessary help/group or professional support. They may contend they can "quit" on their own.
  • Timing: is off; the addict is perhaps not ready. Sobriety and complete abstinence not be a realistic goal (yet, hopefully.)

Boundary Alert- What are Boundaries?
What is Healthy vs. Less Healthy?

What do we mean when we say a person “has no boundaries?” or they have “blurry” or “fluid” boundaries? What is a boundary in general? How does this factor in to the realm of substance abuse and in general most all of mental health and mental health treatment, not to mention most every facet of life?

Boundaries are an extremely important, critical, delicate factor of life; they are also frequently filled with a dysfunctional dilemma of complex dynamics. In the simplest of definitions, a boundary designates some extent, line or limit where something begins and ends. Boundaries are about where you and what pertains to you and your life, your responsibility your choices and consequences begin and where they end. Boundaries are essentially something that most individuals theoretically establish to signal a message or some limit or framework about how and what their life is about.

There are personal boundaries that potentially anyone may have. Then there are boundaries that exist between people, groups, society, nations, or any designated separate entities. Boundaries might influence many different areas of one’s life. For example, how they behave in public vs. private; at work vs. home; with friends vs. family; at a formal setting vs. a casual one. Boundaries influence how a person conducts their life in a variety of contexts. How any individual applies the concept of boundaries to their life will impact their actions, choices and consequences and how those/this process may affect someone else.

Untreated or non-sober, addicts and alcoholics will undoubtedly have a problem(s) with their boundaries. They may have blurry boundaries in that they live a chaotic live and are thought of as being  “all over the place.” Poor boundaries leads to a lacking awareness or care about what they are doing and what the implications of their behaviors, choices and consequences might be to other people. Boundary violations effect their loved ones, family, close friends, significant others, co-workers, neighbors or anyone else they may potentially impact. A classic symptom of untreated addicts/alcoholics is that they have little regard for anyone else but themselves OR they may be completely enmeshed in someone else’s life or are basically “lost” as a complete people-pleasing codependent. *(See the other section of codependency for more details about this phenomenon,) 

Some boundary violators will exhibit rigid boundaries that resist healthy change or common sense influences. The unyielding rigidity will block out the advent of change or hearing or seeing things in a different manner. The inflexibility of the overly stern boundaries can paradoxically protect a person from intimacy or being challenged; this way an addict can "maintain" their sickness without being contested and also keep people away and sabotage positive things and accomplishments.

Having or being in the midst of alcoholism or substance abuse of most any kind is a frequently a consequence of faulty boundaries and also a contributor to compromised marginalized boundaries as well.

“If everyone had healthy boundaries there would be no conflict or problems of any kind in the world/among human beings.”

One basic boundary tenant suggests being cognizant regarding boundaries and “Three C’s.”

We are not able to Cause, Change or Control other people or their behavior/choices and consequences.

The reality is people across the board aren’t so great in the boundary department. And for sure, most addicts, even those in recovery and having been exposed to treatment/therapy and boundary education still have a lot of work and awareness to be doing. The concept of boundaries is complex, subjective and somewhat intangible in the first place. Different perceptions will delineate a different set of boundaries to follow. Also, there are cultural implications to be considered.

Codependency and Al-Anon

Codependency was a term that was first introduced within the 12-Step Community in the 1986 by author, Melody Beattie and her book “Codependent No More- How To Stop Controlling Others And Start Caring For Yourself.”

This term and concept was connected to the 12-Step program world and community because it is a very relevant occurrence in the addiction cycle. The classic point to be made was that with most addicts there was some “Co-Addict” involved that was “enabling” the person and their addiction. This was said to be a codependent relationship. A relationship would be considered codependent if there was an abnormal balance present. The balance abnormality typically consists of one person who likely believes they are taking care of the other person and needs and thrives off of this need and the alleged outcomes of the care-giving. The paradox and Catch-22 of this cycle, is that The Codependent begins to resent the addict they are taking care of. The Codependent starts out having or getting their needs met in a sick “Codependent” way by taking care of or saving or _____ whatever their other half (or friend, family member, child, etc…(addict.) The codependent soon realizes that they are not meeting their needs by this unhealthy caregiving of other person’s needs and the receiver of the “help” is not particularly appreciative or grateful and may not even realize the sick codependent efforts and dynamics. The Codependent builds a resentment even more, although they initially felt it was necessary and a functional healthy relationship..

Alcoholic Family Systems and Classic Family Roles

Addict- The one or more persons that are actively using drugs/alcohol or substance and acting-out in a addict way by being reckless, abusive, dismissive, indifferent, selfish, destructive, hurtful, invalidating, self-consumed by their own untreated addiction or addict-behavior.

Co-Addict (codependent/Enabler)- the one who takes care an enables the addict in a variety of ways. The Co-Addict fosters the sickness and essentially “allows” the addict/alcoholic to continue their addiction and the unhinged damage it causes on the family system.

Hero/Superman/Superwoman/Perfect One- The one who desperately tries to maintain homeostasis and stay out of trouble; this person may be diplomat and a great actor, because nobody is unaffected in an alcoholic family.

Class clown/Trouble-maker/Acting-out “Mascot”- Acts out in order to avoid pain and distract from the addict; makes light of the severity and sickness but is hurting and miserable inside.

Scapegoat or “Identified Patient/ I.P.”- In addition to the addict this person is a safe dumping ground for the family and the addict to deflect away from their abusive sick contributions to the family dynamics.

Other Issues/Specific Programs
addressed by and with The 12-Steps


A family or relationship that has a member or partner who is struggling with a serious mental health issue or eating disorder, for example may exhibit the similar symptoms and dynamics as an alcoholic family system. They will essentially have similar complications and emotional injuries, such as abiding by the dysfunctional rules of “Don’t Talk, Don’t Trust, and Don’t Feel…” They will likely have comparable roles, like the hero, the addict (the depressed person/erratic Bi-Polar, or the overeater etc.) and the scapegoat. Sometimes there is presence of both a serious addiction and a mood disorder, like major depression or Bi-Polar Disorder for example. This is called “Dual Diagnosis.”


Dual Diagnosis- When there is an active addiction or “ism” concurrently comorbid with a mental health condition or disorder, like depression, Bi-Polar or Anxiety etc.


During the late 1970’s Betty Ford Center began operating and serving higher profile/celebrity clients. There was more awareness about alcoholism and addictions as well the need for treatment or “rehab.” Out of this came an acceptance that many of those struggling with addictions were also likely dealing with mental health issues, like depression and anxiety disorders as well as numerous other mental disorders (like personality disorders, eating disorders, PTSD, ADHD, abuse history etc.)

Consequently, it became more acceptable to address the addiction as well as the mental health conditions. It was also more acceptable to approve prescribing psychotropic drugs, like Prozac and other similar “less addicting” substances that were considered a necessary adjunct to the patient’s recovery and sobriety. So contrary to previous more militant approaches to sobriety and recovery that maintained a more rigid stance on what sobriety meant, it was now more acceptable to be on prescribed medications; sometimes it was considered mandatory as part of the recovery (since the addict/alcoholic would otherwise be more tempted to relapse by returning to their drug of choice/self-medicating, rather than comply with their anti-depressant or mood-stabilizer etc as per assessment of the medical physician at the onset of treatment/intake period.)

ADDITIONAL 12-Step Programs and meetings

AA- Alcoholics Anonymous- Support and recovery for those who have a significant conflict with alcohol use abuse and dependence.
NA- Narcotics Anonymous-Support and recovery for those who have a significant conflict with narcotics (i.e. prescription drugs such as opiates or similar) use abuse and dependence.
CA- Cocaine Anonymous-Support and recovery for those who have a significant conflict with cocaine or similar use abuse and dependence.
OA- Overeaters Anonymous/Also OA-HOW (Honest Open and Willing)-Support and recovery for those who have a significant conflict with food use abuse and dependence; this includes compulsive overeating, food restriction, binging, purging, body image issues and compulsive behaviors.
CMA-Crystal Meth Anonymous-Support and recovery for those who have a significant conflict with crystal methamphetamine or similar (speed/uppers) use abuse and dependence.
SCA-Sexual Compulsive Anonymous-Support and recovery for those who have a significant conflict with sexual compulsivity in a variety of contexts- such as profuse multiple sexual partners, compulsive masturbating, pornography, strip clubs, voyeurism, exhibitionism, acting-out in various ways.
SLAA-Sex and Love Addicts Anonymous-Support and recovery for those who are in persistently addictive cyclical unhealthy relationships where the love or sex and the person himself or herself is the drug.
CODA-Codependents Anonymous- Support and recovery for those who have a significant conflict with generally unhealthy relationships; they involve excessive caregiving and meeting the needs of others/of another in lieu of self-care or a healthy boundary between the codependent and their relationships.
Al-Anon- “Al-Anon” designated for friends, family, loved ones or other situation that mimic those
that have been or who are directly affected by and addict/alcoholic or similar behavior.
GA-Gambling Anonymous-Support and recovery for those who have a significant conflict with gambling/casinos and related acting out behaviors.
DA-Debtors Anonymous-Support and recovery for those who have a significant conflict with compulsive shopping, spending, debt accumulation, credit cards, reckless and incompetent financial management with typically devastating consequences.
MA-Marijuana Anonymous-Support and recovery for those who have a significant conflict with marijuana usage, despite the recent movements that have legalized and overly normalized this psycho-active drug.

*There are several other 12-Step Groups for multiple specific focal points of addictions/support etc. that can be researched and accessed online.

It is frequently observed that those in recovery may be involved in one or more or several 12-Step Programs due to the closely-knit nature of the various issues that the different programs address.
For example, an alcoholic may also be self-designated as a codependent or perhaps an overeater or any combination of “drugs of choice.” The “drug(s) of choice” might be a number of different entities such as sex, drugs, food, booze, spending, gambling or people themselves.