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Seeking Help When a Loved One Struggles with Addiction

I’m returning once more to the issue of living with a friend or family member who is struggling with addiction. First, let me thank again those of you who take the time to read these posts and/or comment. It means a lot to me and I am very touched by what I read. It drives home to me yet again how devastating it is to watch a loved one self-destruct, and to live with the insanity of addiction.

A few readers have pointed out that alcoholism affects everyone close to the one who drinks. As Jason C. wisely stated, “It’s nice to think that it’s not your problem. However, if you live with a secret drinker…their alcoholism will cause you problems indirectly eventually.” Or, as Kevin B. said, “There is no running away from alcoholism in your family.” However, not everyone saw it this say. One writer asked, “I don’t see why their partner needs to acknowledge the elephant in the room if they don’t want to.”

Living with alcoholism or addiction creates a no win situation for everyone. Partners or family members may opt for an “ostrich” approach, burying their head in the sand with the idea that “it’s not my life, it’s theirs” – but that can only work for so long. Ignoring or pretending that addiction “just isn’t there” or “isn’t that bad” is, unfortunately, a form of denial. It may work for a little while, until the day the you-know-what hits the fan (again) and the mental blinders are mercilessly smashed. (Ever notice that addiction and drama seem joined at the hip?)

The reverse of “the ostrich” is, of course, to never let the person out of your sight. But constant monitoring and “surveillance work” creates its own insanity, since no amount of control is ever enough. No matter how many bottles you check, or curfews you monitor, or bank accounts, or emails, or social sites (Facebook or Myspace), there’s always something you’re going to miss – and be stuck with a big fat resentment. Plus, the effort itself is draining and demoralizing.

You may be thinking, if you happen to be in this kind of painful situation, “So what am I supposed to do? Give up?” No. There is a lot you can do – for yourself. Follow me. Why do people either rationalize/pretend/deny on the one hand, or control/monitor on the other? One might say, “Because the addictive patterns are overwhelming.” In any event, we can agree that the denial/control type of behaviors are reactions to addiction.

But not only to the addiction. They are also reactions to the partner or family member’s own difficult feelings – such as rage, sadness, guilt, shame and so forth. The thinking, logically enough, is that “if I can get the addicted person to stop, the chaos and drama will stop, and I’ll feel better.” Who doesn’t want to feel better?

Thus the problem seems to lie “out there”…though those very distressing feelings are “in here”. And trying only to change something external to help the internal is a recipe for misery — especially when one is powerless over the addiction. Notice I said “only”. If you’re in the near vicinity of someone needlessly shouting, you ask them to stop. But if they won’t, you have to take care of yourself and go to plan B.

If you live with someone who is addicted, and can somehow intervene effectively, that is terrific. Sometimes this happens. But in many cases, there is very little – if anything – that loved ones can do. (This in itself creates distress.) Nothing may cajole, persuade or force the addicted person to stop, but something must be done. And very often that something means getting support for one’s own emotional trauma and distress. It’s a little like the safety instructions on an airplane: you need to help yourself before you can help the person next to you.

If you’d like help, but don’t know where to start, try asking your doctor, or local therapists, psychiatrists, hospitals, treatment centers, and so forth, about local resources. You can even email a therapist on this very website! Try not to make major decisions about interventions, divorce, legal situations, etc., on your own. Talk to someone with experience. Get support. Trying to figure it out by yourself only leads to more hurt and heartache, and that awful lonely feeling that is so hard to shake. You’d be surprised what’s out there – even online, if local resources are scarce.

I urge you to seek help, if any of this applies to you. It’s the most caring thing you can do for all involved.

This article was originally published on goodtherapy.org

1+1 = 0

Years ago I treated a female client in her 30s (“Mary”), married with two teenage children, who was struggling in her marriage to an alcoholic husband.

Mary and I had a strong rapport, which included a shared sense of humor. She’d tell me laughter was a release of tension for her, and also created a kinship with me, her therapist. Her life was no sitcom, to be sure, but she felt comfortable with a wry observation or two, from either of us, particularly where her children were concerned. Their “teen logic” and rationale for wanting what they wanted, yesterday, often made us chuckle.
One day, however, I inadvertently put my foot in it with an ill-timed laugh, as she described to me an argument she’d had with her 17-year-old daughter over marijuana use. Her daughter was insisting that pot helped her write better papers for school, by “opening up her mind”. I laughed at that briefly (an ex-marijuana user myself), before noticing Mary’s distressed expression. This was a moment where she on a typical day would also laugh, but not today. In fact it seemed as though I may have worsened the tension she was obviously feeling.

I said I was sorry if I had trivialized her feelings; she said that wasn’t the cause of her upset and, in fact, felt “bad” for being too serious about things that day. Upon exploration, though, her feelings were understandable. She was feeling despair after this argument, since her daughter’s defense of pot eerily paralleled her husband’s rationalization for drinking, which “relaxed” him for smoother engagement at home. (A subjective point of view, to say the least.)

Suddenly her daughter, whom she saw as an ally, was seen as a potential “defector” to the cause of addiction – a terrifying concept, which stirred a sense of deep aloneness. It left her, I imagined, with that horrific isolation every member of an alcoholic family – including the alcoholic – feels much of the time. In fact, our relationship (between me and Mary) might have felt compromised in the wake of my misattuned chuckle. Not only did she feel a sudden gaping distance between us, but she also felt “wrong” in the way that many partners or loved ones feel; in this case, she felt she was being “too serious” in not laughing with me, as she usually did, that her feelings were somehow “wrong” for being too serious. Such was the intensity of this negative self-perception that I sensed she may have felt “wrong” just for being. The shame, isolation and self-loathing she felt, in that moment (as a representation of too-frequent other moments in her life, rife with chaos beyond her control), were practically yelling for attention.

It was almost as if she felt invisible: not heard, not seen, because of this fundamental “wrongness” that cancelled her out. In that nightmarish void, the other seems to vanish as well. When we disappear into that temporary annihilating space, it seems the world itself goes blank. We feel hidden, with the terror of never being found.
Fortunately, our rapport was strong enough that I could make reparation for my faux pas. She insisted it was minor, though I was careful to hold a place for the intensity of the loneliness and self-doubt (and, possibly, rage) she may have felt in the office – and even more so at home, given the severity of the turbulence and chaos. (On top of, of course, having to raise two teens in such an environment, without much help from her spouse.)

It brought home to me several things: the primary importance of therapeutic rapport and trust between therapist and client; the repetition of annihilation anxiety that, tragically, appears and re-appears with alarming frequency in the face of active addiction; and most of all, the intolerable isolation that rises up around us when the gap between ourselves and others opens up into a void.

This is why support and allies are so crucial to those in this type of situation; we need connection in the face of such awful stress, which often becomes “normal” in living with addiction, like living with air or noise pollution in big cities. We get used to it, it’s really not so bad. Until it is.

This article was first published on goodtherapy.org. Copyright 2010 by Darren Haber.  All rights reserved.

Home is Where the Heart Isn’t: the Struggle for Healthy Change

I’ve been noticing lately that patients who are more awake and self-connected are also more uncomfortable.

Partly this is because any change, however positive, is…well…change. As in different, unfamiliar. We may not like the familiar, but we’re used to it, and know how to navigate.

Living within a more authentic, self-aware perspective can be like living in a foreign country. You don’t know your way around as well. Some of the signs are hard to read; the usual markers are missing.

This certainly makes us more vulnerable in relationships with others. Being more awake makes it harder to hide our feelings. The good and bad news about getting in touch with these feelings is….we’re more in touch with our feelings. This can leave us feeling exposed, without our usual defenses. It might be harder to hide the pain, anger, anxiety or whatever else has been lying beneath the surface. It can also inject a renewed sense of vitality and courage into our emotional life.  The payoff is big, but it can feel like having two left feet.

This also means we might be relying on others more: our support group, loved ones, therapist, counselor, confidantes, etc. Asking for help isn’t the easiest thing for most of us, so this adds to the sense of vulnerability. Of course, the old defenses – denial, escape, substances, sex, whatever was working until it wasn’t – were ways of masking this vulnerability to begin with; it may feel “new” but it’s only been band-aided over for a while. Sometimes my patients, at this particular point, become irritated or even p.o.’d at me, wondering what in the world I’ve led them into. The answer is, a better way of living. Then again, the old dysfunction –the disconnect, emotional numbing, the “band aids” referred to above – is what feels most familiar. It is also what led most folks into therapy to begin with!

Sometimes we might be surprised at negative reactions of those close to us, as they see these changes taking place, the old ways being shed. Perhaps those of us in the midst of change are viewed as “rocking the boat”. Those of us adverse to any boat-rocking might feel sheepish. How dare we get healthy! In truth we are rocking the boat — in a good way, though it could be threatening to those who cling to the old system. Living openly and honestly is a threat to Denial or Dishonesty or other cunning devils, who live in shadow and fear sunlight. Most often, though, as the benefits of the changes become evident – greater freedom, honesty, spontaneity – these defenses soften, especially if they are met with understanding and patience. Fear is always the loudest promoter of the status quo; meeting it with gentleness and compassion rather than aggression is the least painful way to disarm it.

Ironically, the syndrome I’m describing – the discomfort, disorientation, strong reactions of others – is a good sign: it means change is underway, though things may seem worse on the way to getting better. It means that we are waking up; our heart, jostled out of its deep slumber, may be a bit cranky after a long and fitful sleep. What it’s often saying to us is, “where the hell have you been?!”

Where we’ve been is caught up in a dysfunctional system, doing the best we can to survive. In order to survive, we’ve had to live by our wits – and in our heads, trying always to “figure out” what to do rather than listening to our truer, inner voice. So many patients tell me, “I can’t figure this out anymore”. Great! That often means that the heart is finding its voice, and the head (where dysfunction prospers) is losing its place on the throne. Again, this is a destabilizing threat to the status quo – but that status quo (i.e. misery, in most cases) – is the reason we were seeking help in the first place.

These awkward, clumsy growing pains are moving us towards interdependence (authentic relating) rather than codependence (dysfunctional, disempowering). We’re used to the latter, even if it means putting our hearts to sleep. Living in our heads is the ultimate narcotic, another reason for our culture’s relentless need for “entertainment” and distraction. Codependence is an idea of a relationship, based on preserving a longtime pattern of dysfunction; interdependence lives in the moment, thrives on present needs and emotional reality. Authentic relating requires all of us, at the center of which is a heart struggling yet yearning to awake…

©Copyright 2010 by Darren Haber, MFT. All Rights Reserved. Originally published on GoodTherapy.org. This article was solely written and edited by the author named above.

Why Ask Why?

Many of my patients who struggle with co-dependence or related issues frequently ask, Why can’t I (fill in the blank)?  As in: Why can’t I stop trying to get my loved one to give up drinking?  Why do I continue to chase approval from people who give me only criticism and rejection?  Why do I continue to pick men/women who are so obviously bad for me?

With all due respect, “why” is probably the wrong question.  (I recall being taught as an intern to avoid asking patients “why” at all costs!)  “Why” is a left-brain question, involving logic and reason, when really we’re seeking a more holistic perspective, to give us both a perspective and a feeling of wholeness rather than the internal tug of war that is so painfully fragmenting – and which catalyzes us to seek outside soothing and reassurance, very often from the people that help stoke the flames to begin with!   Thus the “vicious cycle” of self-defeat that has to be broken.

A more fruitful question might be: How can I accept this situation, as it is, right now, so that I might stop beating my head against a closed door and find doors that can open into a better, less dire situation for myself?   And what can I do for myself, once I realize that I cannot change anything but myself?

The “why”, in fact, is a set-up for further frustration, since human beings are so complex and layered; asking “why” can only lead to another dead-end, triggering more frustration and feelings of let-down or inadequacy.  One of the hallmarks of co-dependence, or of struggling to relate to people who are addicted, closed down, unavailable, and so forth….is this haunting feeling of inadequacy, of “not good enough” within, that is excruciating.  If the feeling could speak, it might say I feel so empty inside, I must have someone or something ‘out there’ to fill me, reassure me, give me hope, something to hang onto… Otherwise we often feel as though we’re floating in a void, with sensations of terrifying groundlessness, isolation and abandonment.

This void is usually created early in life, by living with caretakers who are themselves troubled, addicted, angry or otherwise unavailable emotionally.  In most cases, these parents or caregivers do not intend to harm their children.  But their problems keep them focused primarily on themselves, which creates a psychic abandonment and self-perception of worthlessness – since, after all (most kids figure), if I were really worth loving, I’d get more loving attention. Which, in the end, is what most of us long for and pursue for most if not all our lives.

Like anything organic and alive, a child’s Self needs warmth, acceptance, attention and nurturing in order to grow and thrive.  We can’t learn to tend the garden of our own souls if no one has ever taught us! Patients who come to me feeling shame about not being able to care for themselves properly, soon learn that they were, simply, never given proper instruction.  After all, you can’t speak a language or play a musical instrument without lessons.  Life itself requires skills and tools that we can’t put into practice if we never received them in the first place.

Therefore the “why”, leading most often to further frustration, only cultivates this sense of inner impoverishment.  The implication then becomes, Well I must be stupid since I can’t figure it out…another thing I can’t seem to do right. But it’s an impossible task to begin with.  You cannot “figure out” the process of inner growth and healing, anymore than you can figure out whether it is precisely soil, sunlight or water that leads to the blossoming of flowers.  In the end, it is the combination of elements – the how and what – that lead to the desired result.

And in the case of the adult Self who seeks healing, these elements include therapy, support groups, “safe” and caring friends and family (rather than those who are abusive), spirituality, self-care, and so forth.  The anguishing barrenness within us can be transformed into a fertile bed of surprising growth and creativity.  Not always easy, but very possible.

By the way, I welcome your questions regarding any of the above or previous columns.  I’ll do my best to answer at least some of them.  You can ask me care/of the comments on this site or email me at darren@therapistinlosangeles.com.   Thanks for your time as always.

©Copyright 2010 by Darren Haber, MFT. All Rights Reserved. Originally published on GoodTherapy.org.  This article was solely written and edited by the author named above.

Permission to Exist, Part 1: The Guilt of Getting Better

I’ve been surprised in my clinical work by the phenomena of guilt in relation to becoming psychological healthier within a dysfunctional or codependent relationship or family (or “system”). It’s almost as if the person is doing something wrong by becoming more appropriate with boundaries, stating needs, pursuing self care, and so forth. For instance, a former client of mine described an exchange she had with her longterm boyfriend, who struggled with sex addiction, telling him that her stumbling upon his porn collection led her to feel demeaned, rejected and lonely. He became embarrassed, angry and/or ashamed when she related this to him and pled with him to get help. This was fueled by a sense of urgency, since she sensed his addiction tearing away at their relationship.

But then, and here’s the tough part, she began to feel guilty when experiencing his reaction, as if she were responsible for “making” him feel these things; she questioned her actions, wondered if she should have just kept quiet (the usual code of conduct in her family of origin). This self-doubt and sense of “wrongness” grew acute when he reacted defensively by stating, “Quit trying to control me” or “It’s not hurting anyone, you’re overreacting”. The exchange got heated and usually ended in shouting, tears and one of the partners storming out of the house, sometimes for hours or even days.

I currently see a man in his mid-20’s whose girlfriend is newly clean from opiate addiction but refuses to go to NA meetings or therapy. She is clean but not really sober emotionally. As a result she is often sullen, rude, and sarcastic or critical whenever he tries to initiate appropriate emotional or romantic intimacy. He feels pushed away by her remarks (“this isn’t a good time” or “I need my space”) and struggles with how to respond. He wants to say something, but feels guilty when she withdraws, with sulking or silent scorn; he feels it is “all his fault” and that he has somehow injured her fragile ego by being demanding.

Another client of mine, the single mother of a newly sober teenage daughter, initially told me that she was worn out by her kid’s drunken calls asking for financial or even legal help due to her “escapades”. She related that this cycle left her overwhelmed, drained and resentful. She shared these feelings with her at a family meeting – an informal intervention – and said she would no longer bail her daughter out, which helped convince the daughter to get sober. Now she is healthier and making progress, but keeps distant from her mom. Mom tells me she is feeling neglected, almost as if she has “done something” to push her daughter away. She wonders if she was too hard on her at that family meeting, if her complaints created this distance between them. Mom struggles with an appropriate course of action: her daughter is nearly an adult (17), but they used to be close and this new arrangement is disorienting.

In each of these cases, I have found the “co-addicts” to be, by and large, very appropriate with their behaviors and boundaries. In fact, in most cases I feel that the remarks, while hard to hear I am sure, are long overdue! They are often watered-down versions of the hurt and angry feelings they’ve shared with me in our sessions.

What I think I am hearing, when it comes to the addicts’ withdrawal and/or defensiveness, is a highly sensitive reaction to the pain of their partner or loved one. They feel so guilty or ashamed of their behavior that they counter-attack, blame others or distance themselves. It’s likely that they hear hurt or angry feedback as an attack. Most addicts carry tremendous shame, tend to have poorly developed emotional skills (such as non-defensive listening) and are quick to run at the first sign of discomfort. Fortunately, those who continue to work on themselves, to grow and heal, can improve their relationships by acknowledging the hurt their behaviors have caused, commit to changing those behaviors, and hearing such feedback without crucifying themselves or fleeing.

This is also true for the co-addict. The more they work on themselves, the less they’ll blame themselves for doing the “wrong” thing by setting appropriate boundaries. Though it’s far more complicated than what I’m presenting in this short article, my hunch is that the co-addict’s guilt is probably a transference reaction, by which I mean it is a reaction to a “taboo” instilled in childhood, within a dysfunctional system that disallowed the person from stating their own authentic feelings or needs. Quite often it is an alcoholic or empathically-challenged parent who shames their child for saying something too truthful to bear, i.e. “mommy, you drink too much” or “dad, why do you hit mom and me” or some variation therein. The parent often reacts angrily or shames the child into silence. This child is taught that their own worth, value and emotional truth (among other things) is “bad” and needs to be squelched, as it jeopardizes the connection with their caregivers. The child learns to pursue, even into adulthood, the permission to feel what he/she feels, speak these feelings and share them the hope of being heard, of genuine connection. What he or she seeks, really, is the permission to exist. If the loved one does not hear or validate these feelings, the speaker will assume, as if by habit, that they are probably selfish, wrong, etc. Self-blame ensues, and their pursuit ends in failure. Such a pursuit will always end in despair and frustration until the co-addict finds his or her own support to heal, grow and live authentically, with or without permission from anyone else.

©Copyright 2010 by Darren Haber, MFT. All Rights Reserved. Article first published on GoodTherapy.org. This article was solely written and edited by the author named above.

How to Not Enable the Enabler: Part 2

First I’d like to again thank those of you who have taken the time to read earlier posts and send in your comments. Your feedback is much appreciated.

I’ve been discussing ways to help those who are ensnared in the web of addictive chaos, both addicts themselves and those around them. The addict may be someone in your life – or someone close to you (a parent, spouse, sibling). You may be feeling the “ripple effect” of addictive behaviors which create stress and suffering to those in close or proximate “orbit” of the addict’s life.

I did, for instance, hear from some siblings who wrote in to express frustration at the fact that, for years, their addict siblings had come to dominate all the parental attention in the family. Negative attention, yes, but still – the addictive drama had all but “sucked the air out of the room”. As a result, these siblings and their children felt profoundly neglected or ignored. Some parents were so depleted that they couldn’t afford, financially or emotionally, to travel to see their non-addict children. A spouse grew tired of a partner who kept trying to “save” a child with addiction. Similar stories abound where addiction takes root and causes endless grief.

One of the reasons Al-anon can be so potentially helpful is that it allows an opportunity for someone, anyone caught in the addictive web (even tangentially) to vent their darkest and most dire distress. Holding such feelings within creates stress and isolation – and self-criticism. You wonder if you are being “selfish” for feeling neglected, which often alternates with anger or sadness, resulting in a “split” that is quite confusing. Having others validate your feelings or say “I’ve been there too” can bring relief. How reassuring to know that these feelings do not make you a “bad” or selfish person. They are in fact a very normal and human reaction.

Once some of these feelings have been “normalized”, there is often an urge to do something. To take it a step further, perhaps confront the person who is struggling with addiction, or the “enabler” (co-addict), take some sort of action that might lead to a change in the dysfunctional operating system and bring some sanity to the chaos.

You might try – at a calm moment, if at all possible – sitting down with the co-addict whose behaviors eat away at you. “Strike while the iron is cold”: one of my favorite therapeutic sayings.

The trick is to keep the focus on your own feelings, on yourself.

Easier said than done. After all, it’s them who needs to wake up and smell the coffee – i.e., the enabler and the addict, all those involved in the crazy dance. But the co-addict especially: they’re not even drinking or on drugs, so what’s their excuse? They are supposedly the “rational” ones who are in fact throwing away good money, time and attention on someone who has no intention of truly getting clean. Don’t they see how irrational they’re being?

On some level, the “co” probably knows that. Most people who come to my office for therapy know what’s good for them, understand their choices aren’t doing anything but making things worse. That is, they know it intellectually, but the fear, terror, anger and/or shame boiling inside makes rational choice all but impossible. These powerful feelings override the rational part of ourselves and lead to actions – impulses, really – which betray the integrity of what we know is “right”. It’s just that, like the addiction itself, this impulse to “save” or “rescue” (to prevent abandonment on both sides, really) is too strong to curb – which of course only leads to more frustration, shame and other paralyses.

Keep this in mind as you approach the co-addict; in some ways, they are as twisted up as the person struggling with addiction themselves! But by speaking of your own despair, frustration, and so on, you’re actually role-modeling what the co-addict somehow can’t do: focus on one’s inner truth rather than trying to fix or control an outside person, place or thing. Finding healing and giving voice to your own inner truth empowers you to become a beacon of strength and hope for others still lost in the chaos; by finding healing for yourself, you learn new actions that you can pass on to others, so that they might do the same.

You can also, by Jove, simply and un-dramatically state the truth. Your truth, shining light on the dark and difficult feelings you’ve been stuffing for so long. Honesty, like anxiety, is contagious.

For example you might say, “Hey, I miss you. You seem so caught up in helping my brother with his addiction that I feel like I don’t have a mom anymore. We have a relationship too, you know, and you’re important to me, and I wonder what we can do about this.” Or: “I feel like you’re so caught up in trying to save Joan from her addiction that you’re ignoring me, my kids, and my life altogether. She keeps telling you to buzz off, so maybe you should take her at her word and spend time with people who love you and act like it! You haven’t seen your grandkids in ages.” Or: “I feel like the addiction has kidnapped two people…both John and you.”

Note that these statements try and vilify the addiction, not the person. I firmly believe addiction is a disease, not a moral defect. The benefit of this concept is that you get to attack addiction for the hydra-headed, merciless monster that it is. Addiction is tearing your family apart. Addiction causes misery…and you can take new actions against this demon, even if no one else will…

This approach also has the advantage of turning the battle into “me and you against it” (addiction) rather than “me against you” or “me against you and him” (the addict). It creates a common cause and a “team” rather than individual crusaders, which is part of the problem to begin with. To paraphrase Sartre, two can form an alliance by opposing a third. You can now say, “Why don’t you and I support each other in helping ourselves, since John doesn’t want any help. Maybe he’ll want to come along eventually, if he sees that it’s working…”

If the co-addict asks where you’re getting this clarity, strength or hope, you can say “Al-anon”, and/or whatever else you’re doing, reading, etc. And then you can add: “And why don’t you join me?”. Which, as I said last time, is much more effective than “advising” on what to do. Making it happen for yourself is the best advertisement for what you want to see happen.

To be continued. I look forward to your comments, as always.

Feel free to check this blog by the way, where next week I’ll elaborate on some of these themes, and discuss ways to set boundaries with co-addicts who “just don’t get it”…

©Copyright 2010 by Darren Haber, MFT. All Rights Reserved.  Thie article was first published on GoodTherapy.org.  This article was solely written and edited by the author named above

Breathing Room: Enmeshment in Alcoholic Families

Today I return to a topic that has drawn a fairly strong reaction from readers: the “too-closeness” of relationships in alcoholic families. Readers were moderately to severely critical of parents who try to control their children’s recovery while failing to address their own issues. As a residential therapist in a treatment center, I frequently witnessed well-meaning parents undermine their child’s recovery by being in too much (or too little) of a hurry to address problems underlying addiction. Here are some examples:

• The father who, when I called to tell him his son was considering leaving treatment and getting back on heroin, tersely told me he was in a meeting and that I should call his wife since “the children are her department”.

• The mother who kept ignoring the basic facts about her daughter’s potentially fatal drug addiction, and insisted that the real problem was that she was overweight.

• The scores of families who initially complained that their child, now in treatment, was calling and pestering them way too much, which made them anxious… who then called a week or two later (when their child was recovering and doing much better) to say they were receiving less calls, which made them even more anxious.

• The families who lamented that their loved one hated AA meetings – while they refused to attend a single al-anon meeting.

• The father who called and ranted angrily on the phone for 20 minutes about how his addict daughter had “messed up” his life, then insisted he was “neutral” about it and didn’t need counseling for himself, after I suggested it.

Such examples are legion; this barely scratches the surface. The second item above is probably the most common (item four a close second); often I found anxious parents trying to divert the focus from their child’s addiction onto something else, such as depression, anxiety, life problems, and so on. (And when I say “child” I don’t necessarily mean middle- or high-school age, I mean children of any age.) It’s as if heroin or opiate or alcohol addictions are still the elephant in the room that families fear to acknowledge.
Some readers asked me, with what seemed to be an underlying irritation or exasperation, “what’s up with that? Don’t these parents realize they’re only hurting their kids’ recovery?”

The quick and to some degree easy answer is that these parents have issues of their own, have trouble seeing it (i.e. are still in some kind of denial), and thus project all of their own “issues” onto their kid, in the hope of controlling and/or expunging them. As well intentioned as they always are, they are terrified to look in the psychological mirror and understand that nothing happens in a vacuum, that children are at least in part a result of the family “system” that nurtured them at the most impressionable, formative time of their lives.

In observing these kinds of patterns, one learns that denial “ain’t just a river in Egypt”, as the saying goes, and that it exists on a systemic level, reaffirming the concept of addiction as afamily disease, affecting everyone with the blunt and ruthless force of a tornado. Such is its psychic impact, that parents struggle to see how every family member has played a role within the addictive system. Parents of addict families find balance or neutrality almost impossible, relying instead on the ancient defense of blaming, either themselves or their child.

Of course, it’s hard for us humans not to blame under such stressful circumstances – finding scapegoats is an ancient nostrum: surely someone, somewhere did something to cause this. The idea that addiction is a disease and that no one is at “fault” is often quite difficult to swallow. Many parents see it as their own colossal failure; the shame (towards self) and anger (towards the kid, for “bringing this upon the family”) are so intense that denial becomes a necessary mechanism to try and ameliorate intra-psychic anguish.

I have also found two key conceptualizations (systemic and existential) helpful in explaining why parents focus so much attention on their children, to the point of enmeshment or psychic “fusion”. The first is what Minuchin (1978) referred to as “detouring”: a means of parents avoiding their own marital conflicts by focusing almost exclusively on the child’s issues. A common example of this is known as the child “caught in the middle” of her parents’ crossfire and intent to control the family with their own agenda. Imagine two parents in disagreement about the future of their child. The father says to her, be practical and study law at Stanford and the mother says, pursue your passion and study music at Juilliard; the child begins to suffer an anxiety disorder and both parents try very hard, and in vain, to resolve the disorder by their own means. “What’s wrong with our kid?” may be a less daunting question than “what’s wrong with our marriage?” This process is also known as “scapegoating” or turning the child into the “identified patient”.

Another layer of enmeshment, I have found, relates to what Yalom (1980) terms the problem of isolation in modern life. He cites Martin Buber’s vision of two individuals as mountains between which lies a vast emptiness. Relationships, says Yalom, are like bridges that attempt to close these colossal gaps. Most people in addictive families, I have found, suffer from a bone-deep existential or spiritual loneliness. The closest relationship most parents have had is with their children, before the addiction dug its claws in. Thus addiction, in a sense, has “stolen” the child and the sense of closeness that the parent misses terribly – especially when their partner is estranged or distant.

The micro-managing of the child’s recovery therefore reflects, in these cases, a yearning to recapture the warmth and joy the parent felt in better, earlier times, when the child was younger and parent/child closeness was more age-appropriate (even though, upon examination, one often finds that the child even then was engulfed or controlled, serving a narcissistic need of the parent). As the child enters puberty and young adulthood, of course, such closeness is no longer appropriate though the parent can rationalize the need for it as, “my kid needs me… he’s sick and can’t manage on his own!” This is why a parent’s intense monitoring of their child in treatment often feels “incestuous” to counselors; it is a violation of the child’s space, often an attempt of the parent to recreate an earlier phase of the relationship, even if that phase itself represented inappropriate closeness.

This closeness puts the recovering child in a double-bind, since to distance the parent amounts to a rejection, while tolerating such closeness risks engulfment or smothering – a frightening thought, given the fragility of an addict in early recovery. It also, for the parent, may represent an overt or covert attempt to maintain the child in a “surrogate spouse” role, where a parent seeks more intimacy with the child than is appropriate, to make up for the lack of connection between his or her partner. It’s not always the case that a parent’s intent is sexual or literally incestuous, but it is hard to avoid such disturbing undertones when healthy boundaries are violated in the name of parental concern.

The sad fact is that many if not all of these parents have themselves suffered some type of trauma (often addiction related) that predates the child; their own parent, sibling, or spouse may have been absent, distant, or perhaps violent or inappropriate in their own way, disrupting the parent’s sense of self.

Enmeshment becomes “normal” and the only way to feel close to someone. Such smothering closeness also soothes the traumatic anxiety caused by the earlier disruption; the love of a child becomes a healing balm for the fragile, insecure (and traumatized) parent, who tries to keep the child close, too close, even when the child begins to recover and cultivate a newer, healthier self. But without help, the parent may be blind to the fear that accompanies this cultivation, since it puts the risk of abandonment into play. If the kid gets better, he/she could leave the relationship. And without the child serving the parent’s need, that parent often fears he won’t be able to survive.

Love, of course, requires freedom and letting go, and tolerating the “away” phase in the to-and-fro rhythm of relationships. There appears to be an elastic expanding and shrinking distance between people in all relationships, constantly in motion. A traumatized ego may try to control this process and freeze the relationship in one of those phases for the sense of protection or control. Most parents of addicted children need their own support to learn how to avoid this and let go of control (itself an illusion). Hard to blame them for trying, though like the addict they are only groping in the dark for what they think will make it better.

SOURCES:

Minuchin, S. (1978). Psychosomatic Families: Anorexia Nervosa in Context. Cambridge, MA: Harvard University Press.

Yalom, I. (1980) Existential Psychotherapy. New York: Basic Books.

©Copyright 2010 by Darren Haber, MFT. All Rights Reserved. Permission to publish granted to GoodTherapy.org. This article was solely written and edited by the author named above. The views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about this article can be directed to the author or posted as a comment to this blog entry.

My Wife / Husband / Child is Finally in Rehab;
Now What?

So your child or romantic partner (or close friend, sibling, etc) has finally agreed to go to rehab for his/her drinking or drug problem. Now what?

There are some important things you can start doing right away, and approximately none of them have to do with the addict/alcoholic. They are, however, related to the person you’ve likely been ignoring for a while now, if in fact you’ve been living with, helping, or “enabling” the addict.

That’s right, I’m talking about you.

But wait, you’re thinking, I’m not the one with the problem…it’s him (or her), not me!

Well, yes and no. No, you may not be addicted to a “substance” per se, but addiction is a family disease, wrecking nearly everyone and everything in its merciless path. It may take some time to become aware of the emotional and psychological damage on a family level.

Some of you may already be aware that something was severely “off” about the situation, even where your own emotions and strength were concerned. You wondered why you couldn’t just walk away…or hold the boundaries you so earnestly tried to keep…or kick him or her out of your life once and for all, to end the suffering and chaos that was making you crazy. It was so hard to detach, to shut the door on the person once and for all. If he/she wants to throw their life away, then so be it, but I’m getting off this insane merry go round.

And then you discovered, to your horror, that you can’t.

Then, finally, the addict gets to rehab. And yet the “edge” is still there, that worry, that undertow of anxiety. Perhaps the internal “tape loop” would sound something like this:

Sure, they’re safe in rehab now…but what about when they get out? Then what? What if they return to their same old shtick? If they do, yours truly isn’t going to stand for it! Those rehab people better know what they’re doing! But does rehab really work? Are there any real statistics? What if they’re lying to me about how “good” they’re doing? What if their counselor is believing the same old b.s.? And how come I haven’t heard from them…and why I am obsessing about this all over again?

There’s a name for this phenomenon, which some call “co-dependence”, others “enabling”, though for my purposes here I’ll use the term “co-addiction”.

The fact is, addiction is an emotionally-charged way of life that, like a black hole, exerts a darkly magnetic pull on all those in its orbit: spouses, family members, children, siblings: all get pulled in. Those who come from alcoholic families are especially vulnerable. Alcoholics are notoriously adept at sending out S.O.S. signals and then rejecting help when it arrives. Co-addicts are expert at “rescuing” addicts from consequences – and turning a blind eye or minimizing (denial) the wreckage piling up around them, since they often feel “responsible” for “saving” the alcoholic. Though they mean well (we’re talking about family after all), this “rescuing” impulse goes into overdrive, resulting in the insanity of endless failed attempts (to get the person to stop), stifling anger, self-righteousness, existential despair, etc. When the alcoholic finally does get help (thank goodness), the “co” may be left with a huge pile of unresolved emotional and, just as likely, financial wreckage to sift through. Because alcoholism and addiction are so difficult to understand, families often need help and relief as much as the addict.

* * *

If you’re a true co-addict (and this is true if you’re also an addict, even a sober one, who has a friend or family member in recovery or needing treatment), you can’t just “walk away”. Perhaps the professionals have urged you to let go, “trust the process”, but you can’t. There’s a knot in your stomach that just won’t abate, a lump of hot coal burning away… if that “burning” could talk, it might sound something like: Sure, they’re safe and sound in rehab now, but what about me? How come no one’s asked me about all the heartbreak I’ve been through, the time and money and energy wasted… oh sure, he gave lip service to me about the “trouble he caused”, but I’m sure he didn’t mean it…he’s sitting pretty now with three square meals and a cushy bed… who’s to say he won’t get out of that place and start up again… do those rehab people really understand what it’s like living with a dopehead, all the late-night calls and worrying… they probably don’t have a clue… what with the lawyers and police… I’m tired of bailing him out…no more, I say, never again! But hold on, I’m getting worked up again, they told me to stay calm, take it “a day at a time”, whatever that means, I just wish someone would tell me what’s going on or what to do.

If this little “monologue”, or something like it, sounds at all familiar, you’re a prime candidate for al-anon and, possibly, individual or family counseling.

Co-addiction is a curious thing; in many ways it parallels alcoholism. Just as the alcoholic believes that “next time it’ll be different” (i.e., they’ll be able to get a handle on drinking), the co-addict often believes that “next time they’ll be different” (i.e., buying into the addict’s denial, in spite of massive evidence to the contrary). This is sometimes referred to as “ignoring the elephant in the room”. Thus the parallel process of addiction and co-addiction, wherein those close to the addict start to believe the same lies and rationalizations: a way of warding off hopelessness and despair. But the tough, hard-nosed acceptance of the reality of the situation, dire as it may seem, is often the spark that leads at long last to change. And if you, the co-addict, can begin to honestly (and often painfully) accept the ways you bought into the addict’s denial/coping system (i.e., insanity), you can begin to feel some of the same relief the addict receives simply by being sober and stopping the self-destructive cycle.

Another way of putting it is, the addict/alcoholic makes a “higher power” out of the drug or the drink; the co-addict makes – often in very subtle ways – the addict the higher power…meaning that until they’re safe, you’re not. In other words, the addict wants to control the drug, the co-addict wants to control the addict. It’s a variation on that old self-help book, “I’m Ok/You’re Ok”; the co-addict’s version is, “I’m Ok if You’re Ok” or “I’m ok if I’m convinced You’re Ok”.

Truthfully, after all the havoc wreaked by the addict, he/she will never be ok enough to convince you to relax and find true peace of mind. You’re going to need some healing of your own to find the inner balance and serenity you crave – and deserve. Because there are no guarantees, period, and it’s “a day at a time” for everyone, including you. Learning to walk that path often requires a little help, and there’s no shame in that. In fact, asking for help (rather than “toughing it” on your own) is the true way of courage. Paradoxically, knowing where you’re weak (and taking action accordingly) is often a sign of strength.

Both addicts and co-addicts need abstinence – mostly from addictive thinking (i.e., denial, a need for external “fixes” to internal problems, etc). That involves programs for all family members, specifically designed for either the addict or co-addict, that will introduce new ideas and behaviors that may seem radical, at first, but eventually become more comfortable and, even more crucially, effective.

It may sound like bad news, but the truth is, pursuing your own recovery as the co-addict may be the best thing you can do for your loved one in recovery. Curiously enough, surrendering the concept of controlling them and finding your own healing may be the best way to help. Once those close to you sense real change occurring, they will (hopefully) be inspired to pursue change of your own. Once the old lies and rationalizations stop working, the newly-sober addict or alcoholic will have to try something new. She just may feel safe enough, with your new foundation emerging, to try something just plain crazy: tell the truth, warts and all. And being a safe place for your loved one to tell the truth, no matter what, is one of the greatest gifts you can ever give.

©Copyright 2009 by Darren Haber, MFT. All Rights Reserved. Permission to publish granted to GoodTherapy.org. The following article was solely written and edited by the author named above. The views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the following article can be directed to the author or posted as a comment to this blog entry.

Latest on families and addiction

Hi there, please check out my latest post on goodtherapy.org concerning families, addiction and treatment:

http://www.goodtherapy.org/blog/recovery-addictions-family/