How Can I Help? A Question for Families Supporting a Loved One’s Treatment for Addiction

When addiction emerges in a family, signaled by the suffering of one of its members, it can prove deeply unsettling. All sorts of reactions are provoked. Fear, anger, hurt and a sense of helplessness are some of the intense emotions that a family is likely to experience, either as a whole or individually. Also, the social stigma that still so erroneously and harmfully attaches to addiction, affects everyone, prompting feelings of guilt, shame and blame. The biggest problem with stigma is that rather than families opening themselves up to the help they clearly need, individually and collectively, they are inclined to become defensive.

Family culture and behaviour will usually adjust to cope with the distressing presence of addiction, often twisting itself out of shape in the process; even establishing new (unhealthy) norms of behaviour, long before anyone in the family is aware of what is happening. Coping with addiction becomes the organising dynamic of family life. Everyone slots in to some sort of role in relation to (the person with) the condition. Some of the coping strategies end up neither helping the addicted person nor the rest of the family, individually or collectively. Suffering is perpetuated as a result.

Family members don’t always cope with addiction in the same way. Those differences will also be apparent in how they approach the treatment of a family member. Some succumb to a controlling reflex based on fear and the desperate hope of finding a way to get the loved one to stop and change. Another approach is to deny the reality of what is happening while trying to carry on “as normal”. Another might be a blaming, punitive, rejecting attitude. Some will effectively hand over their relative to be “fixed” by the treatment centre — as they would a car that needs repair — staying detached until the job is done. Such family members generally don’t look to involve themselves in the treatment process, while anxiety may cause others to hover intrusively over the treatment of their relative.

It used to be that the addicted person was the sole focus of the family and, almost by extension, the treatment centre. There was a tendency to think that everything would come good if only the patient got well. Nothing else and no one else had to change. It’s not hard to understand why something so apparently straightforward might be the hope. However, that perspective has long since been overtaken; and for good reason. For decades, evidence has been mounting to indicate that a systemic understanding and therapeutic approach is more effective. It would be foolish to ignore this.

Defined by its purpose (such as being a family), a system functions according to the weave of its internal relationships. There are interrelated parts that make up the whole. Each depends on and is affected by the other. If one part of the system changes the rest is inevitably challenged. If something affects the whole it will have an impact on the parts. So when addiction emerges in a family, we now look to help all parts of the system: individual family members (whether addicted or not) as well as the family as a whole. If changes only occur in one part of a family system that has adapted to the presence of addiction while the other parts try to stay as they now are, the chances of recovery diminish.

It all comes down to what stands the best chance of achieving the outcome everyone in the family apparently wants: a recovering family member and a restored family. We again turn to research for guidance. The evidence there tells us that engaging the whole family affected by addiction during the treatment of a family member makes a positive outcome more likely. This engagement needs to include the following:

  1. Identifying and making sense of potentially helpful and unhelpful ways of relating to the addicted individual and to each other; supporting the former and addressing the latter during and after treatment
  2. Increasing understanding of addiction and its impact on family functioning
  3. Given the significant stress suffered by families in living with addiction, recognising and accepting their need for help and support in their own right, rather than just in relation to the addicted individual in treatment

So, how can I, as a family member, help? The answer: Respond positively to invitations to become involved.  Look to improve your understanding of addiction and how it impacts families, including yours.  Resist any urge to control the outcome. Respond openly and honestly to such questions as “How are you?”; as opposed to focussing exclusively on the patient. Accept and engage proactively with the support offered, even if you feel anxious or reluctant at first. Family members who do so generally experience considerable benefit, including a sense of relief

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