The Family Illness Concept
Josie L. Fludd, CHD275 - Lesson 4
Advanced Theory and Techniques
In the Treatment of the Chemical Dependent
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After reading the assigned chapters, I learned that the relationship between alcohol/drug abuse and family dynamics is both extremely complex and poorly understood. A conservative estimate suggests that at least 4-5 people are hurt for every person with a substance use disorder (SUD) (Capretto, 2007). Alcohol and drug addiction is a family disease that includes codependency, enabling behavior, and marital discord, where the family is centrally organized around the addict’s behavior. A family system is made up of individual members and the ways they relate to each other. As a general rule, people tend to marry those who have achieved similar levels of “differentiation of self” (Bowen, 1985, p. 263). Addiction is a family problem; it impacts the stability of the home, the family’s unity, mental and physical health, and the overall family dynamic. When a family member has a drug/alcohol addiction, the whole family usually develops ways of coping with the problems associated with it.
From my own personal experience, I know how damaging drugs and/or alcohol affect the whole family. At the time I figured I was just going through a phase, I was recently divorced, had no children, and didn’t think I was hurting anyone but myself. I can recall the exact day I realized that my family was also suffering. During the height of my addiction, I had quit coming home (unless I needed money or a change of clothes) and practically begun living in the “Hood”. I have six brothers and four sisters, and one day I was sitting in a field getting high (smoking crack), and seen three car loads of people drive up; it was my entire family (five from out-of-state). They all confronted me and asked why I was choosing to ruin my life, and how disappointed my father (who had just passed away) would be if he seen me living like this. I remember feeling so embarrassed and ashamed that they saw me in this condition, and seeing
CODEPENDENCY AND THE FAMILY ILLNESS CONCEPT OF ADDICTION 3 them crying and begging me to come home, I finally realized that I was not only hurting myself, but my whole family as well.
Children growing up in an alcoholic/addict family system experience traumas, which result in specific adult behavioral characteristics and developmental disabilities. They also have trouble establishing effective boundaries in relationships and are often either over-separated or over-attached in partner relationships. When parents are abusing drugs or alcohol they are unable to give the children the type of consistent love and nurturing necessary for proper bonding. The parent is often absent, or when present, is very inconsistent in his or her behavior, and children learn to distrust their own observations and feelings, and feel powerless to change the family system. They cannot speak out and cannot trust their feelings because the rules in an alcoholic/addict family system are don’t talk, don’t feel, and don’t trust. Those who threaten to violate the rules, run the risk of emotional expulsion from the family (Dayton, 2005). When a family member has an addiction, the whole family usually develops ways of coping with it by ignoring the problem, avoid expressing emotions, or by keeping the addiction secret from friends and family. This type of environment often leads children to show anti-social behavior, hyperactivity, depression, behavioral problems in school, and they often turn to drugs/alcohol themselves.
The foundation of the codependency movement rests upon the family disease model of family therapy, which holds that “the solution is for each family member to recognize that he or she has a disease” (FalsSteward, O’Farrell, & Birchler, 2003, p. 148) either of addiction or codependency. Codependency involves a habitual system of thinking, feeling, and behaving toward ourselves and others that cause pain. These habits lead us into, or keep us in, destructive
CODEPENDENCY AND THE FAMILY ILLNESS CONCEPT OF ADDICTION 4 relationships, or sabotage relationships that may otherwise have worked. Addicted families organize around addiction, children know how to lie for their parents, wives work to support their drug or alcoholic husband, and husbands buy drugs to keep their addicted wives “happy”, etc. Families develop survival roles to cope in a dysfunctional alcoholic/addict family. They include the family scapegoat (they divert attention from family issues by acting out), the family hero (the responsible child), the family mascot (they diverts attention from family issues with humor and silliness), the chief enabler (shelters, protects, and denies), and the lost child (the silent one who denies feelings and needs). Children of alcoholic/addict family systems will continue to act out their family role as adults, which usually lead to disrupted relationships, and a cycle of abuse that gets passed down through generations.
Often, a family adjusts so thoroughly to the addiction that it becomes as much a part of its environment as the air they breathe, and the family fails to see the true impact of the disease on them as a family. When one of the parents is the addict, a common pattern is for the non-using spouse to become closer to the children as a way of protecting them from the addict’s influence. Another common pattern is for fights or silent conflicts between mother and father to result in the children becoming closer, and forming a coalition against the addict, or against both parents. If the family remains intact, they learn to manage in spite of the problem, and as time goes by, dysfunctional family life becomes the norm.
The information obtained in this lesson will help when working with chemical dependent clients because I have learned the importance of treating the family system as a whole instead of just the individual. From the family system perspective, the treatment of an addictive disorder involves identifying and ultimately modifying whatever dysfunctional family system allowed the
CODEPENDENCY AND THE FAMILY ILLNESS CONCEPT OF ADDICTION 5 development and maintenance of the addiction in the first place (Bowen, 1985). There are support groups like, CODA, ACOA, Al-Anon, and Al-Ateen that families can attend to be with like-minded families and receive the tools needed to cope, and learn to break the pattern of dysfunction.
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References
Doweiko, Harold E., (2009). Concepts of Chemical Dependency, Seventh Edition, 300-308.
Minuchin, S., Families and Family Therapy. Cambridge: Harvard University Press, 1984.
Weinhold, B. K., & Weinhold, J. B. (1989), Breaking free of the co-dependency trap, Walpole,
NH: Stillpoint.
Kaufman, E., and P. Kaufman. Family Therapy of Drug and Alcohol Abuse. New York:
Gardner Press, 1984
Brown, Stephanie. (1988). Treating adult children of alcoholics: A developmental perspective. New York: Wiley
Volk, R. J., et al. (1988). Family system of adolescent substance abusers. Family Relations
38:266-72.
Lawson, Ann, and Gary Lawson. (1998). Alcoholism and the family: A guide to treatment and
Prevention. 2d ed. Gaithersburg, Md.: Aspen.
References: Doweiko, Harold E., (2009). Concepts of Chemical Dependency, Seventh Edition, 300-308. Minuchin, S., Families and Family Therapy. Cambridge: Harvard University Press, 1984. Weinhold, B. K., & Weinhold, J. B. (1989), Breaking free of the co-dependency trap, Walpole, NH: Stillpoint. Kaufman, E., and P. Kaufman. Family Therapy of Drug and Alcohol Abuse. New York: Gardner Press, 1984 Brown, Stephanie. (1988). Treating adult children of alcoholics: A developmental perspective. Lawson, Ann, and Gary Lawson. (1998). Alcoholism and the family: A guide to treatment and Prevention