Family Addiction, Intervention, and Structured Family Recovery

Flashcards covering relationship dynamics, enabling models, neurological impacts of chronic crisis, child protection, disease concepts, and Structured Family Recovery (SFR).

According to the text, what is the most critical foundation of a relationship, contrary to the common belief that it is love?

The answer is trust. While most people believe love is the most important factor, loving someone who is not trustworthy leads to disappointment and unhappiness because untrustworthiness cannot be ignored or covered up.

What is the difference between trust and trustworthiness?

Trust is a decision and a risk taken by the person offering it, whereas trustworthiness is an evaluation of behavior generated by the person being trusted.

According to Russell Hardin in 'Trust and Trustworthiness,' why can an addicted loved one not be consistently trusted?

The addicted person is losing the competency to be trustworthy, not the commitment. Competency is the core issue because addiction prevents them from consistently reciprocating.

Where does the moral burden lie in relation to promises according to Russell Hardin?

The moral burden is typically on promise keeping and being trustworthy, not on either promising or trusting.

What are four common ways families make decisions regarding trust with an addict?

1. Offering open-ended trust repeatedly despite broken promises.
2. Declaring distrust ('If I can't rely on you, don't expect to rely on me').
3. Trusting with the attitude that the addict should do what they are expected to do despite a low probability of follow-through.
4. Relying on the addict out of sheer circumstance or necessity (such as needing their paycheck to pay bills).

According to organizational advisor Philip Horvath, why is keeping personal agreements critical?

Keeping agreements made with oneself and others provides an internal foundation and identity; breaking an agreement with oneself reinforces the idea that one cannot trust oneself.

What constitutes an addict's 'enabling network'?

A collection of people, professionals, and/or institutions whose combined efforts unwittingly allow addiction to continue flourishing by helping the addict avoid negative consequences.

Why do families inadvertently enable addicted loved ones?

Families enable not only to save the addict, but to save themselves from crisis to crisis, putting out fires because the addict's crisis threatens the entire family system.

What lesson about enabling is illustrated by the story 'The Butterfly'?

A man snipped open a cocoon to ease the butterfly's struggle, but left it with a swollen body and shriveled wings because the natural struggle is necessary to force fluids into the wings for flight. His good intentions crippled the butterfly.

What is the core distinction between enabling and intervention?

Enabling focuses on the problem and handles secondary consequences, whereas intervention focuses on the solution and addresses the addiction as the primary problem.

What statistics illustrate the prevalence of alcoholism and substance use problems in the United States?

Alcoholism claims $1$ out of $10$ people in the general population, and $1$ out of every $3$ Americans is living with or related to someone with an alcohol or drug problem.

What is the fundamental myth regarding the control of substance use?

The myth that people can choose to use mood-altering substances and control whether they become addicted; no one foresees addiction, and the only certain prevention is abstinence.

What is 'innocent enabling'?

A type of enabling generated by a combination of love and denial, where family members help an addict out of messes without realizing that addiction is the true root cause.

In the case study of Robert, how did multiple community members act as innocent enablers after his car crash?

The police drove him home without ticketing him for drunk driving; the victims declined to press charges to avoid family embarrassment; and his parents paid for the car repairs without addressing his intoxication.

What defines 'desperate enabling'?

A stage that begins when denial breaks and reality combines with fear, prompting families to work overtime to cover up, pay debts, and clean up crises to keep the worst outcomes from happening.

What extreme measures did Ryan's parents take during their desperate enabling of his crack cocaine addiction?

They paid off threatening drug dealers, instituted a weekly crack allowance and gas money, replaced a car he traded to his dealer, put their home up for sale, and the father came out of retirement to pay mounting debts.

What diagnostic self-check question helps family members identify whether they have entered desperate enabling?

'Am I doing things today that five or ten years ago, I would have said I'd never do?'

How do John-Roger and Peter McWilliams describe the nature of fear in 'You Can't Afford the Luxury of a Negative Thought'?

Fear is not an actual wall, but an illusion and a feeling that cannot physically stop someone from moving forward unless they allow it.

According to internist Dr. Max Schneider, what physical and neurological risks do enablers face from toxic stress?

Higher incidences of gastritis, stroke, heart disease, insomnia, respiratory problems, anxiety, and depression; premature aging and wrinkling; cessation of new neuron creation in the brain; and increased risk of accidents.

What quote from Dale Carnegie illustrates the transition from enabling to taking steps toward recovery?

'Inaction breeds doubt and fear. Action breeds confidence and courage.'

How does the psychological drive of avoiding pain versus seeking pleasure create an enabling cycle?

Addicts use substances primarily to avoid pain, while family members enable to escape their own emotional distress; when enabling temporarily relieves family pain, it creates a conditioned reward that reinforces the behavior.

How does the Red Queen from Lewis Carroll's 'Through the Looking-Glass' apply to enabling?

Enabling is like running as fast as possible just to stay in the same place; as the disease progresses, families exhaust themselves trying to keep up, often ending up in a worse place.

What is detachment, and why is it insufficient on its own?

Detachment means stopping the management of the alcoholic's problems. It is insufficient alone because without an action plan to address the primary disease, spikes in fear will cause family members to abandon detachment and resume enabling.

What three core elements define structured family intervention?

Structured family intervention is fueled by love, focused on solving the core problem (the addiction), and composed of action.

What common behavioral coping roles do young children adopt when parental addiction goes unaddressed?

Children often blame themselves, try to take responsibility by being perfect, become the 'family clown' to dispel tension, get into trouble to divert focus, or isolate to avoid burdening the family.

How does toxic stress from familial addiction impact children's neurological development?

Because children's brains develop rapidly into their twenties, the toxic stress of addiction can cause permanent physical changes to brain development.

According to Miranda Featherstone's 'New York Times' article, why is open communication essential for children experiencing trauma?

A lack of explanation leaves children to their terrifying amateur imaginations, whereas language provides a symbol to contain experience, regulate emotions, and understand reality through repetition.

What specific program founded by Jerry Moe is recommended for children aged $7$ to $12$ affected by addiction?

The Hazelden Betty Ford Children's Program.

What three descriptive terms define addiction as a medical illness?

Addiction is a predictable, progressive, and chronic disease.

What does 'periodic control' mean during the progression of addiction?

Temporary intervals where an addicted person controls their substance intake, which can mislead loved ones into believing they have cured or mastered their problem, though it cannot be sustained.

What does it mean that chemical dependency is a 'chronic' disease?

There is no cure; once addicted, a person cannot return to non-alcoholic drinking. It can only be arrested/in remission ('Once you're a pickle, you can never be a cucumber again').

What single question helps determine whether a loved one is addicted to alcohol or drugs?

'Is my loved one experiencing repeated negative consequences in any area of her life due to alcohol or other drugs, and does she continue to drink or use anyway?'

How does chronic emergency stress affect family members' decision-making at the hormonal and neurological level?

Cortisol and adrenaline surge to narrow focus on immediate survival, diverting energy away from the thinking brain and higher-order tasks needed for long-term solutions.

What physiological cause accounts for the loss of willpower and motivation after exerting mental effort?

A depletion of glucose, which serves as the primary fuel for the brain.

What professional myth regarding families does the Love First model debunk?

The myth that 'families are sicker than the alcoholic' or inherently dysfunctional. Love First views families as awesome groups reacting normally while caught in crisis.

What is Structured Family Recovery (SFR), and when should the first meeting take place?

SFR is a program uniting the family and the recovering individual to support long-term recovery and prevent relapse throughout the first year of sobriety; the first meeting should occur within a week of the intervention.

Which two companion books guide families from intervention through the first year of sobriety in Structured Family Recovery?

'Love First' and 'It Takes a Family'.