Substance Abuse and Family Systems Chapter 5 Substance Abuse and Family Systems

Chapter Objectives Describe families as systems. Describe the need for the entire alcoholic/addict family system to seek recovery. Explain the use of the term imbalanced instead of dysfunctional when describing maladaptive family behavior. Describe the family roles in an alcoholic/addict family system. Identify rules, values, motto, communication, drugs of choice, and functions of drugs in a rigid, ambiguous, overextended, and distorted family system.

Chapter Objectives Identify and describe the survival roles in an alcohol/addict and imbalanced family system (Wegscheider-Cruse model). Define enabling behavior and give examples of each of the five types of this behavior. Identify the stages of family recovery in an alcoholic/addict family system.

Families as Systems Looking at the family as a system is imperative in addressing the problem of alcohol/drug dependence and addiction. To effectively treat the alcoholic/addict, the rest of the family system also needs treatment.

Family Rules In an alcoholic/addict family system there is the “no talk, no feel, no trust” rule. Talking may cause more problems Trusting usually leads to disappointment Feeling is too painful, and expression of feelings is not allowed because it might cause more trouble.

Imbalanced versus Dysfunctional The term “dysfunctional” is frequently a shame-based, negative label, with a negative emotional tone. Replace “dysfunctional” with “imbalanced”, for this is what we truly are looking at – an imbalance in the individual, and family members’ lives.

Imbalanced versus Dysfunctional The term “imbalanced” gives hope that there is help and a way to better manage the system. There are different types of imbalance in family systems. Rigid Ambiguous Overextended Distorted

Rigid Family Systems Rules – strict interpretation of the rules with no exceptions. Values – things are always right or wrong. Motto – “do it right, or else” Communication – linear, hierarchical. Drugs of choice – Alcohol and/or heroin, sedative hypnotics, narcotic analgesics. Functions of drug – Suppress feelings, stay numb to the trauma in this family system.

Ambiguous Family Systems Rules – we have rules but we don’t enforce them. Rules can be changed. Values – forever changing, based on situation. Motto – “keep peace at all cost; avoid conflict.” Communication – mixed messages that are confusing. Drugs of choice – alcohol and/or heroin, marijuana, hallucinogens. Functions of drug – suppress feelings of discomfort, kill pain, shut out or distort reality.

Overextended Family Systems Rules – be productive, get busy, stay on the move. Values – look good, achieve, willpower, feelings are for wimps. Motto – “we can achieve anything we set out minds to.” Communication – feelings are not expressed, decisions based on what will please parents. Drugs of choice – cocaine, methamphetamines, stimulants Functions of drug – keep on working/doing

Distorted Family Systems Rules – don’t let outsiders know we are crazy. Values – maintain illusion of normalcy. Motto – “aren’t most families like ours?” Communication – mixed messages; limited common perceptions of situations. Drugs of choice – alcohol, hallucinogens, marijuana, inhalants. Functions of drug – distort reality, which is already distorted, to try and make sense, or no sense, of it.

Wegscheider-Cruse’s Survival Roles Survival roles describe the coping mechanisms members use to survive in a dysfunctional family Chief enabler Family hero Family scapegoat Lost child Family mascot

Chief Enabler Assumes primary responsibility for chemically dependent family member. Major enabling approaches Avoiding and shielding Attempting to control Taking over responsibilities Rationalizing and accepting Cooperating and collaborating

Family Hero The achiever, the responsible child, the good child, the model child. Often the firstborn, who escapes the dysfunctional aspects of family through personal achievement. Achieves for the family and ignores personal feelings, values, and goals. Is vulnerable to alcohol/drug problems and/or problems in interpersonal relationships.

Family Scapegoat Diverts the family members away from the real issues in the family and the painful emotions of these issues. Is blamed for all of the family problems. Often acts-out in school and at home, exhibits antisocial behavior and substance abuse due to underlying anger and resentment.

Lost Child Primary function is to allow the dysfunctional family – especially the parents – expend less energy. Often identifies with the pain of parents and siblings and wants to decrease the pain by not contributing to the problem. Denies feelings and needs, frequently disconnecting emotionally and physically from the family. Are at risk for suicide.

Family Mascot Diverts attention away from family issues and pain. Uses humor, silliness, and self-disparaging ineptness. Discounts a sense of self as a price to pay for calm in the family. Feels unworthy of love, unless able to alleviate someone’s pain.

Stages of Family Recovery The family goes through similar stages as the alcoholic/addict in breaking through their own denial systems and grieving the losses, and pain of living in an alcoholic/addict system.

Stages of Family Recovery The five stages of grieving (DABDA): Denial Will not acknowledge that something is wrong. Anger Keeps family from talking about problems/issues. Bargaining “If you will stop abusing alcohol/drugs, I’ll . . .” Depression (or Feeling) Feelings come to the surface and are easily accessed forcing the family to seek help. Acceptance Family recognizes that they have a problem.