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Family and the recovering addictJohn O’Neill, LCSW, LCDC, CSAT Finding the courage to admit that there is a problem and make the difficult choice of seeking help is often a difficult step for an individual. It can be even more challenging for families. Embracing this challenge safely and with hope is a crucial task for each family member. Naturally, with change comes resistance and families face the unconscious desire to maintain the status quo. When a family member suffers from the disease of addiction -- whether it involves substance abuse, sexual addiction, gambling, or other addiction -- the family organizes themselves around the addict and develops coping mechanisms. When Dad is drinking they don’t bother him, ask him for help with homework or expect that he participate in family activities, celebrations and stresses. When Dad enters into treatment, the family system is thrown out of balance. Learning how to engage in and explore the family system is essential to long-term recovery. The National Association of Alcohol and Drug Counselors recently wrote, “Recovery rates for the chemically dependent individual increase significantly if treatment includes participation from and recovery for the entire family.” It is crucial for the family to understand and embrace recovery, not only from an individual perspective, but also from a family perspective. Each member of the family plays an important role in recovery and will face challenges. Understanding and preparing for these challenges is one of the first steps in the journey towards family recovery. It is a journey that naturally will have highs and lows. Just as the family system has changed due to the addict’s use of substances, gambling, sex or other addictions, it will change when the addictive behaviors are addressed. The mere absence of the addictive behavior does not lead to harmony and happiness in the family and quite often frustrates family members. For example, the family may think, “I know that Mom is no longer drinking, why is she still so difficult to talk to? I know she stopped gambling, but now she is harder to live with than before.” Numerous movies, country songs, and articles have illustrated this complex process. An old country song may say it best: “You ain’t much fun since I quit drinking.” If you have ever been around people who stopped smoking, you may have been tempted to purchase cigarettes for them just to help with their irritability. This dynamic plays out within each family and needs to be addressed to facilitate lasting recovery. It is helpful to understand how each client defines family. The traditional nuclear family viewpoint does not appreciate that most clients may define their family differently. The client’s family may include extended blood relatives, co-workers, friends, members of various self-help groups and other members of their community. Understanding each client’s unique family system allows us as helping professionals to engage the client’s family and start family recovery. At The Menninger Clinic we host family workshops multiple times a year. Commonly, we hear frustration from families related to recovery, relapse, and their role in treatment. Over the years we have developed common teaching elements to assist families with their role in recovery. The family’s expectations often lead to stress and frustration: “When Dad was drinking, things were bad. Now Dad isn’t drinking and things should be good.” The misunderstanding of what should or should not occur during the early stages of recovery is normal. Helping families develop reasonable expectations of recovery is crucial to relapse planning and to the overall health of the family system. It is helpful for the family to have a healthy dialogue on expectations remaining flexible with their needs and at the same time maintaining their boundaries. It is not unreasonable to expect that abstaining from an addictive behavior should improve the family’s system. However, it is not uncommon for the addicted client to struggle with depression, anxiety or mental health problems. The absence of the addictive behavior may exacerbate symptoms and create additional stress for the family. Preparing for and having reasonable expectations can help the family cope. As the family addresses their expectations of recovery, the process of collective hope starts. Hope is the fuel for recovery. Dr. Karl Menninger described hope as providing a motive force (emotion) for a plan of action (reason) that has prospects of succeeding. In maintaining hope, the addicted client and family have the necessary energy to continue the work to sustain recovery. It is not easy and hope will be challenged. However, a family engaged in recovery and reflecting on their expectations and hopes is better able to maintain and borrow hope from each other. Families typically ask what is normal when their loved one starts recovery. This is a difficult question to answer and depends upon many variables. Helping each family normalize the fear, frustration, stress and anxiety related to recovery is important. A family may ask: “Is it normal for my loved one to be angry all the time? Why do we still seem to be walking on eggshells? What if my loved one relapses again?” Discussing what is normal can be helpful to the family as they explore the dramatic changes to their family system. As difficult as it may be to classify a behavior, feeling, or thought as normal it is an essential element in providing safety in the family. It is very difficult to organize around change if there is not a sense of safety. Helping a family feel safe in recovery can provide the environment for lasting family change. As the family starts to engage in treatment it is important to highlight their strengths. Helping a family system explore their unique strengths can be an essential tool in developing a recovery and relapse plan. For most families this is a new process and requires patience and time. We encourage each family to be patient and to continue supporting the addicted family member. At the same time, we encourage families to participate in self-help groups and continue the work after discharge from a formal treatment program. As a family explores expectations, develops collective hope, normalizes their feelings, and builds upon their strengths, they start to develop a sense of safety within the family system. They will confront challenges to this sense of safety, but a family system committed to recovery can develop new ways to cope, support each other and maintain hope.
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