Are You Putting Your Life On Hold Waiting for Your Loved One to Recover?

Are You Putting Your Life On Hold Waiting for Your Loved One to Recover?

So, I have a question for you? Do you feel like you’re putting your life on hold waiting for your loved one to resolve their substance abuse problem? I know I did this for years and years. If this sounds like you, too, I have a story for you.

So, about 20 years ago, when I was early in my recovery from family addiction journey, I reached out to my sponsor for support around some awful thing my mother had done. Side note – I know very well that 12 Step recovery is not for everyone, and I’m not trying to endorse it here. It just happens to be part of my own story, so I am sharing about it in that light.

At any rate, what I was calling my sponsor about was something my mother had done some version of a million times before. And I continued to just get totally rocked by it each time she did it again.

And my sponsor could see that, even though I’d been in this support program for awhile, I was still stuck essentially thinking my life was over unless my mother changed.

And she said something to me I’ll never forget. She said, “Madeleine, your mother has the right not to recover.”

And my first reaction to that was like, “Whachu talkin’ ’bout Willis?” And I know that reference is going to age me there, so if you didn’t get that, you’ll have to look the show Different Strokes. But suffice it to say I was absolutely in this totally flabbergasted place, like how could she make such a claim!

But just like a cancer patient has the right to refuse chemo, an addicted person also has the right to refuse treatment, for better or for worse.

And of course, they also have the right to the consequences of that decision.

Now, I know you might be confused to hear me say this because a big part of what I help families do is to learn how to have a positive influence on the substance use, because your loved one does not exist in a vacuum.

You are able to influence them. And doing that in a positive way does improve outcomes.

And I’m not here to go back on that in this video.

But part of having a positive influence on your loved one’s use is to live your own life, to the best of your ability whether they’re using or not. And feeling like you have to wait for them to recover before you can live your life doesn’t actually help anything. In fact it does the opposite.

And my sponsor’s “outrageous” claim is what drove that point home for me.

So let me explain how that works:

One of the things that drives continued substance abuse is shame. Shame may or may not have been part of what started the use, but it is definitely what drives continued use in spite of all the problems it causes.

Because, whether your loved one admits it or not, they are deeply ashamed of their use and of the things their use drives them to do. They are – I promise.

Now, it’s not helpful to act like their behavior is OK, but one of the ways you can help them with the shame is to live your life to the best of your ability. It not only helps you better weather this scary and chaotic journey, it also relieves your loved one of the the fear – and the shame – that they’re totally ruining your life.

So, what’s one very teeny-tiny way you can start to reclaim your life? Can you go back to your book club? Can you call a friend you haven’t talked to in a long, long time. Get you get back out on the golf course with friends? Even if you only did one little thing once a month, it would make a difference.

So what can you do? Let me know in the comments.

But before we wrap up this episode, I want to address one more thing that I’m sure you might be thinking. Maybe you’re feeling like living your life means that you don’t care what your loved one is struggling with, or that you don’t care what happens to them, or that you don’t that the severity of the problem that seriously.

Not at all. You can life your life and still care. You can live your life and still fully understand what’s at stake.

A loved one’s struggle with substances is a completely horrific journey to have to navigate. It’s full of grief and fear – and there’s no way around that, even if you do live your own life to the best of your ability.

And if your loved one doesn’t recover, or God forbid, loses their life to the substance, your heart is absolutely going to break. I’m not pretending it won’t.

But the only way to navigate this journey with your psyche relatively intact is to create a space for your own life, too.

It’s not easy, and I don’t claim to have done that perfectly myself. It was a very up and down journey for me. Every step of the way I’ve had to grieve for the mother I never had.

And my mother passed a little over a year ago, so then I had to grieve for the mother I never would.

But through my own recovery journey – which included living my life to the best of my ability – some days well, some days not so well, I discovered that, yes, my heart was broken over my mother. But there was so much more that my heart could hold.

A number of years ago when I was working at a family recovery program, I told the story of how my sponsor insisted upon me all those years agon that my mother had the right not to recover.

And after that session a mother came up to me and share that she’d been putting her life, and all the things she wanted to do, on hold for years waiting for her son to recover.

She didn’t realize that she had permission to live anyway.

You, too, have permission to live anyway. Not because you don’t care, but because you do. And just because we are experiencing this kind of really heavy problem that we didn’t choose, doesn’t mean that we can’t still choose moments of joy where we can.

Our lives, our psyches, our emotions, hold multitudes. And making whatever room we can for all of it will help both us and our loved ones.

12 Reasons Effective Support is Essential in Family Addiction

12 Reasons Effective Support is Essential in Family Addiction

I talk a lot about the fact that family members can have a positive influence on their loved one’s substance use. They don’t have control, but they do have influence. But there’s a catch:

Getting your own support is key to every single way a family member can have a positive influence on their loved one’s use. None of those other ways will work without it. Not to mention, effective support is absolutely essential for family members to heal.

The reality is you cannot possibly effectively support your loved one if you are not getting effective support yourself, because effective support is the key to your own healing.

There are a dozen reasons effective support is THE most important thing you need in order to heal yourself and improve your loved one’s chances of recovery. So I want to go through those one by one:

First, without effective support, family members develop unhealthy codependent coping mechanisms in an effort to cope with the fear and mitigate the pain of the situation. They are an understandable reaction to this situation, even though they are not productive.

The fear is understandable, and the pain is very real and may be overwhelming without some kind of support. The unproductive behaviors actually support family members in the face of the fear and the pain in the short term, but they don’t fix the heart of the problem.

If family members wish to address the heart of the problem, they need a kind of effective support that will both support them in the long term in the face of the fear and the pain, and help them address the heart of the problem.  

Second, the addicted person is not likely to respond lovingly to family members’ efforts to change. And because addiction can also easily divide other family members, it is quite possible that even other family members will not respond positively to your efforts to change the way you respond to your loved one’s use.

Sadly, other family members are not likely to provide the kind of support you need to change. You need another source of effective support if you’re going to be able to change in the face of this resistance.

Third, when family members stop covering up the problems their loved one’s substance use creates, unfortunately, they ultimately have to face the pain of those consequences: the embarrassment, the financial difficulties, the loss of jobs, the separations or even divorces, and tragically, sometimes even the death of their loved one.

In other words, they have to walk through the grief they may have been using their ineffective codependent coping mechanisms to avoid.

Effective support is essential for family members to have the courage to walk through these problems, to fully grieve, and remain emotionally and spiritually whole on the other side, even though the situation is heartbreaking.

Fourth, one of the things that is essential to healing from our own codependent coping behaviors is to feel our feelings and, again, ultimately grieve a loved one’s substance use and the problems it creates.

Family members need people who are safe to feel these feelings with. Family members need to learn to be vulnerable again. And effective support is essential to this process.  

An effective support person can also help family members identify feelings they struggle to name. This in turn helps family members better identify their needs and determine if boundaries need to be set and what those boundaries should look like. 

Fifth: Following number four, an effective support person can also help family members determine how and when to express their feelings with their loved one. They can help family members work through the feelings and then move beyond the pain so family members do not stay stuck in unproductive coping behaviors.. 

Sixth, effective support is even more necessary if there has been physical or sexual abuse from your loved one. It is not unheard of for the loved one or even other family members to find any possible exposure of that abuse so threatening that they turn the victim of that abuse into a scapegoat, denying or minimizing experiences, or placing the blame for the abuse on the victim. 

Seventh, change takes time. Recovery from substance abuse takes time. And family healing takes time. And you will never do all these things perfectly. Effective support is necessary to have the patience, compassion, realistic expectations, and continued energy to make the changes that will truly make a difference over the long term.

Eighth, just as addiction often comes with other co-occurring emotional disorders, it is not uncommon for both loved ones and family members to have their own emotional disorders beyond family addiction that impact the dynamic of addiction in the family.

Effective support is essential to addressing these other factors. These factors may also require a professional specific to the disorder. 

Ninth, living with addiction slowly undermines our ability to trust ourselves. We need support to rebuild this faculty. 

Tenth, fear and anger will take over and completely replace any love you might have felt if there is no effective support. Effective support will help you keep your heart and your humanity intact.

Eleventh, One way to have a positive influence is to allow your loved one to face reasonable and compassionate consequences for their use. But this is difficult to do and painful to watch them go through. You need effective support if you’re going to be able to do it anyway. 

And twelfth, accusations of others who don’t have a good understanding addiction, and who may be guided by the scores of cultural myths out there, can also unfairly make you feel guilty for your feelings and / or your decisions regarding the substance use. You need effective support in order to be able to stand your ground in the face of this. 

In sum, without effective support, the work of supporting your loved one in a way that actually improves their chances of recovery will be too difficult. Healing yourself while having the compassion that is so important to positively influencing your loved one is utterly impossible without it.

The shame and the isolation associated with addiction affect family members as profoundly as they affect the addicted person. And making changes that will improve your life and positively influence your loved one is not easy. Your chances of being able to do this in isolation are slim.

This is why you don’t need just any support – you need effective support. You will notice that I use the word  effective pretty much every time I mention support. Lots of people will think they’re genuinely offering support when what they’re actually doing is far from it. 

So we need to know exactly what effective support is. So here are four elements of effective support:

One: It comes from someone who does not judge, and who understands the immense challenges of a loved one’s substance use

Two: It comes from someone who understands your experience, either because they have their  
own experience with addiction, or because they have learned about addiction, or because they have professional training around the issue.

Someone who has no understanding can certainly offer compassion, and that can be helpful, but they probably cannot offer the kind of support that will assist you in effectively changing the way you respond to your loved one’s substance use. Compassion is somewhat helpful, but it will not get you where you need to go.

Three: It comes from someone who advocates for your own healing, not just your addicted loved one’s recovery.

Sadly, this is an area where a lot of family support services out there fall short. For example, many treatment programs do not offer any meaningful family recovery services, and of those that do, many of those programs focus solely on actions that support your loved one’s recovery, and ignore the family members’ need for healing themselves.

This means that family members cannot assume that, if their loved one seeks treatment, the treatment center will be an adequate source of support for them, too. Very few treatment centers provide any family support.

Four: When it comes to the challenging choices faced by family members, an effective support person does not tell you what to do. So for example, they won’t tell you to kick them out or to let them move in, to give or not to give them money, to pay or not pay for treatment, to stay in contact or sever contact.

They simply support you in arriving at the decision that feels the best for you and a decision that you most feel you can live with.

Now, there is one caveat to not telling family members what to do: an effective source of support will tell you that you need to take action to protect yourself if you are being subjected to violence.

As the source of support you have in front of you right now, I am going to tell you, if your loved one is using violence or the threat of violence to keep you from responding to or interfering with their addiction, you need to take every action possible to secure your safety.

Pay attention to the cues that they are about to become violent and back off if you see them. Stash money away, hide a set of car keys, find an alternate source of shelter with a family member, friend, or domestic abuse shelter so that you can leave if you need to. Have these things ready ahead of time so if the threat of violence arises, you are fully ready to take care of yourself. 

Nothing else I tell you here will have any effect if you are trapped in a violent situation. You must take action to ensure your safety first.

I hope you are not in that situation, but if you are, please take action right away.

OK, so the next question is, where can you find this kind of effective support? If you have friends and/or family members who meet these criteria, that is a beautiful thing.

Many family members don’t however. Even if you do, you might find a wider support network to be helpful.

So, in the next episode, I’m going to discuss several places you can find that kind of support and the pros and cons of each source of support.

But before I close out this episode, I invite you to share in the comments, to what extent are you finding effective support in the people you may have already turned to? In what ways are the sources of support you’ve turned not as effective as they could be?

Will it be difficult for you to turn elsewhere if you’re not finding the kind of support you truly need in family or friends? Just a note here: It’s perhaps best not to name names in the comments.

We Know Several Things That Support Addiction Recovery, and Yet Treatment Centers Rarely Do Them

We Know Several Things That Support Addiction Recovery, and Yet Treatment Centers Rarely Do Them

So what do you think you know about addiction recovery? And do you ever wonder why relapse rates are so high. Are you baffled by why we haven’t come up with better solutions to this problem? Or have you just resigned yourself to the idea that the addiction crisis just is what it is?

Whatever your answers to these questions, they all inform reason #10 of why I do what I do.

I do what I do because we have known several things that support addiction recovery for decades. Things like cognitive behavioral therapy and positive reinforcement, medically assisted treatment, harm reduction, and whole family support.

All of these things significantly improve outcomes, and yet very few treatment programs implement these evidence-based strategies.

And few people are aware of the senseless barriers that stand in the way of people struggling with a substance use disorder getting effective treatment

Quite the contrary. Many family members are under the impression that if their loved one goes to treatment, they will be getting some kind of standards-based treatment, especially given how expensive treatment is.

They assume that treatment centers must be regulated just like the rest of medicine is.

They assume their loved ones are being treated by people who are professionally trained according to some kind of regulatory standard.

They assume if their loved one relapses and returns to treatment, the treatment center will try a different approach.

And finally, many family members are under the impression that once their loved one spends 30 days in rehab, they’ll be fine.

But NONE of that is true.

In fact, we don’t have a health care system that even makes the full implementation of the elements that support addiction recovery possible. Without insurance or a just plain a lot of money, health care of any kind is difficult to access in the US.

But addiction care is also siloed from the rest of medicine and is either not regulated at all, or regulated by accrediting bodies who get paid by accrediting treatment programs, which is a clear conflict of interest.

People are rarely evaluated when entering treatment – despite the fact that clear and widely recognized addiction evaluation criteria exist. And Most treatment programs don’t have full-time doctors or therapists on staff. Most of the treatment in these programs is offered by people whose only qualification is that they have recovered from a substance use disorder themselves.

And very few treatment programs offer support for co-occurring mental disorders, which almost 50% of people with a substance use disorder have, and failure to also treat the co-occurring mental disorder almost invariably results in relapse.

On top of that, laws that came out of the war on drugs – laws that deny any one known to be abusing substances all kinds of things like housing, food benefits, and nursing care just to name a few – these laws confront medical workers with a catch 22. If they ask someone about potential substance use problems in the hopes of connecting them with care and treatment, and frankly just providing them much more holistic care, they also place that person at risk of losing many of the supports they need to live if that person answers yes.

Medical schools often don’t cover addiction medicine and fewer than 1 percent of people studying medicine go into addiction medicine.

Why? Because the funding they need to practice is not there like it is for other specialties, and many federal, state, and local laws make providing a full-range of addiction care services, including harm-reduction services like needle exchanges and safe consumption sites, impossible.

Furthermore, if you’ve watched my free video series, the Family Guide to the 5 Actions Required for Substance Abuse Recovery, if someone is even lucky enough to be able to access treatment, you know that the brain of an addicted person takes a year or more to fully heal. So 30 days of treatment is nowhere near sufficient.

And the after care plan that many clients completing treatment are provided is simply to go to 12 step meetings and get a sponsor, with no regard to whether or not 12 Step Recovery is the right kind of support for the person. And it very well may not be, particularly given the stance many in 12-Step recovery take against medically assisted treatment – treatment which the research unequivocally shows saves lives. 

Many people struggling with a substance use disorder end up incarcerated. But despite the fact that prisons and jails are legally required to provide medical care to inmates, almost none actually provide substance abuse treatment. Even though, the data from from the few that do show that providing addiction treatment improves outcomes and reduces recidivism.

Recovery is not easy and it takes time. The 5 Actions Required for Substance Abuse Recovery that I talk about in my free video series can’t be completed in 30 days. People recovering from a substance use disorder require ongoing support. Outside of 12 Step recovery groups – which as I’ve just explained are not the right fit for everyone – in today’s addiction care environment, they will struggle to get it.

For example, sober housing, which is one important form of continued support beyond treatment, is even less regulated than actual treatment centers. The numbers of sober housing providers that have essentially become cash cows profiting off of providing the housing, but almost no structure, boundaries, or recovery support, making more and more money as their residents relapse, return to treatment and then come back to sober housing, is beyond shocking.

And then finally, very few treatment programs offer any meaningful family support, even though whole family support has been shown to improve outcomes, and can stop generational cycles of addiction or other types of mental disorders and dysfunction. For families, too, their main option for effective support and their own healing is 12 Step family recovery.

If all of this sounds insane, it’s because it absolutely is.

And that is another reason why I do what I do. All of these failures also mean that culturally we are horribly misinformed. And with the advent of social platforms, this misinformation spreads very easily.

So I’m trying to spread more accurate information. And provide families with the education and effective support they need to address a loved one’s substance abuse, to positively influence the use as much as reasonably possible, and to do the work to heal from the trauma of their loved one’s use, and even generational cycles of addiction or other dysfunction.

6 Ways Family Members Mimic the Symptoms of a Substance Use Disorder

6 Ways Family Members Mimic the Symptoms of a Substance Use Disorder

Do you ever feel like your loved one’s substance use is making you crazy? Or do you react to the use in ways that don’t feel good to you or that you’re not proud of?

If you answered yes to any of those questions, then this episode is for you. This leads me to reason number 9 of why I do what I do.

I do what I do because addiction creates dysfunctional relationship dynamics in the whole family such that family members begin displaying similar symptoms as the substance user. In other words, in a way, families “get sick,” too.

And it’s so easy not to realize this because the behavior driven by addiction is far more obvious. But you may be surprised to learn that families actually display similar symptoms as addiction.

To demonstrate this, in this episode of Hope for Families TV, I’m going to present the 6 symptoms of a substance use disorder and show the ways in which family members often mimic them in unsuspecting ways. I think you will find this to be rather revealing.

So let’s get started:

Addiction Symptom Number One is Obsession: The addicted person is obsessed with the substance. If they’re not actively using or consuming it, they’re thinking about using or consuming it. This obsession goes hand in hand with the excruciating craving for the substance the person experiences.

So what does obsession look like in families?

With Obsession in Families: The family member becomes obsessed with the addicted person – experiences excruciating persistent thoughts and fears around the addicted family member and their behavior

Addiction Symptom Number Two is Increased Tolerance: The addicted person requires more and more of the substance over time to achieve the same effect, and after a while, they will never be able to achieve the initial experience they first had with the substance

So what does increased tolerance look like in families?

With Increased Tolerance in Families: The family member develops an increased tolerance for the addicted family member’s unacceptable and shocking behavior. They tolerate behavior from their loved one abusing substances that they would never even remotely tolerate from someone else.

Addiction Symptom Number Three is Loss of Control: The addicted person loses the ability to control their use of the substance. Once they start, they can’t stop

So what does loss of control look like in families?

With Loss of Control in Families: The family member loses the ability to maintain other important aspects of their lives– they too become increasingly isolated as other meaningful activities and relationships fall by the wayside and everything revolves around the addicted family member

Addiction Symptom Number Four is Persistence: The addicted person persists in use of the substance, despite negative consequences.

So what does persistence look like in families?

With Persistence in Families: The family members persist in their efforts to control or change the addicted family member’s use, despite overwhelming evidence that control doesn’t work, increasing despair.

If you’ve been following my work, you know that I talk about how families have influence. But they do not have outright control. Influence is a kind of soft power, but it’s not control, which is trying to force solutions.

Addiction Symptom Number Five is Loss of Pleasure in Normally Pleasurable Things: Because of the progressive reduction of dopamine receptors in the brain, the addicted person cannot find pleasure in normally pleasurable things. They become increasingly isolated, thus increasing their despair.

What does loss of pleasure look like in families?

With Loss of Pleasure in Normally Pleasurable Things in Families: you see that as the addicted family member becomes the central focus of their lives, family members lose the ability to enjoy life in both simple and grand ways.

And finally, Addiction Symptom Number Six is Avoiding Pain: The addicted person uses the substance to numb emotional pain and mitigate the stress the consequences of their use causes.

And what does avoiding pain look like in families?

With Avoiding Pain in Families: The family members use their efforts to fix, control and berate the addicted person for the destructive behavior in order to avoid their own pain, to avoid grieving the reality of their loved one’s disease, and to avoid coping with the fear of additional tragic consequences that could arise

With all of these symptoms that family members tend to mirror to a greater or lesser degree, family members do these things that mimic the symptoms of addiction in the desperate hope they will compel the addicted person to stop. And for good reason: addiction is deadly. We are all well aware that if our loved ones continue in their use, really, really, really bad things can happen.

The truth is, family members are faced with an enormous catch 22: the reality is, without effective support and pertinent information, our typical reactions to our loved one’s use often make it easier for the addicted family member to persist in their use. But responding differently can feel terrifying.

But families do need to respond differently if they wish to have a positive influence on the use.

And sadly, there are no guarantees – as family members, our only option is to do what we can to improve the chances and support our own healing. And all of this is another reason that effective support is so important for everyone.

More importantly, the fact that families end up mimicking the symptoms of addiction is one more reason why we will never resolve the addiction crisis unless and until we make whole family healing an essential part of the solution.

So, I’d love to know, do you see yourself at all in some of the ways family members mimic the symptoms of addiction?

I invite you to share in the comments below some of the ways you might be mimicking your loved one’s symptoms of addiction. Give examples if you feel comfortable doing so. And feel free to comment respectfully on what others have shared.

Was Your Thanksgiving an Alcohol or Drug-Filled Sh*t Show? How to Shift Your Experience of the Remaining Holidays

Was Your Thanksgiving an Alcohol or Drug-Filled Sh*t Show? How to Shift Your Experience of the Remaining Holidays

So, if you celebrate Thanksgiving, how was it? I ask because Growing up, and even when going home for the holidays as an adult, I never knew how the holiday would go. It was always a crap shoot.

To be honest, at times, it could be a ton of fun and full of laughter. I think that’s what kept me continuing to go back when I could as an adult – hoping that this one would be one of the good ones.

But then there were the ones that weren’t good. And when they weren’t good, they were really, really bad. They were seriously a total sh*t show. A night mare of drinking, arguing, insults, threats of violence. And someone was always the scapegoat or the black sheep for that year. And then, of course the gossip around everything that was wrong with that person would continue well after the holidays were over.

And those horrible holidays happened frequently enough that they clearly weren’t just flukes.

And it wasn’t until I had started recovering from family addiction that I realized that there WERE alternatives to this drug, alcohol, and mental illness-fueled sh*t show. But one of the first steps to that healing was recognizing all the ways the dysfunctional family dynamics kept me sucked into it.

Call this a list of what kept me doing the same thing over and over again during the holidays and expecting a different result:

  • Believing family myths. My family has this myth going that they’re all creative geniuses and that the mental health and substance issues go hand-in-hand with that creative genius. And to be fair, many people in my family are genuinely highly creative. But they would narcissistically argue that the creativity somehow justified the damage of the substance use and other abusive behaviors driven by mental illness or personality disorders.So step one was to stop believing the myths that propped up the family dysfunction. They may be creative people, but they’re mentally and emotionally sick and need mental health and substance use support.
  • Sacrificing safety and well-being for convenience or cost savings. This is really about the things that kept me from being able to leave the gathering when things started heading south. Things like agreeing to stay with family members who are “only trying to help me out” financially, when in reality, that offer came with added expectations of putting up with the chaos. Or driving down with other family members which left me without an easy means of leaving and potentially jeopardizing my ride back if I didn’t scratch the chaos and dysfunction up to “par for the course.
  • Leaving myself with no other options. Part of this goes part and parcel with numbers one and two, but there are other emotional and psychological ways I was left with no other options. There was another part of the family mythology that had me believing that I was nothing without my family, and so the thought of not being part of these significant family gatherings left me feeling like a total loser, small and alone. Like I was totally unworthy of love when in fact the total opposite was true.Unpacking this required me to get Effective Support and to stop isolating myself in the face of the family addiction. I still had to grieve the love that was not currently available to me in my family, but effective support allowed me to create family of my own choosing.This gave me viable options during the holidays, not just people who were willing to take in a “stray” or “holiday orphan” during the holidays, but again, that chosen family that truly wanted my company during the holidays.

So that was how I started to change my experience of the holidays. So I would love to know about you:

If you’re in the U.S., was your Thanksgiving also a shit show? And is a part of you dreading the remaining holidays? Thanksgiving is already under our belts. And so I invite you – if you feel comfortable – to consider how you could support yourself in doing something differently around the holidays.

If my experience above resonated with you, you might consider doing some reflection or journaling on the following three questions:

    • What family myths keep you sucked into the family dysfunction, and thus keep you doing the same thing and hoping for something different? What keeps you believing them?
    • Are you sacrificing you safety and well-being for convenience or cost savings? If so, how? Can you brainstorm other options?
  • Have you created your own mythology around you self-worth or my worthiness that is somehow tied to tolerating the chaos in the family? This can become its own perverted form of FOMO in my experience.

Before you answer these questions, I highly recommend you have a trusted, supportive, and non-judgmental person – who is NOT a family member – with whom you can share what comes up when you answer these questions. Not that you have to share any of it, but I say this because what comes up might feel really heavy, and you may need someone to help you process. This can be a friend, a clergy person, a support group or a therapist. But I don’t recommend sharing what comes up with family members unless you are absolutely sure that what you share won’t be used against you.

So that’s a start. But there are a few other things you can do as well.

    • Acknowledge your feelings. If your holiday was indeed a sh*t show, then it will be important to acknowledge whatever feelings you feel about that, whether that’s anger, disappointment, sadness, frustration or something else. For better or worse, all healing is on the other side of feeling feelings. Which sucks, I know.

      But there’s the catch here. There may actually be a step that you need to take before this one, if your family is anything like mine. And that is to believe that you actually have a right to these feelings. As in, they’re valid and there’s nothing wrong with you for having them.

      I didn’t have a right to my feelings growing up, and when I got upset or objected to anything I was told I was too sensitive and I just needed to get over it. It was no big deal, and I was now creating problems for making a big deal of it. And if I didn’t get over it, I was told I just needed to leave that in the past.Coming to believe you have a right to these feelings requires effective support. And if that’s the case for you, I’ll put a link in the blog to an IG reel I have on what constitutes effective support. And there are links on my resources page to where you might find it.

      But if you feel like you don’t have a right to these feelings, that could be one of the things that keeps you brushing them under the rug year after year, and, like I did for so long, continuing to do the same thing over and over every time the holidays came around and hoping for a different result.

      And you know, the holidays would go “relatively” well just often enough to keep me hoping. But it never, ever, stuck.

    • There’s another thing you can do, but before I mention that, I think a little context would be helpful.

      So, I often do a little ChatGPT work before I write blog posts. It’s a great tool for identifying what the dominant narrative is on the interwebs about any given issue. And when it comes to addiction and family addiction, what comes up often makes me want to hurl.

      To be fair, the previous point did come up, but what ChatGPT had to say about acknowledging your feelings was completely devoid of how difficult that can be and what actually gets in the way it for families. And the next point was to initiate honest and open communication. Theoretically, a good idea.

      In practice, it’s much more complicated.
      In fact, I’m quite confident that you’ve already tried to communicate your concerns, but they have not been heard. And sure, there may be ways in which it would be helpful to shift your approach, but if what you say is not backed up with boundaries, the communication often gets you nowhere, and your words can end up twisted, taken out of context, and then used against you.

      So before we talk about communication, I think it’s important to talk about boundaries. Because when most of the literature talks about communication, they are focusing on communicating your concerns. With words. Depending on the severity of the substance use or other dysfunction in your family, words about your concerns often get nowhere.

      When it comes to unacceptable behavior driven by substance use or other dysfunction, boundaries are actually the most effective source of communication there is. But they’re incredibly difficult to set and even harder to stick to. Because you pretty much have to count on backlash.

      This is why I’m developing an entire workshop on setting boundaries with a loved one’s substance use. It is one of the best forms of communication out there when it comes to family addiction, but it’s damn near impossible to do if you don’t have effective support. 

  • Speaking of boundaries, one of THE most important boundaries to set around the holidays is to Have a Plan B.

    When you leave yourself with no other options, you end up stuck on the ride with the family dysfunction. And for years, I had left myself with no other options, both psychologically with my thinking about being nothing without my family, and also materially with the choices I made during the holidays that left me with no readily available option for stepping away from the chaos.

    I personally had to approach this in a couple of ways. When it came to changing my thinking, I needed Effective Support in order to do that. In my case, I found that both through support groups and professional therapy.

    Once they family mythology no longer had such a tight grip on me, then I was able to make different choices about if and under what conditions I could participate in family holidays. I would only participate if I had my own transportation and a place to stay that was not with a family member. Sometimes that was a hotel, other times I stayed with friends.

    When I could, I would also connect with understanding friends – usually other members of my support group – and ask if they could be my backup holiday gathering in case I had to leave my own family gathering.

    And when it comes to the holidays, the boundaries for me were the conditions under which I was willing to participate, and the Plan B. And when it comes to the Plan B, it’s important to be very clear with yourself about what type of behavior or situation is going to trigger the Plan B.

    I suggest also making a commitment to an understanding friend that you will trigger the plan B if those conditions are met. If you’re at all like me and are conflict averse, it’s easy to say things aren’t that bad when in fact they are. But the Plan B is how you say that the behavior is unacceptable.

    And when you have a Plan B in place, you don’t even need to get angry because you know you’re not trapped. This allows your communication to be far more compassionate. Because it allows people to be who they are while still taking care of yourself. Then healthier communication can happen after the drama of the holidays has subsided.

  • But, the thing is, all of this requires support. If you’re looking at the myths that keep you stuck, you’re going to feel some things. And it’s a lot easier to allow yourself to feel those things if you’ve got a reasonably healthy support system outside of the family.

    If you’ve never before set a boundary, if you’ve never created a Plan B for the holidays, if you’ve never deliberately planned for an easy exit around holiday gatherings, the first time you do that can feel really, really scary. And the reality that all if this is even necessary will also bring up grief. Which again brings you back to feeling your feelings. Again, knowing there are people who have your back will make it much easier to walk through that fear.

    Finally, as with everything around family addiction. Everything I’ve suggested here is easier said than done. And that’s the thing that makes me crazy with a lot of the advice out there to families. They make it sound like it’s so simple. The concepts are simple, but the practice of them is anything but.

    I know very well that I’m suggesting things that can be really scary to execute in practice. So I want to close this post by saying, if you’re not ready to execute on all of this, that’s OK. Maybe you just reflect on how you get wrapped up in some kind of family mythology. Or maybe you just take your own car, even though you have no intention of leaving, no matter what happens. Maybe you just start to feel feelings that you’ve never been allowed to feel.

    Start with what you can and just keep it in the back of your head that in the future you can take it a little farther.

    Family addiction and dysfunction is like a huge cruise ship or a semi. Neither can turn around on a dime. It takes time and often some back and forth.

    But if your Thanksgiving was a sh*t show and you’re even considering what you could do differently, that’s beautiful first step.

One Important Reason Why Treatment So Often Fails

One Important Reason Why Treatment So Often Fails

Welcome to episode #8 in my “Why I do what I do” series!

Have you ever wondered why treatment outcomes are so poor? One of the biggest reasons for such poor treatment outcomes informs reason #8 of why I do what I do.

I do what I do because upwards of 50% of people with substance use problems also have another co-occurring mental disorder, whether that be depression, bipolar disorder, ADHD or some other mental disorder.

While the presence of a co-occurring mental disorder, or what is sometimes referred to as dual diagnosis, presents unique challenges, if both the mental disorder and the substance abuse are not addressed together, the chances of recovery reduce drastically.

And, the chance of the addiction becoming fatal increases significantly as well.

But often treatment programs fail to adequately account for this reality.

Very few treatment providers are equipped to provide the kind of integrated, holistic care that would allow them effectively treat people with co-occurring disorders. Therapists will often turn people away, saying they can’t treat, say the depression, or the bipolar disorder, until the person gets sober.

And yet, the person needs treatment for those things if they are going to have a reasonable chance of getting sober as they are often subconsciously using the the substance treat the mental disorder.

One of the reasons so few treatment programs effectively address the existence of co-occurring mental disorders is that the treatment protocol at many treatment providers is still largely informed by the Minnesota Model, one of the earliest treatment models that have been developed.

The Minnesota Model heavily integrates the principles of 12-Step recovery, and focuses primarily on group therapy, with some limited individual counseling.

The Minnesota Model also relies heavily on staff members who are in recovery themselves. But because substance abuse treatment is not broadly regulated across the United States, these staff members may or may no be professionally trained and credentialed in drug and alcohol counseling. Their only qualification may be that they have recovered from a substance use disorder themselves. They are not likely to have any mental health credentials.

While some people do have success undergoing treatment using the Minnesota Model, addiction treatment is not one-size-fits-all. Different people will require different approaches. And more evidence-based treatment approaches, such as cognitive behavioral therapy, have been developed since the advent of the Minnesota Model.

More importantly, there are underlying factors that contribute to substance use disorders that the Minnesota Model is just not designed to address. Factors like high levels of chronic stress, a history of dysfunctional family relationship dynamics, and trauma, all increase a person’s vulnerability to both substance use disorders and mental health disorders.

But the majority of 12-Step programs, on which the Minnesota model is based, begin the premise that the reasons for the substance use are unimportant. And that just isn’t true in many cases.

And while the 12-Step process can offer tremendous value, it does not work with the majority of mental health issues, especially trauma. These are things you can’t just work steps 1, 2, and 3 on, or turn over to your Higher Power, or do a 4th step on. These things require professionally trained mental health intervention. And this is what many treatment centers don’t provide enough of.

I’ll interject a little bit of my own experience here as a family member who has been working multiple 12-Step programs – which I still have a tremendous amount of respect for – in trying to heal my own experience family addiction.

For much of my time in 12-Step recovery, I was in complete denial about the amount of trauma I had been subjected to because of the amount of addiction and mental health disorders among members of my family. I had pretty much internalized my family’s unwritten rules that anything that happened was in the past and you just needed to get over it. And I couldn’t figure out why other people in my 12-Step recovery groups were experiencing so much more recovery than I was, despite the fact that I was earnestly working the 12 Steps too.

This isn’t to say I didn’t experience any recovery. I absolutely did. But I couldn’t seem to get to where other people were getting, no matter how hard I tried.

Once I realized I did need help addressing the trauma I had experienced, I found a trauma therapist who also happened to be in a 12-Step fellowship. And one of the things that I said to her in our first session was “Do you know how many fourth steps I’ve done?” (The fourth step, by the way, is to make a searching and fearless moral inventory of yourself.) And when I said this to her, she simply said, “Fourth steps don’t heal trauma.” And they don’t. Professional trauma therapy heals trauma.

The 12-Step process can be tremendously valuable in creating structure and providing emotional support for your personal and spiritual growth. They are a beautiful tool for recognizing what you can and cannot control in your life and for taking responsibility for what you can control. And they are an incredibly helpful, and one of the most effective tools I’ve seen, when it comes to healing relationships, which, if you’ve seen my free video series The Family Guide to the 5 Actions Required for Substance Abuse Recovery, you know is an essential part of healing from a substance use disorder.

12-Step programs also provide a shit ton of hope and inspiration for anyone suffering from a substance use disorder or struggling with someone who is. And all of this, of course, supports mental health. But they are not a remedy for genuine mental health disorders.

That absolutely proved to be true in my case. Once I had a fair bit of trauma therapy under my belt, I started experiencing the kind of recovery that I was seeing other people get out of the 12-Step process.

Our entire treatment industry needs to provide much more holistic and personalized treatment options if we are ever going to resolve the addiction crisis. More people die because the treatment industry is failing to consistently solve for the presence of co-occurring mental disorders. Treatment options that can address substance use with co-occurring disorders are unbelievably lacking in this country. Which is insane given that so many people, up to 50% of people with a substance use disorder, suffer from a co-occurring mental disorder, and the substance use is often an attempt to medicate the other mental disorder.

It’s unconscionable that we are letting this reality slide. I do what I do because we need broader awareness of that problem, and we need people, especially families, but really everyone, advocating to change that.