What If You Stopped Trying to Get Your Loved One to Admit There’s a Substance Use Problem?

What If You Stopped Trying to Get Your Loved One to Admit There’s a Substance Use Problem?

I gotta be honest here. I don’t remember the last time I tried to talk to my mother about her substance use or mental health problems. But that’s probably because they all went the same way, like a broken record.

I’d try to explain. I’d try to be as clear as possible. As logical as possible. As persuasive as possible. Over, and over, and over again.

And every time it would end up with my mother retorting with another whataboutism that I felt like I had to defend, or her claiming that nothing she does is ever good enough and how I should be just be grateful that I had a roof over my head and food to eat.

And each time that happened I’d start to wonder if I was the problem. I honestly couldn’t figure out WHY I couldn’t get through to her. I just kept thinking I had to explain it better.

Now, looking back, I realize I honestly couldn’t have made myself any clearer. It wasn’t my explanations that were the problem. I was my hyper-focus on the problem.

You see, there are two issues with trying to get your loved one to see the problem:

1. The substance use changes the brain such that your loved one doesn’t see the substance as the problem. Their brain now sees the substance as the solution. And no amount of logic is going to change that reality.
2. Their brain can still see that the use is causing problems. And given that the brain now sees the substance as the solution, this causes both confusion and shame that your loved one can no better reconcile than your arguments and logic can change the damage to the brain.

And these two things are why those debates, and even arguments, so rarely work. And this is just so confusing to people because reasonable, rational people would discuss it and try to work it out.

But the damage the substance use has done to the brain has deprived your loved one of the ability to do that like a mature, rational adult.

So what do you do?

The answer is simple in nature, but is often challenging in its implementation.

But the answer comprises of 3 things:

1. Show compassion for their struggles trying to navigate their substance use and the problems it poses for everyone.
2. Whenever and wherever possible, engage with them as a whole person, not just as someone with a substance use problem.
3. Set whatever boundaries you reasonably can around the ways their substance use negatively affects you.

And I’m sure you can see as I list these things that they are easier said than done.

You’re likely angry at the harm their drug or alcohol abuse has caused, so compassion may feel like a huge stretch.

And engaging with them as a whole person may feel impossible because their substance use just sucks all other life out of the room.

And finally, you may have tried to set boundaries in the past only to be met with backlash that you just couldn’t ride out or take care of yourself around.

None of this is possible without Effective Support, so I’m just going quickly mention that my Family Addiction Online Support Community and my 5 Ways to Have a Positive Influence on a Loved One’s Substance Use Program are now available, so feel free to check those out. The links are under the programs tab.

But I’ll add some suggestions for taking some first steps in each of these areas.

When it comes to showing compassion, the most important thing you can do is educate yourself about addiction. I have several resources for doing that on my resources page. The Family Addiction Support community also offers a 15-minute training video on exactly how addiction changes the brain, among other monthly trainings. The 5 Ways Program also offers in-dept education on addiction.

But the bottom line is, if you don’t understand addiction, compassion is damn near possible because the harm the continued substance use does just feels too personal.

As for engaging with your loved one as a whole person, as painful as it is, it’s important to tap into who they were before they started abusing drugs or alcohol.

That person is still in there, deeply buried perhaps, but still there. What kinds of things were they interested in then? Especially, if they still show even any remote interest in those things now, engage them in those things.

But beyond that, wherever possible, just engage with them as a full human being.

If they say something about the weather, dive into that conversation with them, no matter how mundane that may be.

I know you may be saying to yourself, “the weather is hardly the issue right now. You’ve got far, far bigger issues than what’s going one meteorologically out there”, but it won’t be helpful to say that.

The whole point is to remind them that they’re still a human being.

And, just like the compassion, this small gesture helps prevent shame around their use from driving more use.

Helping them remember they’re still a human being subtly suggests there might be something to recover for – all without debates and arguments.

All that compassion, however, doesn’t mean that you should accept the harm that they do. Not at all.

Allowing your loved one to continue to hurt you actually harms them because even as their brain thinks the substance is the solution to life, their brain can also see the damage they do, and that brings on shame which only drives more use because the use temporarily frees them from the shame of the harm they do.

So it’s important to set boundaries around their ability to hurt you. And this is an important distinction. Your boundaries should focus on the harm done, not on the use.

If you do this consistently enough, your loved one will make the connection without directly triggering that part of the brain that believes the substance is necessary, that it is the solution.

So your boundaries should first and foremost on your own self-care and communicating those boundaries in that light.

The boundaries are about you taking care of you, not about you trying to punish or control. You’re just communicating that, if you are subjected to these harmful impacts of their use, then these consequences will be implemented so that you can take care of yourself, and any other family members or people who you responsible for caring for.

And then of course implement them.

So, if they use in such a way that negatively impacts a family gathering , they’ll be asked to leave.

That doesn’t mean your loved one won’t be upset about those boundaries – they likely will, but these kinds of boundaries focus on how the substance use is impacting their behavior rather than the actual substance use itself.

And this distinction is less likely to trigger shame. Rather, it will trigger guilt – the recognition that they did something wrong, rather than that who they are as a person is wrong.

And this is what you want. Healthy guilt around the behavior, but not shame around who they are.

With any luck – because we know there are not guarantees, unfortunately, your loved one will start to problem solve for the behavior that is harming others.

This will likely take some time, but it will can create favorable conditions for your loved one connecting the substance use with the behaviors they feel guilty about and from there start to question whether the substance use is really the answer they’ve been convinced it is.

But having compassion for the disease and treating them as a whole human being is key to this because without those things, it’s going to be easier for their brain to convince them that you’re part of the reason they drink or use, rather then reminding them they have relationships in their lives that it’s worth being present for.

Easier said than done, I know. And shifting these responses to the use requires effective support.

Family addiction has huge impacts on the mental health of family members, so we all need support just to be able to take care of ourselves, let alone shift the way we’ve been responding to the problem.

So, I’d love to hear from you: In what ways might you start to engage with your loved one as a whole human being and pull back from hyper-focus on the drug or alcohol abuse? Share in the comments and I promise I’ll respond.

Why Detachment Is A Myth

Why Detachment Is A Myth

I remember the first time someone tried to tell me I just needed to detach from my mother’s addiction. You know, let go. I mean, it seemed obvious to me that they had NO. CLUE. what they were talking about and had NO. CLUE. what I was actually going through with my mother.

I mean, I’d be thinking, “you’re seriously asking me to let go of my MOTHER.” Like, how’s that supposed to work?

And I totally understand the people who say that asking them to detach from their loved one is like asking them to amputate a limb.

Because here’s the reality: no one REALLY detaches.

True detachment is actually a sign of a psychopath – having no feeling for other people whatsoever.

So, not only is detachment not possible, in many cases, it’s not even healthy.

The American Psychological Association defines detachment as a feeling of emotional freedom resulting from a lack of involvement in a problem or a situation with a person. Or, the ability to consider a problem on its merits alone.

Expecting a family member to be able to do either of these things with a loved one abusing substances is both unreasonable and unrealistic. It sets family members up to fail, which I don’t think helps them or their loved one abusing substances.

And the reality is, healing from family addiction requires family members to fully feel their feelings, and most importantly to grieve.

In fact, it’s family members attempts to avoid the painful feelings around their loved one’s substance abuse that drives much of their codependent coping mechanisms or their enabling behavior.

The reality of their loved one’s problem, and the loss of time and opportunities and experiences and healthy connections to the substance use has to be grieved.

Navigating a loved one’s substance use effectively requires families to be both resilient and be in a fairly resourced state. And for that to happen, family members have to feel their feelings. Feel their love for their loved one. Feel their anger over the substance use. And feel their grief over what that substance use has cost both them and their loved one.

In the family addiction space, detachment is often tied to allowing your loved one to experience the natural consequences of their use. And their is definitely value in that. But there are also some exceptions to that rule, as you know if you watched my previous episode on enabling.

But even if you do allow your loved one to experience the natural consequences of their use, as is often the healthy thing to do, the idea that you’re going to find some kind of emotional freedom in that as the American Psychological Association’s definition of detachment suggests is frankly irresponsibly misleading, in my opinion.

Like, seriously, you’re going to feel some kind of emotional freedom if your loved one’s substance abuse lands them in jail? My mother committed multiple felonies and ended up in prison, and there was no emotional freedom to be found in that experience.

Even though that experience was a sort of bottom for me in which I finally realized that I needed support around her problems, her going to prison was a deeply traumatic experience. If there was any gift in it, it’s that I finally got the support I had so desperately needed for so long, but didn’t realize it.

Your loved one’s substance use is going to stir up all kinds of difficult emotions. And when it comes to navigating those emotions, I do not believe detachment is a healthy approach. Those things need to be felt.

Even if you’re letting your loved one experience the natural consequences of their use, your feelings around that are going to need to be processed, to be felt, if you’re going to be able to be resilient and remain in a reasonably resourced state in the face of those consequences. Otherwise, you risk – emotionally at least – getting taken down with your loved one’s use.

So, I’d love to know, what are your thoughts about the concept of detachment. Let me know in the comments. I promise I’ll reply.

What to Do When They Blame You For the Use

What to Do When They Blame You For the Use

In the last episode of Hope for Families TV, I talked about the factors that are to blame in addiction because so often we as family members get blamed for our loved one’s use.

And this is one of the big drivers of the dysfunctional relationship dynamics in family addiction. In fact, this dynamic honestly runs rampant in my family, among addicted members and non-addicted members alike. And it’s just so emotionally abusive and damaging, I want to be able to address it in this week’s episode of hope for families TV.

So there’s good news and bad news here. The good news is that there are healthy ways to respond to this dynamic. The bad news is that it’s not easy. But if you can shift this dynamic, you will have gone a long way in having a positive influence on the problem.

So there are three elements required to address this dynamic:

  1. The first is boundaries.
  2. The second is humility.
  3. And the third Effective Support.

As for boundaries, what boundaries actually look like in this situation is: not engaging. In other words, don’t get offended – at least not overtly – and don’t try to defend yourself. Don’t engage in the argument. Recognize from the outset that an argument around blame will go nowhere. Also, don’t try to blame them back, no matter how responsible you think they are for their problem. Because that goes nowhere either and will likely only escalate the argument and drive them into further use.

I’m going to give you a suggestion for what you can say, but it’s important to say this with as neutral a voice as possible. Because you can engage in the argument even with your tone of voice, and you don’t want to engage in any way, shape or form. You may be angry at being blamed, and that’s understandable.

But it’s important to vent that anger elsewhere so you’re not escalating the situation on your end. And I’ll talk more about your understandable anger in a minute.

But for now you can say something like:

“I know you’re frustrated/overwhelmed/stressed/angry [or whatever feeling they might be demonstrating], but I won’t engage in a blame game. I’m happy to discuss this when you’re able to have a healthy and respectful dialog.”

However you decide to phrase this, what’s important is to neither accept nor deny fault. It doesn’t matter in this specific moment where the fault lies. This strategy is about playing the long game. They want you to play a blame game, but you want to play the LONG game. Because the bottom line is blame games don’t help, and they don’t encourage growth or change in anyone.

If your loved one keeps pushing, walk away from the conversation however you can. The fact is, your loved one likely WILL keep pushing because they’re looking for a reason to drink or use, and you not engaging in the blame game denies them that. You can just keep repeating “I’m happy to discuss this when you’re able to engage in a healthy and respectful dialog.” And then shut the door, get in the car, whatever you need to do to create distance.

As I already mentioned, I KNOW this is not easy. But this is why Effective Support is also required to address this dynamic. And you may need to strategize about how you’ll walk away ahead of time.

Not engaging isn’t going to make you feel like you’ve fixed anything. What it IS going to do is not make things worse. And as I mentioned, you’ve actually had a positive influence, because you’ve made it harder for your loved one to find and excuse to use. A small, but important victory. Because the more difficult it become for your loved one to justify their use, the more willing they may become to look at positive change.

When it comes to humility – and this too requires Effective Support – it’s important to be humble enough to ask yourself if there’s a grain of truth in your loved one’s accusations. This can be just as hard, if not harder, than not engaging.

Because when I’m suggesting you ask yourself if there’s a grain of truth in your loved one’s accusations, first of all, I’m not at all assuming there is. There absolutely might not be. But sometimes there also is. And IF there is, it’s important to look at that. AND it’s important to look at that WITHOUT blaming yourself for their use. Because that is information that you can use to help improve the relationship on your end.

Looking at any shortcomings you may have in the relationship does not mean you are to blame for their use. It means you’re open to growing and changing for your sake, for the sake of your relationship with your loved one, and for the sake of their potential recovery.

If you watched my free video series, the 5 Actions Required for Substance Abuse Recovery, you know that building healthy relationships is one of the things required for successful substance abuse recovery. If you’re willing to look at your part in unhealthy relationship dynamics, this will help them as well.

They, of course, have to take responsibility for their part, but relationships heal when both sides are willing to learn and grow. And if you find that there is an element of truth in their accusations, then reflect on that and see how you might be able to shift that behavior.

You will probably need Effective Support if you’re going to do this well, and that is one of the reasons Effective Support is so important to this process.

The first two elements are all about changing dysfunctional relationship dynamics that develop with family addiction. And that can’t be done effectively in isolation. We’re often too wrapped up in the dynamics to be able to bring more clarity to the situation.

The other reason Effective support is an important element in shifting this dynamic is because you need to be able to do something productive with your anger.

First, you’re going to need to be able to vent that anger to an understanding ear. But second, if you really want to shift dysfunctional relationship dynamics, then you need to take it a step further. You see, anger is important information that should not be ignored. It’s telling you that you need to set a boundary and that you need to take care of yourself around a problem.

And if you really want to be able to excavate that information and determine how you need to take care of yourself and what boundaries you need in order to make that self-care possible, you’re probably going to need an outside perspective in the form of Effective Support. Because without that Effective Support, you’re probably going to get taken down by those same dysfunctional dynamics, and by all the objections your fear around this situation is going to bring up. Effective support will help you ensure that those fears are not the only voices at the table, and it will therefore help you creatively problem solve around what your anger is trying to tell you.

There are links to multiple forms of Effective Support on my resources page, but if none of those sources appeal to you, I encourage you to take a look at my online Family Addiction Support Community. I’ll put a link to that in the notes below.

So in short, when your loved one blames you for their drug or alcohol use, the most important thing is to not engage. And have the humility to see if those accusations contain some information that you can use to help improve the relationship on your end. And for either of those things, you’re going to need Effective Support.

To close, I’d love to know your thoughts. How might you phrase your response to being blamed for your loved one’s use? And do you already see shifts you can make to improve your relationship with your loved one? Let me know in the comments. I promise I’ll respond.

NOTES:
The Family Addiction Support Community

What Are the REAL reasons for Addiction?

What Are the REAL reasons for Addiction?

Whenever I tried to confront my mother about her behavior, she would always find a way to turn the tables and somehow blame me. Her ability to make me the bad guy never ceased to amaze me.

And I know I’m not alone in this. Here a few things I hear from family members:

 

  • “He would always blame us.”
  • “She made it quite clear that I am the bad person.”
  • “He’s angry at me for being angry he’s been drinking.”
  • “He makes me feel like everything I do is wrong.”
  • “Is it normal to feel like I’m the reason they drink?
  • “She’s blaming me for everything.”
  • “He says I’m being mean and selfish.”
  • “He’s found a narrative for making me the bad guy.”

I hear these kinds of things all the time from family members. In so many words, their loved one blames them. Short of that, their loved one abusing drugs or alcohol will constantly pick fights to keep their loved one’s from being able to focus on their substance use, set boundaries, or otherwise support their own well-being.

This is just one of the many ways in which a loved one’s substance abuse creates dysfunctional relationship dynamics in the family.

The bottom line is this, however: your loved one makes their own choices.

Your loved one makes their own choices.

But there’s this truth, too. No one chooses addiction. No one chooses addiction.

So who, or what is to blame for addiction? Well, there isn’t an easy answer, but there is a whole list of factors:

  1. The first is genetics. While we haven’t actually identified a gene specific to addiction, we do know that our different levels of sensitivity to stress is genetic and stress is a huge factor in addiction, as the substance use is usually some kind of coping response.
  2. This means that everything that causes stress is a factor. And one of the things that exacerbates any stress someone abusing substances experiences is the dysfunctional relationship dynamics that their own use generates and creates a vicious cycle.
  3. Next is insufficient support. So when you couple number 2 with the fact that our society has evolved in such a way that people’s support systems are at least 50% smaller than they were in the 1950s, and in some cases those support systems are non-existent, these things together constitute a huge driver of substance abuse problems and a huge driver of why and how they persist generation after generation.
  4. But that lack of sufficient support also extends to our health-care system. Health care in the US is very expensive. You have to have resources that many addicted people don’t have in order to be able to access it. And the challenge with substance use disorders is that every issue that our health care system has is magnified exponentially when it comes to treating substance use disorders, because addiction medicine and addiction treatment is very poorly regulated.

    On top of that there are huge systemic obstacles that make it prohibitive for anyone who wants to practice addiction medicine to actually do it. This even further limits access to qualified treatment professionals using evidence-based methods.

  5. Some of the blame can also go to our cultural attitudes about alcohol consumption. I mean, why does anyone have to explain why they don’t drink? No one asks anyone to explain why they don’t smoke. The pressure to consume alcohol is enormous. Such a huge portion of adult social activities revolve around alcohol. And you’re viewed as strange or a party pooper if you don’t drink. This creates a significant and totally unnecessary added burden to anyone trying to abstain.
  6. And then there’s the pharmaceutical industry that for so long pushed opioid-based pain medication insisting that it was not habit-forming when it most definitely was. And even when the pharmaceutical companies were sued for knowingly pushing this false narrative and these drugs, the award money has not gone to supporting addiction treatment in so many cases. Much of it has gone to law enforcement, despite the fact there is no evidence law enforcement has a positive impact on substance use.
  7. And speaking of law enforcement, this brings us to the War on Drugs. Criminalizing drug use and incarcerating people for possession has only exacerbated the problem.

    But even those areas of the US that have tried to decriminalize drug possession are considering rolling back those decisions as crime only increased – because – going back to reason number 3, our treatment is unregulated and cannot effectively address the problem.

    The places that have successfully decriminalized drugs were only successful because they took the money they saved and invested it in treatment programs and support programs for those recovering from substance abuse. But in the US at least, we do not have an addiction medicine or treatment system that could viably and effectively address the addiction crisis on a large scale. We should decriminalize drugs, but we need an effective addiction treatment system before we do.

Why is all of this relevant to you getting blamed for your loved one’s use?

Because it’s important to know that it’s not you, first of all.

And it’s important know the factors and identify where you want to try and push for change.

In my own work, I focus on helping families disengage from those dysfunctional relationship dynamics – one of which is your loved one trying to assign blame for their behavior to you. But I also help families use evidence-based methods to have a positive influence on their loved one’s use. This is something that the treatment system is way, way behind on.

Finally, we need families to be aware of these methods so they can both employ aspects of them themselves, and pressure the treatment industry to use them more widely. You can check out a brief overview of those methods in my previous Hope for Families TV episode.

And if you’re interested in learning more about those methods beyond my previous Hope for Families TV episode, you can check out online Workshop, The 5 Ways to Have a Positive Influence on a Loved One’s Drug or Alcohol Abuse. I’ll put a link in the show notes.

So, I’d love to hear from you: which of these things do you suspect is the biggest factor in your loved one’s drug or alcohol abuse? If you feel comfortable, share in the comments. I promise I’ll reply.

3 Evidence-Based Strategies Every Family Should Know

3 Evidence-Based Strategies Every Family Should Know

In my family growing up, shame-based confrontation was the name of the game. It’s no surprise that nothing ever really got resolved. Even those who tried to lovingly confront people about issues that were affecting them would end up in a vicious mud-slinging fight. Unfortunately, substance use issues, personality disorders, and other mental health problems go back generations in my family. So if there was a healthy model for conflict or difficult conversations, it was long gone in the past.

Having done my own healing – particularly from trauma – I know now how important emotional safety is to navigating these kinds of encounters. In my own family, no one could change or evolve because the emotional safety necessary to do so was never there. For my own healing, I had to create significant boundaries between myself and my family because there was no way I could create the emotional safety I needed to.

Having to do that is heartbreaking, and in my work, I support families with strategies for creating more emotional safety in their relationship with their loved one so they can have the kind of positive influence on their loved one that will support them in making positive changes.

So for this episode of Hope for Families TV, I’m going to talk about 3 of the most promising evidence-based treatment approaches to substance abuse. I want to highlight these three approaches precisely because they model tools that family members can also adopt to create the emotional safety needed to have a positive influence, and also because, sadly, these methods are not commonly used in actual treatment programs, and they need to be.

And I want to talk about these approaches because I can’t tell you how many times I’ve had families tell me how they got their loved one to go through treatment, and then they relapsed they day after they got out. Now there are multiple contributors to relapse, but I have no doubt that one of the reasons these methods have the evidence behind them that they do is because they build emotional safety.

Other things that make these approaches so powerful is that they’re both customizable, they address motivation to change using evidence-based practices, and – most importantly to my work, they outline methods family members can use to have a positive influence on their loved one’s drug or alcohol use.

So these three approaches are: Cognitive Behavioral Therapy, Motivational Interviewing, and Contingency Management

And I’ll go through what each of these approaches are right now

So, Cognitive Behavioral Therapy – often referred to as CBT, operates on the premise that our thoughts, feelings, and behaviors are interconnected. It acknowledges that substance abuse is often a coping mechanism. By identifying and challenging negative thought patterns and beliefs associated with substance use, aka – the drivers of the use, individuals can develop healthier coping mechanisms and responses to triggers. CBT equips individuals with practical skills to manage cravings, deal with stressors, and prevent relapse so they gain greater control over their behaviors and consciously choose healthier responses to their triggers.

Motivational Interviewing is a collaborative, person-centered approach that explores an individual’s ambivalence towards change. It uses a utilizes strategic questioning and reflective listening techniques to elicit “change talk” – statements that reflect an individual’s desire, ability, reasons, and need for change. By amplifying and reinforcing change talk, therapists help individuals strengthen their intrinsic motivation and commitment to recovery. By fostering empathy, acceptance, and evoking intrinsic motivation, motivational interviewing empowers individuals to explore their values, goals, and reasons for change. Through reflective listening and guided questioning, motivational interviewing’s collaborative, non-confrontational approach helps individuals resolve their uncertainties and strengthen their commitment to recovery and positive change by fostering intrinsic motivation and respecting the person’s autonomy and individual agency.

And finally, Contingency Management leverages the principles of behavioral psychology to promote positive change through reinforcement-based strategies. It operates on the principles of positive reinforcement, offering tangible rewards or incentives to reinforce desired behaviors such as abstinence or participation in treatment. Contingency Management allows for customization and individualization of reward systems based on the unique needs, preferences and circumstances of each individual. By providing immediate and tangible rewards, CM helps individuals stay motivated and engaged in their recovery journey. Whether through vouchers, privileges, or other incentives, CM offers an effective way to encourage and sustain positive changes.

All three of these approaches are evidence-based approaches that have been proved effective in motivating people abusing substances to either fully abstain, moderate, or make changes that lessen the negative impacts of the use.

But they’re rarely used in actual treatment settings. People with substance abuse issues typically have to work with an individual therapist to access any of these therapies.

Why is is this?

Because the treatment industry is largely either completely unregulated or poorly regulated. Which means there is no medical board mandating the use of evidence based approaches like there is in other areas of medicine.

And given that these approaches are highly individualized and require more 1:1 contact with a trained therapist in these modalities – the very thing that makes them so much more effective – for profit, and even non-profit treatment centers, have neither the regulatory nor the financial incentive to implement them.

Most of them are continuing to use non-evidence-based programs dating back to at least 50 years. These programs are rarely individualized, despite what the treatment centers claim, and rely almost exclusively on group therapy and other group programming.

And I think it’s really important that families understand the evidence-based methods out there so they can better understand what they are and aren’t getting for their treatment dollars, and start both demanding more evidence-based options from treatment centers and better regulation and higher standards of care for the treatment industry.

So, I’d love to hear what your experience was of the treatment industry. Feel free to share your story in the comments. I promise I’ll respond.