“When I found out my son was addicted to drugs, I blamed myself. Instead of doing what was best for him, I got into the habit of fixing his messes”
“Rehab was great, but I knew I’d have to go back to my family afterwards. And boy was my family dysfunctional!”
Family therapy is an integral part of addiction treatment. Almost every addict’s family has some level of dysfunction. In some cases, the dysfunction contributed to the person developing an addiction. In others, the dysfunction came about because of the person’s addiction.
But why are the families of addicts so often dysfunctional? And how does family therapy help?
Here is everything you need to know about family therapy in addiction recovery.
Why is addiction a family disease?
We often refer to addiction as a family disease. This is because the dysfunction of an addict’s family, whether it led to the addiction or was caused by the addiction, becomes an integral part of the problem.
Addiction pulls the entire family into its orbit, until no member is unaffected. The family system begins to work in such a way that it bolsters the addiction, making individual recovery incredibly difficult.
In a dysfunctional family with addiction at its core, every member of the family takes on a specific role.
Family roles in an addict’s behavior
There are a number of different roles family members may take on.
A parent or sibling may create a fugitive/detective relationship with the addict. They are constantly on the lookout for addictive behavior, and the more they interrogate, the more the individual feels and acts like a fugitive. The trust deficit only increases, and honesty becomes the exception rather than the norm.
Another family member may enable the addiction. They cover up for the addict’s behavior in a misguided attempt to help them. They may even help the person acquire substances out of concern for their health in the face of withdrawals. The relationship becomes unwittingly manipulative from both sides. When there is an enabler in the family, the addict has a more difficult time resisting cravings.
Codependency is also incredibly common in an addict’s family system. In a codependent relationship, two people rely on each other to fulfil some sort of need. This need is generally emotional but can be physical. For example, the addict may rely on a family member to take care of their needs, such as sustenance and health care. The family member, on the other hand, relies on the addict for validation in their role as the caregiver.
All of these roles can only continue to exist if the addictive behaviors continue. Therefore, a person returning to the family system after rehab may find that their family is unknowingly pushing them back towards addictive behaviors such as distrust, helplessness, and self-destruction.
A volatile environment
Families are impacted by the addiction in other ways, too. The addiction of a family member often makes the home environment feel unsafe. Their behavior is erratic and they may leave substances where another family member (including a child) may find them. They may also bring other addicts or dealers into the home.
Furthermore, the volatility in the home environment also leads to a lack of proper boundaries. Addicted parents do not provide a proper sense of discipline or structure. Family members get overly involved in each other’s business. Dishonesty becomes the norm.
Family members may also experience negative emotions such as anxiety, resentment, guilt, and anger. Children are particularly susceptible, and may start struggling in school and in social situations.
How does family therapy deal with the dysfunction in the family of an addict?
Learning new relational behaviors
In family therapy, the therapist analyses the dysfunctional attributes of the family system. They identify the different roles each member takes on, as well as the dysfunction this is causing in the home.
They then work with the family to develop new relational behaviors. Enabling family members learn to hold the addict accountable for their actions. Distrustful family members learn how to rebuild trust without forced naivety. Codependency is identified and each family member learns to change the behaviors which serve to reinforce the addiction.
The family also learns just how the addiction has impacted their lives. Abnormal behaviors have begun to seem normal, and it is crucial that the family can recognize the dysfunction. They can then begin to change the home environment into a nurturing space, rather than an environment of dishonesty, denial, and unhappiness.
Dealing with blame and resentment
During the process of family therapy, the family learns that assigning blame is destructive. The addict did not want to become addictive, and none of the family members intentionally enabled the addiction or caused dysfunction. The focus is on mending the family and improving the chances of recovery rather than fixating on what went wrong.
This points to another reason why family therapy is so important. As the addict goes through a recovery journey, family members may well feel resentful. They see the addict getting help and growing as a person, and if they still blame them for the dysfunction, they feel it is unfair. This may even lead them to hope that the addict fails in their recovery.
Family therapy not only helps the family learn that addiction is a disease and the addict’s behaviors were not malicious, but also ensures the family is taken along on the journey. They get to learn and grow alongside the addicted individual, ensuring they feel nurtured too.
Stronger than before
Family therapy gets the family to a place in which they are stronger than ever before. They learn healthy communication skills, along with how best to take care of each other without enabling bad behaviour.
Family therapy is an integral part of addiction recovery. The best drug and alcohol rehab centers provide family therapy during inpatient and outpatient treatment, with the possibility of continuing the process beyond addiction rehab.
- Center for Substance Abuse Treatment. Substance Abuse Treatment and Family Therapy. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2004. (Treatment Improvement Protocol (TIP) Series, No. 39.) Chapter 1 Substance Abuse Treatment and Family Therapy
- Jeffrey D. Roth MD, FAGPA, FASAM (2010) Addiction as a Family Disease, Journal of Groups in Addiction & Recovery, 5:1, 1-3, DOI: 10.1080/15560350903547189
- Rob J. Rotunda & Kathy Doman (2001) Partner Enabling of Substance Use Disorders: Critical Review and Future Directions, The American Journal of Family Therapy, 29:4, 257-270, DOI: 10.1080/01926180126496
- Morgan, J.P., Jr. (1991), What is codependency?. J. Clin. Psychol., 47: 720-729. doi:10.1002/1097-4679(199109)47:5<720::AID-JCLP2270470515>3.0.CO;2-5
- Lander, L., Howsare, J., & Byrne, M. (2013). The impact of substance use disorders on families and children: from theory to practice. Social work in public health, 28(3-4), 194–205. https://doi.org/10.1080/19371918.2013.759005
- Wright, P.H., Wright, K.D. The Two Faces of Codependent Relating: A Research-Based Perspective. Contemporary Family Therapy 21, 527–543 (1999). https://doi.org/10.1023/A:1021679222403
- Seaburn, D., Landau-Stanton, J., & Horwitz, S. (1995). Core techniques in family therapy. In R. H. Mikesell, D.-D. Lusterman, & S. H. McDaniel (Eds.), Integrating family therapy: Handbook of family psychology and systems theory (p. 5–26). American Psychological Association. https://doi.org/10.1037/10172-001
- Family Therapy with the Families of Recovering Alcoholics. Donald E. Meeks and Colleen Kelly. Quarterly Journal of Studies on Alcohol 1970 31:2, 399-413