A look at the impact of substance abuse and addiction

on the family unit.

Families

By Emily ShieldsCEP 504 – Pr. LiskerNovember 15, 2012

Research has shown that substance abuse is often linked closely with a lack of ability to form functional relationships with familyTraumatic childhood and adolescent

experiencesContinued strained relationships with family of

origin throughout adulthoodNegative relationship patterns in adult intimate

relationshipsDestructive parenting styles

The cycle of dysfunction

Alcoholic familiesExhibit more negative communicationEngage in higher levels of openly expressed

angerStruggle to maintain functional roles and often

display distorted hierarchyHigher rates of divorceHigher rates of physical, sexual, and verbal

abuse of children than nonalcoholic families

These apply to other types of addictions within the family as well….

Marriage & The Family Unit

Codependency Construct versus

reality“An unhealthy relationship in

which a person who is closely involved with an alcoholic or addicted person… [and] acts in such a way as to allow the addict to continue the addicted behavior” (Gwinnel & Adamec, 2006)

“A relationship in which there is continued investment of self-esteem in the ability to influence-control feelings and behavior, both in oneself and in others, in the face of serious adverse consequences” (Johnson, 2003)

“Codependency is a problematic or maladaptive seeking of identity, self worth, and fulfillment outside the self” (Zelvin, 1997)

PatternsCodependents learn

to measure self-worth by how successful they were in their caretaking behaviorsSelf-esteem is fused

with the relationshipOverlap of “normal”

love relationship boundaries and codependency

It is not OK for me to feel.It is not OK for me to have

problems of my own.It is not OK for me to have

fun or a life of my own.I’m not lovable.I’m never good enough.If people act crazy, I am

responsible.

CodependencyThe Rules of Codependency:

For more on Codependent coping styles and relationships, see p. 303 of Doweiko.

Enabling Enabling refers to the

behaviorTo knowingly behave

in such a manner as to make it possible for the person with an SUD to continue abusing chemicals.

“Dallas” Intervention | Episode: 156

http://www.aetv.com/intervention/episode-guide/season-11/dallas-156#156

Desire to protect the addicted family member

Social pressureStigmaControlAcceptance of

boundary violationsEnabling comes in

many forms

Role reversal and conflict

“Parentification” Financial stress, pressure to lend money to

addicted family memberArguing over taken, stolen, or sold possessions

Loss of trust and safetyUnwanted “visitors”

Disagreements between other family members

Lack of social interaction

The family unit

Child abuse

Adverse consequences for the family

Aggression and domestic abuse

Irritability, verbal abuse, rudeness, criticismDomineering or controlling

behavior

Threatening, pushing, hitting, breaking furniture, throwing objects

Death

Physical effectsPoor sleep,

exhaustionPoor diet, loss of

appetiteHypertension, hair

loss, migraines, back pain, palpitations

Injury as a result of domestic violence or abuse

Chronic anxiety, panic attacks, depression

Suicidal thoughtsPoor concentrationHypervigilanceLow self-esteem

High-stress environments have shown to significantly impact the development of the limbic system (hippocampus, amygdala, and hypothalamus) with prolonged exposure.

Effects of addiction on family members

Psychological effects

Many family members need counseling for psychological, emotional, and physical abuse

Counseling is also needed for behavior modification and coping skills

Some clinicians advocate for a non-pathological model for treatment of familiesDiscard dated, biased, unsympathetic language

and attitudesStress-strain-coping-support model (SSCS)

Family support and therapy

Support Groups & Services

Nar-Anon: www.nar-anon.org Family Addiction Outpatient

ServicesStatler Towers, Ste 555, 107 Delaware Ave., Buffalo

Adult Child and Family Clinic at ECMC462 Grider St., Buffalo

Supportive Living – Council on Addiction Recovery Services201 South Union St., Olean

Women’s Shelters: http://www.womenshelters.org/cit/ny-buffalo

Cornerstone Manor150 E. North St., Buffalo

Buffalo City Mission Women’s Shelter100 E. Tupper St., Buffalo

Community Missions of Niagara Frontier Emergency Housing and Crisis Shelter1570 Buffalo Avenue, Niagara Falls

24-hour PASSAGE Hotline: 285-6984

Resources

Shelters

Doweiko, Harold E (2009). Concepts of Chemical Dependency - 8th Edition. California: Brooks/Cole.

Johnson, P. (2001). Dimensions of functioning in alcoholic and nonalcoholic families. Journal of Mental Health Counseling. Vol. 23, No. 2, April 2001, p. 127-136.

Orford, J., Copello, A., Velleman, R., & Templeton, L. (2010). Family members affected by a close relative's addiction: The stress-strain-coping-support model. Drugs: Education, Prevention & Policy, 1736-43. doi:10.3109/09687637.2010.514801

Orford, J., Copello, A., Ibanga, A., Velleman, R., & Templeton, L. (2010). The experiences of affected family members: A summary of two decades of qualitative research. Drugs: Education, Prevention & Policy, 17(S1), 44-62.

Pasternak, A., & Schier, K. (2012). The role reversal in the families of Adult Children of Alcoholics. Archives of Psychiatry and Psychotherapy, (3), 51-57.

Schäfer, G. (2011). Family functioning in families with alcohol and other drug addiction. Social Policy Journal of New Zealand. (37), 135-151.

Weber, D. A., & Reynolds, C. R. (2004). Clinical perspectives on neurobiological effects of psychological trauma. Neuropsychology Review, 14(2), 115-129.

References