Families are tough enough as it is. When it comes to addiction and families, it can be a major morass. Untangling the triangles of addicted families can be a full-time job. Since one grows up in a family with a history and a present reality, as a child, one’s major frame of reference is the family constellation and the culture that goes along with it. It is rarely questioned even in teen-age rebellion, which is just a reaction to whatever has been.

Every day I talk with individuals who are in their 50’s and just figuring out that the mythology and culture of their youth does not serve them well. The loyalties and the dynamics of their family of origin, now being repeated in their personal lives and families, are faulty and untrustworthy. This is a trauma which leaves some people feeling empty, alone and out in space. 

When this existential betrayal is noted, the tendency is to cut off from the family because of the feeling that the emotional baggage of the family is too much to bear. Unfortunately, cut-off causes one to repeat the patterns of the past since the issues that caused the emotional distress are unresolved.

Individuals who suffer with addiction lose the time they have spent under the influence and are unable to do the emotional work needed to individuate and grow during times of active addiction. The “lost time” phenomenon creates major problems in families because everyone is in a different time warp.

The example that comes to mind is the addicted person’s attempts to rejoin the family after getting sober. Classically, the individual who is new to sobriety and recovery is attempting to “stay in today.” The other family members are living in the memories of the past when the addicted individual was using and creating chaos. The sober family is waiting for “the slip” or relapse behavior which triggers incredible anxiety in the family system. This anxiety is passed over to the recovering family member who is then more likely to relapse because of the scrutiny and fear built into the family system.

This is where family therapy and Al-Anon come in. The anxiety of potential relapse has to be put on the table and faced as a real problem rather than an unspoken fear that is tip-toed around. The concept of boundaries and powerlessness on the part of all family members has to be introduced and discussed if there is to be real progress.

The people that taught me therapeutic interventions talked a lot about surfacing toxic issues and getting the elephant in the room recognized. It is much easier to ignore or skirt around what everyone is worried about but no one will verbalize. Families generally are very good at this charade. Not talking maintains the homeostatic mechanisms that keep the family just as crazy and dysfunctional as ever.

Individual change is essential. Who is willing to take the first step and stay on the path to healing?

About the Author

Joseph Troncale, M.D. FASAM
Joseph Troncale, M.D. FASAM, has been working in addiction medicine for 20 years. He is the Medical Director of the Retreat.

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