Saturday March 25th 2017

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Healing the addicted family: What is family addiction therapy?

By Harold Clifton Urschel III, M.D., M.M.A.
Chief Medical Strategist, Enterhealth

Recovery isn’t only for the addict!

Q: Do family members of addicts need treatment?
A: Without a doubt! Even though many people who care about an addicted loved one may not be aware – they need therapy too.

Among the most important things to understand about addiction recovery is that the person struggling with addiction isn’t the only one who needs to recover. Continue reading this article to learn what families of addicts need help in understanding. We’ll also outline the healing process for families. At the end of the article we welcome you to post your questions.

Is it really just the addict’s problem?

Does addiction affect the family? Addiction does not affect one person in a vaccum. It affects EVERYONE around them. In fact, the out-of-control and unpredictable nature of these behaviors puts a huge amount of stress on family members. Additionally, the family members often develop unhealthy coping skills to deal with the stress, which must all be unlearned if they are to begin healing and return to a normal life. What’s worse, these behavioral changes arose over the entire course of the addiction, so most family members often don’t even recognize that there’s a problem.

However, after years of living with someone with a brain injury from an addiction to drugs or alcohol, families are usually broken, angry, confused and desperate for ways to help their loved one. Compounding this situation is the common belief that the patient is the sole problem and that their treatment is the only solution.

6 truths families of addicts should understand

It’s critical for families to understand the following:

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1. Your loved one’s sobriety won’t automatically solve the issues within the family that have been brewing as long as the addiction.

2. Normalcy won’t suddenly be restored after the person struggling with addiction gets better.

3. As much as the patient is addicted to drugs or alcohol, the family is addicted to the behaviors of addiction – meaning the reactions, excuses and the cycle of emotional distress that develops when dealing with a loved one who uses drugs or alcohol.

4. The built-up stress of living with a loved one battling addiction can cause dramatic changes in the brain chemistry of every member of the family. This can lead to a host of conditions including:

  • depression
  • anxiety
  • hypervigilance
  • insomnia
  • a constant state of exhaustion
  • isolation
  • high blood pressure
  • obesity

5. Research shows that the family of an addict does need treatment – and without delay. In some cases, family members even get caught in their own addictions as they develop unhealthy coping skills.

6. Your loved one is not purposely trying to cause the family pain. Addiction has a powerful hold on the addict and keeps the brain of the addict hostage for some time. When families understand that addiction is a chronic but treatable medical brain disease, they’re able to begin to better understand how to cope, address and interact with their loved one struggling with addiction.

How can families begin the healing process?

At Enterhealth, we urge families to simultaneously undergo treatment while their loved one receives the medical attention they need to get sober. We believe that educating families about addiction – including that the family needs help, too – is the first step in helping a patient’s family begin the healing process. So, the first step is to understand typical responses families go through, and to know that your situation is NORMAL. Here are ways that families typically respond when addiction is present.

When addiction enters your life: Typical family responses

Family dysfunction is an expected outcome of living with an addict. Addiction causes families to adapt in ways to survive. These new family dynamics and the feelings that accompany them are surprisingly destructive, and can cause any family to become dysfunctional. What do they look like?

1. Adapting to the dysfunctionality of addiction

Most family members have no inkling as to how much they’ve been affected by living with a loved one with an addiction. Over time, they’ve adapted to the erratic and chaotic behaviors caused by addiction – routines are constantly being interrupted by unexpected or even frightening kinds of experiences and reality is frequently bent, manipulated and denied in an attempt to maintain family order.

2. Resorting to maladaptive emotional responses

Living in intensely emotional environments may cause family members to feel overwhelmed and resort to dysfunctional interactions, shutting down and withdrawing in order to control the chaos. The family organizes around trying to manage the unmanageable disease of addiction, and works to maintain whatever harmony they can.

3. Taking the blame for a loved one’s addiction problem

It’s very common for family members to take their loved one’s addiction personally, meaning they start placing or accepting blame to justify the reasons their loved one is struggling with drug or alcohol addiction. These feelings of guilt and shame are what often stops the family from getting help.

4. Enabling a loved one’s addiction

In the early phases of addiction, family members want to believe the addict will stop using drugs or alcohol on their own. As the addiction continues to progress, the family unknowingly enables their loved one’s behavior, “until they can stop on their own.” The family of an addict can become so entangled in caring for their loved one’s addiction that they start losing track of taking care of themselves.

5. Covering up the issue instead of seeking treatment

Family members of addicts expend a significant amount of energy on caretaking and covering up the negative behaviors connected with addiction. The stigma attached to addiction also puts family members in a state of isolation. They tend to worry over who will find out about their loved one’s addiction and stress over how the addiction can remain a secret until the problem is “fixed.”

Symptoms from living with an addict

Some other common symptoms of family members affected by living with addiction include:

  • Difficulty managing anger
  • Isolation or withdrawal from friends and family
  • Excess irritability
  • Insomnia or excessive sleep
  • A constant state of exhaustion
  • An increase in health problems
  • Depression, anxiety, mood swings
  • Lower or a loss of self-esteem and self-confidence
  • Loss of interest in personal hygiene and appearance
  • Substance abuse in other family members

This is why getting the substance abuser sober is only the first step in healing. Everyone in an addicted family system needs help.

The Addicted Family: What can be done?

Most treatment programs only teach the family how to deal with the loved one experiencing the addiction, not how to heal themselves. If the family is left untreated, the individual in residential treatment will return to the same stressful, unhealthy environment with dysfunctional interactions, making relapse more likely.

Family members must learn three (3) critical ways of being:

  1. How to address their individual issues or needs
  2. How to heal as a unit, simultaneously with their recovering loved one
  3. New stress management techniques for healthy interaction and coping

At Enterhealth Ranch, we engage the entire family as we’re treating their loved one, helping everyone understand the dramatic ways they are affected by living with someone who has a serious but treatable addiction. Our goals are:

  • To reboot the family in a healthy way
  • To help them to heal by teaching them healthy stress management techniques
  • To teach them how to have helpful and clear conversations
  • To get people to re-connect with outside support systems
  • To relate to the loved one with clear and loving boundaries

For patients at Enterhealth Ranch – our residential treatment center – the following family treatment is included, averaging about five (5) hours a week, and is geared towards helping the entire family-unit heal:

  • Individual family member therapy with a PhD- or Masters-level therapist – in person, over the phone or via Skype
  • Family therapy with the patient
  • Multi-Family group therapy

For families who participate in individual and group family therapy, they can typically expect to see a healthier family dynamic within six months to one year. That may seem like a long time, until you consider how long a family has been living with the deteriorating ways of addiction in every aspect of their lives. Healing takes time, and Enterhealth wants families to know we are committed to helping families through the recovery process at every step.

Continued family therapy

More in-depth treatment is recommended for many families and can be scheduled through Enterhealth Outpatient Center of Excellence in Dallas. During both family group and individual therapy sessions, family members have the opportunity to share their experiences, concerns, as well as empathy with other families dealing with addiction.

Enterhealth believes these extra therapy sessions help families continue to heal by providing additional support from other families struggling with the same issues. Sharing these experiences in family therapy helps families come to the realization they’re not alone, which helps remove the stigmas associated with addiction, such as guilt, embarrassment, shame, etc.

Family therapy sessions also reiterate how important it is for families to stand by the boundaries and limitations put in place, how to love their family member during the recovery process and how to emotionally move forward and continue to heal as a family unit and as individuals.

Healing the addicted family

Want to learn more about the process of healing and therapy for addicted individuals and their families? Please leave your questions in the designated section at the bottom of the page. We welcome your feedback and try to provide a personal and prompt response to all legitimate inquiries.

Photo credit: geralt

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About Dr. Harold C. Urschel III, MD, MMA, Chief Medical Strategist

Dr. Urschel is Co-Founder and Chief Medical Strategist for Enterhealth, one of the finest residential and outpatient treatment programs in the nation. Known as one of the country's foremost authorities on substance abuse and addiction, Dr. Harold Urschel is the author of the New York Times best seller, “Healing the Addicted Brain.” He is a coveted speaker on substance abuse and the latest treatments of the chronic brain disease of addiction on both the local and national stage.

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