Addiction inflicts damage to relationships with family and loved ones. It creates ruptures in trust and communication and can contribute to emotional instability, financial difficulties and lack of safety.
Repairing fractured family connections is a central goal of drug and alcohol rehabilitation. During treatment, rehabilitation facilities use family programs to give families and loved ones the opportunity to find healthy ways to support a person whose addiction may have caused them pain and suffering. Clients gain full awareness of the extent of the damage addiction has created in these relationships, and family members get to understand some of the common roles they may have played in the progression of addiction. Through family programs and family therapy, all parties are given a chance to feel heard, to hear others and appropriately interpret and understand their feelings. The knowledge gleaned from this rewarding process provides clients and families with essential insights as they work to make meaningful amends and move forward from active addiction.
Table of Contents
Family Roles in Addiction
When confronted with addiction, clients and their families often engage in reinforced patterns of behavior, usually without any conscious knowledge that they are doing so. This phenomenon in families was described in the 1960s and 1970s by psychotherapist Virginia Satir and others, then adapted specifically to by psychotherapists Claudia Black and Sharon Wegscheider-Cruse in the 1980s. It is therefore of critical importance that family members recognize which roles they may be assuming.
The roles that family members play include:
- The Addict: A person suffering from active addiction uses substances as a means of coping with difficult emotions or circumstances. The addicted individual tends to create chaos and tension within a family and avoids responsibility for doing so through denial, rationalization or other types of resistance.
- The Enabler: This family member tries to protect the addicted person from consequences and pain. This often occurs to the enabler’s own detriment, since enablers take on a large, exhausting role and tend to neglect their own self-care in the process. The enabler personality type often makes excuses for or justifies the behavior of the addicted, disproportionately assuming responsibility for the damage done by the addicted family member and thus keeping the addicted person shielded from the accountability necessary to recover. The enabler role tends to be the epitome of codependency.
- The Hero: These role players tend to be the “star” of the family, and — in an unconscious attempt to reduce the destructive force of addiction — achieve high levels of success and accomplishment. They try to represent the family’s best qualities to the outside world. Internally, however, this role tends to create perfectionistic tendencies and high levels of anxiety. These qualities also can lead to rigidity, poor communication and the inability of the hero to ask for help.
- The Scapegoat: Compared to the other roles, the scapegoat is a less passive-aggressive role. In the face of another family member’s addiction, scapegoats tend to become directly defiant, acting out in unhealthy ways for attention. As the name suggests, people in the scapegoat role can assume the polar opposite space of the hero, being underachievers and acting irresponsibly, sometimes even engaging in substance misuse as well.
- The Mascot: Mascots use humor to diffuse the tension and pain caused by the presence of addiction. Humor becomes a means of control and is used to gain attention, but it also results in emotional underdevelopment. As a consequence, those in the mascot role are usually immature. They do not often earn family trust and are viewed as poor decision makers.
- The Mediator: In this family role, individuals act as go-betweens to other family members. However, in their roles, they seek to stamp out anger and hostility, even when such emotions may be part of healthy communication. As a result, mediators tend to have a high tolerance for inappropriate behavior and tend toward self-sacrificing behavior and avoidance of conflict. The product of these tendencies can be deep wells of fear and unspoken resentments.
- The Lost Child: The primary defense against the chaos of addiction for the lost child is invisibility, and thus the lost child gets forgotten within the family. Those in this role become independent, immersing themselves in solitary activities. They ask very little of others, leading to unmet needs and low self-esteem.
These roles do not always cleanly divide between individual family members. Often, one person in the family assumes multiple roles (e.g., hero and enabler) or a single role may be played by multiple family members (e.g., children become the collective “scapegoat” in a family with an alcohol-dependent parent).
The Importance Of Family Involvement In Addiction Recovery
Both families and clients must navigate complex emotions during recovery. Feelings like guilt, resentment, loneliness, anger, jealousy, relief and resignation can all swirl within the family unit, sometimes going completely unacknowledged. Family therapy gives family members and friends space and permission to productively and actively voice these emotions.
As recovery creates changes in a person with an addiction, it also creates new dynamics within family structures that must be negotiated between family members. For example, a family member who had been in an enabling role (which unconsciously fulfilled a need) will have to gain more consciousness about the potential pitfalls of enabling behaviors and find a different way to engage their relatives. This family member would need to actively look for and root out codependent actions to reduce the risk of a return to the use of drugs and alcohol. Families must be able to make adjustments and challenge prior strategies that may have been adaptive during active addiction, but may not be helpful during early recovery.
Family Program Services
There are many ways to participate in the recovery efforts of a loved one. Treatment facilities often offer family counseling sessions and family weekend days where family members can meet clinicians and see what rehab is like for a person in recovery. During these times, members of the family can participate in therapy sessions and take on a more central treatment role.
Some of the many ways families can provide healthy input include:
- Participate in family Therapy: During family therapy, family members may engage in a wide range of activities that support themselves and their addicted loved one. Families can meet and talk with the treatment team, understanding the roles of the team, how treatment plans are formed and how the team provides insight and accountability. They can also participate in group therapy sessions, where they can learn healthy ways of expressing emotions and hear from other family members about their experiences. In some cases, families can even undergo private counseling sessions with their loved one to work through family dynamics.
- Improve Communication: Family members who are recovering from the sting of addiction must learn how to ask for what they need and negotiate conflicts without inflicting unnecessary damage. Positive communication first involves a willingness to express emotions honestly, and it can take practice before family communication improves.
- Set Healthy Boundaries: Better communication leads to the ability of family members to ask for what they need and say “no” when it is appropriate. Just as an individual in recovery must learn to recognize triggers for use, family members must also recognize situations where limits must be set on potentially harmful behaviors and where healthy boundaries may need to be held firmly.
- Rebuild Trust: When an individual with an addiction learns to be honest and transparent and begins taking responsibility for the damage caused by addiction, it allows for the family to begin the process of rebuilding trust with the individual. While the process is often fragile in the early stages and can be disrupted by dishonesty or by return to use, trust can be reinforced with continued dedicated efforts from both family and the person in recovery.
Convincing A Loved One To Get Treatment
Individuals in active addiction usually are not fully aware of the damage they have created and do not seek treatment until the consequences are too dire or urgent to be ignored. Families may need to serve as catalysts for convincing their loved one to seek treatment but may encounter significant resistance from an addicted person. Sometimes the family ecosystem has adapted so strongly to the unhealthy environment that families may not be aware of the extent of the problem. Legally binding and involuntary commitments to treatment are utilized in some circumstances, and the social pressure of staged interventions can also provide significant assistance in convincing an individual to seek treatment.
Supporting A Loved One In Rehab
People in recovery often receive a large morale boost when their families and friends are involved in their treatment. Such support is invaluable, but it also must remain healthy in its approach; support of a loved one in rehab involves recognizing when unhelpful patterns may be developing.
It is of critical importance for family members to learn to engage in healthy self-care. Family members who are able to do so are far better able to support their loved ones in recovery. At times, this support must come from an emotional distance, especially from family members who have been affected particularly negatively by addictive behaviors.
Recovering As A Family
Multiple studies show that family involvement in recovery efforts leads to longer stretches of abstinence, fewer instances of return to drug use and better psychosocial and treatment outcomes. The benefits of family involvement during recovery can extend far past the immediate episode of addiction treatment. Challenging the usual maladaptive modes of communication and helping the family replace them with healthier alternatives is a focus of much of the effort in family programs.
Who Can Attend Family Programs?
In addiction treatment, the word “family” is highly inclusive. It can refer to direct relatives of the person in recovery — spouses, partners, siblings and children — but it can also be expanded to include extended family, a close circle of friends or anyone else who is likely to have significant personal interactions with an individual in recovery from addiction. Any of these individuals can and should attend family programs when possible. The only true requirement for attending these programs is a desire to better understand the impact of addiction on family members and the addicted person.
Family Support Groups
Mutual support groups such as 12-step programs often play a major role in an individual’s recovery efforts, and they can be an integral part of family therapy as well. Groups like Al-Anon and Nar-Anon are structured to provide support to those with a family member suffering from an addiction. These groups can provide significant levels of support by:
- Modeling productive relationships
- Helping family members process their feelings about addiction and treatment
- Providing fellowship with those who can relate to the presence of addiction in a family
Finding Family Programs Near Me
Family programs are usually associated with a treatment facility, but can also be implemented as part of an aftercare plan at an independent practice. If your loved one is currently receiving treatment at a rehab center, the clinical treatment team will be able to guide you on how to best carry out and maintain family therapy. It is important to understand that the art of communicating with close family members about difficult situations is a lifelong, ongoing skill that needs to be developed, and family programs allow for such skills to be well-honed.
Family Programs At The Recovery Village
The Recovery Village encourages clients to involve families actively and thoroughly through the addiction treatment process. We help clients and their families become more effective communicators with each other. If you are looking to find a family program for addiction treatment or if you want to gain insight into the interplay between addiction and family dynamics, The Recovery Village can help. We understand how family and addiction treatment affect each other. Addiction is a family disease and healthy family relationships help create sustainable recovery.
Family therapy programs offer relatives the chance to communicate effectively and heal relationships that appeared irreparable before addiction treatment. By contacting us today, you can learn more about the family programs offered at The Recovery Village. If you are seeking substance use disorder treatment for yourself, you can also learn about our extensive treatment options. Give us a call today.
Satir, Virginia, et al. “Changing With Families.” Science and Behavior Books, 1976. Accessed July 26, 2019.
Black, Claudia. “It Will Never Happen to Me!” Ballantine Books, 1981. Accessed July 26, 2019.
Wegscheider, Sharon. “Another Chance: Hope and Health for the Alcoholic Family.” Science and Behavior Books, 1981. Accessed July 26, 2019.
Center for Substance Abuse Treatment. “Chapter 1 Substance Abuse Treatment and Family Therapy.” 2004. Accessed July 26, 2019.