An article by Gerard “Jerry” J. Egan LMHC
Being involved in the addictions treatment business for over thirty years I have witnessed the damage and trauma that substance use, abuse and dependency have inflicted on families and friends of an addict or alcoholic. Most of the time the impact is clearly experienced but rarely ever fully understood. It is my hope today to clarify the severe misunderstandings that occur to the family and their relationship with the addict or alcoholic. It is my opinion that many times a person will relapse due to the confusion and frustration they experience when dealing with the significant others in their lives. In fact relationship problems are probably the number one reason that a recovering person will fail to recover.
To begin our discussion it is first necessary to outline in as simple a manner as possible the reasons that any human being searches for and develops a relationship. Relationships by their definition are designed to allow people to get their needs met. Whenever people approach each other it is for the purpose of needs satisfaction otherwise there would be no reason for the contact. This is the same whether it is a simple transaction with a cashier at the food store or a deep emotional exchange between two lovers the reason for the interaction is for the satisfaction of human needs.
Addiction poisons the interaction between people in the following manner: It causes many powerful and negative feelings and emotions that interfere with the ability to get needs met. Due to living with the addict or alcoholic the person has experienced confusion, despair, betrayal, deceit, disillusionment, anxiety, fear, worry, anger, frustration, desperation, depression, terror, sadness and this is just a very short list of the emotional impacts. The result of this emotional damage is that the significant other becomes very hesitant in their willingness or ability to help meet the emotional and intimacy needs of the addict or alcoholic. It is this hesitation that the addict experiences as rejection and that triggers relapse. Since their significant other has rejected them, or they just simply do not have the ability to meet those needs the addict then runs for the cover and comfort that substances provide.
When an addict or alcoholic relapses numerous times the family becomes very hesitant to believe in that person. Anytime someone believes in someone they are manifesting much hope that things can change and improve. When a person relapses after their family or significant other had built up hope; the pain of losing hope causes such intense suffering that the person becomes very reluctant in becoming enthusiastic or excited about the addicts latest recovery attempts. They develop a “fear of having hope.” It is only by risking having hope that they can be hurt again and by being negative or even cynical towards the belief that the person can and will recover; they in fact are protecting themselves from emotional pain and suffering. The addict and alcoholic view their reluctance to show any enthusiasm or encouragement as rejection and the pain of rejection can certainly cause the loss of recovery.
The addict must recognize that all people have a right to protect themselves from injury and the addict must not take it personally if their significant other is reluctant or hesitant in demonstrating support and enthusiasm while they are in early recovery. The family or significant other is simply taking a wait and see attitude. It is in this manner they protect themselves from disappointment. If they do not show or feel hope then they cannot suffer the great pain associated with having their hope taken away when the person relapses. Therefore it is helpful for the addict to accept that their significant other is not trying to hurt them but are just trying to protect themselves from having their hope destroyed one more time.
When Your Loved One is in Treatment: A Family Guide
Not in your loved one’s recovery, but in your own. You need to remember that you are in a process of recovery yourself. The only difference between your loved one’s recovery and yours is that in many instances you have felt the pain and misery every step of the way. You have witnessed the suffering and have felt the pain of that suffering. Your loved one was often intoxicated or too high to notice the pain they were creating, although they are very much aware of the pain at this moment that their abusing and using has caused, you have been aware of this pain and misery for awhile now. To that end, it is important to take care of yourself. To do that it is highly recommended that you get involved in AL-ANON, CODA (co-dependency), or any other 12 step group supporting the family and significant others of loved ones who are addicted. These self help groups are usually readily accessible throughout your community offering the necessary support, help, and guidance in, not only better understanding the disease concept of addiction, but in better understanding what it is that you need to do to take care of yourself and your loved one. These support groups are made up of those who have walked or are walking in the same path as yourself. These groups can offer you the necessary support, guidance, and help in making decisions about what is best for you and your loved one’s future. Chances are that you will still need to make some very difficult decisions about your loved one in the future, it is best that you don’t do it alone but with the help of those who have been through this before.
If you are finding it difficult to attend these groups, you may want to consider therapy or family therapy. It is not uncommon for the family to have endured long periods of stress, fear, tension, and anxiety. In some instances, the family and significant others have been traumatized by the behaviors of the addicted loved one. Depression, anxiety, and stress disorders for the family are all too often common fallout of the addictive process. Just because your loved one may have made the decision to get involved in treatment it doesn’t mean that your stress and anxiety is about to leave you. Research has shown that stress and tension remains within the physiological make up of a person for extended periods of time. In certain instances, this stress and tension can actually remain within the body leading not only to emotional difficulties but also contributing to physical illnesses. Sitting down with a trained therapist who is knowledgeable in the field of addictions and recovery can offer extremely useful insight into the recovery process. Therapy isn’t as time consuming as it once was and someone who is specifically trained in the field of addictions can be extremely useful. Professionals trained in the field of addictions are very much aware of the difficulties that you have been through and know precisely many of the issues you may be struggling with.
Another good way you can become involved is by reading the Alcohol Anonymous “Big Book.” The principles, or the 12 steps, that are outlined in the book have been a mainstay and foundation of the recovery movement since its inception in 1939. Alcohol Anonymous is located throughout the world and has helped and is helping tens of millions of people on a daily basis suffering from addiction. The reason that Alcohol Anonymous has been credited with being so effective over the years is believed to be in part due to the result of people adhering to the principles of the 12 steps. One of the arguments that we often hear is that the “Big Book” is a religious oriented book and that the book focuses on God too much. Nothing can be further from the truth. Although the “Big Book” does focus on the concept of a God, it focuses more on the perspective of a higher power and the importance of a person achieving a spiritual awakening. The 12 steps are nothing more than simple basic principles on how to live life. The philosophy behind these principles is that by following and working these steps a spiritual awakening will occur allowing us to live a more peaceful, content, and prosperous lifestyle. As we often point out to the people we work with, most successful people, not just those suffering from an addictive disorder, follow the 12 steps. They just don’t know that they are following the principles of Alcohol Anonymous. One would be hard pressed not to see the beauty and simplicity of these basic principles. For your convenience, we have outlined the 12 steps for you in the back of this book. Please take a look at them and by all means take a closer look at the “Big Book” to see how they are integrated into a person’s recovery.
Just Say No
One of the more important steps that the family and significant others can take in their loved one’s recovery is to learn to say “NO!” As you are probably all too aware, this word is easier to think about than it is to actually say. But it is absolutely crucial that you learn how to say it and your loved one learns how to hear it. And when you say “no,” it is important to say “no” to everything. Regardless of how minor or reasonable the request may seem you need to simply say “No!” This is not to teach your loved one a lesson about his or her past choices or to help you practice “tough love.” Saying “no” and learning to hear “no” is an extremely important step in changing behavior patterns. Changing the behavior patterns of individuals is one of the most important elements to a successful recovery.
Who was it that your loved one called in times of a crisis? Who was called at the last moment to solve a problem? There is no secret here. In a majority of instances, it was you. Saying “no” sets in motion a new way of thinking and, more importantly, a new set of behaviors. One of the behaviors that your loved one needs to accomplish is for your loved one to think through their particular dilemma, no matter how small, and to tap into their own problem solving potential and capabilities. All too often people suffering from an addictive disorder have a tendency to look for the “short cut” to a problem or want that instant gratification. All too often, that “shortcut” has been you. By simply saying “no,” even to the smallest request, forces your loved one to start thinking and behaving differently. Even more importantly, it places the person in a position of problem-solving. This is exactly what needs to be accomplished. By doing this, the person has an opportunity to tap into or develop appropriate problem solving skills by thinking about their particular dilemma and all the possible ways it can be solved. Up to this point in time, they have usually depended on only two sources for their solutions: you or the substance. When the family or significant relationship is not readily accessible as a “shortcut,” they are more prone to ask their peers, staff, or therapist regarding a solution. This is what allows your loved one to begin to develop or tap into their problem solving skills. Another important facet of this process is getting the person to build up their frustration tolerance rather than getting immediate gratification.
Now that you understand the rationale behind the “no” and are hopefully practicing it, guess what happens next? Anger, and a lot of it. It is usually directed at others but you will get your fair share too. In the beginning, most of the complaints will be directed to what went wrong in your loved one’s life and what is going wrong now. Your loved one is sure that we don’t understand their situation and that we lack the necessary compassion and caring that it is going to take in order for them to get better. Well, nothing is further from the truth and the best way to understand this process is to think in term of “green beans and ice cream.”
The brain in the early part of recovery is not too different than a very hungry 10 year old child who hasn’t eaten all day long. Think about it. Imagine a 10 year old that hasn’t eaten all day long. They come home and are being offered a choice between a big bowl of green beans and a big bowl of ice cream to satisfy their hunger. I wonder which one they are going to choose.
Your loved one has been consuming massive amounts of “ice cream” for months and in many instances years in order to satisfy their hunger. There is no way they are going to choose the “green beans” over the “ice cream.” This is usually the time that your loved one will be experiencing their most frustration and anger. Your loved one will be convinced that this is not the place for them to recover and “get me out of here or else” is likely to be their rallying cry for you to give in to their threats, demands, and promises. Do not give in. This phase is typically short lived and temporary. You have to remember that their discomfort and pain in the early part of treatment is for the most part not getting their way.
Probably one of the most influential forces that a person can have in their recovery is their family or significant other support system. Not that it is the responsibility of the family to get their loved one to recover, but the family can be an extremely helpful support in reminding their loved one about the process of recovery. Often time recovery is not a steady state of progression. Rather, it is a process of two steps forward and one step back. By following some of these basic guidelines regarding a loved one’s recovery, the family can be an enormous on-going support.