Mary McAllister, LMSW & Margaret Klein, LMSW
Family members have different ideas about why. Thoughts and opinions are presented with blame, emotion, confusion, and often, resignation.
They don’t “just stop” because they have an addiction. It’s not a lack of courage or willpower. No one is at fault and loved ones cannot control or cure it. Addiction is a disease of the mind, body and relationships. It is the need for something in order to function normally. The body and mind are at dis-ease without that substance.
Left untreated, addiction is primary, progressive and chronic. It affects behavior, thinking and moods. changes in appearance, hiding feelings, minimizing use, unpredictability, denial and lying are all part of the disease.
What is it like for family members to live with these characteristics in their loved ones?
Typically they learn to adjust to the pain and chaos associated with their using family member. Still, their lives slip into the realm of unmanageability; if not completely, in part. They become responsible for the family’s status quo and making sure that the boat doesn’t rock. in contrast to the user, they are hyper-responsible, ever vigilant in those areas the addict no longer prioritizes.
This is the concept of family disease in addiction. The affliction lives in all members of the system. For the addict, it is about use of substance. For the family member, it is about emotional and behavioral patterns of coping (that don’t work either).
Seeking short-term stability and relief from the prolonged and cyclical exposure to intoxication, the family grows to accept a dysfunctional set of rules. Accommodation then becomes the central organizing principal of the family.
Imagine, if you will, a rubber life boat which houses the addicted family. All members shift and sway, each adjusting as a result of the other’s movements. Adjusting to the disease and organizing everyone around the dysfunction, families will keep the boat afloat at any cost.
This visually describes the family disease. The addict’s and family member’s behaviors and characteristics are similar, parallel and symbiotic. Family members often develop an obsession with the addict’s drinking and drugging. They become preoccupied with getting their loved one to stop using. Out of concern and loyalty, family members love, protect and shield addicts from negative consequences which paradoxically enable the drinking and drugging to continue. There is tremendous confusion and chaos, and a sense of failure, which can cause family members to lose self-esteem. There can be marked physical, emotional and spiritual changes. They live within their own cycle of blame, anger and frustration. Without treatment, family members think that getting their loved one sober is somehow within their control, perhaps even their responsibility. Family members search to find the magic words to try to get them to stop. Without knowing, family members remove any vote of confidence for the addict to function in a responsible way in their own lives.
Family recovery insists that addiction is a disease which impacts all members of the system. Recovery educates and alerts both family members and addicts to behaviors, thoughts and feelings that perpetuate the cycle of intoxication and introduces the concepts and characteristics present in healthy, functional families.
Family recovery shifts its exclusive organizing principal and focus away from the substance abuser. The health, dreams and goals of the whole system (in addition to the identified patient) are considered. Family members re-learn to focus on themselves, rebuilding healthy patterns. Rituals, recreation, communication and routine are just a few goals of this new dynamic.
Treatment is for the entire family. In an atmosphere of support and guidance, all members will begin, once again, to focus on their own needs. By setting boundaries with their loved ones, family members can quickly feel better about their lives. Learning new methods to understand and communicate information, manage behaviors, practice self-care and self-expression, and find supportive others, they become much better equipped to truly help their loved ones. This is how the family can help the addict to “just stop”.
Mary McAllister, LMSW, is Coordinator of the Family Program at Freedom Institute. She has trained at the Ackerman Institute and provides individual, couples and family work, as well as facilitates education and therapy groups for families and significant others. Contact Mary McAllister at 212.838.0044 ext 32 for more information about Freedom Institute’s Family Program.
Margaret Klein, LMSW, is a clinician on the Family Program team and has trained at the Ackerman Institute. She provides psychotherapy services to individuals, as well as facilitates education and ongoing support groups.