Most of my other blogs focus on the addict. In this one, I want to focus on the addict’s family because it is often a family member who contacts me first about treatment. What becomes clear in just about every conversation is that the addict has altered the family’s dynamics over a period of months or years, creating a state of disequilibrium that has all family members on edge.
The presence of addiction in a loved one, in particular one’s child, inspires a myriad of feelings that leave family members disturbed, if not downright depressed. In the many family sessions I have done (where I meet with the family with and without the addicted individual), family members describe intense feelings of guilt. Would the addict not be an addict if we didn’t move when he/she was a teen? Why didn’t we see the warning signs early? How did I allow myself to be so manipulated? Why did I enable my son’s/daughter’s addiction for so long?
To make matters worse the addict, although impaired, is often very perceptive when it comes to his/her ability to cause emotional pain in others to get what he/she wants (money, a place to stay, etc.). He/she may say horrible and hurtful things to those he loves, trying to “unload” his personal pain on others around him. On an intellectual level we know that it is the drugs that are talking – that our addicted son or daughter doesn’t really mean what he/she is saying. Nevertheless, it hurts – especially when we want so much to help our loved one.
My Approach To Addiction In A Young Adult
In addiction treatment, we have spent far too much time looking for a silver bullet – that curative medication or approach that will simply make the problem disappear. We want something simple, something that is standardized and guarantees results. Of course, there is no magic tool, just a number of approaches that, along with hard work on the part of the patient and family, can free the addicted individual from the chains of addiction.
Given all the frustration and intra-family turmoil caused by the addicted individual and our wish for a simple solution it is easy to understand the attraction of the “tough love” approach. If the addict is manipulating the family and causing emotional pain to family members, simply cut him or her off. Kick him/her onto the streets. The theory is that he/she will hit “rock bottom” and then reassess his/her life, leading him/her back to family and a productive existence.
From the standpoint of logic this makes sense. If a family is enabling the addict then go to the opposite extreme – “tough love”. However, in my experience this is a very dangerous approach. Anecdotally it may have saved a few lives (I’m sure we have all seen some variation on this approach on television at some point), but it has also ended the lives of many addicts leaving family members with guilt and shame.
What is wrong with an approach that seems so “logical”? The answer is simple. The addicted brain does not follow the rules of logic. Without slipping into the complex world of neurobiology (you can look at some of my other published articles and blogs for that), we can make the general statement that drugs of abuse “highjack” normal brain function. Control is transferred from the pre-frontal cortex (the center of logical thinking) to the ‘nucleus accumbens’ (a center of emotion).
Once this hijack of the brain takes place, the well-intentioned “tough love” approach does more harm than good. A logical brain faced with a decision weighs the options appropriately. If I steal this, I end up in jail. Therefore I won’t steal it. This kind of logic is the basis of law enforcement. The addict’s brain doesn’t work like that. It is completely preoccupied procuring the drug at all costs. If that means hurting others, participating in illegal activities and putting oneself in dangerous circumstances, the addicted brain will still move ahead. If an addict is offered a choice between maintaining his/her housing and family ties but without the drug, and being homeless on the street with an ability to buy the drug (often as a result of illegal and immoral activities), he/she often makes the seemingly illogical decision to maintain the addiction.
So what works? A measured and structured approach, individualized for every patient with numerous supports from several disciplines including general medicine, psychiatry, psychology, social work and recovery coaching. It is not a miracle and it doesn’t lend itself to catchy sound bites or engrossing videos. It is hard work. In summary, the team leader (who could be from any of the above disciplines) puts together a team that will best suit the patient’s needs. A physician handles detoxification and ongoing psychiatric treatment, a psychologist does therapy (generally cognitive-behavioral or psychoanalytic) and a social worker or recovery coach provides sobriety strategies and sobriety-focused teaching and counseling. At ‘Detox at Home NY’ we work together as a team not only to maintain sobriety, but to address psychiatric and social concerns as well as family dynamics. Everyone’s path to recovery is a little different. However, the key to success is maintaining honesty and open communication between all family members, repairing the rift that addiction has caused.