The Impact of Addiction on the Family
Substance use impacts the entire family unit and can lead to intergenerational cycles of trauma with far-reaching effects.
Estimated watch time: 47 mins
Available credits: none
Overview:
A personâs addiction doesnât just affect their life; it also impacts the lives of their friends, family members, loved ones, employers and acquaintances in general. In this presentation, Licensed Clinical Social Worker Michael Cadron discusses the difficult experiences family members often endure when a parent, child or sibling is struggling with substance use and addiction.
After watching this presentation, the viewer will:
- Understand the phases the family experiences when substance misuse is present
- Identify consequences of familial relationships and the familial roles that emerge
- Know how persistent, intergenerational cycles of trauma can occur
Presentation Materials:
Michael Calderon is a Licensed Clinical Social Worker and Licensed Clinical Alcohol and Drug Counselor who has been practicing clinically for nearly eight years. Michaelâs clinical work includes working with adults and youth experiencing a wide spectrum of mental health disorders, couples, families as well as individuals who are dually diagnosed with substance use disorders. Additionally, he has worked as a substance use navigator for Somerset, Hunterdon and Warren Counties where he provided education to professionals and the general public about mental health and substance use disorders impacting youth, provided information and referrals for youth to receive substance use treatment and provided recommendations to increase opportunities for youth who are in need of substance use services to receive treatment.
He is also a voting member on the Local Advisory Committee on Drugs and Alcohol for Warren County, the president of the Hackettstown Stigma-Free Taskforce in Warren County, New Jersey and Alliance Coordinator for Hackettstown. Prior to his career as a psychotherapist, Michael was a special education teacher who taught students with behavioral disabilities, learning disabilities and severe mental health diagnoses.
Welcome to the Community Education Series, hosted by The Recovery Village and Advanced Recovery Systems.
Hi everyone. I am so happy to see so many of you from all over, but I am Jordan Katz. Iâm a licensed social worker and clinical outreach specialist for The Recovery Village Cherry Hill at Cooper, right here in Cherry Hill, New Jersey. We offer the full continuum of care for adults struggling with substance use disorders and co-occurring mental health disorders, including detox, residential and outpatient programs. Iâm going to put my phone number in the chat, so if anyone has any questions, feel free to reach out to me.
I have the pleasure of introducing Michael today. Michael Calderon is a licensed clinical social worker and licensed clinical alcohol and drug counselor who has been practicing clinically for nearly eight years. Michaelâs clinical work includes working with adults and youth experiencing a wide spectrum of mental health disorders, couples, families, as well as individuals who are dually diagnosed with substance use disorders. Additionally, he has worked as a substance use navigator for Somerset and Warren Counties, where he provided education to professionals and the general public about mental health and substance use disorders impacting you, provided information and referrals for youth to receive substance use treatment, and provided recommendations to increase opportunities for youth who are in need of substance use services to receive treatment. He is also a voting member on the local advisory committee on drugs and alcohol for Warren County, the president of Hackettstown Stigma-Free Taskforce in Warren County, New Jersey, and alliance coordinator for Hackettstown. Prior to his career as a psychotherapist, Michael was a special education teacher who taught students with behavioral disabilities, learning disabilities, disabilities and severe mental health diagnoses. Welcome, Michael. We are so excited to have you speak for us today. Thank you.
Michael:
Thank you. I see we have people from all over here. Thatâs terrific. Welcome, everyone. Iâm here to talk to you about the impact of addiction on the family and family system.
I did just want to add â everyone, if you scroll up in the chat, I did throw the PowerPoint in there so you are able to view it on your own screen as well as viewing Michaelâs.
Great. Alright, so what Iâm going to start with is kind of discussing what family systems is. That comes from the family system theory, and it suggests that the behavior of individuals cannot fully be understood unless you look at the system in which the behavior is occurring. In this case, weâd be talking about the family system, and each system would, as far as if somebody was at work, they may behave differently. So, we have various systems; weâre focusing, of course, on the family system, and you need to observe to really get an idea about the individual. You observe their behavior and the emotional unit to understand that all families maintain an order. They have to maintain order through structure, boundaries and roles for each family member in the system. Each family member tends to function in a way that keeps the family system in balance and maintains the status quo, or what we would call homeostasis. So, itâs this functional thing, but what happens is if somebody changes that behavior or a behavior, it will impact the system and change how the system is functioning, which often causes some emotional discomfort among other things within that system. Itâs important to identify how various parts interact with one another, and understanding how they interact can help us to understand how the system breaks down.
The one thing that I wanted to just talk about too is, what is addiction? A lot of people have different ideas about addiction. Addiction is a brain disease, and itâs marked by uncontrollable as well as compulsive substance-seeking and use, despite experiencing severe medical or physical consequences as well as social consequences. In addition, the person becomes addicted emotionally and/or physically, depending on the substance of use. They are both equally addictive, but in different elements. When we talk about physical addiction, we talk about that withdrawal, where people exhibit withdrawal symptoms. For example, somebody who has a severe alcohol use disorder may withdraw having DTS, or delirium tremens, and thatâs important to know weâre talking about a disease of the brain. This is it â anything else, I like to compare it to diabetes. Weâre not necessarily born with diabetes, but people sometimes are very susceptible to diabetes. Other people will eat poorly and eventually develop diabetes. An addiction to drugs or alcohol does develop from use. However, the person thatâs doing that â itâs not their intention. It never is their intention. Itâs something that eventually can happen, and it can happen more or less quickly, depending on the individual. So, itâs a disease â that a brain obtaining and using the substance becomes the individualâs primary goal, which is usually to the detriment not only of themselves, but other people within their system. Their family system, in particular. And it can impact, in a pejorative manner to signify, the goals and responsibilities of everyone who is involved with them.
So, effects. The effects on the relationship. It impacts every member of the household. What we talk about is thereâs different phases, so the first phase is the learning phase. This is where it first starts. The members of the household, they often become aware that thereâs emotional tension within the family. People arenât getting along as well, fuses are a little shorter and relationships become strained. The communication decreases, and arguments tend to increase disagreements. People will be short with each other; theyâll assume whatâs being said to them and react rather than hearing what it is and kind of staying calm about it. Relational boundaries become inconsistent and undefined, so what may have been okay today is not okay another time. And then the emotional connections to the family unit are weakened, so this time in the phase is when youâre most susceptible to the possibility of domestic violence. Because what ends up happening is the frustration, the anger, all these different things start to increase. As those things increase, it also impacts the person using the substances. Their emotionality increases, and thatâs when we can start to see some abuse, whether itâs child abuse, domestic violence, occur.
So, the harmful phase: The trust for the substance user starts to diminish. Before theyâre using, we kind of can see a problem, but it may not be identified or spoken about. Other people within the family may be just kind of rationalizing. âNo, this is normal. This is what people do or kids do. They donât have a problem. Itâs not a big deal. Itâs a phase.â Iâm now in a harmful phase; as it goes on, we are now starting to see this lack of trust. Family members tend to exhibit hypervigilance towards the substance users. What that may look like is they are on top of them, wanting to control what theyâre doing. âWhere are you going? Who are you with?â Things like this. âWhat are you doing?â Trying to see how much money theyâre spending. They take on greater personal responsibility and reduce expectations of substance users. What that may look like is now all of a sudden, theyâre blaming themselves, or, âIf Iâm not constantly checking in with this person, this person is going to slip and theyâre going to start using again, or theyâre going to do something stupid and get themselves in trouble, so I have to take care of that.â
Whoever the person is that feels that way, they become defensive in their thinking and behavior. Very sensitive to criticism about what theyâre doing or how theyâre interacting. That can be both family members, as well as the substance user. They experience feelings of blame, resentment, anger, and/or fear towards a substance user. These are the people in the family. As we start to see, itâs a problem. Now that could be, âWell, you know, your problem is harming everybody. Itâs changing everything. Iâm not getting the attention I need.â Or somebody else â itâs impacting their work schedule because theyâre having to leave work to take care of certain things due to substance use. But at the same time, people often will feel guilty about it.
Now, they feel guilty about being angry with the individual, or they feel guilty as if â often, youâll see parentsâ guilt where, âIf I did something better⊠what did I do wrong? My kid wouldnât be using.â Even children can feel that way if their parents are using. âIf I behave better, my parents wouldnât need to drink or use drugs.â So thereâs a lot of conflict, a lot of emotionality going on during the harmful phase. Also, thereâs often financial instability at this time, and what that means is that the substance user often will â their behavior, their substance use may impact the way theyâre working, so it could cause problems at work. Should it cause them to get fired, they would then â if theyâre the primary income â that could cause a lot of problems financially. It also caused them to lose health benefits for the entire family. Also at this time, the substance user often will take things or steal things often from family members, whether itâs money or objects, to try and trade or sell to get money for their addiction.
And then we go from the harmful phase to the escape phase. And during this time, this is kind of the last phase family members experience â overwhelming feelings. They just feel drained. Theyâre tired or overwhelmed. Theyâre tired of it. Theyâre tired of whatâs going on. They often donât know how to help themselves, and they look for means to emotionally escape the circumstances which develop in his or her lives due to substance use. At this time, you see sometimes where, in a married couple, there may be an affair outside of the marriage to escape. Even if itâs not the other parent whoâs using â if itâs another family member, you might see some escapes by using drugs or alcohol themselves as a way to self-medicate. Theyâre just looking for a way to just take off some of the tension one way or another to lessen what theyâre experiencing. And then family members tend to emotionally withdraw from social activities as well as friends and extended family. They pull back, oftentimes. Theyâre just not interested in doing any of that, and often, we see withdrawal and signs of depression as well. And oftentimes people are depressed during this, within the family. Iâm sorry. It wasnât the last phase.
So, the family denial phase â that is the last phase. I apologize, I think I said the last one was earlier. During the family denial phase, the user begins to experience consequences, which results in a shift in their thinking. When we talk about stages of change, for those of you familiar, you know the first stage is precontemplation, which means, âMaybe I have a problem, but Iâm not really ready to do anything about it,â or they donât even acknowledge that they have a problem. âNo, everythingâs fine. This is temporary. I donât do that much.â They rationalize. And then we talk about contemplation. When they get into contemplation, now thereâs this idea. âWell, maybe I need to do something about it. I think this is a problem.â And thereâs a formulation of some ideas on how to go about solving the problem.
And then when we get into the prepared stage now, theyâre starting to do things. Theyâre starting to do things now â get into recovery, in this case. âWhere do you want to stop using?â Theyâre coming up with a plan and theyâre starting to practice the plan that theyâre coming up with. And then when we get to the action stage, they are actually doing â consistently â all the things that they need to do to recover. So, as somebody starts to move towards contemplation from precontemplation, thereâs no problem identifying that, âThere is a problem and I need to do something.â Thereâs a shift that starts to occur within the family, and during that shift, whatâs going to happen is we are changing â again, the status quo â to homeostasis. By doing so, it creates discomfort within the family, and what often happens is thereâs conflict with the family. They donât consciously say this to themselves, but they think, âOkay, we want everything â we want this person to be healthy. We want them to be better. But now because theyâre better, itâs changing a lot of other things, and Iâm not really comfortable with that.â
So, it is a resistance that may occur, and then it is a denial phase that there is a problem. Now itâs like, âOh, it wasnât that big of a problem.â They experienced an immediate need to maintain homeostasis to try and bring things back. Emotionally stabilizing the individual as well as a family unit as a whole â thatâs by bringing it back to the homeostasis in an attempt to do that. And thereâs feelings of failure in his or her family role for the person thatâs feeling this way, or they may assume responsibility to the substance user to overcompensate for personal feelings or failure and guilt. One of the things that often happens to, letâs say, a person in recovery â theyâre doing well. They havenât â letâs say itâs alcohol â they havenât drank in a month or two, and so maybe for a family member to say, âHey Joe, why donât you have a beer? Itâs a holiday,â and theyâre like, âIâm not drinking anymore.â âOh, one wonât kill you.â And you talked to somebody like that in early recovery â all of a sudden, the brain starts thinking, âWell, maybe I could have one,â and then weâre right back to where we were.
Inadvertently, thereâs this attempt at sabotage, in a way. I donât think people are intentionally doing that, but theyâre wanting things back â kind of normal. They want the person to be normal and maybe everything to go back where it was but the person to be healthy, and it can happen both ways. So, it was a real struggle. And during this phase, the family membersâ behaviors are often intended to help the substance user through those behaviors, which tend to be harmful. Theyâre trying to help, but theyâre not doing a great job of helping, often. Children suffer consequences, in particular, when their parents are using. It really impacts the caregiver-child relationship. It decreases/increases risk for child abuse, and weâre talking about emotional, physical â as well as sexual. Abuse is drastically increased.
When a parent has a problem like this, thereâs a tendency to really not look at things globally. They look at it from their perspective â what their wants and needs are â so they have a lower tolerance. Thereâs less ability to tolerate discomfort of any kind, emotional or anything else. And then thereâs also â as we all know, when you use drugs, it definitely has an inhibition there. Weâre more likely to do things that we wouldnât normally do, and also drastically increases the possibility of children being neglected by their caregivers, where even their basic needs may not be provided for. So, children in the family, they kind of â this phenomenon thatâs called â they become parentified. What that means is they now assume the role of the parent. Typically, the child that typically would assume this role is the eldest child, and what they ended up becoming is they are now assuming the role â age-inappropriate for them â as a caregiver of a parent. This could even occur where theyâre parenting the parents.
Iâll give you an example. A woman I had worked with â at age eight, her parents were both alcoholics, and she would have to come home from school. She would have to make sure her siblings were cooking, they were doing their homework, and keep them on task. She cleaned the house. She would cook dinner. She would actually have to go food shopping oftentimes âcause there wasnât any food in the house, and she would have to, at times, go to the bar and actually tell their parent or parents it was time to come home because they didnât have money for food or whatever and she needed to go. And they would bring her to the food store, but they wouldnât even shop. They would send her in and wait for her. So, I mean, she was doing all the roles of the parent at eight years old, which is certainly an inappropriate age. They learn to parent themselves as well, so they have to learn how to suit themselves, how to make themselves feel better, how to provide for the family, and have to learn how to take care of themselves at a lot quicker rate than theyâre ready for. Oftentimes, parentified children tend to be more prevalent in single-parent homes. One of the reasons is, a lot of times, apparent with the substance use problem. Working, then after work, theyâre unavailable because theyâre using, whether theyâre at home or just not actually mentally available. So the eldest child, once again, will tend to take over that.
Some other consequences â what we call negativism. Communication tends to be based on complaints and criticism, which contributes to a negative, harmful environment. So, the parent is constantly criticizing the child. In turn, depending on age and child temperament, they may start criticizing the parents as well. And then this becomes the norm and the dynamic of their relationship. Negative attention is rewarded by the parents. So, when a parent has a substance use problem, oftentimes, the child has difficulty getting the parentsâ attention, and what they tend to do is then they act out. The parent has an intolerance for acting out, and now theyâre getting the attention they need. So, youâre rewarding bad behavior. What do we know about rewarding any behavior? We can expect more of it the more itâs rewarded. So rather than the appropriate behavior being rewarded â because a negative behavior is something that causes some discomfort â theyâre rewarding that by constantly paying attention to that. Parents tend to be inconsistent with household rules and boundaries, so this can create anxiety within a child. Children need boundaries; they need household rules or expectations that are clearly enforced and defined so they know what they can and cannot do. When they arenât, it becomes very confusing. Thereâs a feeling that people donât care. They donât love them, the child. Because if theyâre allowed to do certain things one day, they may do something the next day â it may not be allowed. It just creates a lot of angst for a child in this situation.
Then we have parental denial. Parents misusing substances often will minimize, or theyâll rationalize the use of substances. Like, âOh, everybody has a couple of beers after work. Itâs a way to relax,â or they deny it. Theyâll say, âI donât really do it that often,â or, âI donât do it at all,â when in fact, they are. Then another dynamic happens when we have a child whoâs using substances. Often, parents will deny or minimize their childrenâs use, and one of the reasons for this is nobody wants to think, âThatâs our child thatâs using drugs or alcohol, having a problem,â so thatâs one reason. Another is, âEveryoneâs going to think Iâm a bad parent if theyâre using something,â so they go into denial mode. Itâs an involuntary thing. Itâs not something that they say on purpose, like, âOh, Iâm just not going to recognize it,â but itâs a defense mechanism that their brain invokes, and now theyâre denying it because, âI canât even consider that Iâm a poor parent.â Just because a youth is using substances, doesnât make someone a poor parent, but that tends to be the perception of the parent â or worried about what the neighbors or the school or anyone else might think. So they minimize or they deny itâs happening.
Also, by accepting it and moving forward, now thereâs an accountability. Now, âI have to do something,â and sometimes, parents donât know. âIf I acknowledge it now, where do I go? I donât even know what to do. How do I do this? My kid has a problem. I donât even know what the first step to take,â you know? Savannah and Jordan can tell you, it was like me with the technology today. Theyâre trying to explain some things and Iâm like, âYou got to give it to me in very simple terms because Iâm not great with technology. So if something happens with my technology, I donât even know how to help myself. I have to call someone, and if theyâre not available, Iâm stuck.â Parents often feel that way when their child is using substances. In both circumstances, the substance use continues with little to no resistance, and often, other children and adult family members feel invalidated. So, if you have somebody else in the family who is recognizing it and itâs being minimized or denied, they feel like their opinion â their view â doesnât even matter. Their concern doesnât matter.
Some of the things that happened â as far as in the relational dynamics, especially with the parent/child â thereâs miscarried expressions of anger. I touched on this before; family members develop resentments regarding the environment, each other, substance user, and at times, others in society. So, what that means â thereâs tension in the household. Because of the attention, it could really ignite some emotions, and other members of the family may be short with each other and develop resentment to each other. If other members have a different perspective or a different opinion of whatâs happening and then they donât agree again, that can cause strife within a relationship â tension. Resentment is often resentment for the substance user, but there could be resentment from the substance user towards family members as well. As far as resentment or frustration with others in society â a lot of times, whatâll happen is, we never know what happens behind closed doors in someone elseâs house. Weâll think of somebody whoâs having the perfect life. In a good way to kind of put a picture to this, if youâre feeling depressed, donât go on Facebook because youâre going to go on all your friends on Facebook and youâre going to see them at the beach. They always have a smile. Theyâre always doing something fun.
This is what they choose to present to us, but weâre like, âOh my God, they have the perfect life. And look at the hell Iâm in,â so we tend to have resentment. When we see somebody in society who seems to have it all together â their family seems to be the perfect family â we actually get angry and resent them if weâre dealing with something like this. Not everyone, but it can happen, because itâs like, âWhy do they get to have this great family and I have this disaster on my hands?â Or, you know, whatever it is. Theyâre often afraid and reluctant to express individual feelings within the family, and then may misuse substances, as I said before, to manage repressed feelings as self-medication. So, if one person is really looking at whatâs happening and deciding something has to happen in the rest of the family, they may not say anything because theyâre going to get a lot of static and resistance from the other family members. Thereâs going to be a lot of anger. Itâs going to cause a lot of conflict. And again, to avoid all of that, they may not bring it up and they may be villainized, like, âOh, youâve always been jealous of them,â or say something else to this individual whoâs bringing it up within a family.
Unrealistic parental expectations parents often will experience. Theyâll want things too high for a child, so set unreachable goals. Again, think about it â when someoneâs addicted to substances, they definitely have a distorted point of view. They may think, âMy child should get straight Aâs,â and maybe that childâs not capable of straight Aâs, and then if they donât get straight Aâs, now thereâs consequences for it. Or, âYou need to be playing varsity sports at a sophomore level,â and theyâre just not really â they may have some sports talent, but they may not be developed enough for that. It may be this unreasonable goal that they cannot reach, or itâs a goal that will just take so much effort to reach that itâs not realistic to expect that of a child. Then on the other side of the coin, we see where parents will set the expectations too low. âYou know what? Theyâre going to school. Whatever their grades are, at least theyâre going,â Or theyâll actually be negative towards their child. Theyâll tell their child they are stupid.
Now we have the self-fulfilling prophecy, where the child now believes that theyâre not capable of more â that theyâre only capable of what theyâre being told by their parents or what their parents are behaving like, âcause sometimes, our behavior even sets expectations. And they learn to expect failure from themselves. Not only that, but when you think about it, one of the most important ways of learning is modeling. And when you have somebody â a parent or both parents â that have addiction, they are not modeling the kind of behavior thatâs going to result in a child excelling or succeeding or meeting or exceeding expectations in what theyâre doing. The drugs and alcohol often take precedent, especially when itâs a problem and other people are not able to excel. And even if theyâre excelling in one area of their life, they are not excelling in all areas. Other areas have taken a hit because the substance has become the most important thing in their life, and something has to be sacrificed for that. They have to find a place for it.
Also what happens is codependency, which is a term that can be a little controversial â to call somebody codependent â but Iâm going to just use this in the general sense. And basically, what it is is family members attempt to control the substance user because they feel the substance user is incapable of taking care of him or herself. So, what does that mean? They tend to do it. âI donât want you upset, Iâll do it,â whatever it is. Or rather than having somebody be accountable to call for work, maybe their wife will call them out for work and say theyâre sick so that they donât have to face it. Itâs a way of doing things that actually tends to limit the consequences or the accountability for the one using the substances and then, in effect, what they donât realize is it actually helps that person continue. Theyâre not receiving the consequences or all the consequences, so it takes away from the impact it would be if they had to face those consequences, which enables them to keep using. And the family member experiencing the codependence of his or her feelings often needs to intensely focus on the substance userâs.
What we mean by that is, rather than looking at a mirror and cleaning up my end of the street â if itâs me thatâs the codependent â and say, âIn order for this to get better, I have to do this,â itâs a lot easier to put all my focus on someone else than to look in the mirror. Thatâs a hard thing to do, especially when you feel like youâre contributing to something negative. So, thereâs a tendency that they feel that theyâre doing good. Theyâre telling themselves, and they believe in their mind, often, that theyâre doing good by focusing on the substance user intently and trying to protect them and trying to minimize their consequences. And at the same time, they think theyâre going to get them to stop using the drugs or alcohol that they are. But this is a bit distorted thinking. Thatâs not whatâs going to happen. Hereâs why codependency is â we call it a stigmatizing term â a little bit controversial: Because we were labeling the person as somebody whoâs doing harm, but really, the person believes that theyâre doing something good, usually.
Also what we have is historical and intergenerational trauma which occurs. So, what we mean by that is â as a therapist, I use, at times, genograms. Itâs a tool that I will use to take a look at different patterns that develop within families. Basically, itâs a family tree, for any of you who may not know. They not only display the names and ages and all that, but it also displays all the issues within the family. We have symbols to depict each thing, as well as some of the good things, but a lot of times, more focused on the negative because, as therapists, weâre looking to help them improve those areas that are life. And what you can often see is you can see a pattern within the family of substance use. And I donât just mean substance use, but sometimes, youâll see a pattern, like â for instance, âWow, itâs really interesting for five generations, every female in the family who became a mother actually had an alcohol use disorder.â
These things tell us things that we can use to help the family understand whatâs happening and change those dynamics. This is what we call historical or intergenerational trauma. We can see things like that also with child abuse as well as domestic violence. Itâs amazing how you can watch a pattern develop and repeat, and itâs a collection of emotional and psychological injury over an individualâs lifetime and across generations. Again, that pattern I was talking about â these detrimental behaviors that tend to be replicated with each generation, which create fixed patterns of harm. So, we tend to do what we learn. A lot of times, we tend to enact ourselves. So, if someone has been abused, thereâs a higher risk that theyâre going to go on and abuse their child, and then so on and so on.
Also to note, oppressed populations are at a higher risk for intergenerational trauma. Iâll give you an example: Native Americans or African-Americans, undocumented immigrants, they do have a higher risk of this because of their experiences and what they go through. People who are undocumented â some of the awful conditions they have to go through to get to the country and things that have been done. And then there could be a tendency, especially if they had that done as a child, where that abuse can change the way your brain is developing and raised. You could end up going on to abuse yourself. I donât want to get too deeply into that, but even those experiences can be influential. Thereâs books that have described different oppressed societies with some of the things that have been done to them by society itself and have then been also instituted within their own families, because thatâs what theyâve learned â and thatâs my point. That puts them at a higher risk for this kind of thing.
Alright, intergenerational cycles of trauma â again, the developmental influences. What we look at here is what we call ACEs, which is adverse childhood experiences. Actually, if you go online and you were to look it up, thereâs a questionnaire with 10 questions to determine the level of ACEs. The more ACEs a person has, the more likely that they are to have had trauma and have it impact them in a negative way. So, when people have ACEs, this is definitely impacted, and the more ACEs we see through generations, the more we see those behaviors repeated. It also often occurs as a result of parental mental illness. So, if somebody has a severe mental health diagnosis, oftentimes, theyâre not good at regulating their own behaviors or even having insight about the impact of their behaviors, so that can impact a child. Parental substance misuse â again, we talked about that â and then also being a victim of or witnessing child abuse. Whether itâs emotional, physical or sexual, the risk increases significantly when parental substance misuse is present. So, the abuse has increased, but also, that increases the ACEs. Again, if these things are happening through generations â some of these behaviors â we can see that pattern again. And then historical or intergenerational trauma is maladaptive patterns of thinking and behaving. Iâm sorry, I should have defined that first â itâs maladaptive patterns of thinking and behaving thatâs passed from generation to generation. Thatâs why we see some of these things repeating.
So, what are the effects of this trauma that occurs through generations? It negatively alters the family structure and organization of the family. All family membersâ behaviors tend to go to extremes, meaning that often â when we talk about extremes â weâre seeing a very high level of emotionality. And when we have addiction within a family, those families have, typically, a high level of emotionality there. They donât regulate their emotions very well. Thereâs a lot less logic being used and a lot more emotions. Communication and boundaries are inconsistent and unhealthy, and thatâs something that if you grow up in a household with no boundaries or very limited boundaries, thereâs a tendency that you will then have a household yourself â if you have children â with limited and unhealthy boundaries. Interfamily relationships are unhealthy, strained and are fractured.
When we look at the unhealthy part, weâre looking at how they communicate, how they interact with each other, the regard they hold for one another. Again, if thereâs abuse in the family, social relationships are reduced and kept at an emotional distance. Thatâs kind of typical, right? If somethingâs happening â when we think about, say, addiction, thatâs a big secret. We donât want everyone to know, so one way that we keep that a secret is we kind of withdraw. We stay within the family; we stay close to the chest with it and we donât talk about it. Weâre told â and this happens intergenerationally too â oftentimes, family members are told that itâs not to be spoken about. âWeâre not going to talk about your uncleâs drinking. You donât talk about that outside of the family.â The entire family often experiences societal stigma. So if one person has â or if thereâs a history of the family having substance â that family often gets labeled in a very negative way. My last name is Calderon â Iâll just use mine so I donât offend anybody. âOh God, those Calderons, man. You want to stay clear of them. Theyâre all a bunch of drug users, even going way back to their grandfather when they were in this town. He was the town drunk. Just stay away from that.â
We stigmatize them and, all of a sudden, everybody connected to the family. Now, it has this negative connotation, and we forget all about the person and we just label them based on one or a couple of family membersâ use of substances. All family members are at risk for, in this instance, depression, anxiety and other mental health disorders. They have difficulty recognizing, expressing and regulating emotions. As I said, thereâs a lot of self-destructive behavior and very low self-esteem among the members that go through this intergenerational cycle. Post-traumatic stress disorder is common. Self-destructive behavior, we mentioned. We talked about self-destructive behavior; that could be overspending. That could be physically self-harming. That could be a variety of things that weâre looking at. Substance misuse happens, poor physical health and/or outcomes and a high rate of suicide in families that have experienced this.
The family disease, which is boundaries. Most of you Iâm sure know, but Iâm going to define boundaries for you. Boundaries are building blocks of all human relationships, and it gives us an idea of whatâs acceptable and what limits we have and whatâs not acceptable. So, give me a quick example of a boundary. We all seem to have an acceptable â well, with COVID, it may change in the future â but an acceptable distance to speak, right? If someoneâs too close to you, youâre going to step back, maybe put your hand up. People generally know that boundaries, and society will have these same kinds of boundaries with what the expectations are. Behaviors and roles and set limits, which establish reasonable, safe and permissive ways for others to see and interact with each other. Boundaries are enforced. Therefore, boundaries include a response when personal boundaries are violated, which notify the other party of the problem and reset or redefine the acceptable boundaries. Again, somebodyâs talking too close, we might put our hand up. We might step back or lean back. Thatâs a way for us to let them know theyâre invading our space, which means theyâre actually violating our boundaries.
Families maintain boundaries with other systems outside of the familyâs influence. A good example would be school. With the schools, they maintain a certain level of boundaries. Individual family membersâ interaction with the outside world â the way the family, as a whole, interacts with the outside world. These are all the different systems I was talking about. How does the family or individual in the family system interact within these families or these other systems, like school? It could be work, social gatherings. It could be community sports â whatever it is, the boundaries are all there, and we all interact differently with those boundaries and try to find whatâs acceptable. But also what guides us is our families and whatâs acceptable within those boundaries.
Family boundaries are very based on how open or closed the family is to non-members and systems outside of family unions. So, if itâs a closed family, theyâre not bringing anybody inside. Iâm half Italian. You think of the tight, âYou keep that in the family, we donât share that, that stays in the family.â Very private, right? So, thatâs closed. They may be open in other ways, but thatâs closed. So, keeping everything very, âWeâre not talking about family issues with anyone else.â And open family â theyâre more open and itâs like theyâre willing to share, which means that theyâre more open to having different types of relationships and closer relationships outside of the family. Close family, they tend to stay very tight-knit and their close relationships tend to be within the family.
So, when I look at a family disease, thereâs roles that tend to happen. I donât have time to get into that today, but what we can talk about is the family rules. When weâre talking about a family who has addiction within the family, the rules dictate the behavior in the home and, to a point, outside the home, as far as whatâs shared. So, these are the typical rules, right? âItâs a secret we want to keep. Donât think for yourself, donât name, donât challenge, donât trust, donât feel, donât ask for change.â These are all ways to keep things as they are, which is comfortable. These are all unwritten rules. Itâs not like a family puts it on the refrigerator: âYou canât do these things.â But in a family with addiction, there is a tendency â especially if theyâre in one of the earlier phases that I discussed â there is the tendency that you will get some kickback and some resistance and some anger and resentment because you are moving the homeostasis and they donât want you to do that. So, âfamily problems should stay in a family,â which influences how family members do or do not reach out for help. It is discouraged, typically, within the family to reach out for help. Thatâs not something that often happens. Somebody may reach out for help, but typically, the family unit has a tendency to try to prevent that from happening because itâs going to change the dynamic within a family.
What can somebody do who finds themselves in this situation, or what can you do if you have a family member that is struggling with substance and family members that are struggling as part of that system? Well, the first thing you do is maintain fair, firm and consistent boundaries and expectations. What that means is theyâre fair, theyâre meeting expectations and boundaries. They know what is expected. Itâs very clear. Youâre sticking to it and consistent. Youâre always enforcing those, especially with somebody who does have a substance use disorder. Consistency is so important; if you want to help that person, they need these boundaries.
You also want to promote healthy and appropriate emotional expressiveness. Promote healthy and appropriate emotional expressiveness. So, we want to reduce the emotionality. We also want people to actually talk. We want to help them to not criticize one another. How can we speak? How could you express yourself in a way where you could say, âI am not comfortable,â or, âI donât like whatâs happening,â without criticizing the other individual? Often, we suggest using âIâ statements, meaning you start the sentence with, âI feel this way when this occurs.â We want to validate each personâs feelings with frequency whenever itâs possible. Validation is a powerful tool, and itâs interesting â you can validate somebody, even when you think theyâre completely inappropriate and out of line.
If youâve got somebody thatâs an adult throwing a tantrum like a child, and youâre thinking to yourself, âThis is ridiculous,â thereâs one way to validate that person that can get them to drop their guard. Lower their emotion just a little â maybe enough to be able to process what youâre saying. What I like to say to those people is, âI can see how extremely upset you are.â I am validating your feelings, but I am not validating their behaviors, okay? Iâm not suggesting itâs okay. Iâm simply validating that I can see how upset you are about whatâs happening. I may not think they have a good reason to be upset, but I can still validate what I see. And that is a powerful tool that often gets people to calm down because theyâre like, âYeah, you kind of get it.â And then you may be able to get what you need from them or to speak to them in a way that maybe can lower their guard and their emotionality further.
We also want to utilize protective factors, which is to identify strengths and resources within the family. Every family has a strength; it could be resiliency. It could be, you know, whatever. Whatever that strength is, we want to look at it and build off of the strength. There may be strong leadership from somebody within the family that we can kind of look to to lead through this, and someone that the other family members look to as a leader, so theyâre more apt to follow them. If we can help them with healthy communication and healthy behaviors, that may be a way to help the rest of the family. We want to build off whatever the strengths are. We want to confront each other without being confrontational. So, what does that mean? We want to focus on the issue. You confront it, but you donât have to come at them in an emotional way. Again, you can use the âIâ statements: âI was very disappointed or very hurt by your behavior when you did this.â Iâm confronting them in an inappropriate way. We can encourage open communication and active listening. What we mean by active listening is that youâre participating. If someoneâs saying something you agree with, thereâs a head nod. There may be some questions. Maybe you add to what theyâre saying â appropriately â and then we can maintain a safe and nurturing space.
After that, we have some resources on the sides for you â for families and for individuals. Childrenâs System of Care. Iâll let you guys look at this âcause I realize we have 10 minutes for questions here. Some other resources â I apologize, these are some of the counties from where I used to work. I actually wasnât even aware that there were gonna be so many out-of-state people, so forgive me for that. These, again, are county resources. These are some very basic resources for anyone â for families. And then my references. Iâll go back to that one, and those are some other websites and resources. So, thank you for your attention. Thank you for coming. Does anyone have any comments or questions?
It is 3:00 p.m. and I donât see any other questions in the chat, so Iâm just going to go ahead and throw my email in there. If you have anything you would like to follow up on, please feel free. Michael, if youâd like to do the same. Any additional questions, you can throw them his way. But I just wanted to say thank you so much for joining us again today. We host these events every Wednesday from 2:00 to 3:00 p.m. This Friday, we also have a continuing education event, so be sure to join us for that. But thank you, everyone. Hope you have a great rest of your day, and hang on for Michaelâs email. Thank you.
Thank you for watching this video. We hope you enjoyed the presentation.
The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.