Family Response to Addiction

Transcription

1 Family Response to Addiction ROOM TO GROW: THERAPY, SUPERVISION, CONSULTATION, PLLC Family Response to Addiction Mary Sue Green, Ph.D., LMFT Parris M. Green, MS, LMFT 1

2 Addiction 2

3 Factors Parental monitoring Parental warmth and relationship quality Intrapersonal factors Social factors Peers 3

4 Parents Parental Monitoring How often does one of your caregivers know what you are doing when you are away from home? Have a pretty good idea of your plans for the day? Parental Warmth and Relationship Quality I enjoyed being with my parents. There is a feeling of togetherness in our family. Self Intrapersonal Refusal strength Sensation seeking!pproval of others use Social Activities Normalizing peer and friend use 4

5 Peers Peers (deviance) Peers get into trouble Peers get into fights Peers steal Monitoring Warmth Quality Use 5

6 Activities Normalizing Refusal Skills Adult Supervision Sensation Seeking Delinquent behavior Positive or Negative Thinking Peers Parental Monitoring Warmth Refusal Strength Sensation Seeking Approval of Others Use 6

7 Second jobs Long hours Income Monitoring Developmental Levels 13 years old Deviant peers NOT relationship quality Parental monitoring related to deviant peers 15 years old Relationship quality NOT monitoring or deviant peers 7

8 Developmental Levels Between 15 and 17 years old Deviant peers more likely to use Relationship quality less like to use NOT parental monitoring Use at age 17 more likely to be using at 23 Deviant peers related to using Relationship quality less likely to use Bottom Line Family-based services are the most effective approach for preventing substance use and treating both adults and adolescents with drug or alcohol problems. 8

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10 Stages of Addiction 10

11 Introductory Phrase Introductory Phase Unaware of problem Behaviors not related to use Confusion 11

12 Maintenance Phase Maintenance Phase Problem exists Attempt to solve problem Help does more harm than good 12

13 Disenchantment Phase Disenchantment Phase Anger Guilt Shame Blame 13

14 Failure Separation Unhealthy Rules Hopelessness 14

15 Upcoming Poll! 15

16 Upcoming Polls Send a text to In the text, put MARYGREEN793 Now you re ready for polling questions Mork, Mindy, AliAnn 16

17 Dharma, Greg, Jason 17

18 Stages of Change 18

19 Stages of Change Precontemplation Traditionally called... We can Asses Benefits Awareness Impact of behavior Stages of Change Precontemplation Contemplation Review Picture Make a decision Set a date 19

20 Stages of Change Precontemplation Contemplation Preparation Share plan Set goals Plans Barriers Stages of Change Precontemplation Contemplation Preparation Action Leave Get support Encourage 20

21 Stages of Change Precontemplation Contemplation Preparation Action Maintenance Realistic perspective Assist with what works Mork, Mindy, AliAnn 21

22 Dharma, Greg, Jason 22

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24 What we already know! 24

25 Pattern Demand (pursue) withdraw Overfunctioning and underfunctioning Triangulation Eraser What else? Fusion and emotional cut off Enmeshment and disengagement Rigid or chaotic patterns Boundary problems 25

26 Stages of Recovery 26

27 Recovery (Spaniol, 2010, p. 482) Recovery is a painful and deeply emotional process. It involves facing the reality of our experience and its emotional impact, and, readjusting our attitudes, feelings, perceptions, and beliefs about ourselves, others, and life in general. Recovery Recovery is also a process of selfdiscovery, self- renewal, and transformation. Recovery means that people can deal with their pain and have a life that includes hope, personal meaning, intimate connections with others, and goals for the future. 27

28 Recovery short version Recovery is a change in attitudes, beliefs, and behaviors. Paths to recovery 28

29 Stages of Recovery Withdrawal Honeymoon Wall Readjustment Stages of Recovery Withdrawal Willing to be part of the recovery process? Honeymoon Wall Readjustment 29

30 Stages of Recovery Withdrawal Honeymoon Focus on own behaviors and attitudes. Recognize and discontinue triggers Wall Readjustment Stages of Recovery Withdrawal Honeymoon Wall Move past resentments Do not express anger Trust in recovery Readjustment 30

31 Stages of Recovery Withdrawal Honeymoon Wall Readjustment Changes need to continue Accept limitations Balanced, healthy lifestyle 31

32 Early Recovery 3-5 years Responsibility for own Emotions Behavior Attitudes and Beliefs Early Recovery Emotions Fear Behaviors Rescuing Control Attitudes and Beliefs Blaming 32

33 Ongoing Recovery Insights Emotional Pain New Identity 33

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35 Website: Phone: Family Response to Addiction ROOM TO GROW: THERAPY, SUPERVISION, CONSULTATION, PLLC 35

36 1 Families Response to Addiction Texas Behavioral Health Institute 2017 Mary Sue Green, Ph.D., LMFT Parris Green, M.S., LMFT "Addiction is a family disease. One person may use. but the whole family suffers." Prevention Schools have Say No to Drugs campaigns. Parenting programs have two mechanisms. They provide caregivers with social and emotional skills to support youth. They provide youth with an environment that cultivates social and emotional skills necessary for health affect regulation (Beardsley, et al; Brody, et al). Parental monitoring and parental warmth are big predictors of teen use. The levels of parental monitoring and warmth predicts a teens refusal strength, sensation seeking, and approval of others use. Father-only and mother-only families have lower levels of monitoring because they tend to work second jobs and work longer hour because of lower levels of income when there is one parent in the household. Developmental Level At 13 years old, family relationship quality does not predict using. The highest risk was association with deviant peers. Parental monitoring is related to association with deviant peers. At 15 years old, family relationship quality is a predictor of use. Parental monitoring and association with deviant peers are not predictors of use. Between the ages of 15 and 17, peer association leads to more likelihood of use, while family relationship quality leads to a less likelihood of use. Parental monitoring did not predict use. Those who used at age 17 are more likely to still be using when they are 23 with the same predictors in play - peer association to using and family relationship quality, less likely to use. Bottom line: Family-based services are the most effective approaches for preventing substance use and treating both adults and adolescents with drug use problems. Family's Response Introductory Phase During the introductory phase, partners and family members are probably not affected very much. They may be completely unaware of the use. They may see behaviors that stem from occasional use, but not associate them with a drug problem. They may have confusion about occasional odd behaviors and may wonder why the person occasionally neglects responsibilities and fails to meet obligations. An example is that a person who attends worship services every week, neglects to because they have a hangover. Family's Response Maintenance Phase During the maintenance phase, partners and family members realize that a problem exists and attempt to solve it.

37 They may give financial assistance. They may make up excuses for the thoughtless behavior of the person using. They start to work more to earn more, they take care of the children, they work to keep up friendships, they take on all the responsibility of maintaining the household. These efforts are only a temporary stop gap. The real problem is the use and its consequences. The problems continue to mount as long as the use continues. Family members want to help, so they pick up the slack for their loved one who is using. This behavior actually does more harm than good. It helps the person stay addicted because the behavior of family members covers up the consequences of using. This gives the person more time, energy, and money to continue using and to cover their using. Family's Response Disenchantment Phase By the time the person reaches the disenchantment phase of addiction, family members are on a roller coaster. They are angry. They have given up trying to solve the problem because nothing they have tried to make the person quit using has worked. They try to ignore what is going on. At the same time, when they can't avoid seeing the consequences of the using, they start to blame. They blame the person who is using. They blame themselves. They feel guilty and ashamed because they cannot control the situation. Family's' Response Disaster Phase In order to save themselves, family members often separate from the addict. Family members feel a sense of failure and hopelessness. They internalize all the bad feelings. They learn to behave and think in ways that preserve the peace. The new ways of behaving and thinking are not healthy for individual or family well-being. Unhealthy family rules are the norm. Children behave in ways that interfere with their ability to have healthy relationships later in life. Recovery is a painful and deeply emotional process. It involves facing the reality of our experience and its emotional impact, and, readjusting our attitudes, feelings, perceptions, and beliefs about ourselves, others, and life in general. Recovery is also a process of self-discovery, self- renewal, and transformation. Recovery means that people can deal with their pain and have a life that includes hope, personal meaning, intimate connections with others, and goals for the future. Recovery is a change in behaviors, attitudes, and beliefs. Family Member Goals Withdrawal Stage At this point, family members have one major decision to make: Are they willing to be part of the recovery process? Family members will find it is easier to be involved if they view the drug or alcohol use as the problem - not the person. 2

38 3 Family Member Goals Honeymoon Stage Family member's focus should be on their own behaviors and attitudes. Family members need to recognize and discontinue triggering interactions. In fact, family members' behaviors and attitudes significantly increase or decrease the addict's chances of achieving and maintaining recovery. Family members work with the addict to support the primary goal of abstinence. Family Member Goals The Wall It is time for family members them to move past resentments. They need to guard against expressing anger toward the addict. They need to start trusting in the loved one's recovery and work to support their family member. Family members need to relearn how to take care of themselves. They return to the normal routines of life and pursuing activities that are rewarding and self-nourishing. Family members can join Al-Anon or Narc-Anon It is time for family members to explore how the family communicates, how poor communication may have led to problems, and how communication can be improved. Family Member Goals Readjustment Stage Family members should be mindful that many of the changes they have made in their lives to offer support for recovery will need to continue and become permanent. Family members have to accept limitations (I don't like that word), let's say changes needed when living with a person in recovery. For example, needing to avoid certain social situations or having a plan to leave a situation, if needed. The family should maintain a balanced, healthy lifestyle and avoid relapsing to the family members' former behaviors. Early Recovery (3-5 years) Family members need to accept responsibility for their own emotions, behaviors, attitudes, and beliefs. Fears (emotions) Fear that that the addict will return to using. Fear of being alone if the addict returns to use. Fear that they will say, do or won't do something that will lead to relapse. Fear of communicating because it may lead to the same outcomes as when the family member was using. Fear of expressing emotions (if they know how).the focus before was on the emotions of the using family member, not on themselves. Ignoring their own emotions can lead family members to the old behavior of "walking on egg shells"-- determining how they should behave based on the addicts mood. Rescuing (behaviors) Taking on the responsibilities of the addict instead of allowing them to be responsible for themselves. The inability to release responsibility for the addict. Continuing to try and control the addict, along with everything else.

39 4 Control may be about changing the family or it may be about maintaining the family status quo. Basically, trying to control the pace of the recovery process. Individual Goals and Interests (behaviors) Because the focus has been on the family member who was using, other family members may lack individual goals and interests. It is important that they can focus on creating their own new identity. They need to focus on their own needs without blaming. Blaming (attitudes and beliefs) Family members may be holding on to resentments. Resentments manifest in emotional symptoms, i.e. depression or anxiety Resentments may manifest in behavioral symptoms, i.e. old behaviors from the using days such as manipulation or triggering, criticizing or lecturing the addicted family member from a place of superiority, or attempting to regain control. Ongoing Recovery The therapist and family work on gaining insights to facilitate change within oneself and in relationships with others; increasing the ability to tolerate and work through emotional pain; and engaging in higher levels of differentiation of self as a new identity is embraced. Wow, that is a lot! (hopefully, there will be some chuckles.) During this time from the withdrawal phase of recovery to ongoing recovery--a span of over 5 years, we need to remind clients - and ourselves - to be patient with the process of recovery. It unfolds on its own time and cannot be rushed.