The World Health Organisation defined alcoholism (addiction) as a family disease in 1956. It took the 1955 American Medical Association definition of alcoholism being a disease, one step further. “Family disease” is not arbitrary terminology.
This statement could not be clearer. With this clarity in mind, how many treatment centres in the world have a family workshop component in their residential clinical care programme? How many treatment centres collude with the unhealthy system of fault finding and blaming the scapegoat/addict by ignoring the family in pain?
Families are usually at their wits’ end.
Having conducted family work since the mid 1980s, it is easy to see that codependent family members are often at their wits’ end as they struggle to understand why they cannot ‘control’ or ‘cure’ their addict/alcoholic while they subconsciously believe they are often the ‘cause’ of the designated patient´s problems.
Families struggle with dysfunction, disease, addiction and everyone finds themselves plunged into crisis. Feelings of hurt and anger emerge while those who feel unloved attempt to make things right for everyone. Instead of normal coping that occurs when problems arise, unhealthy alliances form. This drives family members further apart.
Family members know something is wrong and it must be fixed, due to love being replaced with contempt.
So what can be done to help?
The next order of things is an intervention to deliver the designated patient into the hands of professionals (rehab). This might or might not work; either way, happiness often eludes the family.
What the family does not realise is that the whole system’s way of coping has become toxic. After coping with a long-term chronic situation of stress, families need something to relieve them of the unhealthy alliances and the dysfunctional coping which they have used as a defence from the illness and pain caused by everyone feeling abandoned, lost and wounded.
Next… the suggestion for family therapy is made. Most often, the first response from the family is resistance, or denial. “Why should WE get help?” “They’re the problem” and “How much does it cost?” In reality, everyone in moments of despair knows that they need help but are afraid of being exposed, revisiting the pain and potential confrontations.
Family members are especially afraid of what will happen if they relinquish their defences and allow themselves to love and be vulnerable again. What if the family´s resistance to get help is too strong? What if they resist a family workshop which is one of the most effective adjunct therapies connected to the addict’s treatment process?
If the family does not enter the therapy process – with or without the designated patient – they will stay in the unconscious rigid patterns of feelings and behaviours. Anger, shame and disappointment will persist and the addict, on returning home/reconnecting, will walk into that wall of anger and rigidity and they find no place for their newfound self and behaviour.
Since people’s communication is often of a circular nature, old ways of thinking, old attitudes and old patterns of communicating will be immediately present and will set the scene for everyone to take up the same place and the same roles just where they left off. No change will be evident and all will be the same; as horrible and painful as before. Sound familiar? It’s called addiction, but whose addiction drives these rigid patterns?
Failing to attend a family workshop process supports the common complaint that “we’ve wasted our time and money again”. Family work offers healing to families who need and deserve new tools to get back to normalcy. Effective family work turns the time and resources spent on treatment into a wise investment.
When giving focus to family workshop programmes, I do not mean family therapy per se, although the process is specifically designed to be therapeutic. I do not mean a weekend visit at the rehabilitation centre. It is also not a group session slotted into the programme schedule for family members to let staff know how bad-and-wrong the addict has been and how much they have suffered. What is most effective is a full-fledged family workshop designed to open lines of communication that have been closed or damaged due to a septic environment of crisis coping mechanisms.
Families do not need to be told how they have got it wrong. Families need information so that they can see the dysfunction as well as their part of the dance. Families need education regarding the tools they can use to make healthier choices for themselves thus no longer enabling the addict to stay stuck in a negative pattern of self- defeating behaviours.