Addiction is a family disease. The Recovery Book advises family members of people in recovery that “Everyone in your family, as well as other people in your lives, have been affected by addiction in some way. Now you all need to work on getting your lives back to some kind of normal.”
This advice is based on the family-disease model of addiction, which looks at substance abuse as an illness that affects the entire family. Family members of the person with an addiction may develop codependency, which causes them to enable the substance misuse of the identified patient (IP).
A detailed study by the Center for Substance Abuse Treatment (CSAT) and the Substance Abuse and Mental Health Services Administration (SAMHSA) explains the importance of the complex role that families can play in substance abuse treatment.
“They can be a source of help to the treatment process, but they also must manage the consequences of the IP’s addictive behavior. Individual family members are concerned about the IP’s substance abuse, but they also have their own goals and issues. Providing services to the whole family can improve treatment effectiveness.”
Including family members in the addiction treatment of the identified patient sometimes runs into difficulties. “Occasionally, the first challenge is that family members don’t accept the disease concept. They think of addiction as a character flaw,” says Lakeview Health family therapist Ken Wynn. “Or they view addiction as a condition that affects mostly the addicted patient.” They argue that the addicts are the ones who used drugs or alcohol, so they are the only ones who need treatment.
Family therapy needs to address this and other misconceptions about addiction to enable family members to support the sustained recovery of their loved one. Lakeview Health offers families the opportunity to participate in a three-day family workshop. The workshop is a group session with several families. “The first day is mostly educational,” explains Wynn. “We provide a lot of information about addiction as a disease. We talk about family systems in general and the various roles people fall into. We discuss the dangers of codependency and enabling behaviors. We spend quite a bit of time talking about the value of good communication and how to set healthy boundaries.”
Participants in the workshop get to share their experiences. Family members have a chance to let the patient in recovery know what the substance misuse has done to them, and patients, too, have an opportunity to share their feelings openly. Both sides work on rebuilding trust and learning to avoid behaviors detrimental to recovery.
To paraphrase the poet John Donne, no addict is an island entire of itself; every person in recovery is a part of the main. The CSAT/SAMHSA study points out that the disease of addiction can affect the entire ecosystem of the family. “In families with substance abuse, family members often are connected not just to each other but also to any of a number of government agencies, such as social services, criminal justice, or child protective services. The economic toll includes a huge drain on individuals’ employability and other elements of productivity. The social and economic costs are felt in many workplaces and homes.”
Family therapy will help partners and parents better understand the disease of addiction and—consequently—the behavior of their loved one. Treatment often comes after years of irresponsible behavior of the addicted individual, and feelings of mutual resentment must be addressed in therapy so the whole family can heal.
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