Andrey Nailor, M.D.·Published 4 October 2008·10 min read
Key points
I decided to talk about recovery for families in this secton, before the one on recovery for the addict, because the addict's family can provide one of the most critical support systems in the struggle for sobriety or one of the biggest obstacles.
While addiction is progressing in a family, an enormous amount of change is taking place, as we've seen.
Family members are often so exhausted and enraged by the time the addict enters treatment that no one in the family is willing to expend any further effort.
If you're at that point, or close to it, I'd like you to consider two things.
I decided to talk about recovery for families in this secton, before the one on recovery for the addict, because the addict's family can provide one of the most critical support systems in the struggle for sobriety or one of the biggest obstacles.
While addiction is progressing in a family, an enormous amount of change is taking place, as we've seen. The family is struggling to stay together and keep on an even keel, while at the same time trying to "fix" the problems caused by the addicted member. The entanglements and manipulations that occur along the way are deeply entrenched.
Family members are often so exhausted and enraged by the time the addict enters treatment that no one in the family is willing to expend any further effort. They feel that it's time for the addict to shape up and take responsibility and for the treatment center to relieve them of some of the burden for a while. Blame gets shifted to the addict alone, and it's often hard for family members to become engaged in a therapy program just for themselves.
If you're at that point, or close to it, I'd like you to consider two things. Despite the frustration and anger, you're going to be much better off in the long run if you undertake your own recovery. Your active participation is helpful in many ways to the addict who is trying to recover, so you are promoting your desire to see the family's problems get "fixed." But, perhaps more important, you will probably find that there have been a number of ways in which the addiction has damaged your self-esteem, your sense of effectiveness as a person, your ability to trust, and your faith. You need some care. You have been taking care of everyone and everything else for a long time, and it's time for you to devote some effort to getting your own emotional needs met. Recovery will help with that.
The addicted person doesn't always get better. In fact, there may be more losers than winners in this game.
Addiction is a relapsing disorder, which means that some periods of abstinence may be followed by a return of the active addiction. It is difficult for people to get into a good program of sustained abstinence and long-term sobriety. You cannot bank on the addict getting better so that you can get better. The odds are it's not going to happen.
But you can recover from the damage and distortions that the addiction has caused in your life and in your family even if the addict is unable to achieve long-term sobriety.
Facing the Problem As we've seen, just as the addict develops denial while the addiction is progressing, families practice their own kind of denial, typically wishing to preserve a sense of normalcy and suppressing unpleasant feelings and realities.
Although you can probably easily identify the addictive behavior as a problem - the addict's irresponsibility, dishonesty, unpredictability - you may have difficulty recognizing problems of your own that might be related to the addiction.
Written and revised by
Andrey Nailor, M.D.
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For example, you might be consistently engaging in rescuing behavior, not only of the addict when some crisis occurs but of everyone you care about, even in minor matters.
You may see this as being a caring and selfless person, and certainly you wouldn't be motivated to help if you weren't such a person to begin with. But what you're not seeing is that you are staving off anxiety and depression by becoming overinvolved in other people's problems; this is part of your denial.
You might simply be minimizing what's going on because it would be too painful to admit the full truth to yourself. {pagebreak}
Although you might be able to acknowledge that your loved one has had some "problems" with addiction, you don't see the necessity of doing everything that the drug counselor is suggesting. After all, the person isn't as bad off as some others you know of who are addicts.
This is a form of denial that is common to family members and addicts alike. Wise "old-timers" in AA and other 12-step programs address this line of thinking with one word - yet.
Wife of an alcoholic at an open AA meeting: "My husband's drinking is not that bad. At least he hasn't had a DUI." Old-timer: "Yet."
The severity of the problem is not measured by the type of consequences. If it's addiction, it's severe. People who have been around addiction and recovery for a long time know that anything (bad) is possible if it has to do with the addiction and with the future.
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Family members sometimes avoid recovery and minimize the addict's problems for another simple, but often overlooked, reason. They themselves may have a problem with addiction. This is not an uncommon situation. People who have grown up in families with addiction often unconsciously seek out a partner who has the same kind of problem. Addiction, as we've seen, has a strong genetic basis. So the spouse of an alcoholic, for example, may have a genetic vulnerability to alcoholism. We've noted that a permissive environment and psychological pain are both conducive to the development of addiction. It would be hard to find a better environment for the promotion of addiction than that of an addicted family.
Often the addictive behavior in the family member is disguised. The addiction might be to mood-altering prescription medication. Someone might have an eating disorder (very common in the families of addicts), be a compulsive gambler, or have a sexual addiction. These problems may be hidden under even more denial, and for a good reason.
It's one thing to openly recognize that the addict, who is often getting center stage, has a problem. It's quite another to admit that the fallback person - the enabler on whom the family is depending - has one also. This person has the addiction in addition to being under enormous pressure to be fully functional, even overly functional at times. There's no time to deal with any more problems, or so it may seem.
Unfortunately, things probably will not go well if the family is unable or unwilling to take the steps to face and then to work on these additional issues.
Getting Better Recovery for family members begins in much the same way that it begins for the addict. First, there must be an admission that there is a problem and a willingness to accept help.
Next comes the discovery of just what the problem really is, followed by a gradual, lifelong learning process that leads to more effective coping and to emotional growth.
There are four principal avenues of treatment: education about addiction and recovery, group support, individual support, and psychiatric help.{pagebreak}
Education Educational materials not only provide you with information about what you are going through but help to normalize your experience and show you that you are not alone. Millions of people have been where you are right now, and there are probably hundreds in your area, or nearby, who are going through it at the present time. Feelings of guilt and shame usually run rampant in a dysfunctional family, and the simple knowledge that you are not bad, peculiar, or crazy can be very helpful.
Most alcohol and drug treatment centers provide an onsite educational program for family members. This usually includes videotapes and lectures given by a licensed addiction counselor who can answer questions and provide support. If you are not presently in contact with a treatment center, as is often the case, you can inquire at local centers to see if they provide a family program for people in the community who are living with an addict not currently in treatment. Some nationally based facilities that provide services for families can be found in appendix B of this section. Some useful books are listed there as well, along with Web sites of interest. Be a little leery of the Web sites if you are "surfing"; some are excellent, some are very informal, and some are misleading.
Group Support Meeting regularly with a group of people who are in similar situations and developing long-term, supportive relationships is a must for family members. This usually entails devoting some evenings to 12-step meetings. You will have to find someone to watch the kids, get yourself up and out, find the place the first time, go through the whole procedure of getting to know people, and make a commitment to come back. But just do it.
In all my experience of working with addicts and their families, I have found that there is simply no substitute for this aspect of treatment. You may read all the books on the shelf and go to all the classes you can find on addiction and still not make any real progress if you don't get involved with a support group and stick with it no matter what. You may even go through extensive individual counseling and not make the kind of progress you make with a support group.
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I can't emphasize that enough.
Individual Support In 12-step support groups, members are encouraged to choose a sponsor - a person who is further along in recovery and who is willing to take some time to talk with you on an individual basis. Sometimes this will involve looking at the different steps and "working" them. Sometimes it will mean simply sharing your mutual experiences and looking for more productive ways to cope with problems as they arise. Going to a 12-step group without using a sponsor is rather like going without a guide to a country where you don't speak the language.
Support group meetings, however, are not places where you'll want to talk about sensitive personal information. Even though most groups insist on anonymity and confidentiality, it's not the same thing as the kind of confidentiality you are entitled to in a professional relationship with a counselor or a therapist.
Individual counseling or therapy is not a must for everyone, but it's an important adjunct for many people in recovery. You can find a good therapist by asking for referrals from a treatment center, from other support group members, or from professional associations in your area. Appendix B lists some resources to help you with this. Do be sure that your counselor or therapist is familiar with addiction and recovery.
Psychiatric Help You may also need to consult with a psychiatrist for problems with depression or anxiety, or if you are feeling overwhelmed. A psychiatrist is a good resource person, too. A comprehensive psychiatric assessment with a review of your activities in recovery can be very helpful. The psychiatrist might be able to make suggestions or useful referrals. On occasion, medications are prescribed for symptoms if they are beginning to interfere with your functioning or coping skills.
Seek out a psychiatrist who is familiar with addiction and recovery, preferably one who is board certified in addiction psychiatry. You can check the appendix for ways to locate a qualified psychiatrist in your area.
If you have picked up this section because you have a family member who is addicted, I urge you to get started right away with your own recovery. Let me conclude this section with a little story about a woman I know who has been active in Al-Anon for a number of years and is one of the happiest people I know.
Kathleen's husband was alcoholic, as was her father. Their marriage was in serious trouble, and, when it looked as if her husband would lose his job because of his drinking, she began going to Al-Anon meetings. She told the group how, one day, she had finally realized what it was all about. Her six-year-old had been playing with a toy truck, and one of the wheels had fallen off. He brought it to her, and, while she was trying to fix it, he kept reaching up to help. When she saw that she couldn't get the wheel back on with his little hand in the way, she told him to sit nearby. It wasn't long before the truck was fixed. She realized, suddenly, that this was what she had been doing for years when it came to her husband's drinking. She would ask God to help, and then get in the way because she wanted it fixed now, although she was afraid it really wasn't fixable. She learned in Al-Anon that she didn't have to fix it, that she couldn't fix it. She could sit nearby and let God work. She said, "I don't get into triangles anymore." Although it took several years, her husband eventually went to treatment and is now in recovery.
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