How to detach from addicted loved ones
By Michael C. Gordon, MD

Addiction is a chronic and progressive disease in which the afflicted individual has lost control of his or her use of mood-altering substances or behaviors. In most cases of drug or alcohol addiction, recovery is only possible with total and permanent abstinence from all chemical substances. Codependency, on the other hand, is a disorder in which an individual has become preoccupied with the addictive or otherwise dysfunctional behavior of a close friend or loved one. Codependency recovery also requires total abstinence in the form of detachment.

Detachment is the cognitive separation of the addict from the addictive behaviors and selectively responding to the person rather than those behaviors. It acknowledges one’s own lack of control of the other person’s addictive behaviors — an acceptance that if the codependent cannot control the behavior, he or she might as well leave it with the addict. The codependent spouse might worry that the addict will get intoxicated at exactly the most inopportune time. In codependency recovery, he or she learns this worry itself exists only in the mind.

Most people initially find the concept of detachment somewhere between bewildering and absurd. If they don’t worry about the addict, who will? They can’t just ignore the problem and act as though nothing is wrong. What if the addictive behaviors have a direct impact on the codependent (e.g. physical abuse, spending the paycheck on drugs or alcohol)? It takes most people several weeks or months to fully grasp the part they play in their own problem of codependency. Once they recognize their role in the addiction, however, they are on the road to codependency recovery.

Similar to a recovering addict, a recovering codependent requires a great deal of support and help, whether through their own 12-Step program such as Al-Anon, or through professional help, or both. Typically the denial of the codependent is greater than that of the addict because it appears so obvious to the codependent that the problem exists outside of oneself. “I don’t have a problem. He is the one with the problem. I will be fine if he gets himself straightened out.”

Addiction is a disease that affects the entire family and thus, recovery is a family affair. Often those closest to the addict are just as sick (or more so in their own way) as their addicted loved one. An essential ingredient in this situation is denial, an ego defense mechanism that prevents people from consciously acknowledging painful reality. And just as the addict is in denial, so might be the spouse or other close family member.

The addict may experience two stages of denial. The first stage is failure to recognize that alcohol/drugs are the problem. Instead, alcohol/drugs are seen as a necessary resource to utilize in order to cope with life, rather than a problem itself. Once this level of denial is broken, the addict then moves to the second stage: He or she believes that although a substance abuse problem exists, help is unnecessary. This also must be broken, or the addict is doomed to drink or use again.

Family members encounter only one stage of denial: failing to acknowledge that alcohol/drugs have become a problem in their own lives. For example, it is obvious to the husband that his wife has a problem with alcohol. His problem is her drinking and associated behaviors. He thinks that if only his spouse would quit drinking then everything would be all right. So, he devotes all his efforts to problem-solving and attempting to change her behaviors. The spouse may not realize that his wife is struggling with alcoholism and in fact, could become offended if someone suggested such a thing. Drinking may not be recognized as an illness.

In many respects, codependency recovery is more difficult than addiction recovery. Oftentimes, codependent behavior is established during childhood, growing up in a dysfunctional family system. The denial is more deeply entrenched. Furthermore, the goal of codependency recovery is not as clear. The addict is not confused about whether or not he or she is drinking/using — it is objective and measurable. However, the codependent can easily fall into a relapse of worry, resentment, bitterness, self-pity, or other negative emotions before he or she realizes what has happened.

There may be additional gray areas for the codependent. Where, for instance, do legitimate concern end and obsessive worry begin? The challenge is considerable and cannot be managed alone. Fortunately, there is an abundance of helpful literature on the subject, support groups abound, and well-trained, knowledgeable counselors and therapists are available to assist in the codependency recovery process. Clergy members also can serve as a beneficial resource, drawing on their religious training and education in mental health difficulties.

All too often, the codependent is the family member in the most emotional pain. Talking to a professional who understands the disease of addiction and has a passion for helping others find healing is highly recommended. This can be the beginning of recovery not just for the codependent, but for the entire family as well.

Michael C. Gordon, MD has practiced addiction medicine since 1971. His current practice includes patient evaluation, individual psychotherapy, group therapy, and medication management. Dr. Gordon is the founder of The Atlanta Center for Pain and Addiction Management, an evaluation and treatment program for people with both chronic pain and substance abuse disorders, located in Smyrna, Georgia. For more information, call (770) 801-0980 or visit www.michaelcgordonmd.com.

Most people are aware of the role genetics play in addiction, and it is not surprising that substance abuse increases the incidence of physical violence and serious child neglect within a family. However, by far, the greatest consequence of parental addiction is the loss of effective, substantive and stable parental involvement that is essential for child development. Children of alcoholics and addicts experience interrupted, damaged or slowed cognitive, emotional and behavioral growth. Their mothers and fathers simply cannot provide good daily care and attention because they are preoccupied with drinking and/or using. Likewise, a non-using parent often is not fully available to the children, spending time and energy instead on dealing with the addict. In this way, children’s developmental needs go unmet, leading to emotional wounds and/or overt behavioral deficits.

While the effects of addiction on parenting are complicated, the most common patterns for parents who abuse substances include the following:

• Checking Out: It is not possible to be present in the life of a child when a person is abusing alcohol and/or drugs. Oftentimes, addicts are not physically present, leaving the home to use or ‘score’ (sometimes leaving children unsupervised), or by passing out, sleeping it off or just being too ‘out of it’ to interact with their children. Similarly, children of alcoholics and addicts do not have emotionally present parents who are tuned in to their hurts, wants and needs. The substance abusers do not provide effective discipline for their children; they cannot help their children deal with failure or anxieties; and they do not teach their children valuable life skills or coping behaviors, play with them or monitor their school progress. In fact, sometimes they fail to notice their children at all.

• Disinhibition: It is well known that alcohol and drugs reduce inhibitions, and this extends to parenting as well. When parents drink and/or use, their behavior is unpredictable and inconsistent. For some, this means spurts of impulsive and ‘fun’ activities with their kids, only to become angry, irritable or sullen later on. Intoxicated parents forget their promises, say hurtful things to their kids and expose their children to age-inappropriate language and behavior. In response, children of alcoholics and addicts learn to observe the climate of the home and the addicted parent’s mood — often the level of use itself — in order to know how to behave. Children need a stable, predictable routine with parents who are reliable and dependable. Without these, they tend to be anxious, insecure and fearful, and they cannot develop properly.

• Fractured Parent-Child Relationships: Addicted parents do not have complete, stable relationships with their children. When addicts are feeding and nurturing their relationship with alcohol and/or drugs, they cannot give the same energy to the parent-child relationship. For some families, the parent-child bond is never established; for others, the attachment is not secure and children learn they cannot trust their parents. Still, for others, the early attachment is adequate, but is not nurtured and developed over time, so that as children grow, their relationship with the addicted parent does not — and cannot — grow with them.

Common Responses to Parental Substance Abuse
Children of alcoholics and addicts tend to have one of two broad reactions when addiction is present within the family unit: over-responsible or under-regulated. In the face of parental substance abuse, over-responsible children take on household tasks like cooking, cleaning and laundry far earlier than their peers. They provide for their siblings in ways a parent should, by making sure they are dressed and fed, signing forms and documents their siblings need for school, and even protecting them from the addicted parent.

Over-responsible children tend to care for their addicted parent as well, covering up when he or she is intoxicated, cleaning up after messes made and frequently monitoring the parent to ensure he or she is still alive. These children are referred to as parentified, because they take on a parental role in their family and miss out on just being a kid. Even if their parents recover later, the joy and innocence of childhood are forever lost. And, quite predictably, parentified children often become adults who are drawn to addicts as spouses or partners, spending their entire lives in a state of codependence.

The other most common reaction to parental substance abuse is the development of behavioral or psychological problems. These are under-regulated children of alcoholics and addicts who act out in response to inconsistent parenting, or who develop anxiety and depression. They become oppositional with adults, aggressive with peers and have multiple disciplinary infractions at school. They cope poorly with frustration, don’t know how to calm themselves when they are frightened or sad and cannot form meaningful relationships with others.

As these children of alcoholics and addicts age, they tend to perform poorly in school, are more likely to be identified for special education services and have a greater chance of dropping out of school or getting involved with the juvenile justice system. And, of course, these children are more prone to become addicts themselves; they are attracted to deviant peer groups, directly perpetuating the cycle of addiction. Under-regulated children of alcoholics and addicts are often referred to as mirrors, because they adopt the same types of patterns and problematic behaviors as their chemically dependent parents. Moreover, when mirror children become adults, they have fewer resources to be effective parents themselves — another way in which addiction affects families from generation to generation.

Without a doubt, the effects of parental addiction are dramatic and can be devastating. But they are not irreparable and do not have to be the destiny of your children and family. Children of alcoholics and addicts can be more resilient than adults, and they can respond well to positive, healthy change whenever it starts. Here are some recommendations for recovering parents and families:

1)    Break the stronghold of addiction. Get into gender-specific treatment that addresses the underlying issues of addiction. If you are sober/clean, participate in regular 12-Step meetings and establish a recovery community of your own. Sobriety sets the stage for rediscovering your role as a parent, adopting more effective parenting strategies, creating a relationship with your children and helping your children restore their psychological health.

2)    Make amends. Good parenting needs to be a central part of any family recovery plan. Just as drugs and alcohol have arrested an addict’s personal development, development as a parent also has been derailed. Acknowledge that substances have hijacked your parenting skills. Make amends to your children both by admitting your wrongs and forming new ways of parenting. A living amends is essential for healing.

3)    Be informed. The Substance Abuse and Mental Health Services Administration (SAMHSA) offers educational information, articles and links to local services. Blogs and chat rooms provide forums for families to discuss substance abuse issues.

4)    Learn how to be a more effective parent. Take a local parenting workshop geared toward the age-appropriate needs of your child. Many libraries offer free parenting courses. Active Parenting Now (www.activeparenting.com) organizes local workshops on a regular basis, as well as online parenting classes. If you’d like a more individualized approach, several local therapists provide parent training or coaching.

5)    Consider family treatment. Most families need help to repair the damage caused by addiction. MARR’s Family Recovery Center provides counseling, education, resources and support for the entire family while the addict is in treatment and afterward as everyone adjusts to sober living. Or, seek a private therapist who specializes in family therapy and recovery from substance abuse.

6)    Encourage child participation in Al-Anon or Alateen. There are many local support groups for children of alcoholics and addicts, whether the parent is in recovery or not. In addition, online groups and chat rooms are offered. Visit the Al-Anon website for more information.

7)    Forgive yourself. It’s never too late to restore relationships. For parent-child relationships to grow, and for families to heal, forgiveness is a necessary part of the process.

MARR emphasizes community living as an important aspect of treatment that blends adults across all age groups to promote healing

For more than 45 years, MARR has built its addiction treatment programs around three pertinent principles: 1) community life, 2) spiritual growth and 3) gender-specific treatment. We have seen remarkable success when these components of recovery are introduced early on. While programs for young adults are not uncommon in the world of addiction treatment, MARR purposely combines clients of all ages and from all walks of life.

We focus on community living as foundational for helping our clients to grow. When a group of individuals struggling with addiction lives together in a drug-free environment where they are bound to hold one another accountable, something magical takes place along the way. They face their fears, connect with peers, share responsibilities, learn how to ask for help, resolve conflict in a healthy manner, experience a structured daily routine, and become active participants — not only in their communities but in their own lives as well.

Each client who comes to MARR brings his or her family history to the community they’re living with in treatment. Let us explain. Addiction is a family disease. From an adult whose life revolves around the actions of the spouse, to a parent who wants to help even when the helping enables addict behavior, to an overachieving sibling, the addict’s relationships are intertwined with his or her substance abuse. At MARR, a client may reside with another community member who has similar traits to a family member. Various members of the family unit are represented in their treatment community.

Every family has its own system, and the individuals within that system relate to one another in learned ways. When an addicted loved one enters treatment at MARR and becomes a part of the community, he or she is likely to respond to situations in ways that parallel his or her family system. MARR’s goal is to help the client identify unproductive behaviors and take responsibility for the role he or she has played in the past, then learn healthier coping and communication skills.

In essence, we choose not to separate clients according to age groups simply because we trust in the natural chemistry that happens within everyday community life. We encourage clients to address the issues they’ve been avoiding during active addiction, in order that they may experience the true freedom and joy that emanates from life in recovery.

Roles in the addicted family system are changed when there is an alcoholic/addict in a family system. The family typically adapts to the chemically dependent person by taking on roles that help reduce stress, deal with uncertainty, and allow the family to function within the craziness and fear created by the alcoholic/addict.

There is a problem with taking on these roles. While they tend to reduce stress, they do not reduce anxiety. Instead, they allow the alcoholic/addict to continue in his or her behavior. These patterns are developed for survival so that the family members believe they are reducing the stress added into the family system. The following are roles that family members often take on in these relationships.

The Enabler – The Enabler is a family member who steps in and protects the alcoholic/addict from the consequences of his or her behavior. The motivation for this may not be just to protect the alcoholic/addict but to prevent embarrassment, reduce anxiety, avoid conflict or maintain some control over a difficult situation. The Enabler may try to clean up the messes caused by the alcoholic/addict and make excuses for him or her, thus minimizing the consequences of addiction.

The Hero – The Hero is a family member who attempts to draw attention away from the alcoholic/addict by excelling, performing well, and generally being “too good to be true.” The Hero has a hope that somehow his or her behavior will help the alcoholic/addict to stop using. Additionally, the Hero’s performance-based behavior helps to block emotional pain and disappointment.

The Scapegoat – The Scapegoat is a family member who creates other problems and concerns in order to deflect attention away from the real issue. This can be through misbehavior, bad grades, or his/her own substance use. Oftentimes, the Scapegoat is very successful at distracting the family and others from the addicted individual.

The Lost Child – The Lost Child is a family member who appears to be ignoring the problem completely. There could be a fight, with yelling and screaming, and the Lost Child will be absent or secluded from the situation. They are often perceived as the “good” child because much time is spent alone with books or involved in isolated activities. While the Lost Child will not be successful at drawing attention away from the family problem, he or she is able to avoid stress personally.

The Mascot – The Mascot attempts to use humor as a means to escape from the pain of the problems caused by addiction. He or she will often act out by “clowning around,” cracking jokes, or making light of serious situations. While the Mascot can certainly help lighten up a desperate situation, the real intent is to ease tension, keep the peace and serve as a distraction. Many comedians come from dysfunctional homes.

Anger management is an essential skill in early recovery. We learn the lesson at an early age that anger is a negative emotion. As a result, we often suppress anger.

There are destructive ways to express one’s anger. But it can also be a constructive and healthy emotion if appropriately managed. This basic, natural feeling serves as a warning sign that something is not right in our environment. Anger serves as an important part of the brain’s fight-or-flight response to a perceived threat.

Addiction turns substance use into the primary form of anger management. Anger is always unhealthy and dysfunctional when combined with substance abuse. The addict uses drugs and/or alcohol as a means to suppress the unpleasant feeling.  But the anger is merely exacerbated. This requires further use of substances to cope. This vicious cycle must be addressed in addiction treatment.

Everyone gets to decide how angry he or she wants to be. Anger can be controlled. The human body cannot distinguish between physical and emotional threats. Both result in similar symptoms. These include shallow breathing, high blood pressure, clenching of the jaw, sweating, and accelerated heart rate. In addiction recovery, we teach the addict or alcoholic to acknowledge these warning signs before exploding.

At MARR in Atlanta, clients acquire new life skills like anger management. They deal with anger without the use of drugs or alcohol. They also learn healthy ways to manage this intense emotion. These include talking it over with another person, exercising, pausing, and praying. In short, our clients learn to confront natural feelings of anger positively.