Addiction and the Role of Family

1
Addiction and the Role of Family

• Marilyn G Stein
• MGS Consulting, LLC

2
(No Transcript)
3
Prevention efforts can

• Dispel myths about substance abuse. Assure family
  members that they are not alone.
• Provide information that helps families
  understand addiction.
• Tap into resilience and pro social coping skills
  for both parents and children by offering simple,
  concrete suggestions for coping that promote the
  use of innate resilience.
• Link to local resources. What does your community
  offer for children and

4
About Addiction

• Addiction is a chronic, progressive, primary
  disease of the brain that stems from an altered
  brain chemistry.
• If left untreated or mistreated, this disease can
  and will result in death.
• It is a disease characterized by denial and
  relapse.
• It is manifested by repetitive, compulsive use of
  substances (drugs, alcohol, food) or activities
  (sex, gambling) despite adverse consequences.
• It has strong genetic components.
• It cannot be cured and requires lifelong
  treatment.

5
A Brain Disease

• Drug addiction is a brain disease that develops
  over time as a result of the initially VOLUNTARY
  behavior of using drugs.
• For many people the compulsive use is truly
  uncontrollable.
• Similarly schizophrenics cannot control
  hallucinations
• Depressed patients cannot control their moods
• Addicts cannot control their use

6
Another Definition

• A pathological love and trust relationship with
  an object or an event.
• Craig Nakken,
• The Addictive Personality

7
The Progression of Addiction
8

• Every drug user starts out as an occasional
  user, and the initial use is voluntary but as
  time passes and use continues the drugs change
  the brain.
• Alan Leshner

9
The Reward Pathway

• The brain stem is in charge of all of the
  functions our body needs to stay alivebreathing,
  circulating blood, and digesting food
• The limbic system links together a bunch of brain
  structures that control our emotional responses,
  such as feeling pleasure when we eat chocolate.
• The cortex, known as the frontal cortex or
  forebrain, is the thinking center. It powers our
  ability to think, plan, solve problems, and make
  decisions.

10

• There are many doors into the reward control room
  of the brain.
• Food and sex are natural doors.
• Objects and events are chemical doors.
• Some doors to the control room are bigger and
  more easily opened. When the chemical door is
  bigger and opens more easily, addiction follows.
• The Selfish Brain
• Robert Dupont

11
About Genetics

• Whether teens engage in pathological
  relationships with objects or events is
  environmental
• HOWEVER
• Genetics and biology determine whether the
  behavior develops into addiction.
• Robert Dupont, The Selfish Brain

12
Like a Dog with a Bone

• The Dog
• Never wants to let go
• Pesters till it gets what it wants
• Never forgets
• Is easily reminded that it is could get another
  bone
• Really LOVES the bone

13

• Traits of a healthy family
• carry out basic functions
• provides emotional safety
• promotes individuality
• promotes continuity
• communicates effectively
• accesses support as necessary

• Traits of unhealthy family
• lack of safety
• poor boundaries
• ineffective communication
• mistrust
• extremes

14
The ideal childhood

• Kids from healthy families dont have to protect
  themselves externally so they get to go inside
  and see how they feel.

15
Impact of Addiction on the Family

• When a parent is addicted to alcohol, drugs, or
  processes, over time the entire family is
  organized around the addict and the emotional
  chaos he or she generates.

16
The entire family system responds

• When a family member is addicted, the whole
  family usually develops ways of coping with the
  problems.
• The family avoids talking about the issue, so
  there is less communication.
• avoids expressing emotions
• keeps the addiction secret from the community.
• Feeling is out of the question

17
The burden of trauma and neglect

• Early neglect, trauma and abuse predict future
  problems including borderline personality
  disorder
• All dysfunctional behavior patterns grow out of
  actions and attitudes that were supposed to solve
  a problem.
• How is this true?

18
Unhealthy Families

• Life in unhealthy families demand the skill of
  external self protection.
• The result is those from unhealthy families are
  unfamiliar with their internal landscape because
  it is scary.
• They look for external distractions that soothe
  their discomfort like cutting, sex and drugs.
• These distractions initially work but over time
  cause more pain.
• All dysfunctional behavior patterns grow out of
  actions and attitudes that were supposed to solve
  a problem.

19

• Adverse Childhood Experiences
• Childhood abuse, neglect, and exposure to other
  traumatic stressors which we term (ACE) are
  common
• The ACE Score has a strong and graded
  relationship to health-related behaviors and
  outcomes during childhood and adolescence
  including early initiation of smoking, sexual
  activity, and illicit drug use, adolescent
  pregnancies, and suicide attempts.

20
ACE is

• A study of the relationship of adverse childhood
  experiences to adult health status.
• In over 17,000 persons studied, results show
  addiction to be a readily understandable although
  largely unconscious attempt to gain relief from
  well-concealed prior life traumas by using
  psychoactive materials.

21
The Adverse Childhood Experiences (ACE) Study

• Recurrent physical abuse
• Recurrent emotional abuse
• Contact sexual abuse
• An alcohol and/or drug abuser in the household
• An incarcerated household member
• Someone who is chronically depressed, mentally
  ill, institutionalized, or suicidal
• Mother is treated violently
• One or no parents
• Emotional or physical neglect

22
(No Transcript)
23

• What was done to you?
• What wasnt done for you?
• Someone who was not allowed to be aware of what
  was being done to them has no way of telling
  about it except to repeat it. Judith Miller
• (See article Child Witnessed Domestic Violence)

24
Activity for use with Clients

1. List family members
2. Write 4 words that describe each family member
   listed.
3. Consider if each family member is a positive or
   negative influence in your life?
4. Will each family member listed support your
   goals?
5. How will you handle those who arent able to
   support your goals

25
CAGES

• 1.Have you ever wished that your parent
• would Cut down on his/her drinking?
• 2.Have you ever felt Angry about your
• parents drinking?
• 3.Have you ever felt Guilty about your
• parents drinking?
• 4.Does anyone in your family have Eye-openers
• (drink first thing in the morning)?
• 5.Does your family keep Secrets or tell lies

26
How do family members contribute to the problem?

• They Avoid Just keep the peace, take care of
  problems, dont upset anyone.
• They Minimizing Its not so badthings will
  get better when
• They Protect Protecting their image with
  co-workers and friendswhile we protect our own
  image.
• They Taking responsibility Hes hung over so
  Ill take out the trash, cut the grass, etc.
• They Act superior Treating the addict like a
  child.
• They Suffer If I can just be patient, things
  will get better. Or God will take care of it.

27
Symptoms of the Dis Ease

• Weak Boundaries
• Enabling
• Co-dependency

28
Personal Boundaries

• One's own body
• One's own possessions
• One's own space which surrounds the body and
  possessions
• One's own relationships (and roles) with others
• One's own internal space (emotional,
  intellectual, cultural, spiritual space)

29
Enabling behaviors

• What are they?Enabling behaviors are those
  behaviors that support our addicted loved ones
  chemical use.
• These behaviors let the addict off the hook.

30
Enabling sounds like

• Denial Expecting the alcoholic or drug addict
  to be rational or to be able to control their use
  is denial. Accepting blame for their use is
  denial.
• Using with the addict or alcoholic So we can
  watch them, limit their intake, make sure they
  dont drive drunk.
• Justification Agreeing with their
  rationalizations got a stressful job so he/she
  deserves two martinis after work.
• Keeping feelings inside We get our feelings of
  fear denied and we begin to keep our feelings
  inside.

31
Being in tune to your feelings and needs

• Are you focused on the addicted person rather
  than on your feelings and needs?
• Are you putting yourself aside in your attempts
  to help them?
• Are you abandoning yourself in your efforts to
  get them to stop abandoning themselves and
  harming themselves? Ask the family member If
  you focus on your own feelings and your
  responsibility for yourself, what would you be
  doing differently?

32
Co dependence

• Unhealthy relationships lead to co-dependence.
• Defined as Someone whose core identity is
  undeveloped or unknown. Someone who maintains a
  false identity built from dependent attachments.
• An addiction to security.
• Source Charles Whitfield

33
Are you co-dependent?

• If you were to ask yourself these questions about
  your family, what would be the truthful answers?
• Do my feelings about who I am come from being
  liked by you?
• Do my good feelings about who I am come from
  receiving approval from you?
• Is my mental attention focused on pleasing you?
• Is my mental attention focused on protecting you?
  
• Is my self-esteem bolstered by solving your
  problems or relieving your pain?

34

• Myth I can keep my loved one from drinking or
  drugging
• RealityYour loved one is sick. He or she has a
  disease. Youre sick, too. Its called
  CO-DEPENDENCY. Youre part of a denial system but
  you just dont know it. Youre in no position to
  "cure" your loved
• You can only control yourself. You cant control
  your loved ones addiction.

35
The three Cs

• You didnt cause it
• You cant control it
• You cant cure it.
• Abraham Twerski, MD

36
Resiliency

• The capacity to rise above adversity to be hurt
  and rebound at the same time. To keep hacking
  away at the thorny underbrush and moving through
  life.
• (Wolin, S. and Wolin, S. (1993).

37
Resilient children

• Find ways to feel good about themselves and life
  in spite of the powerful influence of their
  parents.
• Understand that everything is not their fault
• Internalize their successes they take own what
  goes right in their lives.

38
7 key resiliency

• 1) Insight - the ability to ask tough questions
  and give
• honest answers
• 2) Independence - the ability to separate
  emotionally and
• physically from ones troubled environment
• 3) Relationships - the ability to develop
  fulfilling
• relationships with others to fulfill needs
• 4) Initiative - the ability to take charge of
  personal problems,
• set goals and be productive
• 5) Morality - the ability to seek a fulfilling
  personal life,
• demonstrate ethical conduct, and possess
  self-respect
• 6) Creativity - the ability to impose order and
  beauty on
• the chaos of troubling experiences and feelings
• 7) Humor - the ability to resolve conflict and
  heal pain
• through humor
• Wolin and Wolin (1984)

39
Protective factors, which support aresilient
personality

• Consistent behavioral limits,
• Praise,
• Encouragement,
• Approval,
• Guidance,
• Physical affection
• Companionship (Needle, 1983).
• PANDORA'S BOX

40
Key Factors of Resilient Kids

• Future focused
• Strong sense of identity
• Ability to be flexible
• Willingness to see through a different lens
• Sense of purpose

41
Resources

• Addictive Thinking Abraham Twerski
• Co dependent No More Melody Beattie
• Facing Shame Marilyn Mason
• In the Realm of Hungry Ghosts Gabor Mate, MD
• The Four Agreements Don Miquel Ruiz
• The Addictive Personality Greg Nakken
• The Places That Scare You Pema Chodron