Families and Addictions

Saskatchewan Alcohol and Drug Services

Provincial Working Group

FAMILIES & ADDICTIONS

COURSE

A family is like a mobile: each person’s actions affect the others.

Reprinted with permission from

THE ADDICTIONS FOUNDATION OF MANITOBA

October 2003



VISION STATEMENT

We are a committee of Provincial representatives committed to providing networking, leadership, support and consistency

by developing, enhancing and evaluating services.

WORKING WITH FAMILIES SUBCOMMITTEE

The purpose of the subcommittee was to develop a model of providing clinical services to family members based on best practice evidence.

As part of the work of the subcommittee, the manual Families and Addictions Course, Addictions Foundation of Manitoba, September 2000

was selected as a resource for the use of Saskatchewan addiction personnel when working with family members. The manual is congruent with the

Saskatchewan approach to services for family members and with the principles of working with families as outlined by the subcommittee in their report to the

Provincial Working Group, September 2003. The manual incorporates currentresearch and materials for working with families affected by the substance use of a family member. The subcommittee recommends it as a resource to be used

in conjunction with the document Saskatchewan Alcohol and Drug Services:Motivational Assessment Process for Family Members, April 2002.

The subcommittee gratefully acknowledges the permission granted by AFM to reproduce this resource and trusts it will prove

useful to Saskatchewan addiction personnel.

The subcommittee welcomes feedback on use of the manual. Feedback may be directed to:

The Provincial Program Support Unit2003 Arlington Ave.

Saskatoon, SK S7K 2H6Telephone: (306) 655-4510 Fax: (306) 655-4545

Email to [email protected]



FAMILIES & ADDICTIONS

COURSE

A family is like a mobile: each person’s actions affect the others.

Reprinted with permission from

THE ADDICTIONS FOUNDATION OF MANITOBA

October 2003

FAMILIES AND ADDICTIONS COURSE

Purpose

To provide participants with a knowledge base of the addictive process in family systems and

the recovery needs of family members.

Objectives

Upon completion of this course, participants will be able to:

• identify the characteristics of an addictive process

• describe the survival behaviours and roles that are adopted by family members

affected by an addictive process

• describe how to conduct an initial family meeting

• identify recovery needs and goals for all family members

PWG2

TABLE OF CONTENTS

The Addictive Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

Definition of AddictionsFive Characteristics of AddictionDefinition of Co-dependenceThe Iceberg (A Unifying Model of Dependence and Co-dependence)Core Beliefs of Addictive ThinkingThe Dragon Named ShameThe Faces of ShameGuilt and ShameThree Processes of Addictive ThinkingThree RulesAddictive Thinking and Resulting Behavioural Roles

The Addictive Process and its Impact on a Family System . . . . . . . . . . . . . . . . . . . . .15

Definition of a Family System with an Addictive ProcessAssessing the Family DynamicsHealthy Versus Addicted Family SystemsUnderstanding Family RolesThree Generational Genogram

Recovery Needs and Goals . . . . . . . . . . . . . . . . . . . . . . . .25

Stages of Recovery for the Family

Appendices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29

BoundariesWorking with Family RolesSculpting a FamilySculpting ShameStructured Family InterventionRecoveryGenogram Construction

Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47

Print and Video

Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49

PWG 3

PWG4

THE ADDICTIVE PROCESS

Addiction destroys love as well as freedom. In the presence of our addictions

we’re not free to ask what we really desire.

Sam Keen

Definition of Addiction

The Addictions Foundation of Manitobacurrently uses the following definition foraddiction. “Addiction refers to an unhealthyrelationship between a person and a moodor mind-altering substance, experience, eventor activity, which contributes to life problemsand their re-occurrence.” (adapted fromT. Kellogg)

List as many substances, activities orprocesses that you can think of that couldbecome addictive:

Five Characteristics of Addiction

Addictions have five factors in common:

1. A compulsion to look to someone or something outside of self for safety, security and self-esteem.

2. Preoccupation with that substance or process to the extent that attention is diverted from other important priorities.

3. Loss of control over the use of the addictive substance or behavior.

4. A tendency to continue the behavior in the face of adverse consequences.

5. Significant personal losses or major life consequences.

Definitions of Co-dependence

“Co-dependence is a dysfunctional patternof living which emerges from our family oforigin as well as our culture, producing arrestedidentity development, and resulting in anover-reaction to things outside of us and anunder-reaction to things inside of us. Leftuntreated, it can deteriorate into an addiction.”

(Friel and Friel, 1988)

“An absence of relationship with one’s self.”(T. Kellogg,1985)

List some examples of co-dependentthinking and behaving:

Co-dependence

Co-dependence occurs:

• When we have an absence of relationship with self – if we are not aware or consciousof who we are, what we feel, what we think, what our values are, etc.. (If we don’t know these things about ourselves, we can never share them with another person.)

• When our behaviour is determined by someone else’s.

• When others rely on us to maintain their destructive behaviors and addictions.

• When we are subordinate to others and thereby not true to our own feelings.

PWG6

UNIFYING MODEL OF C0-DEPENDENCY AND ADDICTIONS

Co-dependency – (Identity & Intimacy Problems)

Guilt

Shame

Fear ofAbandonment

Ing

est

ion

Ad

dic

tio

ns

Ga

mb

ling

De

pre

ssio

n/A

nx

iety

Re

lati

on

ship

Ad

dic

tio

ns

Stre

ss-R

ela

ted

Dis

ord

ers

Pro

cess

Ad

dic

tio

ns

Adapted from Friel & Friel, 1988

ConsciousExperience(externalbehaviours)

UnconsciousExperience(internalprocesses)

PWG 7

Three Processes ofAddictive Thinking

I am not O.K. the way I am. There is a void that

needs to be filled.

There is something or someone external

to myself that will fill this void.

My happiness is dependent on finding

this substance, possession,person or activity.

Three Rules

There are three unspokenrules in a family systemwith addictive process.

They are:

…DON’T TALK(no honest communication)

…DON’T TRUST(no openness

about problems)

…DON’T FEEL(no expression of feelings)

Core Beliefs of Addictive Thinking

“I don’t know who I am without him/her/it.”(co-dependency – identity & intimacy problems)

“I have a vague sense that something is wrong.”(guilt)

“I am a bad, unworthy person.”“I am not good enough the way I am.”

(shame)

“I don’t need anybody.”“I will not survive if you leave me.”

(fear of abandonment)

PWG8

ADDICTIVE THINKING AND THE RESULTINGBEHAVIOUR ROLES

Roles:

Addict

Dependent

Offender

Under responsible

Distancer

Immature

Victim

Core Beliefs:

“I am bad”

“I do not deserve”

“Others are moreimportant”

“I can’t trust anyone”

Roles:

Co-addict

Co-dependent

Victim

Over Responsible

Pursuer

Psuedo-Mature

Offender

PWG 9

THE DRAGONNAMED SHAME

Shame as a Natural HumanEmotion:

Shame is an emotion which gives us permission to be truly human. Shame tells us our limits. Shame tells us that we needsomething from someone other than ourselves.Our shame tells us we are not God. Shame is the psychological foundation of humility.

Shame as a State of Being:

Shame can be transformed into a state of being which takes over one’s whole identity.To have shame as an identity is to believe thatone‘s being is flawed, that one is defective as a human being. Shame is an inner sense of being completely diminished or insufficientas a person. It is the self judging the self. A pervasive sense of shame is the ongoingpremise that one is fundamentally bad, inadequate, defective, unworthy or not fullyvalid as a human being.

Shame-bound Family Systems:

A shame-bound family is a family with a self-sustaining, multigenerational system of interaction with a cast of characters whoare (or were in their lifetime) loyal to a set of rules and injunctions demanding control,perfectionism, blame and denial. The patterninhibits or defeats the development ofauthentic intimate relationships, promotessecrets and vague personal boundaries,unconsciously instills shame in the familymembers, as well as chaos in their lives, andbinds them to perpetuate the shame inthemselves and their kin. It does so regardlessof the good intentions, wishes and lovewhich may also be part of the system.

(M.A. Fossum & M.J. Mason, 1986; J. Bradshaw, 1988)

FACES OF SHAME

PhysicalFeatures

Mental Features

BehaviouralFeatures

SpiritualFeatures

• warm face

• lowered eyes

• down-cast head

• muscle tension

• flushing neck and chest

• faltering energy

• self-criticsm

• belief that others agree with personal devaluation

• negativity

• expectation of ridicule and disdain

• thoughts compound shame

• disassociation

• addiction

• withdrawal

• perfectionism

• criticism (blaming others)

• rage

• crisis at the very core of existence

• disconnection from our true selves

• loss of sense of communion with others

• loss of connection with higher power

PWG10

GUILT

How could I have done that!

SHAME

How could I have done that!

Guilt:

a painful feeling of regret one has

about behaviour thathas violated.

I did . . . . .

I didn’t . . . .

Shame:

an inner sense of being diminished

or insufficient as a person.

I am . . . . .

I am not . . . .

PWG 11

SOURCES OF SHAME

Sources of Shame in Family of Origin

Sources of Shame in Our Culture

Parental Rejection

How we Shame Ourselves

Deficiency Messages

• deficiency messages

• parental rejection

• physical and sexual abuse

• family secrets

• parental perfectionism

• pressure to succeed

• conformity: focus on image and appearance

• prejudice and discrimination

• institutional shaming

• abandonment

• betrayal

• neglect

• disinterest

• automatic thinking

• habitual withdrawal

• isolation

• perfectionism

• self-hatred

• You are not good.

• You are not good enough.

• You don’t belong.

• You are not loveable.

PWG12

MAJOR RULES OF SHAME-BOUND SYSTEMS

Always do the right thing – be good, strong, right, perfect – make us proud.

Preoccupation with standards that keep changing.

Always be in control.

Use whatever you have to in order to stay in control.

Never talk about “it.”

And never talk about your problems.

Stay out of touch with feelings.

Feelings are not expressed openly.

Don’t rock the boat.

Do not communicate directly.

Don’t be selfish.

It’s not okay to play.

Do as I say – not as I do.

PWG 13

HEALING SHAME

Develop a caring relationship with someone who is trustworthy.

Shame is healed in group.

(Prolonged individual counselling may perpetuate shame.)

Name it.

(Recognition.)

Claim it.

(Stop the inner abuse.)

Tame it.

(Neutralize to counteract the toxic effects.)

PWG14

THE ADDICTIVE PROCESS AND ITS IMPACT

ON THE FAMILY SYSTEM

THE GOLDEN EAGLE

A man found an eagle’s egg and put it in the nest of a backyard hen. The eaglet hatched with the

brood of chicks and grew up with them.

All his life the eagle did what the backyard chickens did, thinking he was a backyard chicken. He scratched the earth for worms and insects. He

clucked and cackled. And he would thrash his wings and fly a few feet into the air like the chickens. After all,

that is how a chicken is supposed to fly, isn’t it?

Years passed and the eagle grew very old. One day he saw a magnificent bird far above him in the cloudless sky. It floated in graceful majesty among the powerful wind currents, with scarcely a beat of its strong golden wings.

The old eagle looked up in awe.“Who’s that?” he said to his neighbour.

“That’s the eagle, the king of the birds,” said his neighbour. “But don’t give it another thought.

You and I are different from him.”

So the eagle never gave it another thought. He died thinking he was a backyard chicken.

Anthony de Mello“The Song of the Bird”

Structure

Structure is the way the family is organized. It includes five components: rules,roles, rituals, hierarchies and boundaries.(Jacob, 1987).

RULES: Rules are the stated and unstatedguidelines for family function that becomeestablished and fortified by repetition. Theyexpress a family’s core beliefs and values aswell as a family’s defenses. (Brown, 1999)

ROLES: Role is the function performed bysomeone or something in a familiar situation,process or operation. Roles are expressedthrough repetitive behaviours and interactionswith other family members. (Brown, 1999)

RITUALS: Rituals are customs or family pro-cedures that establish and maintain a family’sidentity and contribute to cohesiveness.(Brown,1999).

HIERARCHIES: Hierarchies are ordered subsystems within the family that are definedby function and task. For example, parentsare at the top of the hierarchy and hold most of the responsibility for maintaining the family’s survival.

BOUNDARIES: A boundary is a border, an imaginary fence or line of demarcationbetween individual family members, betweensubgroups within a family (parents/children,boys/girls,etc.) and around the family itself.(Christian, 1997). Boundaries represent oursense of ourselves and our perception of how we are different from others physically,intellectually, emotionally and spiritually.

Process

COMMUNICATION: Communication is the exchange of information between familymembers. (Brown, 1999)

INTERACTIONAL PATTERNS: Interactionalpatterns refer to the dynamics of familymembers. Think of these dynamics as a dance(Brown, 1999). Imagine that the family is like a mobile. When one part of the mobilemoves, all other pieces are affected.

ASSESSING THE FAMILY DYNAMICS

Definition of a FamilySystem with an

Addictive Process

A family with an addictiveprocess is one in which the

environment or context of dailylife becomes dominated by theanxieties, tensions and chronictrauma of active addiction. Thesubstance or activity becomes

the central organizing principleof the family system, controllingand dictating core family beliefs

and influencing all aspects ofbehaviour, as well as cognitive

and affective development.

(Adapted from Brown & Lewis, 1999)

PWG16

HEALTHY VSADDICTEDFAMILYSYSTEMS

• clear, consistent • discussed• negotiable

• free movement between roles

• facilitates growth• source of pride

• regular, reliable, treasured

• parental responsibilities remain with parents

• stability, security• freedom to be a child

• clear• autonomous• respected• flexible

• direct• clear• effective• self-esteem enhancing• overt

• emotional closeness• relaxed atmosphere• spontaneous• openness, moderation• mature, reflective• trusting own perceptions

interpretations, beliefs

• unclear, contradictory• random, capricious

Don’t feelDon’t trustDon’t talk

• locked into one role • stunts development• source of shame

Hero, Scapegoat Lost child, Mascot, Co-dependent, AddictVictim, Rescuer, etc.

• non-existent or unpredictable• dreaded, associated with the

addiction

• role reversal• role confusion• improper balance of family• power, financial and emotional• burden

• blurred• intrusive/enmeshed• violated• rigid/wide-open

• indirect• unclear• ineffective• shaming• covert

• emotional distance• tense atmosphere• cautious• defensive, extreme• impulsive, out-of-control• mistrust of perceptions,

interpretations, beliefs• questions what is normal

Rules

Roles

Rituals

Hierarchies

Boundaries

Communication

InteractionalPatterns

Healthy Addicted

PWG 17

UNDERSTANDING FAMILY ROLESSharon Wegscheider-Cruse

You may recognize from your own experience the roles that follow. They occurin all troubled families, even occasionally in healthy families during times of stress.The chronic pain of the family with addiction leads to adoption of roles which aremore rigidly fixed and are played with greater intensity, compulsion and delusion.Family members adjust to the pain by hiding their true feelings behind predictablebehaviour patterns. We are talking about behaviour, not people. The role is not calculated behaviour – it is subconscious and its goal is to preserve the family system.Each role grows out of its own kind of pain and has its own symptoms, offers its ownpay-offs for both the individual and the family, and ultimately exacts its own price.

PWG18

THE HERO

This is an adult role assumed by a child in the family whose job is to provide self-worth, hope,

pride and success for the entire family. This childassumes this role because one or more of the parentsis not emotionally available due to their own dysfunction.

Appears

• Looks good • Has it made • All together

• Good natured • Successful • Considerate

• Popular •High achiever • Responsible

• Non-emotional • Over-involved

• Over-committed • Works hard for approval

• Compulsive caretaker • 9 years old going on 30

• Obedient • Rigid about rules

• Others come first • Intellectual

• Intolerant of non-achievers • Secretive

• Never satisfied with achievements

• Goals remain forever beyond today

• Quiet martyr, seldom shows anger with words, but it leaks through into behaviours

• Achievements attempt to make up for lack of parental nurturing

Feels: miserable, inadequate, hurt, confused,angry, afraid, unworthy of success, guilty.

“I will not feel for myself.”

“I must feel for others.”

“I will not upset the family or others.”

“I will take care of everyone, everything.”

“I can’t afford to make mistakes.”

“Everyone thinks this way.”

“I should be able to handle everything, anything.”

“I’m okay if I do good.”

“I’ll never give up.”

“I’m responsible for everything.”

“I really don’t needanything, anyone.”

“I won’t ask for help because I should know.”

“I will not have fun, if I don’t work, it doesn’t count, I won’t exist.”

“If I do play, I must win.”

“I will try anything to please you, because you must approve of me.”

“On the outside I will adapt, onthe inside I will trust no one.”

“You can depend on me.”

“I will grow up fast.”

Internalized Messages

PWG 19

THE SCAPEGOAT

This role is designed to provide a focus of attentionaway from the real source of family dysfunction

and to provide a target for all of the pain the familymembers feel.

Appears

• Counter-hero • Bad kid, the heavy

• Irresponsible

• Goof-off • Gets in trouble

• Doesn’t seem to care

• Withdrawn from family

• Relies on peers to provide belonging/needs

• Starved for attention

• Among the first to use chemicals, become sexually active

• Angry • “Born mad” • Low achiever

• Defiant • Dishonest

Feels: angry, fearful, lonely, hurt, rejected, hateful, jealous.


“I’ll show you.”

“I don’t need anyone.”

“I don’t value anything you value.”

“I won’t know what is inside me.”

“I won’t feel.”

“I don’t care.”

“I will never belong.”

“It will never be okay.”

“You can’t hurt me.”

“I won’t connect.”

“You’ll never get it right with me.”

“I’ll get even.”

“The books will never balance.”

“I can never win at your game anyway so I’ll play it my way.”

“I trust my friends, not you.”

“I won’t succeed.”

“I can never do enough.”

PWG20

PWG 21

THE LOST CHILD

Their role in the family is to offer the family relieffrom the problematic situation that having another

child in the dysfunctional system would cause. Theyoffer this relief by becoming invisible.

Appears

• Shy • The loner • Takes care of self

• Often over/underweight • Independent

• Aloof • Withdrawn • Avoids stressful situations

• Finds comfort in privacy of self

• Keeps a low profile

• Creates an imaginary reality where everything is perfect and safe

• Treasures pets, things • Conforms

• Placates • Controls by passivity

• Super-organized • Secretive

• Stress-related illnesses • Early sexual activity

• Early suicidal ideation

• Lacks skills for intimacy

• Greatest chance of being labeled schizophrenic

Feels: bad about self, hurt, angry, lonely, inadequate.


“I am invisible.”

“I don’t count.”

“The only one who will be there for me is me.”

“I have no worth.”

“I have no self.”

“I don’t exist.”

“I won’t be involved at all.”

“I won’t be seen or heard, ever.”

“I have to get sick in order not to die, Mom and Dad will then rally around me.”

“I’m afraid of everything, the world is so big.”

“What I can control is me, no one can get in unless I let them.”

PWG22

THE MASCOT

Their role in the family is to bring good feeling tothe family system. They are to provide comic

relief, fun and humour to an otherwise grim envi-ronment.

Appears

• Super-cute • Precious

• Parents like to show them off

• Does anything that will gain attention

• Develops stress-related illnesses

• Manipulates and controls

• Poor concentration • Poor learner

• Hyper-active, often medicated

• Charming • Dishonest

• Seldom taken seriously

• Inappropriate use of humour i.e. timing, targets

• Judged and treated as immature, thus development is retarded

Feels: fearful, insecure, confused, lonely, anxious, tense.


“If they laugh, they must like me.”

“I will stay little and cute.”

“I will adapt and put myself aside.”

“I aim to please, I’ll make you feel good about yourself.”

“I laugh instead of cry.”

“No one will ever like me if I am serious, they won’t take me seriously.”

“I’m helpless, I can’t think, I can’t decide.”

“Please don’t be mad at me.”

“I can fix it up with a little humour.”

“I am responsible for it.”

“I have to keep moving or no one will notice me.”

THREE GENERATIONAL GENOGRAMOF FAMILY WITH ADDICTIONS

• brain damaged• AA• Al-Anon• Church

• “failure”• overeater• “couldn’t save the

marriage”• covered up for

Robert• chose recovery after

failed marriages

• “bartender”• at 13 was defiant,

angry• “no faith in myself”• intimacy difficulties• alcoholic• later recovery

• “fixer”• protector of

younger and parents

• over achiever• actor• ACA group

• “dreamer”• fantasy world• avoided home• don’t talk• experienced

recovery issuesmore than addiction issues

PWG 23

Rigid Rules

• “big boys don’t cry”• don’t feel• work is most

important

•Scandinavian• strong work ethic

• English Baptist• “hot bed of emotions”

Be Be

Dick Robert Cindy Candy

Rigid Rules

• children should be seen and notheard

• don’t feel• don’t talk• cover up

• alcoholic

• alcoholic• military

service

• workaholic• doctor

• alcoholic

• alcoholics • alcoholic • workaholic• ACA

• violent arguments

Pam

PegWalt

The Subby Family

PWG24

RECOVERY NEEDS AND GOALS

The real voyage of discovery consists not in seeking new landscapes

but in having new eyes.

Marcel Proust

Like footsteps or a shadow, losses do not go away.

Recovery asks that they be acknowledged and assimilated.

Patty McConnell, 1986

STAGES OF RECOVERY FOR THE FAMILYBrown & Lewis, 1999

STAGE ONE: DRINKING

FAMILY FOCUS:• denial of alcoholism• denial of loss of control

of drinking

TASKS:• building therapeutic alliance• challenging denial• acknowledging realities of alcoholism• focusing on alcoholic behaviours and

distorted beliefs

STAGE THREE: EARLY RECOVERY

FAMILY FOCUS:• more congruent with primary

tasks of therapy if each family member is committed to recovery

• fragmented and defensive if one partner is in recovery and the other is not

TASKS:• to continue to learn abstinent behaviours

and thinking• continue focus on individual recovery• integration of new attitudes, behaviors

and thinking• stabilize individual identities• begin to work the 12 steps• detachment, family focus guided by individual

needs• re-establish and maintain attention to

children• maintain parenting responsibilities• establish supports outside the family

STAGE TWO: TRANSITION(includes end of addictive behavior and beginning of abstinence)

FAMILY FOCUS:• predominately defensive • to contain an increasingly out-of-control

environment • to hold existing system together • to maintain denial and all core beliefs that

sustain it• shift to abstinence

TASKS:• to break through denial • to realize that family life is out of control • to begin and continue a challenge of core

beliefs• to allow the addicted system to collapse• to shift focus from system to individual• to begin detachment and recovery for

individuals• to enlist outside support• to learn new abstinent behaviors and

thinking• to learn and practice relapse monitoring• to re-establish attention to children

STAGE FOUR: ONGOING RECOVERY

FAMILY FOCUS:• more congruent with the primary

tasks of therapy if family mem-bers maintain commitment to recovery

• fragmented and defensive if one partner is in recovery and another is not or if neither partner is in recovery

TASKS:• to continue abstinent behaviour• to continue to expand individual identity• to maintain individual programs of recovery• to add a focus on couple and family issues• to deepen spirituality• to balance and integrate combined individual

and family recoveries• to explore and work through issues of ACOA,

childhood and adult traumas

PWG26

A D

EV

ELO

PM

EN

TAL

MO

DE

L O

F R

EC

OV

ER

Y F

OR

TH

E F

AM

ILY

Bro

wn

& L

ew

is,

1999

ENV

IRO

NM

ENT

SYST

EM

IND

IVID

UA

LD

EVEL

OPM

ENT

DR

INK

ING

TRA

NSI

TIO

NEA

RLY

REC

OV

ERY

ON

GO

ING

REC

OV

ERY

Dri

nki

ng

Ab

stin

ence

Ch

ron

ic, a

cute

tra

um

a;

ten

sio

n, a

nxi

ety,

ch

aos,

inco

nsis

tenc

y, u

npre

dict

abili

ty,

ho

stili

ty, p

erva

sive

sh

ame,

gu

ilt, e

mp

has

is o

n c

on

tro

l

Un

safe

Alc

oh

ol i

s th

e ce

ntr

al o

rga-

niz

ing

pri

nci

ple

go

vern

ing

path

olog

ical

and

pat

hoge

nic

fam

ily h

om

eost

asis

; th

efa

mily

is d

om

inat

ed b

yd

efen

sive

acc

om

mo

dat

ion

sto

pat

ho

log

y; t

igh

t, r

igid

bo

un

dar

ies;

po

lari

zed

re

lati

on

s; a

dap

tati

on

Pro

du

ces

pat

ho

log

y; n

orm

alta

sks

of

fam

ily d

evel

op

men

tar

rest

ed; e

mp

has

is o

n s

ho

rt-

term

sta

bili

ty in

wh

ich

pat

ho

log

y is

no

rmal

ized

Un

hea

lth

y

Att

ach

men

t b

ased

on

mai

nta

inin

g p

ath

olo

gic

al,

pat

ho

gen

ic b

elie

fs,

beh

avio

ur,

and

aff

ect

tom

ain

tain

sys

tem

; sac

rifi

ceo

f in

div

idu

al d

evel

op

men

tto

sys

tem

s p

rese

rvat

ion

Inte

nsi

fica

tio

n o

f ch

ron

ican

d a

cute

tra

um

a; d

ang

er

Un

safe

In a

sta

te o

f co

llap

se; h

itti

ng

bo

tto

m; t

igh

ten

ing

of

def

ense

; rig

idit

y; b

ritt

le,

dan

ger

ou

s

Un

hea

lth

y

Sacr

ific

ed t

o p

rese

rve

end

ang

ered

sys

tem

; d

om

inat

ed b

y tr

aum

a;d

efen

ses

agai

nst

su

rren

der

;cr

acks

in d

enia

l; d

esp

air,

def

eat

Ch

ron

ic a

nd

acu

te t

rau

ma;

chao

s, c

risi

s d

om

inat

ed;

beg

inn

ing

‘tra

um

a o

fre

cove

ry’

Un

safe

Co

llap

se o

f sy

stem

; vac

uu

m;

‘tra

um

a o

f re

cove

ry’;

shif

t to

ext

ern

al f

ocu

s an

dsu

pp

ort

Un

hea

lth

y

Shif

t to

ind

ivid

ual

fo

cus,

wh

ich

has

pri

ori

ty o

ver

syst

em; s

hif

t to

ext

ern

alh

elp

, att

ach

men

t to

re

cove

ry; t

ime

of

inte

nse

dep

end

ency

; fee

ling

s o

f d

epre

ssio

n, a

nxi

ety,

aban

do

nm

ent,

co

nfu

sio

n,

fear

, do

min

ance

of

imp

uls

e

Mo

vin

g t

ow

ard

sta

bili

ty;

still

can

be

chao

tic;

ho

pe,

mix

ed w

ith

ten

sio

n, a

nxi

ety;

con

tin

uin

g ‘t

rau

ma

of

reco

very

’

Mo

vin

g f

rom

un

safe

to

safe

Rec

ove

ry o

rgan

izes

th

e sy

stem

(Ty

pe

I); s

plit

o

rgan

izat

ion

(Ty

pe

II);

no

rec

ove

ry o

rgan

izat

ion

(Typ

e III

); e

mp

has

is o

nse

par

atio

n c

on

tin

ues

; p

aral

lel l

ives

fo

cuse

d o

nex

tern

al s

up

po

rt a

nd

atta

chm

ent;

fo

un

dat

ion

o

f n

ew s

yste

m u

nd

erw

ay

Stab

le h

ealt

hy

or

mo

vin

gto

war

d h

ealt

h

Focu

s o

n a

lco

ho

l; re

cove

ry;

inte

nse

ed

uca

tio

n; l

ess

do

min

ated

by

imp

uls

e; n

ewid

enti

ty; s

till

con

fusi

on

;p

erh

aps

dep

ress

ion

, an

xiet

y;in

ten

se s

elf-

exam

inat

ion

,se

lf-d

evel

op

men

t

Stab

le, p

red

icta

ble

, co

nsi

sten

t; n

ot

org

aniz

ed

& d

om

inat

ed b

y cr

isis

or

trau

ma;

sup

port

s ab

stin

ence

;co

mfo

rtab

le, s

ecu

re

Safe

Stab

le, h

ealt

hy

new

sys

tem

;o

rgan

ized

by

reco

very

pri

n-

cip

les

(Typ

e I)

; cap

acit

y fo

rse

lf a

nd

sys

tem

fo

cus,

‘I’ a

nd

‘we,

’ wit

ho

ut

sacr

ific

e o

fei

ther

; po

ssib

le f

amily

sto

ry

Stab

le, s

plit

org

aniz

atio

n(T

ype

II)

Cap

acit

y fo

r co

up

le f

ocu

s,b

ut

no

t o

rgan

ized

aro

un

dre

cove

ry; h

ealt

hy

or

no

th

ealt

hy

Stab

le, d

ry (

Typ

e III

); n

o

syst

ems

chan

ge;

like

lyu

nh

ealt

hy

Stab

le in

div

idu

al r

eco

very

;b

ehav

iou

r, id

enti

ty s

ecu

re;

cap

acit

y fo

r in

terp

erso

nal

focu

s, c

ombi

ne ‘I

’ and

‘we’

Spir

itu

al d

evel

op

men

t; s

hif

tfr

om

ext

ern

al c

on

tro

l to

in

tern

al (

Hig

her

Pow

er);

inte

nsi

ve s

elf-

exam

inat

ion

,d

evel

op

men

t th

rou

gh

12

-ste

p p

rog

ram

, th

erap

y,re

ligio

n

Typ

e I C

ou

ple

:Bo

th p

artn

ers

are

acti

vely

wo

rkin

g r

eco

very

pro

gra

ms.

Typ

e II

Co

up

le:O

ne

par

tner

is a

ctiv

ely

wo

rkin

g r

eco

very

an

d t

he

oth

er is

no

t.Ty

pe

III C

ou

ple

:Nei

ther

par

tner

bel

on

gs

to a

rec

ove

ry g

rou

p.

STAGES OF RECOVERY FOR THE FAMILYBrown & Lewis, 1999

Drinking Transition Early Ongoing

Recovery Recovery

Environment

System

Individual

Development

PWG28

APPENDICES

A young Indian boy went to the villageshaman. The boy was troubled and said to the

elder, “Help me. There is a war inside my heart.Part of me wants to travel east, and another

part wants to travel west. What do I do?”

The old man nodded. The boy’s problem was afamiliar one. “Within each man,” the shamansaid, “lives two dogs. Both dogs are strong andfight for the man’s heart; one to go east, and oneto go west. The man chooses which dog will win

by deciding which dog he will feed.”

Author Unknown

BOUNDARIES

Boundaries are our sense of ourselves and our perception of how we are different from others physically,intellectually, emotionally and spiritually. Boundaries exist

for our protection. Our boundaries are not fixed; theychange with what we feel and the people we are with.

We get to know our physical comfort zones through our

physical boundaries. When wehave healthy physical bound-aries, we can determine how

and when we want to betouched, and who we will allow

to touch us. It means we givethat right to others.

Physical boundaries are most often violated by physical

violence, incest or neglect.Children who are touched

inappropriately by parents mustdeny their discomfort and

repulsion in order to survive theabuse in a family. If a father

makes sexual advances towardhis daughter, she’ll probably

learn to ignore the sensation ofher skin crawling, her stomach

tying in knots, and have to holdher breath in order not to feel.

Our bodies and emotions tell uswhen someone is violating ourspace. But many children with

alcoholic parents learn to distrust their senses and theiremotions. They often ignore

bizarre events and treat crises as if they were normal. Physicalboundaries are violated by phys-ical violence, incest and neglect.

A healthy intellectual boundary lets us trust how

we view the world. It allows us to know what we want and need, and helps us to sort out our desires from those of others. A flexible intellectual boundary lets

us accept information from the outside world

and look at it before we make it “ours.” Intellectualboundaries are blurred by

parents who too tightly controltheir children’s perceptions.Often, children who become

dependent on their parents tothink for them don’t developintellectual boundaries. This

kind of relationship encouragesdependency and discourages

responsibility. Intellectualboundaries are violated by

messages that say appearance is everything, good times

are enshrined/bad times are forgotten, you are crazy if youthink something is wrong here.

Physical Boundaries Intellectual Boundaries

PWG30

Emotional boundaries are formed early in our life and

are greatly influenced by thenature of the bond with our

parents. Emotional boundariesprotect us with an internal shield,

helping us determine where emotions are ours and letting

us deflect emotions that are notours. When we have healthy

emotional boundaries, we canhonestly determine our feelings

about any situation, person, placeor thing. If we take responsibility

for expressing our emotions and notice the impact of ourbehaviour on others, we havehealthy emotional boundaries.

Typically, when parents are irresponsible with their feelings, their children will

become irresponsible with theirs.If a father repeatedly rages

uncontrollably at a child, thatchild will inherit feelings of rage

and shame. The only way a child avoids this is to have

an emotional boundary.Unfortunately, young children

do not immediately possessboundaries. If the father were

to explain to the child that his rage was his own and hadnothing to do with the child’sbehaviour, perhaps this boy or

girl would develop an emotionalboundary. Emotional boundaries

are violated by role reversal, emotional incest, shame and

humiliation and enmeshment.

A spiritual boundary gives us thesense that we are not earthly

beings trying to become spiritual,but spiritual beings in humanform. This spiritual boundaryallows us to believe there is aPower in the universe greater

than ourselves. A healthy spiritualboundary lets us embrace our

humanness. When we grow upwith the notion of a Higher Powerwho loves us unconditionally, wefeel that we can make mistakes

and we’ll still be loved. Infants arenot born into this world hatingthemselves. Healthy children areable to give and receive love. It is the mutilation of our spiritualboundary that causes us to fallout of love with ourselves and

disconnect from our Higher Power.

Boundary confusion is also a problem. “Where do I end andwhere do you begin?” “What amI responsible for and what are youresponsible for?” The tendency isfor adult children in many situa-tions to become responsible foreverything. If something goeswrong, somehow it was their

fault. This can result in the personbeing in a constant state of guiltand anxiety, striving even harder

to “make things work.” Manyadult children enter the helping

professions and experience problems with clients, becomingover involved and not drawing

a clear line between the counsellor/client relationship. This is emo-tionally and physically drainingand these people (counsellors,

nurses, teachers) often suffer fromstress resulting in “burn out.”

Emotional Boundaries Spiritual Boundaries

PWG 31

BOUNDARIESRigid boundaries (too strong)Diffuse Boundaries (too weak)Flexible boundaries (healthy)

Rigid Flexible Diffuse

Intergenerational Boundaries

Family Boundaries

Dad

Children

Rigid

Children

Flexible

Children

Weak

Mom Dad Mom Dad Mom

Rigid Flexible Diffuse

PWG32

WORKING WITH FAMILY ROLES

Chemically dependent

• To be listened to with understanding and compassion• Establishment of trust (an ally)• Redirection from problems and issues to feelings• Release of feelings, especially rage• Basic information re: family systems and intervention• Honest feedback re: role behaviour and consequences• Group participation• Focus on own needs

• Appreciation of good qualities (who they are rather than what they do)• Establishment of trust• Basic information re: family systems and intervention• Honest feedback re: role behaviours and consequences• Permission to maintain role until improved self-esteem allows movement• Group participation

• Impeccable honesty• Genuine caring• Active listening to hurt, anger, self-hate• Respect• Education re: the characteristics of addiction• Strong continuing emotional support• Sense of belonging• Feedback on behaviour with no hint of blame• Practical guidance in resolving life problems• Group participation

• Warmth, openness• Caring• Patience• Gentle drawing out of isolation• Teaching of relational skills• To be noticed, individual qualities identified• Group participation

• Quiet, relaxed atmosphere• Consistency• Assurance that they are okay and have value• Information on things about the family that he/she needs to know• Professional help for emotional problems, learning disabilities• Group participation

ROLE NEEDS IN COUNSELLING

• Intervention

Mascot

Lost child

Scapegoat

Hero

Chief enabler

PWG 33

Sculpturing is a most useful tool in assisting persons to understand the dynamicsof relationships, as well as to experience non-verbally their internal processes and emotions.

Basically, sculpturing is putting people in physical postures that best demonstrate a given situation. You can sculpt any relation-ship you want to work with.

To do a sculpture depicting the dynamicsof family where there is addiction, chronic illness, secrets or extreme rigidity, the followingmethod may be used:

• Invite one participant to take the part of the identified problem (i.e. be the bottle of alcohol, the gambling, the secret, the workaholism, etc.). Invite this person to stand in the center of the room. Props, such as chairs, may be used in sculptures. If applicable, the use of alcohol as the problemoften speaks to the group members, as many come from backgrounds where therewas alcoholism.

• Invite another participant to be the addictedperson – have them choose what sex they wish to be – have them place themselves inrelation to the problem, asking them how close they would see themselves. Other group members may make suggestions. There is no right or wrong way of doing this.Wherever they place themselves becomes a starting point for teaching.

• Next, invite another participant to take thepart of the spouse or partner of the addict.As before, have them place themselves in relation to the problem and person, etc.

• Now, add (one by one and in birth order) fourpersons to represent the children in the family.

• Once this sculpture is complete, ask each participant, starting with the person with the identified problem and working down to the last child, the following questions:– What is is like for you right now being

in the place you are?– How are you feeling?– How do you see your relationship with

each of the other members of the family?

The teaching will come from the participants themselves. The facilitator, withknowledge of the role within such a family(hero, scapegoat, lost child, mascot, enabler),can build upon what is presented by the individuals involved. There is no correct wayto do the sculpture. However the sculpture is made, the input from the participants willshow the dynamics of the family.

The facilitator encourages observationsand questions from other group memberswho are not in the sculpture. Some things tonote are:

• who is close to whom• who is far away• who is pointing a finger• are there coalitions• who is below• who is above• any observations on looking at the family

In bringing the sculpture to a close, inviteparticipants for any other comments or obser-vations. Thank them for their participationand invite them to become themselves again.

Participants will have a tendency to moveinto the dynamics of their own feelings oforigin, or current family. They are encouragedto stay with their present experience in thesculpture, as time will be given following thesculpture for them to reflect on their ownfamilies.

A good way to move from the sculptureis to have individual group members reflectwith specific questions on their own role intheir family of origin and its effect on theirlives today.

SCULPTING A FAMILY

Before proceeding, invite participants tovolunteer for a role that is/was not their own(i.e. a first-born could choose to be a middlechild, the spouse of an addict could chooseto be the addict, etc.). This opens the oppor-tunity for participants to experience whatit is like to be in another person’s place.

PWG34

The great thing about a family sculptureis the flexibility it provides for the

facilitator to take from the experienceof the participants and teach whatever

dynamics of family systems is appropriate. The facilitator needs to

trust the process and the participants’knowledge and intuitive sense of

the dynamics of addiction in families.No two sculptures are exactly alike, as are no two families. In general,

the systems look alike and each familyhas its own particular personality.

Trust the process and be prepared to be surprised!

PWG 35

SCULPTING SHAMEExplain to the participants that we wish to do an experiential

exercise which will be to sculpt the emotion shame from theirown personal perspective. Request that the group arrangethemselves in pairs in various places in the room, but whereeveryone will be able to see each other. This exercise works bestif all participants take part and if there is an odd number – thenone group can have three people.

Once the group is divided into pairs, ask them to decideamong themselves who will be the “artist/sculptor” and whowill be the “clay.” Ask the artists to request permission from the“clay” if they wish to touch them physically. Now instruct theartists to place their clay in a position that depicts shame intheir minds. Wait and allow for questions, or circle through theroom and encourage individuals. After the artists complete theirtask, ask the “clays” to hold their positions for a moment.

Approach different sculptures and ask the individuals portraying them: “What does it feel like to be in this position?”“Does any part of your body hurt?” “What can you see withyour eyes?” “Who can see into your eyes?” Allow differentsculptures to explore their feelings. Be the observer with thegroup of artists as to what other features become obvious whilein this shame position.

Now ask the “clays” and the “sculptors” to reverse so thatthe other person is able to portray their experience of shame.Explore the same types of questions, encourage people to reflecton their experience of the “clay” and on the experience of the “artist.”

PWG36

Because many addicted persons do not“hit bottom” on their own, in the 1950s theJohnson Institute in Minneapolis developed a method of raising people’s “bottom” byconfronting them with data concerning theiruse. Historically, intervention in the addictionsfield has been a process of confronting anaddicted person and convincing the personto enter a treatment program.

Over the years, the AddictionsFoundation of Manitoba has modified theJohnson method to move the focus from the

addicted personto the family system. Movingfrom a sense of“confrontation”towards one of“invitation,” family membersenter into

a process of education which leads to anawareness of the dynamics of addiction in their family system. The family and its individual members, as well as the addictedperson, are invited into recovery.

In simple terms, “intervention” isdescribed as “to step in.” It is concerned people coming together to face their ownreality. Having processed their experience,they may decide to present this reality, in a receivable way, to the person in the familywho is experiencing an addiction. Becausethe family members have taken the time towork through their own issues and dynamics,any meeting with the addicted personbecomes an experience of sharing their grief at the loss of relationship, rather than a negative confrontation.

Family intervention is a process, not anevent. It is based on the belief that addictionis a family issue which calls for interventionand treatment for the entire system.Empowerment of any family member, or any constructive change in family patterns or functioning, means that intervention hasoccurred. Intervention is appropriate at even

the earliest stages of the addiction to reducesuffering and long-term effects on the family.

Some of the advantages of a systemsapproach to family intervention are:

• It helps the family to understand why individuals act the way they do.

• It forces everyone to think in relationalpatterns.

• It reminds the family that change in one part of the system affects the whole.

• It helps the family to understand resistance and, therefore, to honour it.

• It eases the notion of blame.

• It helps all to think of the problem within the broader context, including biological and social differences.

• It values experience and honours the fact that the true expert on the family is the family itself.

The goals of the family interventionprocess are as follows:

• To work with the strength and health of the family to increase motivation for familyrecovery.

• To convey the whole family message.

• To empower the family to change patterns that work against family recovery.

• To encourage family members towards long-term support.

• To facilitate entry into a treatment or mutual support program for all family members, including the addicted person.

• To address the common fallacies held by families in an addictive process. For example:– Family members don’t need help.

STRUCTURED FAMILY INTERVENTION PROCESS

PWG 37

– The one using or acting out must want toquit – the family has nothing to do with it.

– Treatment cures the addiction problem.– When addictive use or behaviour stops,

family problems stop.

There are six principles of interventionwhich are essential if the family decides to proceed to a meeting with the identified person:

• There must be concerned persons if a structured intervention is to occur. This process is not about hidden agendas, such as getting back for past misdeeds, venting of anger and frustration, etc. One of the reasons family intervention takes time and process is to allow family members to process and move through their own issues.

• The data presented at a structured intervention must be specific and clear. Generalizations, vague statements that include “you always,” moralizing, preaching,etc. have no place in an intervention. Intervention is about presenting informationin a manner that can be heard by a person who is usually defensive and out of touch with reality.

• The care and concern of family involved in an intervention meeting is usually what theidentified person remembers as significant. Individuals in an addictive family system

tend to holdemotions inuntil a toler-ance breakoccurs andthere is blaming andventing or

anger and frustration. The addicted person does not perceive this as coming from a sense of caring. A family who takes the emotional, psychological, spiritual and social risks involved in addressing the issue directly does so because of love and caring. The intervention meeting is a time for themto share this caring and concern directly and honestly.

• Intervention statements must be non-judgmental. Through time and process,

the family members have addressed the issues of defensiveness and self-protection they have needed to function in a system with addiction. In recognizing their own behaviours and reactions, they often move to a more clear understanding of addiction.They are more able to separate the person from the behaviours and stay simply with the clear data, refraining from lectures andmoralizing.

• For an intervention meeting to be effective,the family must have a plan of action.Rarely, in the life of the addicted person, is therea concrete plan of actionto address the issue. Physicians say: “You should do something about your drinking.” It is the rare occasion when this is followed by a referral to an addictionprofessional or agency. The family says: “Do something about your drinking – or else.” Rarely is this followed by a clear, specific request for recovery. What is differentin an intervention meeting is that the familyhas developed a clear, specific plan for the addicted person to get professional help (i.e. “We have a time and place and professional help available.”)

• Family intervention really is family inter-vention, and the plan of action for family members and the family unit comes in theirnew behaviour. Throughout the entire process,family members have been looking at the effects of addiction on themselves and their family, they have looked at their beliefs, defence mechanisms, roles, rules, communication and interaction. They have looked, and most of them have seen, how their lives have been externally referenced, how they have lost parts of themselves in trying to change what was not in their power to change. Having seen their lives more clearly, they want to make changes – changes for themselves and for their own well-being. In the initial method of structuredintervention, the focus was on a bottom-linefor the addicted person. In a family inter-vention, the focus is off the identified personand on individual and family health. A family

PWG38

member’s commitment to their own health and recovery usually has consequences for the addicted person, but it’s not about the identified person – it’s about all family members and the system.

Family intervention takes time, it is aprocess. It is very helpful if the initial meetingscan be multiple family groups. This providesan opportunity for families coming from isolation to address the don’t talk, don’t trust,don’t feel rules that have usually developedin the system. Often, it is easier for them tosee the dynamics of another family than tosee the dynamics of their own. Ideally, this is done in a minimum of four, two to threehour sessions. Many families decide at this

time to move on with their own lives, entering recovery programs of their own.Others decide to do their own recovery whileproceeding towards a structured intervention.Regardless of the path taken by a family,debriefing sessions are appropriate at theend of this particular process.

The role of the facilitator in the familyintervention process is to provide informationto the family; to facilitate the exploration of their family system; to model trusting,talking and feeling; to chair the structuredintervention if the family so requests; tomake appropriate referrals and to affirm thestrength, courage and resilience that broughtthem to the process.

One of the spin-offs of the structured intervention process isthat participants learn a simple way of communicating within theirown family system which can also be used in other areas of theirlives where difficult information needs to be shared. The process ofmaking an intervention statement can be used by those who arelearning new ways of communicating (i.e. learning to talk to oneanother.) The simple structure is as follows:

• CARE… “I care about what’s going on”

“I value our relationship”

• CONCERN… “I’m concerned about…”“I’m worried about…”

• SPECIFIC DATA… “What I saw (see)”

• MY RESPONSE… “What I feel about it”“How I am behaving in response”

• COMMITMENT “I’ve decided to look at…”TO SELF… “I need to…”

• INVITATION “It would be helpful to me if…”TO JOIN ME… “Would you consider…”

PWG 39

The goal of recovery is recovery of each person in the family. In the past, it has been assumed that only the addictedmember needs recovery and that the systemgoal is to preserve the couple or family unit.Recent research indicates that focusing onthe preservation of the family system caninsure the maintenance of the addictiveprocess. The collapse of the addicted fam-ily system is a necessary part ofrecovery and is facilitated byencouraging family members to focus on their own personalgrowth process by redirectingtheir energies away from theaddicted member. The depen-dent member needs to redirecthis/her energies away from the mood-altering substance or activity and towards healththrough a rehabilitation programand 12-step recovery work.Family members are encouragedto pursue their own healing through affectedpersons programming and 12-step recoverywork. Often, family members of a dependentperson will be the first from an addictivefamily system to seek help for themselves,and it is not essential for the dependent person to choose recovery in order for thefamily members to choose recovery. Ideally,all recovery occurs in a group setting whereunconscious issues around shame may beexplored and healed with witness.

Brown and Lewis (1999), who interviewed couples and families in variousstages of recovery from alcoholic family systems, remain strongly committed to thebelief that recovery is dependent on dissolutionof the system from the inside. The need forthe family system to collapse is central to theirwhole theory of recovery. “It is the collapse ofthe family structures and defense mechanismsthat protected and maintained the drinkingthat clears the ground for the transformativeprocess of recovery. As one family said, ‘You’renot just putting your life back together; it’s a new life’.” (p.19, Brown & Lewis, 1999).They discovered that seeking outside help(treatment programs, 12-step groups,

therapists, religious affiliation) facilitates the collapse of the unhealthy system andprovides stabilization during recovery.

Brown and Lewis were able to definefour stages of the recovery process for theindividual and also for the family. The stagesinclude:

• Drinking • Transition (hitting bottom & abstinence) • Early Recovery • Ongoing Recovery

Transition and EarlyRecovery stages can last as long as three to five years.They refer to three domains fortherapists to use to assess thefamily in recovery: environ-

ment, system and individualdevelopment. Environment refers

to the experiences of daily, routine familylife. A question one might ask to assess this is: “Is this a safe place, physically andemotionally?” System refers to how the partsrelate to the whole. Questions one might askare around defensiveness, rigidity, respect forautonomy, how responsibilities are shared, etc.Individual development refers to progressthrough 12-step recovery, security in personalidentity and ability to engage in interpersonalrelations.

Friel and Friel (1988) describe the recoveryprocess using the following basic principles:

1. Recovery is a process.2. Recovery cannot be done alone. 3. Recovery is painful. 4. Recovery means changes in how we feel,

how we act, and in what we believe.5. Recovery means getting out of our roles. 6. In recovery, we recover choices. 7. Recovery requires transcending paradoxes

(i.e. letting go of black and white thinking).

Sharon Wegscheider-Cruse (1981) suggeststhat the goals of all family members at theprimary stages of recovery are the same:

RECOVERY

PWG40

1. To let down the wall of defensiveness. Feelings of high pain are often sealed off from self and others. Caring and attentive listening is often the best tool in assisting persons to move through such defenses as delusion and denial.

2. To let the pain emerge. It is essential that family members be allowed to identify andfeel their feelings fully in an atmosphere of acceptance.

3. To begin to experience some positive feelings.Having moved through the painful feelings,family members will gradually come to life again, recognizing that feelings are life.

4. To accept the family issue and one’s own part in it. As part of the system, all family members have become part of the problem.An admission of this is essential to further recovery work.

5. To make a personal commitment to an Ongoing Recovery program for the family and for themselves. A personal commitmentis required to take the initiative for continuing care.

Claudia Black suggests that one approachto recovery is through addressing the threemajor rules in families with addiction: “don’ttalk, don’t trust, don’t feel.” Talking abouttheir own personal experience of life withoutfear of condemnation or lack of validation isimportant. For many family members, feelingsof disloyalty arise as they begin to share theirfamily secrets, but as long as the secrets remain,the addictive process continues. Beginning to identify personal needs and to articulatethem is a part of the recovery process.Learning to communicate in a clear manner is often completely new for families. Lack of trust is an issue that permeates the family,particularly the couple, during the early stagesof recovery. Recovery of trust begins withtrust in self – trust in one’s own perceptions,beliefs, intuitions, intellect, feelings, value,experience and boundaries.

In the initial stages of recovery, familymembers await a relapse, often resorting toold familiar behaviors around over-responsibilityeven while the dependent person is makinghealthy life choices (Bepko,1985). In thisTransition phase, confusion in roles is problematic for all family members as old roles

PWG 41

do not fit anymore and new ones have notyet been learned comfortably. A child may reactstrongly to a parent’s appropriate exertion of authority, experiencing new parental limitsas demeaning. (Brown & Lewis 1999). In families where only one parent embracesrecovery, there can be continued chaos, confusion and dissolution of the system anda less likely chance of system recovery. When

both parentsembrace recovery,children can havegreat difficultywith the drasticchange in reality.What was deniedbefore – thedrinking – is nowthe acknowledgedfocus of everything

(Brown & Lewis, 1999). Children of parents inTransition are at risk of further neglect as theirparents have to pursue individual workintensely in order to maintain recovery goals.According to Brown and Lewis, children needthe same kind of support that their parentsare receiving. This includes education aboutalcoholism that is appropriate to the child’sage, and opportunities to share their own feel-ings about what has been and is happening.

In Early Recovery, Brown and Lewisdescribe people as settling into new identitiesas an alcoholic and co-alcoholic and settlinginto abstinent behaviors. They state this isprimarily a period of intense education andsupport for new behaviors, as well as attentionto the self and individual growth. One partnermay still be ahead of the other, a differencethat may cause severe conflict or a growingdistance. Brown and Lewis noted that indivi-duals who each have a focus on the self reportthe greatest satisfaction as a couple in thisstage: they are busy and are no longer lookingto the partner for self-fulfillment. This distancecan be interpreted as marriage failure by thecouple or the counsellor, but most often it ispart of the normal process of recovery.

Many couples report that the stage of Early Recovery can last from three to five

years while they develop stability, predictability,consistency and confidence in recovery. Thecouple relationship remains secondary to theindividual focus, even though the couple maybe very involved with each other. The Type Icouple (both partners embracing recoveryprograms) experience living parallel liveswhere attachment to outside support takespriority. For the Type II couple (one in recovery,one not), the growth of one partner threatensthe other partner and conflict is frequent.Brown and Lewis noted that children mayremain frightened of the changes as theyexperience the joy of sober parents but stillfeel abandoned as the parents pursue theirrecovery programs. The Type III couple (abstinence but no recovery) report they feellike they are still living with an alcoholic inthe house.

Brown and Lewis report that the couplesthey interviewed in Ongoing Recoverydescribed this stage as a period of calm withstability, predictability and consistency. Thesecouples state they have come to realize thatrecovery is not an outcome but an ongoingprocess. The researchers describe the familyin Ongoing Recovery as settled into a newstructure with equity between partners, clear rules and roles, appropriate boundariesbetween parents and kids, open and honestcommunication, and having the ability to enjoy the realities of separateness andtogetherness. They also took note of theType II and Type III couples where recoverywas uneven between partners or whererecovery did not move beyond abstinence.Type II and Type III couples experience considerable pain as the conflict of livingwith two different realities is relentless.Growth is impeded and intimacy is obstructedby tension and mistrust. In families where bothpartners have embraced recovery programs,children are given a second chance. Parentsare able to acknowledge feelings, talk aboutrealities, valid past experiences and beempathic to their children. In couples wherethe recovery is uneven, children will continueto be affected by the conflict and will havedevelopmental delay due to their vigilantfocus on their parents.

PWG42

CONSTRUCTING A GENOGRAM

Male

Female

Unknown Sex

Adoption

Still-born –Sex unknown

Marriage with date shown

Divorce or separation

Common-law union

Death with date shown

1980 1962

PWG 43

EXAMPLES OF GENOGRAMS

Children of a marriage Eldest recorded first

Twins and siblings

Remarriage

M.D.

M. M.D.

PWG44

CONFLICT. The parties do not get along well. They are uncomfortable with each other, and there is tension (high or low) and nonverbal or opendisagreement most of the time.

CLOSE. Two people are caring, supportive and loving to each other.

VERY CLOSE. Two people have a “special” relationship characterized by overinvolvement (enmeshment). They are very dependent upon each otherand neither has a clear, separate identity; they are not emotionally separatefrom each other.

DISTANT. Emotional distance is evidenced by people who go out of their way to avoid or ignore each other. An indifferent attitude prevails.

CUTOFF. A definite breach has occurred and two people are estranged fromeach other. There is unresolved emotional attachment denied by separation,withdrawal, running away, isolation or refuting the still intense connection.There may be no contact, but there is still a very strong tie to a person.

ENMESHED AND CONFLICTUAL.

DISTANCES GENOGRAM SYMBOLS

Father Mother

PWG 45

PWG46

RESOURCES

Two monks were returning home in the evening to their temple. It had been raining and the road

was very muddy. They came to an intersectionwhere a beautiful girl was standing, unable to crossthe street because of the mud. Just in the moment,

the first monk picked her up in his arms and carried her across. The monks then continued on

their way. Later that night the second monk,unable to restrain himself any longer, said to

the first, “How could you do that?! We monksshould not even look at females, much less touch

them. Especially young and beautiful ones.”

“I left the girl there,” the first monk said. “Are you still carrying her?”

A Zen Story

Print

Bratton, Mary. A Guide to Family Intervention.Health Communications Inc., Pompano Beach, FL.1987. ISBN 0-932194-52-4

Bepko, Claudia with Krestan, Jo Ann. TheResponsibility Trap: A Blueprint for Treating theAlcoholic Family. The Free Press, New York, NY.1985. ISBN 0-02-902880-9

Brown, Stephanie, Lewis, Virginia. The AlcoholicFamily in Recovery: A Developmental Model. TheGuilford Press, New York, NY. 1999. ISBN 1-57230-402-2

Christian, Sandy Stewart, MSW (ed.). Working withGroups on Family Issues. Whole Person AssociatesInc., Duluth, MN. 1997. ISBN 1-57025-124-X

Dayton, Tian, Ph.D. The Drama Within:Psychodrama and Experiential Therapy. HealthCommunications Inc., Deerfield Beach, FL. 1994.ISBN 1-55874-296-4

Edwards, John T., Ph.D. Treating ChemicallyDependent Families: A Practical Systems Approachfor Professionals. Johnson Institute, Minneapolis,MN. 1990. ISBN 0-935908-56-0

Foster, Carolyn. The Family Patterns Workbook:Breaking Free from Your Past & Creating a Life of Your Own. The Putnam Publishing Group, New York, NY. 1993. ISBN 0-87477-711-9

Friel, John, Friel, Linda. Adult Children: The Secretsof Dysfunctional Families. Health CommunicationsInc., Deerfield Beach, FL. 1998. ISBN 0-932194-53-2

Friel, John, Friel, Linda. An Adult Child’s Guide to What’s “Normal.” Health Communications Inc.,Deerfield Beach, FL. 1990. ISBN 1-55874090-2

Fossum, Merle A., Mason, Marilyn J. Facing Shame:Families in Recovery. W.W. Norton & Company,Inc., New York, NY. 1986. ISBN 0-393-30581-3

Muller, Wayne. Legacy of the Heart: The SpiritualAdvantages of a Painful Childhood. Simon &Shuster, New York, NY. 1992. ISBN 0-671-76119-6

Potter-Efron, Ronald & Potter-Efron, Patricia.Letting Go of Shame: Understanding How ShameAffects Your Life. Harper & Row Publishers Inc.,New York, NY. 1989. ISBN 0-06-255411-5

Richard, Dr. Ronald W. Family Ties That Bind: A Self-Help Guide to Change Through Family ofOrigin Therapy. International Self-Counsel Press Ltd.,North Vancouver, BC. 1987. ISBN 0-88908-655-9

Satir, Virginia, Banmen, John, Gerber, Jane,Gomori, Maria. The Satir Model: Family Therapyand Beyond. Science & Behavior Books, Inc., PaloAlto, CA. ISBN 8314-0078-1

Treadway, David C. Before It’s Too Late: Workingwith Substance Abuse in the Family. Penguin BooksCanada Ltd., Markham, ON. 1989. ISBN 0-393-70068-2

Wegscheider, Sharon. Another Chance: Hope andHealth for the Alcoholic Family. Science & BehaviorBooks, Inc., Palo Alto, CA. 1981. ISBN 0-8314-0059-5

Wegscheider-Cruse, Sharon, Higby, Kathy, Klontz,Ted, Rainey, Ann. Family Reconstruction: TheLiving Theatre Model. Science & Behavior Books,Inc., Palo Alto, CA. 1994. ISBN 0-8314-0083-8

Wegscheider-Cruse, Sharon, Cruse, Joseph R. & Bougher, George. Experiential Therapy for Co-dependency. Science and Behavior Books, Inc.,Palo Alto, CA. 1990. ISBN 8314-0075-7

Videos

Pieces of Silence by Robert Subby

It’s Not My Problem by John Bradshaw

Compulsive Relationships: The Players andPersonalities by Claudia Black and Terry Gorsky

Relationship Building: Achieving Intimacyby C. Black and T. Gorsky

Relationship Styles: Compulsive, Apatheticand Healthy by C. Black and T. Gorsky

Healing the Family Within by Robert Subby

PRINT & VIDEO RESOURCES

PWG48

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*Available from the Saskatchewan Health Resource Centre

BIBLIOGRAPHY

Flight from the Shadow

There was a man who was so disturbed by the sight of his own shadow and was so displeased with his own footsteps that he determined to get rid of both. The

method he hit upon was to run away from them.

So he got up and ran, but everytime he put his foot down there was another step, while his shadow

kept up with him without the slightest difficulty.

He attributed his failure to the fact that he was not running fast enough. So he ran faster and faster,

without stopping, until he finally dropped dead.

He failed to realize that if he merely stepped into the shade, his shadow would vanish, and if he sat down

and stayed still, there would be no more footsteps.

Chuang Tzu

Black, Claudia. It Will Never Happen to Me.Denver: MAC, 1981.

Bradshaw, John. Healing the Shame that BindsYou. Deerfield Beach, FL: Health CommunicationsInc., 1988.

Brown, Stephanie & Lewis, V. The Alcholic Familyin Recovery: A Developmental Model. New York:Guildford Press, 1999.

Friel, John & Friel, Linda. Adult Children – TheSecrets of Dysfunctional Families. Deerfield Beach,FL: Health Communications Inc., 1988.

Jacob, T. (Ed.). Family Interaction and Psychotherapy:Theories, Methods and Findings. New York:Plenum, 1987.

Kellogg, Terry & Harrison, Marvel. Broken Toys,Broken Dreams. Amherst, MA: BRAT Publishing,1990.

McConnell, Patty. A Workbook for Healing AdultChildren of Alcoholics. San Francisco: Harper &Row, 1986.

Wegscheider-Cruse, Sharon. Family Reconstruction:The Living Theatre Model. Palo Alto, CA: Scienceand Behavior Books, Inc., 1994.

BIBLIOGRAPHY

PWG50

PWG 51

PWG52

Documents

Families and Addictions