Family Dynamics in Addiction Recovery: Partnerships and Pitfalls

Recovering from addiction in the nondisease approach requires accepting personal responsibility and agency. If this is true, and we accept that nobody else or any external force is the cause of our addiction, where does that leave family and intimate relationships?

People are social animals. We all seek and welcome support, love, companionship — yes, sex. And people’s addictions are built into that socialness.

Expectations and acceptance 

When we deal with people for a while, we build up expectations. We count on them to behave in certain ways. These expectations are often positive — we expect them to be reliable, caring, supportive.

But we sometimes build expectations about personal weaknesses into relationships. As in saying, “Sally can never do X,” or “David will always have that problem” — where “that problem” may be an addiction, like smoking, alcoholism, compulsive shopping or eating — and so on.

If you expect someone to do something, in some sense you are accepting that behavior. And acceptance is key to family peace and to personal peace of mind. Otherwise the relationship might be too conflictual. Nobody wants to spend all their time yammering at their loved ones, or being yammered at.

And, at the same time, this acceptance allows us to proceed with our lives, and for our loved ones to proceed on their own. That’s the philosophy of Al-Anon — for partners of alcoholics: “I’m not responsible for their alcoholism, or for their recovery. That’s on them.”

Enabling

“Enabling” is the term that describes partners and families who not only allow a person to misbehave or maintain an addiction, but even encourage them to do so. They count on their loved one’s addictions.

Case: Rosalyn and Larry had been a couple seemingly forever. They began dating in high school, continued through college, and got married upon graduation.

People were always impressed by how well Rosalyn and Larry got along.  There was no sniping, like that which occurs with many long-term couples. Rosalyn and Larry each accepted who their partner was.

That extended to their body types. Rosalyn had always been a little plump. She never expected to be the homecoming queen. But Larry accepted her as she was and told her, “I love your body — you’re beautiful to me.”

And Rosalyn repaid Larry’s acceptance. For Larry was himself considerably overweight. Rosalyn simply chalked it up to Larry’s genes. His mother, father and sister were also overweight.

One night walking down their town’s business center, they passed the local pizza shop. Although it was 11 o’clock at night, Larry said, “I feel like a hoagie.” He proceeded to enter the store and to buy a full hero sandwich of cold cuts, cheese and mayonnaise.

The next morning, when Rosalyn awoke, she found Larry cold to her touch. Age 28, he had died during the night of a heart attack.

Support for change 

Larry hadn’t died overnight due to that one hoagie, like a drug overdose. But he was certainly setting himself up for a fall.

And now all their mutual acceptance and appreciation was meaningless. Rosalyn faced life alone.

What might have been an alternative?

Lynn was married to Brook. Living a sedentary lifestyle, she had begun gaining weight in her twenties. While Brook, a natural athlete, who was physically active every day, did not.

At one point Brook said to Lynn, “You know what might be fun — if we walk to the park down the block when we wake up.” Which they proceeded to do. Lynn soon found herself enjoying being in motion. After several months she was startled to see that she had lost 23 pounds.

Other people present both challenges and help 

When people eat, drink, smoke, or take drugs compulsively, this always involves their families or social networks. In particular, who you are intimate and hang around with makes a difference. If you associate with people who eat, drink and drug heavily, you are likely to also.

Indeed, sometimes family and friends prefer that people maintain unhealthy habits, even addictions, even if they don’t share them. These can reassure them about their own problems or foibles. Remember that Rosalyn felt more relaxed about her own weight — and that Larry loved and accepted her more readily — because of his obesity.

On the other hand, what if people you love and associate with have healthy habits that you don’t. Then their healthy ways of doing things can be assets for you as well.

If they drink and eat moderately, or are sober, this makes it that much easier for you to follow the same path. This occurred for Brook and Lynne.

Setting Boundaries 

There are certain things you may not put up with — being beaten, for instance. But sometimes it’s hard to draw the line. What if someone is very good to you, but their addictive behavior hurts and troubles you?

Case — should I leave my alcoholic boyfriend?

Mary came from a family of heavy drinkers and she herself on occasion drank to excess. So rejecting someone for a drinking problem was hard for her.

This was her dilemma with Bill, her boyfriend whose drinking bothered her. Mary worried she was a control freak because she grew up with very little control. But, in fact, she was very successful at her work and now limited herself to two drinks at a time.

Bill was something else. When he got paid on Saturday he gave Mary his share to pay the bills and he kept the rest. They kept beer in the house and he drank quite a bit every day at home. He didn’t become drunk; he just drank a lot. And sometimes after work he went to the bar.

By the time Fridays came around Bill wanted Mary to go out with him. Otherwise he went to the bar alone. When he went to the bar alone he left after dinner and returned after Mary was in bed — often he didn’t return until the bar closed. Then Mary worried all night.

Overall Bill was a bit of a sad sack. Mary believed that his ex-wife screwed him financially and with his kids. He owed money to everyone: child support, taxes, creditors, Mary. He always held mediocre, non career-type jobs.

But Mary sympathized with Bill. He was never mean to her. Indeed, he always said that she was the only good thing in his life. He would never cheat on her. Mary would say: “He’s a great guy. He’s good to my kids and great to me — the best man I have ever met. I don’t want to lose him. But I fear that he will never change. And I don’t think I can deal with that.”

So that’s Mary’s dilemma: a great guy who is nice to her and her kids but whose drinking and overall behavior she can never really accept. She repeatedly asked herself. “Am I fooling myself? Am I helping Bill destroy himself? I really love him but I cannot do this anymore.”  But Mary was no fan of AA and didn’t want Bill to get help unless he wanted it.

In many ways Mary was doing fine — this was the best that her life had ever been. And Bill was a part of that life. But was this what the rest of her life was going to be?

Creating Change

Simply listening to Mary’s description wasn’t very encouraging. Clearly the situation would become miserable for her over the decades.

You wished that she could do more for herself, and perhaps for Bill.

The solution for Mary is to set boundaries, however hard that was for her given her  background and her sympathy for Bill.  She clearly needed Bill

(1) to drink less,

(2) not to stay out all night and to worry her,

(3) to find more productive ways of spending his leisure time,

(4) to deal head on with his work and family obligations.

And she was willing to work with him — to use her skills and support to help make this happen.

Communication techniques

How could Mary communicate these boundaries to Bill as being necessary for her to continue the relationship?

The critical elements in creating change around an addiction are to be nonjudgmental and non punitive, to express caring and love, to request specific changes, to offer help and support, and to make clear that otherwise the relationship cannot continue.

Specifically,

1. Mary should make clear to Bill that she really cares for him and feels that he cares for her and that she doesn’t want to lose the relationship.
2. She should avoid an accusatory tone or appear to be overbearing or hectoring.
3. She can then lay out her detailed requirements, or asks, for specific changes.
4. She should frame these in terms of her own needs, and not as put downs of Bill, saying these are what she knows she needs in order to continue their intimate relationship.
5. She should be clear that — as much as she would regret losing Bill — their connection was causing her too much pain to continue in its current form.
6. Finally she could tell Bill she will do everything she can to help him — for instance, go to a movie with him when he wanted to go out for the evening, enjoy a beer or two with him, let him go to a bar occasionally if he returned home in time to go to bed.

Most important for Mary to proceed is that she herself believes that her demands are not unreasonable, and that they are essential for her happiness and for the relationship to succeed.

Conclusion 

The roles of loved ones and families make us ask what addictions really are. Are they inherent biological traits that you are born with? That “disease” view doesn’t adequately describe Lynn, Rosalyn, or Mary — or Larry, Brook or Bill. The disease view of static people isn’t helpful for change.

Instead, we should recognize that, for better or worse, intimate partners are in constant dynamic relationships around addiction.

In fact, no addiction is an island in itself, one that exists completely independently of other people. All human behavior is critically influenced by physical and social and intimate settings and support — including addictions.

Further Reading:

• How to help a family member with alcohol addiction
• What To Do If Your Loved One Has a Drug Problem
• Struggling with Love Addiction or a Codependant Relationship?

 

Family System References and Resources:

1. Family Systems Theory and Therapy – When using a family systems lens, mental health professionals view substance abuse as a symptom of dysfunction within the family. Additionally, professionals recognize that the whole family is affected by someone’s substance abuse.. . . If the family members are open, bringing about positive change within a family can have positive effects on those in recovery. For example, oftentimes family members can be enabling to those struggling with substance abuse. A therapist can help members recognize those enabling behaviors and replace them with more helpful ones while gaining insight.
2. Reciprocal Partner Counseling – Families and other members of the social network of persons with AUD play an important role in supporting successful changes in drinking. . . .there is evidence that active partner coping predicts positive outcomes. Specific types of active partner coping that support successful change include(a) decreasing negative or controlling behaviors that serve as antecedents to drinking;(b) increasing supportive and problem-solving communication;(c) reinforcing positive behavior change by the partner with an alcohol problem;(d) increasing shared positive activities;(e) reducing family member drinking behavior to support changes in the drinking of the person with AUD
3. Community Reinforcement and Family Training (CRAFT) – Community Reinforcement and Family Training, or CRAFT, is an approach for families who have a loved one struggling with substances, but who is not really interested in making changes or getting help. CRAFT is about learning a different method to communicate with and support your loved one. It’s about taking care of yourself, while also learning how to interact with your loved one in a way that increases the likelihood of making a real change. The old method – either help them, or help yourself by distancing yourself from them – is never a choice you should have to make. CRAFT teaches you a series of strategies such as:

• • Understanding how to communicate positively (even when things aren’t going so well)
  • Using positive reinforcement to focus on what is working, while allowing for the bad stuff they are doing to impact them
  • Taking real steps and developing a real awareness of what it means to take care of yourself, not as an afterthought, but as a priority for the whole family