It is essential that we as beginning therapists learn to accurately recognize and evaluate family dynamics, in order to effectively treat families and improve functioning. Families have multiple functions which aid in the development of balanced individuals and which ensure flexibility in family life. First, the family serves as a physical, social, economic, and emotional support system to facilitate individual development during all stages of life. Second, families help the individual gain an internalized set of core values and morals—which will continue to guide lifelong behavior or serve as a starting point to reevaluate one’s own values. Finally, families socialize members to become a part of society and act within the roles that will be expected or demanded of the individual. One of the most damaging behaviors to healthy family dynamics and individual development is drug and alcohol addictions.
Unfortunately, when substances are abused to the point that one becomes addicted, all aspects of family life are affected and compromised. Each relationship must take into account the behavior resulting from substance abuse and redefine the boundaries that maintain the relationship. It should be remembered that initially the substances served a seemingly beneficial role—escape reality, increase confidence, improve energy levels, etc.—but the unhealthy dynamics that follow addiction are a result of what the drug eventually does to the individual. In counseling families, a therapist should explain this concept to help family members conceptualize that the addict did not want or intentionally create the negative consequences of the use and subsequent addiction.
All too often, as addicts come to treatment centers, or self help groups (AA, CA, Rational Recovery), many of the supportive relationships within the family have been strained to point of breaking, i.e. bridges have been burnt. The underlying issue here is that the needs of the addict surpassed the needs of the family; put another way, family relationships were no longer mutually supportive but individually draining. In these relationships, trust is frequently violated and emotional closeness is replaced with guarded skepticism. It is not uncommon to hear stories of wedding rings and family heirlooms being pawned in order to go on “one more run” or an entire paycheck being blown in two days without having paid a single bill. The end result is that the support system is not able to bear the burden of the addict any longer, and the addict becomes isolated in addiction and early recovery.
The internalized values of the individual, who is dependant upon substances, frequently deteriorate in an insidious fashion. Small compromises of personal values, which serve as justifications for continued use, will ultimately lead to greater compromises. Eventually, many addicts exhibit behavior that they find shameful and would not have done had they been clean and sober. The resulting shame and guilt frequently lead to exacerbated use, complicated by unhealthy interpersonal dynamics. The shame of having abused children while drunk can be deadening. The shame at having cheated on a spouse to get more drugs can destroy confidence. The guilt of having caused so much pain in others can be crushing. This destructive cycle, though painful, eventually forces the addict to examine the real source of guilt and shame—the inconsistencies between their behavior and their values.
Consider now the role of socialization upon the family dynamics of addicts. American culture posits the importance of individualism, independence, and resilience as a matter of national pride; these values also serve as powerful expectations against which we are personally measured. Partly as a result of these cultural expectations, individuals and families do not like to air their dirty laundry—it represents a loss of control. Unhealthy dynamics can develop in an attempt to present an outward alternate reality, thus a family secret comes into play. The secret is simple: we’re not okay and we have problems that we can’t solve on our own and we don’t know what to do about it. It would be a mistake to assume that these families are easily recognizable or helplessly “dysfunctional”. Failure in some aspects of life does not, in any way, exclude success in others. Thus, a family secret may actually mobilize compensatory behaviors to aid the family to appear more “functional” within the cultural or situational context. All the while, relationships and the attending ability to solve familial problems atrophy like a paralyzed limb.
Two final topics that must be covered are enabling and codependency. A family member who enables may, unknowingly and with the best of intentions, inadvertently support a family member in addiction. A classic example is that of a man who has his wife or girlfriend call in sick for him on Monday morning. Of course, this occurs for many reasons. The woman may be accounting for the consequences of a lost job if she doesn’t call, violence may ensue if she doesn’t cooperate, or she may be trying to be supportive. The enabler does not intend to encourage addiction, but that is a likely result, because the addict will not have to face the true consequences of the behavior. Pain is actually a very strong motivator for change and accepting full personal responsibility for one’s behavior will ensure that the pain is rightly placed.
Codependency is an unhealthy relational pattern similar to enmeshment. The codependent, in a sense, is addicted to the addict. If the addict is happy the codependent is happy, if the addict is mad the codependent must be to blame, if the addict finds someone else to love then the codependent must not be good enough. The codependent’s emotional and behavioral state is directly dependent upon the emotional state of the other person, typically the addict. The unfortunate result is a form of predictability coupled with a loss of personal control. In other words, they know how to push each other’s buttons. Much like enabling, the addict uses this as a perpetual excuse to use. Likely exchanges may sound like these: “if you hadn’t pissed me off I wouldn’t have used,” “if you had dinner ready I wouldn’t have been so mad,” and “if you wouldn’t be so nosy I wouldn’t leave so often.” Once again, the addict becomes insulated from the true consequences by shifting responsibility for emotional reactions to the codependent. More than one addict has admitted to causing a fight in order to go use. This pattern seems to reinforce itself in many ways and potential solutions are buried in the continual cycle of addiction and codependency.
The practitioner attempting to engage families with addicted members must be prepared to recognize the attending dynamics and show compassion for all of those involved—including the addict. Addiction seems to take on a life of its own and leaves a vast, destructive path in its wake. Blaming and accusations should not be a part of treatment in any form; rather, helping family members to accept responsibility for their behavior, and their behavior only, proves essential. This may be painful for all those involved, especially the addict, because too often the addict becomes emotionally numb and has lost touch with both the pain and joy of living. Frequently, autobiographies are required of the addict during treatment in order to help uncover and feel the high and low points from the past. Clinicians need to help the addict find a new way of coping with these ups and downs of life without using drugs or alcohol.
There is no way to cover all of the possible aspects relating to family dynamics of addiction within such a limited space. It is therefore essential to continue to learn more about the topic. Some further items for consideration include relapse, Ala-Non, family rituals, grief and loss, boundaries, control, defense mechanisms, intimacy and closeness, abuse and neglect, fear, and trust. Fortunately, families are resilient and have great capacity to heal and adapt. By learning about addictions and the dynamics associated with addictions, we can more effectively engage the family in their healing process to find what has been lost—serenity.
