Addiction and Family
This helps us understand not only the impact of addiction on families but provides a perspective on what has to be taken into account to achieve recovery. It helps us recognise also that the way those family members relate to the addicted individual will have an impact for better or worse. Because addiction can be quite an alarmingly dramatic condition we tend to think more about the addicted person’s effect on the rest of the family and less about the effect of family behaviour on that individual. We need to look at both.
The person who has fallen into addiction may experience and show very obvious signs of a problem. In clinical terms, they are often described as “the identified patient.” The natural tendency is therefore for them to become the focus of family attention. In fact, so powerful is addiction, it frequently ends up becoming the organising dynamic in the family, using up time, energy and resources. It resets the norms of behaviour within the family as everything begins to revolve around that problem and how best to deal with it. The mobile is no longer in balance; no longer easily able to reset itself in a healthy way.
Family, Addiction & Feelings
Family members generally experience a range of emotions in reaction to one of the family developing an addiction, including the emotional volatility, dishonesty, the unmanageable approach to life and personality change that comes with it. Family members often begin in a state of denial. Unable to acknowledge, face up to or comprehend what is happening, they may cover up or collude in the addiction, which is often referred to as “enabling”. It helps no one. This denial may in part be due to stigma by association. They may feel guilt and shame and a sense of failure. As reality breaks through, fear and desperation, anger and frustration, hopelessness and despair become the norm, as does a loss of self-esteem. They feel rejected, abandoned or punished as their family member is increasingly lost to the condition. They are haunted by the possibility it could prove fatal. They feel utterly disempowered.
In their desperation, individually and collectively, family members become ever more preoccupied with how to get the addicted person to stop the addictive behaviour. They embark on an obsessive struggle with this goal their exclusive purpose. As a result, they live in a state of chronic stress which has been shown to have a measurably damaging effect on their mental and physical health. Symptoms include loss of mental capacity and the ability to concentrate; nervous tension and involvement in conflict. They may suffer from a variety of aches and pains, lose energy, experience stomach upsets or injuries and find their immune system compromised.
The struggle of the family with their addicted member often seems to mirror the addicted person’s relationship to their drug or behaviour of choice. Addiction is characterised in part by the person’s narrowing focus on the use of a substance or behaviour. The increasingly futile struggle to get its use under control becomes a full-time preoccupation. The family can become similarly obsessed with controlling the addicted family member, either by enabling (effectively giving or allowing them what they want), trying to inhibit or manage their consumption, or threatening and manipulating. Both addicted person and family are trying to regain control; one of the uses of mood-altering substance or behaviour, the other of the addicted individual and so the family’s equilibrium. In their parallel worlds, driven by fear, neither wants to let go and give up.
“How Are You?” = Help Me
The trouble for families is that this way of going about trying to get their loved one to change often only contributes to making the problem worse and increases their own distress. Furthermore, many healthcare professionals have similarly tended to focus exclusively on the person with the addiction and, as a result, are not as helpful to families as they could be.
Family members are often surprised when asked, “How are you?” rather than how is the addicted person. Family members need to be helped in three ways: as people suffering in their own right, as part of the treatment of the addicted individual and as members of a whole family. So used to focussing exclusively on the person with the addiction, we often find that family members have lost sight of themselves and their own needs. They are no longer in touch with themselves. They have become bent out of shape in the struggle to get someone else to change; an outcome on which their peace of mind, indeed sanity, has become dependent. (Note the term). In a real sense, they too have become lost to addiction.
One of the challenges in helping family members to give up their overwrought investment in the change of the other person is a tendency to feel they are going to be blamed for that individual’s addiction. To avoid responsibility for their recovery, the addicted individual may encourage this idea. Of course, that only postpones recovery. One way to address this is a change of perspective for everyone; one that disarms stigma. It can help to present a family with the neutral, non-judgmental idea that addiction is simply a condition that has emerged in the family and happens to have done so in a particular family member. The addiction is a clear signal of distress and that change is called for. The family can now individually and collectively work to recover. Everyone is encouraged to take responsibility to deal with their own issues individually, while collectively the family shares the responsibility for improving the welfare of the whole.