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How Families are Affected by Addiction

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Title: How Families are Affected by Addiction


1
How Families are Affected by Addiction
  • Robert J. Ackerman, Ph.D.
  • Community Healing Centers/SPADA-WMU
  • Kalamazoo, MI
  • October 14, 2009

2
Un-Treated Chemically Dependent Family Assumptions
  • its not that bad yet
  • its their problem
  • cant talk about it!
  • the longer the substance abuse continues the
    more problems are blamed on the chemical
    dependency

3
  • nothing can change or improve as long as the
    substance abuse continues
  • if only the substance abuser would stop,
    everything would be OK
  • substance abuse stops, its over, cant talk
    about it!

4
Four Basic Assumptions Family Systems Model on
Addiction (Steinglass, 1987)
  • The family is a behavioral system in which
    addiction related behavior has become a central
    organizing principle
  • The introduction of addiction skews the family
    toward short term stability at the expense of
    long term growth.
  • The family gradually accommodates family life to
    the co-existent demands of addiction.
  • The types of alterations that occur in
    regulatory behaviors profoundly influence the
    overall shape of family growth and development.

5
Family Ritual Assessment Rituala customarily
repeated act or series of acts
  • Independent Rituals
  • Those rituals that are positively maintained by
    a family in spite of the addicts influence on
    the family.
  • Addicted Rituals
  • The replacement of positive rituals by negative
    ones in the presence of the addict.

6
Family Ritual Assessment
  • Co-dependent Rituals
  • Learned negative rituals due to living with
    addiction that are practiced even without the
    presence of the addict.
  • Recovering Rituals
  • The re-emergence of independent rituals and or
    the development of healthy family rituals with or
    without the sobriety of the addict.

7
ASSESSMENT OF FAMILY FUNCTIONING BEAVERS SYSTEMS
MODEL
  • Based on how well a family functions as a group
  • Family structure doesnt matter, ie. single
    parent, etc..
  • Emotional state of a family depends upon
    intimacy-power-control

8
Family Functioning Levels
  • Level 5 Families
  • Severe Dysfunction
  • most pain, chaos, no clear authority figure,
    members focus on side issues that are usually a
    problem, avoid real problems, 8 of American
    families
  • Level 4 Families
  • The Borderline Family
  • more functional, but is run by a tyrant who
    insists on her or his way and tells, members to
    what to think, do, and feel, 24 of families

9
Family Functioning Levels
  • Level 3 Families
  • Midrange Families
  • members live by a series of internalized rules,
    actually the rules rule them, too much role
    performance behavior, guilt, intimidation., and
    manipulation is what keeps members in line, not
    their own wishes
  • Level 2 Families
  • Adequate Families
  • rules are consistent, clear authority figures
    (parents), flexible

10
Family Functioning Levels
  • Level 1 Families
  • Optimal Families
  • same as above, but members feel a strong sense of
    belonging and acceptance
  • Beavers W.R. (1982). Healthy, midrange and
    severely dysfunctional families. In F.
    Walsh(Ed.), Normal Family Processes (pp.45-66).
    New Guilford Press

11
(No Transcript)
12
Why Survivors of Dysfunctional Families Are Not
All the Same
  • 5. Gender implications and
  • interpretations
  • 6. Age and developmental factors
  • 7. Cultural considerations
  • 8. Off-setting contributing factors

13
Why Survivors of Dysfunctional Families Are Not
All the Same
  • 1. Degree of dysfunction and the
  • parental role
  • 2. Type or kind of dysfunctional
  • parent/s
  • 3. Different reactions to stress
  • 4. Personality and perceptions

14
Family Dimensions with Chemical Dependency
  • PERCEIVED ISOLATION
  • I guess at what is normal.
  • I feel different from other people.
  • I have difficulty with intimate
  • relationships.

15
  • INCONSISTENCY
  • I have difficulty following projects through to
    the end.
  • I look for immediate as opposed to deferred
    gratification.
  • I manage my time poorly and do not set my
    priorities in an way that works well for me.
  • SELF-CONDEMNATION
  • I judge myself without mercy.
  • I have difficulty having fun.
  • I take myself very seriously.


16
  • CONTROL NEEDS
  • I overreact to changes over which I have no
    control.
  • I am either super responsible or irresponsible.
  • APPR0VAL NEEDS
  • I constantly seek approval and affirmation.
  • I am extremely loyal even in the face of evidence
    that
  • the loyalty is undeserved.
  • I lie when it would be just as easy to tell the
    truth.

17
  • RIGIDITY
  • I lock myself into a course of action without
    serious
  • consideration to alternate choices or
    consequences.
  • I seek tension and crisis and then complain.
  • I avoid conflict or aggravate it, but rarely deal
    with it.
  • FEAR OF FAILURE
  • I fear rejection and abandonment, yet I reject
    others.
  • I fear failure, but down grade my successes.
  • I fear criticism and judgment, yet I criticize
    others.
  • Adult Children of Alcoholics The Effects of
    Background and Treatment on ACoA Symptoms R.
    Ackerman E. Gondolf, International Journal of
    the Addictions, 26(11), 1159-1172, 1991.

18
Major Areas of Concern for Children of Addicted
Families
  • Worrying about the health of the addicted
    parent.
  • Being angry and upset by the unpredictability
    of the addicted parent and the lack of support
    from the non-addicted parent.
  • Worrying about fights and arguments.

19
  • Being scared and upset by violence or the
    threats of violence.
  • Being upset by a parents deviant behavior.
  • Being disappointed by broken promises and
    feeling unloved.
  • Feeling responsible for their parents
    drinking/drug taking.

20
Unspoken Rules of Troubled Families
  • 1. Be in control at all times.
  • 2. Always be right, do the right thing.
  • 3. If something doesnt happen as planned, blame
    someone or yourself
  • 4. Deny feelings, especially the negative or
    vulnerable ones like anxiety, fear, loneliness,
    grief, rejection or need.

21
Unspoken Rules of Troubled Families
  • 5. Dont expect reliability or consistency in
  • relationships.
  • 6. Dont bring transactions or disagreements
  • to completion or resolution
  • 7. Dont talk openly or directly about
  • shameful, abusive, or compulsive behaviors
  • in the family

22
Recovery Lag
  • not all individuals/families are affected the
    same way
  • not all parts of the individual/family will need
    intervention
  • not all individuals/family will respond the same
    way to treatment
  • not all personal or family issues/problems will
    recover at the same rate
  • not all members of the family will need the same
    amount of support
  • not all individuals/families will recover to the
    same degree

23
Strength-Based Recovery
  • Victim
  • List the ways that you feel
  • or believe that you have
  • been victimized
  • 1.
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.

24
  • Victim Missing
  • List the ways that you feel As a result of being
  • or believe that you have victimized what did
  • been victimized you miss?
  • 1. 1.
  • 2. 2.
  • 3. 3.
  • 4. 4.
  • 5. 5.
  • 6. 6.

25
  • Victim Missing Change
  • List the ways that you As a result of being How
    you would
  • feel or believe that you victimized what like to
    be
  • have been victimized did you miss?
  • 1. 1. 1.
  • 2. 2. 2.
  • 3. 3. 3.
  • 4. 4. 4.
  • 5. 5. 5.
  • 6. 6. 6.
  • The most important element is Choice

26
Identifying strengths needed for change
  • Identify the behaviors/talents you used to cope
    with dysfunction.
  • Identify the strengths you learned from
    surviving dysfunction.
  • Which strengths can you use in other
    functional/dysfunctional situations?
  • How did you learn self-care and what strengths
    can you use now to increase and maintain your
    physical, emotional and spiritual health?
  • What are your cognitive (thinking) and emotional
    strengths today?

27
Fundamental Strategic Goals for Strength-Based
Models
  • Recognize and build on existing strengths in
    individuals, families, and communities.
  • Build new strengths in individuals, families,
    and communities.
  • Strengthen the larger social environments in
    which individuals, families, and communities are
    embedded.
  • Engage individuals, families, and communities in
    a strengths-based process of designing,
    implementing, and evaluating interventions.

28
Family Risk Factors
  • FRF
  • (Family Risk Factors)
  • FPF FRF
  • (Family Protective Factors) (Family Recovery
    Factors)
  • DFR
  • (Degree of Family Resiliency)

29
Resiliency in the Family System
  • The property of the family system that enables
    it to maintain its established patterns of
    functioning after being challenged by risk
    factors.
  • The familys ability to recover quickly from a
    misfortune, trauma, or transitional event causing
    or calling for changes in the familys patterns
    of functioning.

30
Central Concepts in Family Resilience (McCubbin,
et.al.)
  • Family Vulnerabilitythe family systems
    susceptibility to deterioration and dysfunction
    in the face of risk factors
  • Family Crisisthe family susceptibility to
    continued instability, disorganization and
    dysfunction

31
Processes of Family Resiliency (McCubbin et.al.)
  • Adjustmentwhich involves the influence of
    protective factors in facilitating the familys
    ability and efforts to maintain its integrity,
    functioning, and fulfill developmental tasks in
    the face of risk factors
  • Adaptationwhich involves the function of
    recovery factors in promoting the familys
    ability to bounce back and adapt in family
    crisis situations.

32
The Impact of Gender in the Addicted Family
DYSFUNCTIONAL MOTHERS DAUGHTERS
SONS Role Models Image
Conscious Relationships with
Relationships with Women
women Parenting skills Protect
and defend Identity
Trust Trust
Emotional Incest Trying to please Shame and fear
33
  • DYSFUNCTIONAL FATHERS
  • DAUGHTERS SONS
  • Relationships Role Models
  • Role Confusion Not good enough
  • Intimacy Under-Fathered
  • Sense of self Lack of emotions
  • Sexual Abuse Just Like Him
  • Perfectionism

34
Goals in Family Recovery
  • To learn about the disease of addiction
  • To learn necessary skills about living with
    addiction
  • To learn how to support sober behavior
  • To learn how to discourage excessive alcohol and
    drug use
  • To learn how to communicate with the substance
    abuser and other family members in a positive
    manner

35
  • To learn that you have a right to recovery and
    to identify your own recovery needs
  • To learn how to support treatment for the
    substance abuser
  • To learn how to create or re-create a positive
    family environment
  • To learn that recovery takes time and not all
    family members will have the same issues and that
    not all family members will recover at the same
    rate
  • To learn to make decisions and responsible
    choices

36
  • To learn how to function socially in new ways
  • To learn how to establish relationships with
    friends, family and others
  • To learn how to follow a recovery plan
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