1. ©2010 McGraw-Hill Higher Education. All rights reserved. Chapter 5 Substance Abuse and Family Systems

2. ©2010 McGraw-Hill Higher Education. All rights reserved. Families as Systems Systems seek balance Dependency causes imbalance

3. ©2010 McGraw-Hill Higher Education. All rights reserved. Families as Systems Healthy – balanced, open, flexible, predictable Imbalanced/dysfunctional – rigid, inflexible, unpredictable – Richard Fields thinks “dysfunctional” is too shame based and we should not use it. – Virginia Satir described a dysfunctional family system as a mobile that requires a delicate balance. She described functional communication as “leveling.”

4. ©2010 McGraw-Hill Higher Education. All rights reserved. Alcohol Family System Family Rules in an alcoholic or user family: 1. Don’t talk 2. Don’t trust 3. Don’t feel Carl Whitaker described a family as “the source of all kinds of electrical energy, with positive and negative voltages.

5. ©2010 McGraw-Hill Higher Education. All rights reserved. Rigid Family Systems Rules – Strict interpretation of the rules with no exceptions; inflexibility with no extenuating circumstances. The rules keeper (usually father) is exempt from the rules. Values – “There is only one way to do things and that is the right way – my way.” Things are always black or white, right or wrong. Motto – “Do it right, or else.”

6. ©2010 McGraw-Hill Higher Education. All rights reserved. Rigid Family Systems cont’d Communication – Linear, hierarchical. The father is usually dominant, powerful, and unapproachable. Mother softens the impact of father’s harshness. Drugs of choice – Alcohol and/or heroin,other sedative hypnotics and narcotic analgesics. Functions of drug – Suppress feelings, especially anger, and stay numb to the trauma in this family system.

7. ©2010 McGraw-Hill Higher Education. All rights reserved. Ambiguous Family Systems Rules – We have rules but we don’t enforce them, and we change them if someone is annoyed or inconvenienced. Values – Forever changing, based on the situation Motto – “Keep peace at all cost, avoid conflict.”

8. ©2010 McGraw-Hill Higher Education. All rights reserved. Ambiguous Family Systems cont’d Communication – Mixed messages that are crazy making. “Do what you know we want, without letting us know what it is we want.” Drugs of choice – Alcohol and/or heroin, marijuana and hallucinogens. Functions of drug – Suppress feelings of discomfort, kill pain, shut out reality and/or distort reality.

9. ©2010 McGraw-Hill Higher Education. All rights reserved. Overextended Family Systems Rules – Be productive, get busy, stay on the move Values – Look good, achieve, do it with willpower, feelings are for wimps Motto – “We can achieve anything we set our minds to.” “The right stuff.”

10. ©2010 McGraw-Hill Higher Education. All rights reserved. Overextended Family Systems cont’d Communication – Feelings are not expressed or integrated; decisions are based on results and what will please the parents. Drugs of choice – Cocaine, methamphetamine and other stimulants, alcohol Functions of drug – Keep on working/doing, even though feelings are not congruent with work or intimate relationships.

11. ©2010 McGraw-Hill Higher Education. All rights reserved. Distorted Family Systems Rules – Don’t let outsiders know we are crazy. Act as if we were a normal family, just a bit eccentric. Values – Maintain an illusion of normalcy, despite significant physical, emotional and interpersonal problems of the family. Keep outsiders guessing about us. Motto – “Aren’t most families like ours?”

12. ©2010 McGraw-Hill Higher Education. All rights reserved. Distorted Family Systems cont’d Communication – Mixed messages; parents and children are unavailable and have limited common perceptions of situations. Drugs of choice – Alcohol, hallucinogens, marijuana and inhalants. Functions of drug – Distort reality, which is already distorted, to try and make sense, or no sense, of it.

13. ©2010 McGraw-Hill Higher Education. All rights reserved. Styles of Communication (SATIR) Placaters – discount themselves Blamers – elevate themselves by discounting others Intellectualizers – discount their own feelings Distractors – distract from painful feelings, avoid conflicts

14. ©2010 McGraw-Hill Higher Education. All rights reserved. Family Roles (Wegscheider-Cruse) the family hero the family scapegoat the lost child – The one most likely to commit suicide the family mascot the chief enabler

15. ©2010 McGraw-Hill Higher Education. All rights reserved. Kinds of Enabling Behaviors (Charles Nelson) 1. Avoiding and shielding to sidestep issues 2. Attempting to control 1. E. g., by buying things to divert the addict from drug use 3. Taking over responsibilities 4. Rationalizing and accepting 5. Cooperating and collaborating

16. ©2010 McGraw-Hill Higher Education. All rights reserved. Imbalanced Denial Feelings – embarrassed, humiliated, shamed Defenses – minimization, rationalization Linkage to society – friends and relatives “maintain the denial” Motto – “normal family illusion” Goal – deny problem Family Systems

17. ©2010 McGraw-Hill Higher Education. All rights reserved. Imbalanced Anger Feelings – confusion, fear, anxiety Defenses – “raging and ragging”, control to chaos, trial & error Linkage to society – search magical solutions Goal – cover-up real issues and feelings Family Systems

18. ©2010 McGraw-Hill Higher Education. All rights reserved. Imbalanced Bargaining Goal - “maintain in chaos” Bargains – compromise values, love/hate – let go/hold on, avoid making a decision, confused – doesn’t know what is appropriate Depression/Feelings – feelings are experienced Acceptance – there is a problem, on road to recovery Family Systems