Families

1. Families A look at the impact of substance abuse and addiction on the family unit. By Emily Shields CEP 504 – Pr. Lisker November 15, 2012

2. The cycle of dysfunction • Research has shown that substance abuse is often linked closely with a lack of ability to form functional relationships with family • Traumatic childhood and adolescent experiences • Continued strained relationships with family of origin throughout adulthood • Negative relationship patterns in adult intimate relationships • Destructive parenting styles

3. Marriage & The Family Unit • Alcoholic families • Exhibit more negative communication • Engage in higher levels of openly expressed anger • Struggle to maintain functional roles and often display distorted hierarchy • Higher rates of divorce • Higher rates of physical, sexual, and verbal abuse of children than nonalcoholic families These apply to other types of addictions within the family as well….

4. Codependency “A relationship in which there is continued investment of self-esteem in the ability to influence-control feelings and behavior, both in oneself and in others, in the face of serious adverse consequences” (Johnson, 2003) • Construct versus reality “An unhealthy relationship in which a person who is closely involved with an alcoholic or addicted person… [and] acts in such a way as to allow the addict to continue the addicted behavior” (Gwinnel & Adamec, 2006) “Codependency is a problematic or maladaptive seeking of identity, self worth, and fulfillment outside the self” (Zelvin, 1997)

5. Codependency For more on Codependent coping styles and relationships, see p. 303 of Doweiko. Patterns The Rules of Codependency: • Codependents learn to measure self-worth by how successful they were in their caretaking behaviors • Self-esteem is fused with the relationship • Overlap of “normal” love relationship boundaries and codependency • It is not OK for me to feel. • It is not OK for me to have problems of my own. • It is not OK for me to have fun or a life of my own. • I’m not lovable. • I’m never good enough. • If people act crazy, I am responsible.

6. Enabling • Enabling refers to the behavior • To knowingly behave in such a manner as to make it possible for the person with an SUD to continue abusing chemicals. • “Dallas” Intervention | Episode: 156 • http://www.aetv.com/intervention/episode-guide/season-11/dallas-156#156 • Desire to protect the addicted family member • Social pressure • Stigma • Control • Acceptance of boundary violations • Enabling comes in many forms

7. The family unit Role reversal and conflict • “Parentification” • Financial stress, pressure to lend money to addicted family member • Arguing over taken, stolen, or sold possessions • Loss of trust and safety • Unwanted “visitors” • Disagreements between other family members • Lack of social interaction

8. Adverse consequences for the family Child abuse Aggression and domestic abuse • Irritability, verbal abuse, rudeness, criticism • Domineering or controlling behavior • Threatening, pushing, hitting, breaking furniture, throwing objects • Death

9. Effects of addiction on family members Physical effects Psychological effects • Poor sleep, exhaustion • Poor diet, loss of appetite • Hypertension, hair loss, migraines, back pain, palpitations • Injury as a result of domestic violence or abuse • Chronic anxiety, panic attacks, depression • Suicidal thoughts • Poor concentration • Hypervigilance • Low self-esteem • High-stress environments have shown to significantly impact the development of the limbic system (hippocampus, amygdala, and hypothalamus) with prolonged exposure.

10. Family support and therapy • Many family members need counseling for psychological, emotional, and physical abuse • Counseling is also needed for behavior modification and coping skills • Some clinicians advocate for a non-pathological model for treatment of families • Discard dated, biased, unsympathetic language and attitudes • Stress-strain-coping-support model (SSCS)

11. Resources Support Groups & Services Shelters • Nar-Anon: www.nar-anon.org • Family Addiction Outpatient ServicesStatler Towers, Ste 555, 107 Delaware Ave., Buffalo • Adult Child and Family Clinic at ECMC462 Grider St., Buffalo • Supportive Living – Council on Addiction Recovery Services201 South Union St., Olean • Women’s Shelters: http://www.womenshelters.org/cit/ny-buffalo • Cornerstone Manor150 E. North St., Buffalo • Buffalo City Mission Women’s Shelter100 E. Tupper St., Buffalo • Community Missions of Niagara Frontier Emergency Housing and Crisis Shelter1570 Buffalo Avenue, Niagara Falls • 24-hour PASSAGE Hotline: 285-6984

12. References • Doweiko, Harold E (2009). Concepts of Chemical Dependency - 8th Edition. California: Brooks/Cole. • Johnson, P. (2001). Dimensions of functioning in alcoholic and nonalcoholic families. Journal of Mental Health Counseling. Vol. 23, No. 2, April 2001, p. 127-136. • Orford, J., Copello, A., Velleman, R., & Templeton, L. (2010). Family members affected by a close relative's addiction: The stress-strain-coping-support model. Drugs: Education, Prevention & Policy, 1736-43. doi:10.3109/09687637.2010.514801 • Orford, J., Copello, A., Ibanga, A., Velleman, R., & Templeton, L. (2010). The experiences of affected family members: A summary of two decades of qualitative research. Drugs: Education, Prevention & Policy, 17(S1), 44-62. • Pasternak, A., & Schier, K. (2012). The role reversal in the families of Adult Children of Alcoholics. Archives of Psychiatry and Psychotherapy, (3), 51-57. • Schäfer, G. (2011). Family functioning in families with alcohol and other drug addiction. Social Policy Journal of New Zealand. (37), 135-151. • Weber, D. A., & Reynolds, C. R. (2004). Clinical perspectives on neurobiological effects of psychological trauma. Neuropsychology Review, 14(2), 115-129.