Addiction touches everyone in a relationship with the addicted individual—everyone who loves cares for, knows, or deals with them. Of all the diseases that afflict human beings, few inflict as much damage on relationships as alcohol and substance use disorders. Unlike infectious, deficiency, physiological, and genetic, and non-genetic hereditary diseases, alcohol and substance abuse (along with other mental illnesses such as personality and psychotic disorders) take a toll on relationships. They stress and strain relationships to the point where they become untenable, and beyond repair. Those who battle alcohol and substance use disorders often feel shame and guilt about the impact of their addiction on others. But submitting to the process of recovery can, in the fullness of time, with care and effort, heal an individual’s shame and guilt. Once a person has advanced in recovery, they can begin the essential work of repairing relationships—if both they and the people they harmed seek reconciliation.
In every healthy relationship, there are core traits and principles that are readily identified and inviolable if the relationship is to flourish and thrive. Respect for one’s self and for the other person is an essential hallmark of a healthy relationship. It is a mutual and reciprocal exchange of caring, concern, and kindness. In a relationship absent of respect, one or both individuals try to assert their power and try to control the other. This lack of respect can lead down a dysfunctional path that normalizes aggression and result in emotional, verbal, physical, or sexual abuse. In families, each person has specific roles that hold together the family as a flourishing unit.
A healthy relationship enriches both sides. It is marked by mutual respect, open communication, honesty, and full disclosure that forms trust, independence from each other, pride and confidence in each other, regard for the other person’s feelings, constructive feedback, advice, and support; humor, peaceful resolution, and a willingness to enrich and sustain the relationship. A healthy relationship is a mutually beneficial one that allows both parties to thrive and flourish and brings out the best in both of them. In families, these same positive, nurturing qualities form a binding narrative around the family that allows them to flourish and prosper as a single unit, and as individuals.
An unhealthy relationship on the other hand is a dysfunctional relationship where one or both do battle to control the other. Such relationships are marked by disrespect, dishonesty, withholding, lack of communication, jealousy, unkindness, and cruelty. Criticism, unsolicited advice, lack of support, aggression, manipulation, detachment, isolation from each other, dependence, controlling, and constant fighting are also hallmarks of unhealthy relationships. Similarly, a family that displays all the above either between family members, or in concert, will fail to thrive as there are no binding narratives, or care for each other, that hold the family unit together
For a person grappling with addiction, the first and most important priority is to secure their drug of choice for consumption when they feel the urge to use, by any means necessary.
People take drugs for a variety of reasons:
Not all alcohol and substance use leads to dependence and addiction. Some engage in experimental use once or twice; others use for recreational purposes to elevate mood and improve social interactions. Situational use happens when someone is trying to overcome negative states such as stress or problems. Intensive use or bingeing occurs when those functioning well enough use for short periods for the rush; and therapeutic use occurs when people use alcohol and drugs as medication to relieve physical or psychological pain.
Addiction to alcohol and substance abuse are powerful chronic disorders that can rapidly accelerate, and make it difficult for the user to control, manage, cut down, or stop. The cycle of addiction precipitated by initial use predictably leads the user to incremental increases in the consumption of substances. The gradual increase in substance ingestion cultivates tolerance, creates dependence, and ultimately explodes into a full-blown addiction. It happens slowly and then suddenly. Eventually, the cumulative toll on every aspect of the user’s life, on everything he or she touches, and on everyone in his sphere including loved ones, causes harm and ruins relationships.
Loved ones should recognize that addicted individuals in the grip of addiction cannot summon discipline or self-control, or self-will, or morals, or ethics to extricate themselves from the claws of addiction. Addiction is a devouring force that can only be addressed through evidence-based treatment.
An individual in full-blown addiction is motivated by a single priority that supersedes everything and everyone else in their life. The sole focus is to acquire the alcohol or drug of their choice for use when they need it. To this end, they will do anything to secure the substance they need, at any cost. Nothing and nobody else in their orbit is of consequence to those who suffer from alcohol and substance use disorders. Many accounts from clients document their urgent actions to secure their drug of choice with no regard for ethical, moral, legal, or criminal consequences. Deep in the throes of addiction, they feel no remorse for stealing money from friends and family for drugs. They rationalize their actions with their own need to consume their drug of choice. Thus, they relegate their relationships and everything else in their life to second and third place, behind drugs and alcohol. This manifests in different ways.
Addicted individuals cannot be relied on to fulfill obligations to friends, family, and at work. Their addiction and finding their next fix consumes their days and takes precedence over their obligations and duties to others. The only relationship that an addicted individual cares about, which would be an irreplaceable loss, is their drug of choice. Everything else assumes a subservient or non-existent role in their lives.
Those suffering from alcohol and substance abuse disorders often manipulate, gaslight, cheat, lie to, or steal from, their family, friends, and others. They rationalize their conduct as something they need to do to maintain their addiction.
Those struggling with addiction may withhold themselves emotionally, physically, and verbally from their loved ones. They may gravitate to others who are addicted to avoid family obligations and to protect themselves from criticism and demands from family and friends. Their continued behavior leads to a breakdown in communication with those who love, care for, or know them. Hyper-defensive about their actions, they will often explode in rage or become violent when their loved ones express their concerns about their addiction.
The effects of a loved one’s addiction fray the ties that bind and bond families. Where before each member in a family had defined roles within the family ecosystem, with individuated and distinct relationships with each other, addiction changes the unit. The addicted individual is unable to function in the family unit and the whole family system may fray and eventually collapse without intervention.
Previously unthinkable scenarios such as theft, crimes, financial problems, legal trouble, overdoses, school and college expulsions, employment termination, marital infidelity, domestic violence, medical issues, personal injury, and injury to others may occur in families of addicted individuals.
The strain of the addiction affects all members of the family, erasing harmony in the household, and infecting every member of the household with negative emotions ranging from anger and sorrow, to depression and anxiety, to shame and guilt.
Parents may harangue, nag, shame, or threaten the addicted loved one to give up the addiction. Fathers and mothers may fight with each other over the addicted child, blaming each other. Parents may question their own parenting and blame themselves for their child’s addiction. Siblings of the addicted will also suffer from their loved one’s addiction, experiencing stress, fear, and trauma. A teen suffering from an opioid addiction may frighten siblings during drug-induced episodes of rage and mania. An addicted sibling may show physical decline and mental illness, or disappear or run away. In worst cases, a sibling may have a life-threatening drug episode, or die from an overdose.
When the addicted individuals are parents, their responsibilities to their children and to the household will have to be assumed by the sober parent or by the children. In addition to traumatizing children, the marriage itself is compromised. As the addicted spouse deteriorates and is unable to fulfill their obligations, the sober spouse will have to step up to take care of finances, home management, and childcare. This can result in anger, distrust, despair, rage, fear, and resentment at the addicted spouse.
All these events have an adverse effect on the whole family. The drama of pronounced changes can destabilize the family as a whole, harm them individually, wreck their relationships with each other, damage their collective and individual relationship with the addicted family member, and their own relationships with future partners and their own families.
Families of addicted loved ones are vulnerable to a host of trauma-related maladies including PTSD, complex PTSD, anxiety, guilt, and depression. They are also vulnerable to a condition called chronic sorrow, also known as living loss. This affliction is unique to parents caring for children with chronic illness and disabilities. The deep ties and bonds that hold a family together can sever if things continue as they are.
After an addicted individual enters treatment, completes detox with or without Medication-Assisted Treatment, and begins cognitive-behavioral treatment, and is established in sobriety, the work of recovery becomes a daily opportunity to create a life full of potential and possibilities. Once sobriety, the hardest part of recovery, has been established as a foundation and the work of recovery has been maintained for an extended period, it may be time to do the work required to repair relationships.
This is no easy task as the vessel of relationships has been shattered and broken. On the one side, there is the individual in recovery who is filled with sorrow, remorse, regret, guilt, and shame. On the other is the family member who is filled with distrust, hurt, and anger. But, the vessel can be repaired.
In Japan, broken pottery is renewed through the ancient art of Kintsugi, the art of repairing broken vessels and ceramics with expensive gold lacquer to accentuate its breakages and imperfections. Kintsugi sometimes referred to as the art of precious scars, is embedded in the idea that something that could be thrown away easily is worth saving, that flaws, breakage, and scars are part of life and should not be hidden or disguised. But rather, that in the repair, the imperfections be highlighted with gold to render it an even higher value. When this philosophy is extended to people, in particular to relationships between addicted individuals in recovery and their loved ones, it allows the pain and sorrow and damage of addiction to be acknowledged, renewed, and refreshed through forgiveness of past failures, and acceptance of human imperfections. It allows the recreation and reimagining of family, and an invitation to love each other again through the lens of a new vision.
During the process of reconciliation, while the person in recovery is receiving full treatment including individual and group therapy, and participating in AA and other support groups, it is important that family members also participate in counseling and support groups. Each party needs to work toward reconciliation by educating themselves on triggers, emotional management, enabling and co-dependency behaviors.
Addiction Treatment and Recovery is an opportunity for the whole family to reimagine and reinvent the family unit, while their loved one receives treatment for their addiction. Rather than viewing treatment as a solution to the cure of their loved one, families should view recovery as a space to also heal themselves and to learn new skills that serve the whole family.
The notion that everything will be fine if only the addicted individual fixes his/her addiction needs to be dismissed. Parents and spouses should be open-minded about the ways they may unconsciously be affecting their loved ones and triggering or kindling or enabling their addiction, or creating a dysfunctional codependency. A willingness to see recovery as an opportunity to change, learn, and develop themselves and acquire new skills will be helpful in the long run for themselves individually, for the family as a whole, and for the loved one in recovery. Just as the loved one endures pain and suffering and setbacks in rehab, the family too will have their emotional and psychological lives exposed. While their loved one is recovering from addiction, the family will be able to develop into fully resourced individuals educated in their knowledge of addiction in the context of family.
By keeping an open mind and reserving judgment, families can be a part of the recovery process. They too can take an active role in healing themselves, learning, growing, and flourishing.
Those in recovery should be the protagonists in their story of reconciliation since their addiction was the cause of the breach in their relationships.
As those in recovery go through the 12 steps of Alcoholics Anonymous, they will be faced with the issue of repairing their relationships.
Those in recovery should be mindful that the process of repairing relationships can be slow and take a long time.
Staying sober is essential. Being courageous and taking responsibility for one’s past actions without rationalizing it is important. Understand that the choice to resume the relationship rests with the family member and do not force them to follow your timeline. Resolve to tell the truth and communicate with honesty, Apologize and ask for their forgiveness. Forgive yourself and work on relieving yourself of guilt and shame. Do the work and then step aside for them to make the decision to resume the relationship or not.
At New Leaf Detox & Treatment, we are committed to meeting the needs of our patients with the most advanced best practices in addiction medicine and treatment and evidence-based standards of trauma-informed care, while always mindful of each client’s individual needs.
After the extensive patient-provider engagement, careful screening, and medical and psychological evaluation, our clinicians design individualized plans to meet each patient’s specific needs. The plans are comprehensive in scope using a variety of treatment modalities from our cornucopia of specialized care plans that include Medication Assisted Treatment. New Leaf’s Medication Assisted Treatment plans for best client outcomes feature three of the four FDA Approved MAT drugs: Buprenorphine, its extended-release injection Sublocade, and Naltrexone. These three MAT regimens and protocols have high success rates for clients when complemented with counseling and psychosocial support.
The patient begins cognitive-behavioral treatment with an individual therapist as well as in groups with a counselor to address the whole host of issues afflicting the patient, including anxiety disorders. Psychotherapy plans and specific treatment modalities tailored for the patient include individual counseling, group counseling, anxiety-focused therapy groups, and process groups and activities. The primary clinician and individual therapist and group counselor work in concert to treat the patient by resolving the underlying issues that led to addiction, followed by a variety of custom treatments that fortify the patient, clinical assessments throughout the process, and a considered discharge plan. Peer support, onsite medical assistance, family involvement, and post-treatment follow-up support are part of New Leaf’s standard of care.
The family broken by addiction can be reinvented and reshaped into a happy, thriving, functioning family, through work on both sides. It can be reconciled through delicate work, counseling, communication, and repair. Its imperfections and scars can be metaphorically highlighted and refined in gold, while at the same time joining together the shattered pieces into a new whole.
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