Families on the Frontlines

I'm back...I hope everyone is working toward healing themselves.  It is important for us all.

Every major professional organization in the world, such as the World Health Organization, American Medical Association, etc. agree that addiction is a disease process and a major public health problem. They also agree that when someone in a family is affected by this condition everybody in the family unit is negatively impacted. Family members generally begin to develop ways of coping with the problem of addiction that are unhealthy. They may reduce their level of communication with each other, avoid showing emotions and keeping the situation secret from friends, relatives or co-workers and they may start taking on the responsibilities that the addicted person should be fulfilling. 

Family members are on the front lines in the "war on drugs," but they are not trained for the task and are usually operating as isolated units that generally do not communicate comfortably with each other or with the larger community in which they live. They are the invisible casualties that are piling up on the battlefield of this war and they are suffering on a daily basis in isolation and struggling with the pain and fear they are experiencing as a result of their loved one's addiction.  As family members struggle to figure out how to help their loved one, without help for themselves they gradually begin to take on the pain and anxiety that the addict should be feeling. Families need help but aren't getting it. 

When people are struggling with drug abuse in their family they grasp for answers. They are anxious to seek information about how to make it stop; they want to know how to get their loved one to stop using drugs and get into treatment.  Family members become stressed out and they don't process information well.  Many times what they do hear is that the user can get help only when they want it, and that translates into hopelessness and they feel even more powerless. What is going on, everything is focused on the addict. Paradox: More focus on the addict the worse the family feels.

What do family members need to learn?

Family member need to learn what they actually believe is true about addiction, what they have enough confidence in that they are willing to act on it. Family members beliefs about addiction will continue to shape what they think, feel and do in relationship to the addict, other family members and themselves.

Family members need to learn about issues of control and stress management and how stress and fear can destroy family relationships. Control issues are at the core of addiction and it is the loss of control that frightens family members the most. Family members can learn what they have control over and what they don't have control over.  Family members don't have control over the addicted person's behavior but they can exercise control over the type of behavior that occurs in their home if they are willing to.  Armed with the knowledge that their are things that you can control, if you are willing to do that, you can begin moving a direction that is healthier for the family and may increase the possibility the addicted person will seek help.  The skill of managing stress in a healthy manner is extremely important to learn.  Stress, fear and anxiety play a central role in the struggle with addiction in the family. This is absolutely normal and at the same time must be acknowledged and managed. When family members learn to manage their fear and anxiety they will be better able to take back control over their own lives and respond to the addicted as well as other family members in a healthy way.

Taking a Break

Aloha,

As you can see I have not posted additional information for about a month.  I am taking a break until the new year.  There is plenty of information and links on this blog to keep everyone busy for awhile. 

It is important to remember that the key to family recovery is to work on your own issues.  The more focused and obsessed you become with the addicted person in your life the less ready you will be to be helpful to them or yourself. 

The addicted person will attempt to manipulate you and will tell you what you want to hear to get what they want.  This is not personal this is what addicted people do to everyone, it is the nature of the disease of addiction.

Don't get sucked into their words, observe their behavior without trying to manipulate it. Don't take their behavior personally.  It's not about you, they can't see beyond their own needs so when they are selfish, self centered, manipulative and irresponsible the correct response from you is not "oh my god, look what they are doing now." But it is "of course, that's what addicts do." 

One more thing,  allow them to feel the pain they create in their lives.  Too many times the family members take on that pain and that is the wrong thing to do and it delays the chances that the addicted person will seek help.

How to have a "healthy" relationship with the addicted person in your family

If your family member is actively involved in their addiction you can still have a "healthy" relationship with them but it will look and feel a lot different than a normal healthy relationship.
You can't have a normal healthy relationship with someone who is actively using drugs.
What is different? Number one you should not trust them. Not trusting them even if you want to is a good thing because it is a sign that you are understanding the reality of their situation. It is also important to develop a non judgmental understanding of your loved one's condition this is an important step in having a healthy relationship. Non judgmental does not mean you like what is going on but does mean you understand what is going on, and are willing to avoid falling into a power struggle with your loved one.

You need to be very consistent in your communication with the addicted person and avoid trying to manipulate them like the plague. It is important to learn how to take back your life while you reduce your urge to manipulate them manage their life while your life falls apart.

People that care about the addicted person tend to get scared, or angry when they can't make something positive happen. When family members don't get support their relationship with the addict becomes driven by anxiety and is focused on trying to make something happen to change the situation. This sets up a power struggle and the addicted person starts focusing on you as the problem and you are focused on trying to manage their life while your life starts to disappear.

It is important for you focus on maintaining the quality of your life and give consistent messages to the addicted person in your family. The messages should be that you love them and you want them to get help for their addiction and you will hold them accountable for their behavior. Without the drama of a power struggle there is no resentment and anger that gets in the way of communication. This leaves an opening for the future when they are struggling and start to believe they do need help for them to talk with you.

Words and Action

At some point in the struggle with addiction in our families, we ran out of words. The only thing left was action. This is where the rubber hits the road. At some point, it is time to allow reality to demonstrate to the addicted person that there are consequences associated with addictive behavior. We don't have to create these situations, the addicted person will create them as a result of the way they live their life. What our part involves is allowing the consequences to impact the addict. Addicts will respond to experiences before they will respond to words. As long as they are still in denial about their addiction they will blame those around them for their suffering even though they are the source of their own pain.

The addicted person must understand that their addiction is their issue not yours or anyone else's. If they are to enter and stay in recovery their understanding that their addiction is theirs is absolutely essential. They will never acquire this understanding unless they are forced to figure out how to solve problems that they create in their own lives.

Family members and friends can play an important role here by reminding the addicted person that they are loved, that they have a medical condition and that treatment is available. Many times an addicted person's first step in solving their problems is to agree to go to treatment. When they think all their options have run out and there is nobody left to manipulate and they don't know what else to do, they remember that their mother or sister or friend kept saying go to treatment, so they go.

In order for family members to be able to have the will to allow their loved one to struggle on their own the family members need support and education. You can't do this alone and you must believe in what you are doing and have a clear understanding of why you are doing it.

More About Boundaries

How do I create effective boundaries between me and the addicted person that I love? To begin you have to understand what you are doing and what is it that you are trying to accomplish? Also you want to know when a boundary is effective?

So many family members live in a rigid world of automatic reactions to the addicted person in their lives and have no understanding of what they can do that is helpful. What they are doing doesn't seem to be working but they don't know what else to do. If they seek help they are told that it is important to take care of themselves and allow the addicted person to suffer the consequences of their behavior. These suggestions seem unnatural to many people. If someone you love is suffering you must help them, anything else seems selfish and cold. People feel they are not being a "good" wife, husband, parent, child or friend. This confusion is why it is so important to understand what you are doing and why you are doing it when creating boundaries.

It is true that an addicted person will not seek help until they experience a level of pain that breaks through their normal system of denial. It is also true that it is not the family's job to make the addicted person suffer and hope that this will make them go into treatment. This type of thinking is a recipe for frustration.

It is important for family members to be able to manage their expectations, and to understand that there is no perfect system for interacting with an addicted person. Creating boundaries means that you stop trying to manage someone else's life at the expense of your own.

Effective boundaries means that when an addicted person experiences a negative consequence because of their addiction you don't interfere to buffer the experience. You manage your expectations by understanding that this negative experience may not be the one that gets them into treatment but is necessary for them to experience and deal with because it is their life and they created this experience. You have issues to deal with in your own life that you have probably neglected in the past by coming to the addicted person's rescue.

You should always be experimenting with ways to live a normal life in spite of your loved ones addiction. You can start by experimenting with small stuff. I have had a number of mothers who have had their adult children wind up back home. The adult children don't pay rent, don't do chores but are using drugs/alcohol. The mothers do what many other mothers do, their kids laundry. The problem is that these kids are 23, 28, 34, or 46 years old. My first question to them is why are you doing their laundry? It seem that it was one of those automatic behaviors that is problematic when dealing with addiction. They thought it was just what a "good" mother did. I usually suggest they try an experiment and stop doing their adult kids laundry. Their laundry is their responsibility not yours. There are a variety of different types of small things like this such as cooking them dinner, buying them cigarettes, letting them use your car that you can decide that you don't want to do any longer. This is not punishment. This is about adults demonstrating responsibility for themselves.

Another aspect of creating effective boundaries is understanding that you cannot control their addiction but you can control your environment and how you decide to respond to your loved ones addiction. You start getting an idea that you are being successful at creating effective boundaries when you find yourself moving from rigid responses driven by fear and expectations to having a choice in how you want to respond in every situation.

Creating Boundaries

Creating boundaries is an important skill to learn in order to respond in a healthy way to the addicted person in your life.

The key to your ability to create real boundaries is your willingness to hold the addicted person responsible for their addict behavior for the benefit of the family, not to manipulate the addicted person into better behavior. This is a skill that must be learned.

I have talked with family members that wanted to create "consequences" for their addicted loved one for a variety of bad reasons, because the family was angry at the addicted person, or because they wanted to punish the addicted person for being addicted, or the family wanted to manipulate the addicted person into treatment.

The first thing to understand is that the family does not create consequences. The family creates boundaries, and the addicted persons behavior results in consequences. One aspect of boundaries are clear rules or limits on behavior that everyone in the family is expected to honor, including the addicted person. Developing boundaries involves both perception and emotion. Being able to see that your loved ones addiction is not your issue can be very difficult. Boundaries help create a dividing line between the issues the addicted person must deal with in order to get help and issues that the family members must deal with for their health. Family members often spend too much time trying to solve their loved ones addiction and as a result they begin to loose touch with their own needs and identity.

Some family members have asked the question, what are examples of creating boundaries.? The most important examples of creating boundaries are invisible and are created through support and education. They involve an internal shift involving the understanding of addiction and learning to not overreact to your emotions. Family members are able to create healthy boundaries when they begin to understand that their loved one can only recover when they take responsibility for their own issues, family members can't do it for them. Healthy boundaries are created when family members can overcome the guilt, the anger, the disappointment, and the perception that they are responsible for this situation and are expected to make it better.

Remember the three C's: You didn't Cause it, You can't Control it and You can't Cure it.

When family members begin making this internal shift then they can create healthy boundaries that don't involve manipulation, anger, punishment and they will be able to follow through and uphold these boundaries.

Anyone can look as though they are creating a "boundary" but if it is done for the wrong reasons it just keeps the addicted person and the family members more enmeshed in an unhealthy dance.

If you enforce a rule or boundary and you are doing this because it is good for you and your family your on the right track.

If you enforce a rule or boundary and it is about trying to manipulate the addicted person your on the wrong track.

What People Ask!!

The last 50 people who have come to this blog have asked about information related to, the manipulative behavior of addicted people, being able to trust the addicted person again, the creation of boundaries and how to say no, enabling behaviors and coping strategies to deal with the anxiety, stress and fear associated with living with addiction in the family.

Over the past 12 years of talking with family members who are struggling with addiction in at least one or more of their family members these questions make up about 90% of what they are dealing with and want to get better at managing. The other few 10% of issues has to do with whether addiction is a disease and questions about specific drugs.

I would like to make a small statement related to the addiction as a disease question. Forget the word disease. I call it a medical condition, you can call it anything you want. All reputable medical organizations in the world will say addiction is a disease process. The most important concept to understand, no matter what you decide to call addiction, is that you can not control this condition and the addicted person can not either.

The addicted person can learn to manage their condition only after they have acknowledged their addiction and become willing to take responsibility for managing their own recovery.

It is important to clearly understand that addiction is a medical condition which results in changes in brain chemistry that alters the normal perception and decision making process in the brain. These changes are caused by chronic use of the addicted persons drug of choice, whether it is alcohol, methamphetamine, cocaine, etc.. The primary message that addicted persons are giving themselves is that their drug of choice is what makes life worth living. The drug replaces you, other family members, education, career, economic responsibility and hobby's. I'm sure you can add many others through your own experience. The primary activity for the addicted person is to acquire and use their drug of choice.

All addicted people will manipulate those around them and their environment to ensure that they meet their goal of getting and using their drug. Manipulation is the normal behavior of an addicted person. It is not personal, it is just what addicts do. When you begin to understand this you can better decide on your choice of strategies for not allowing yourself to be manipulated by the addicted person.

Yes, addiction is not personal!! It is hurtful because you can see that the person you love is hurting themselves and others but it is not aimed at you. Addicted people, because of the changes in the brain brought on by their compulsive drug use can not see other peoples suffering. Addicted people are trapped in a narrow focus of getting and using their drug of choice. Because you are thinking logically you see offers of help and support. Because the addicted persons brain is altered they see the offers of help and support as roadblocks to be overcome or manipulated out of the way to meet their goal of using their drug of choice. You are simply a witness to their addict behavior. The more you are gradually able to learn to lessen the personal aspects of your response to your loved ones addiction the better able you will be to respond effectively to the chaos they create in their lives that effects your life.

Trust issues are important family issues. Many family members trust what an addicted person says because they want to trust them and want them to be trustworthy. They trust what they say because they think they should. They trust what they say because they think if they don't they are abandoning them. It is important for family members to understand this about addicted people, if their lips are moving they are lying. Never trust what an addicted person says, even if you want to. Remember just as addiction is not personal neither is this. Addiction happens to the most wonderful people. This isn't an attack on their character. This is an acknowledgment of the realities of addiction.

Learning to trust again. Nobody deserves your trust just because they are breathing, or they are related to you. If you think about people you really trust it is probably people that follow through on what they say they will do. They may not be perfect but their behavior matches up with their words.

What about the addict? If you understand addiction, and that the primary goal of that addict is to acquire and use their drug of choice they also follow through. The problem is they won't tell you the truth. If you understand that no matter what they tell you it is all for the drug it is easier to say no. Never call an addicted person a liar. The information about not trusting them is for you to understand when responding to their very predictable addict behavior. If you want to learn to trust them again remember it is all about the behavior, just observe. As they begin a program of recovery you may note that they are beginning to "walk their talk", as they say in 12 step programs. Start out slow and allow trust to be earned, no judgments.

Creating boundaries between you and the addicted person in your family is an important skill to learn. Without boundaries you can not learn to respond effectively to help improve your emotional well being and also be helpful to others in your family. An important part in creating boundaries is coming to the understanding that the addicted person you love has different issues than you. For example, their addiction is not your issue. In order for them to begin any process of recovery they must take responsibility for their condition. Many family members try and try take responsibility for their loved ones recovery and they become more and more frustrated and hurt. The issues you need to be focusing on are related to you and are separate from your loved ones medical condition. These issues need to be addressed for you to be successful in your own recovery.

Getting support is probably the most important behavior a family or individual family member can do for themselves and the addicted person in their family. Addiction thrives on isolation, fear and shame. Part of your recovery is learning how to be yourself again and to live a healthy life even with the stress of addiction in the family.