Families and Addiction: Navigating the Pathways of Dysfunction
By Brian M. Wind, PhD
Do You Come from a Dysfunctional Family?
Many people struggle to answer this question. In the course of having discussions with my patients about their families of origin, I secretly know the real answer to the above question about family dysfunction. Unless the patient with whom I am having this discussion is exceedingly rare, the patient’s honest answer should be,
“Yes, my family was dysfunctional.”
Lest this strike some readers as offensive, a disclaimer should be provided: there is a broad spectrum of dysfunctionality when it comes to families. On one end of the spectrum are families for whom a rather benign level of dysfunction exists, while others on the opposite end of the spectrum have a glaring, pervasive, and damaging level of dysfunction. The difficulty lay in determining where a family falls on the spectrum of dysfunctionality. Many people make the fatal mistake of assuming that the façade of functionality exhibited by one family is fair to compare to their concrete knowledge of the dysfunctional inner workings of their own family.
The only perfect family is one that no one knows.
A Hypothetical Case of the Smith’s
Take, for example, a hypothetical family – the Smiths. Mr. Smith is an alcoholic, and Mrs. Smith is severely codependent. The relationship began years ago with a “sizzling” dance of sorts, with codependent Mrs. Smith being drawn toward the exciting, charismatic, and alcoholically predisposed man in her life. As time progressed, Mr. Smith’s predisposition toward using alcohol as a primary method of coping transitioned to his meeting criteria for a diagnosis of alcohol use disorder, and Mrs. Smith’s codependent traits became increasingly glaring.
Together, they make a decision that having children would “fix” their problems, and may serve to stifle the dysfunctional nature of their marital relationship. Much to their dismay, they discover the reality that having children does not, in and of itself, provide a solution to the problems in their relationship.
Over time, and through perseverance in their tumultuous relationship, the Smiths produce four children. Now with multiple children in the home, the chaos in their relationship has reached a climactic point. The alcoholic patriarch of the family is frequently absent secondary to his alcoholic behavior, and when he is present, the family often wishes he were gone. Mrs. Smith has become the “chief enabler” of her spouse, often covering for him, all the while despising his behavior and longing for “the good old days” in which their relationship was exciting and she felt loved.
One of the main tasks in Mrs. Smith’s day-to-day life has become creating the façade that all is well in the family, while maintaining a couple of close friends who hold her up as a martyr for tolerating her alcoholic husband’s behavior. The codependent relationship between this Mr. and Mrs. Smith has become as stormy as ever.
Lack of Bonding Leads to Inadequate Attachment
Along the way, and as a result of the enmeshment of the couple’s turmoil ridden relationship, the Smith children begin to inherently receive a message that they must not be worthy of their parents’ time, attention, and love. After all, the first “fiduciary” relationships we as human beings are supposed to establish is with our parents. In fact, the lack of an established bond that should occur as part of these fiduciary relationships has been shown to be the driving force behind inadequate attachment, a la Ainsworth’s (1964) Attachment Theory.
Establishing a healthy bond is next to impossible when a father and mother are emotionally unavailable for their children, secondary to being enveloped in a tumultuous marital relationship.
Chronic and Toxic Shame Follow
As a result of an inferior bond with their parents, the Smith children feel less than adequate, traumatized, and by way of the adverse childhood experiences associated with their dysfunctional household, these children develop a sense of chronic and toxic shame. Tragically, this sense of shame is likely to remain with each of the Smith children to some degree throughout the course of their lives.
The Development of Dysfunctional Roles
The children begin to develop into dysfunctional family roles, with the oldest child serving as the hero (who can do no wrong), the second child falling into the role of scapegoat (who can do no right), the third adopting the role of the lost child (who is most damaged by the family trauma), and the youngest child serving as the mascot (who deflects the family’s pain with entertainment). Each child adopts a dysfunctional family role, and over time these roles may adapt and change with the changing Smith family dynamics.
As the children progress through their formative years and develop personality traits, a pattern is seen in the traits they develop. Most often, they acquire traits such as:
- Emotional liability
The Effects of Dysfunction on Love and Work
As they enter their teen years and transition into early adulthood, these traits seem to impact the Smith siblings in two main areas – personal relationships and professional functioning, consistent with Freud’s idea that humans with psychopathology are impacted most in their ability “to love, and to work” (Glover, 1994).
The Smith children still carry the heavy burden of toxic shame, never feeling that they fully “measure up” to standards imposed by themselves and/or others. They suffer from chronic feelings of inadequacy, and seem to struggle in relationships. They feel most useful at work and may have a predisposition toward “workaholism”, people pleasing, and overachieving, or perhaps they “give up” on trying to demonstrate adequacy, and as a result become underachievers.
They are drawn toward codependent professions in which they are focused on tending to the needs of others, all the while subconsciously towing the heavy line of their adverse childhood experiences.
While the Smith siblings share personality traits, they begin to travel different pathways as part of their attempts to cope with their emotional pain. The dysfunctional pathways lead them in the direction of:
1. Staying the course of codependency – Because of the damage done via adverse childhood experiences, and the codependent traits they carry with them throughout the span of their adult life, these individuals ultimately follow the same course as their mother Mrs. Smith, choosing a mate who is highly dysfunctional;
2. Progression to addiction – Despite a solemn oath to avoid being like their father Mr. Smith, these individuals fall prey to the sense of ease and comfort provided by indulging in mood altering substances, sex, gambling, or a wide range of other high risk behaviors; and
3. Development of “psychopathology” – Secondary to the emotional damage sustained as part of the adverse childhood experiences endured in the Smith family household, these individuals develop mood, anxiety, trauma, and/or other psychological disorders.
Of note, the above-listed pathways are not necessarily mutually exclusive.
The Ripple Effect in Dysfunctional Families
Smith siblings may travel one or all of the above pathways of dysfunction throughout the course of the lifespan. At each sibling’s core – a codependent, traumatized child with a sense of toxic shame. This tragic reality is the result of the “ripple effect” of a family disease, and often can be traced back multiple generations.
Treatment is a Blessing
Sadly, many people like the Smith children will never make it to treatment. The prevalence of undiagnosed and untreated addiction and mental health disorders are staggering (NIDA, 2011).
For the fortunate few who make it to treatment, a skillful clinician is provided an opportunity to get to the “heart” of the problem, accurately diagnose the wounded soul entrusted to their care, and design a scientifically based treatment plan to address the core issues stemming from the dysfunctional family of origin. This, in essence, is the art form associated with treating addiction and co-occurring mental health disorders.
A Reintegration into New, Health Relationships
Sufficed to say, the above provides ample evidence that addiction (and co-occurring mental health disorders) is a family disease. As such, addiction must be treated from a family systems perspective, to the degree that this is possible. It has been hypothesized that addiction is the result of a complete disintegration of meaningful relationships, resulting in a sense of disconnect and isolation (Archon, 2017). If this hypothesis is true, then the “antidote” to addiction would be interpersonal connectivity, and responsible treatment of addiction and co-occurring mental health disorders should centrally involve a reintegration into new and healthy relationships.
This reintegration is at the core of the wellness movement for an individual in early recovery, with a recovery friendly network of relationships being of critical importance. Often, the family must be at the center of this network of relationships in order to optimize the chances for long term success in recovery.
At JourneyPure , the family is of central importance to our treatment process. Our family programming involves:
- Intensive weekend family programming
- Extensive psychoeducation regarding the family disease of addiction and co-occurring
mental health disorders
- Genogram work to explore the family history
- Experiential therapy to provide insight regarding family dynamics
- Integration of family members into the Recovery Support Team of JourneyPure Coaching, a
unique and innovative recovery coaching software program
Through diligent work, skillful clinical insight, and persistent efforts, JourneyPure’s family programming tools yield a beautiful reuniting of family members, and lay the groundwork for success in family recovery. Our patients return to life with deep, meaningful, and supportive relationships with their family members, and families are provided with the tools they need to heal core wounds, function in a healthy and adaptive manner, and end the cycle of disease that has plagued them for generations.