Family Impact

Introduction

  • Family structures are diverse

  • When family members abuses substances the effects on the family may differ according to family structure.

  • Substance abuse has distinct effects on different family structures.

REACTIONS OF THE FAMILY BASED ON THE STAGE OF DRUG USE

At the Start

  • The family tries to deny the problem, although they  start to realize it exists. 

  • The user rationalizes and the family feels ashamed   they have reacted in an exaggerated manner to the problem. 

  • Conflicts begin, as well as a need to “control”

  • Anxiety and sleep disorders

Use Progresses

  • The family begins to isolate themselves out of fear and  shame.

  • The family struggles to maintain equilibrium, looking to the addict to recover and re-take his/her role in the family.

  • The family attempts to hide the problem.

  • Promises are made and self-respect decreases.

  • Increased fear, anxiety, and insecurity.

  • There are threats.

ADVANCED STAGES

  • The system becomes more disorganized and the family stops trying to control the member’s use.

  • The family is focused on alleviating the tension, accepting the blame for the drug use.

  • Communication is closed off among members.

  • Revenge can take place:  love affairs, overspending, pulling away from the family.

  • Depression, deterioration

FINALLY

  • The chaos becomes intolerable.

  • The role of the user disappears within the family.

  • An attempt to escape the situation can take place: a separation or divorce. If the user manages to get into recovery, the family can reorganize and accept him/her back into the system.

IMPACT OF SPECIFIC DRUGS

Cocaine

  • More impulsivity

  • High levels of mania or depression

  • Child negligence

  • Criminal activity

Alcohol

  • Parental lack of supervision, alternating with periods of appropriate care

  • Secrets in the family

  • Family not expressed in the family

Heroin

  • Criminal activity

  • Uninvolved parents, lethargy

  • The drug becomes the center of the family’s universe

  • Secrets within the family

PATTERNS OF INTERACTION LIKELY TO BE PRESENT

  • Negativism

  • Parental inconsistency

  • Parental denial

  • Miscarried expression of anger

  • Self-medication

  • Unrealistic parental expectations

FAMILIES WITH MEMBER WHO ABUSES SUBSTANCES

  • Client lives or with partner: can be economic and psychological

  • Might have anger, stress, anxiety, hopelessness, neglected health, shame, stigma, isolation

  • Codependency may arise:

    • describes overly concerned with the problems of another to the detriment of attending to ones own wants and needs.

    • It pathologizing caring functions

  • Clients that lives with spouse and minor child

    • Detrimental effect on children

    • Children may have to prematurely accept adult responsibilities

    • Positive outcome are possible

FAMILY SYSTEMS

  • Families may function with a system that is only understood by its members only.

Attributes:

  • Secrecy

  • Fear

  • Conflict

  • Role reversal

  • Emotional chaos

FAMILY DYNAMICS OF ADDICTION

Addict’s Family Survival Roles

  • Scapegoat

  • Lost child: isolated from the family

  • Mascot

  • Enabler: misguided in the belief that their actions are helping the addict

  • Hero

DYSFUNCTIONAL FAMILIES/FAMILIES WITH PROBLEMS

  • See a problem as if nothing can be done about it, so, “why try to resolve it?”

  • Have low self-esteem, hide their feelings, and use excessive self-control.

  • Use defenses to hide their pain.  More specifically, the defenses deny any real feelings.

  • Have unclear or inconsistent rules that depend on who imposes them, what day, which child they have to do with, etc.

  • There is not a safe environment to give opinions or express feelings.

  • Avoid pain and don’t notice it in others.

  • Parents compete with the children, they don’t accept   growth, and they don’t speak of sexuality.

  • There are clandestine coalitions, crossing generations. The coalition between parents is weak, rigid or vacillating. 

  • There is negativism, low levels of affect, arguments, not much anger control.

DRUG DEPENDENT FAMILIES

  • Are rigid with fixed ideas of right and wrong.

  • Give evasive responses, have low self-esteem, little responsibility and blame each other.

  • There are no alternatives – they react compulsively and rigidly with fear as their primary defense mechanism.

  • Rules are completely rigid or don’t exist at all.  There’s chaos – it’s impossible to follow the rules. 

  • Denial of stress, they cannot deal with anything else.

  • Denial of problems, they ignore them.  They have strange rules in which no one can speak of problems, even the most serious ones, especially the drug use.

  • They fear change, treat adults as children and children as adults.

  • There’s role confusion. The children are in charge and the   family is chaotic, and sometimes there is only one parent in   charge of everything.

  • Attitudes that doubt everything, open hostility, sadism, attempts to manipulate and hurt others.