The family with an addicted loved one is a complex web of relationships, communication styles, roles and strategies. The Family Recovery Solution™ (TFRS) sees that each person in a role attempts what they think is a viable solution to the problem. Each person individually manages the stress in their own nervous system and compensates for the addiction in an attempt to stay connected as a family. Most importantly, The Family Recovery Solution™ acknowledges that behind all strategies are intentions to help a family situation that society sees as shameful. The intention of TFRS is to offer a program that supports families to grow bigger than the shame. Any one person in the family can initiate the process. The possibilities include transformation for all who wish to engage.
The Continuum of Addiction Treatment
Addiction has a long history of mixed messages, strong judgements and positional thinking. Currently, most national organizations recognize addiction as a brain disease: distorted thinking from a hijacked brain. Treatment for the addicted individual ranges from self-help groups to medical interventions that attempt to balance the brain. In between these extremes are mentor coaching, cognitive behavior therapy (CBT), dialectical behavior therapy (DBT), trauma therapies, and numerous helpful self-care processes. All of which are helpful at different stages of recovery and healing.
TFRS supports the continuum of healing modalities for the addicted individual, while inviting the whole family system into a family process of healing from the ramifications of addiction in the family. The intention is to build an understanding of the larger context of addiction relative to the family’s situation today, inspiring individual insight, a unified recovery message, and informed choices. Each family has opportunities for tools and resources to develop resilience as they manage the ups and downs of addiction and recovery. Confidence in navigating future connections is a natural result of the continued practice. The intention is to build multiple coordinated external resources around the family change process.
The Problem with Definitions
The definition of addiction as a brain disease has done a couple of things. First, it has medicalized treatment options. Second, it has expanded funding sources, making it possible for third party payers (insurance companies) to cover the cost of addiction treatment. This has been a large step forward, but it comes with a mixed message.
When addiction is defined mainly as a brain disease, it can send a message that healing addiction is simply healing the brain of the addicted individual. Often, family members do not understand that they also need to change. The complex web of relationships, communication styles, roles and strategies—basically, the family—is often marginalized in the healing process. The focus of services through treatment that is generally paid for by third party payers is on the addicted individual. Unfortunately, family change can be an afterthought. Confusion results.
Through treatment of the addicted individual, the invisible patterns of coping roles that family members have employed in reaction to the addiction may be exposed with good psycho-education. But the myopic definition of addiction puts the addicted individual in the spotlight and the family in the shadows. Combining the lack of support for family change with the potential for escalated situations from the ups and downs of addiction and recovery, increases potential for the family reverting to the historic invisible patterns of coping.
TFRS aims to expand the context, shine light on the impersonal structure that drives the invisible patterns, and empower everyone to look with new eyes and see what makes sense. From this new understanding, each family member decides what is best for themselves. Transformation is possible.
Addiction arises out of a specific context. When the context is missed or minimized, several things happen:
The change/healing process for the addicted individual is also minimized.
The family finds it hard to be part of the solution.
There is increased potential for relapse.
There is increased potential for disconnection and/or withdraw.
There is increased potential for more confusion and/or conflict.
Media and culture deliver messages that are often in conflict with research.
The concepts of “sober brain” and “addicted brain” are oversimplifications of brain science, but they can be used to shine a light on an example of this: conflicting information about whether an individual can assess their own risk.
The “sober brain” represents an optimal functioning cortex. The fully functioning cortex has the capacity to catch a lower brain impulse, pause to consider potential scenarios that may result if the impulse is acted upon or not, and make an informed decision. In the “addicted brain,” there is a strong drive from the lower brain to go directly from impulse to action. The cortex is offline. There is no pause to consider potential scenarios.
Despite what research tell us, marketing messages appeal to the “addicted brain,” not the “sober brain.” In other words, while the research tells us that the “addicted brain” cannot adequately assess risks, particularly where addictive behavior is concerned, marketing messages are often designed precisely to appeal to the “addicted brain.”
Conflicting messages from our culture increase the confusion for addicted individuals and their families. Families do their best to make decisions, but the problems created by narrow definitions, minimized context, conflicting messages and roles played out unconsciously do not make it easy when it comes to dealing with an addicted loved one. Even for a fully functioning cortex, setting realistic expectations around addiction treatment and family change is no small challenge.
Family members take on stress while watching the gradual process of addiction in their loved one. Often, the stress is normalized, not recognized. A part of that stress is the lack of support to resolve the conflicting messages in our culture. Just like the slow, gradual process of addiction, the gradual process of more and more negative stress from addiction in the family activates a sequence of events in the body of each family member—automatic reactions and contracted patterns of coping.
Internal Warning Signs
Stephen Porges’ visual diagram of the nervous system (see Diagram 1) is one way to understand this slow progression of stress negatively impacting family members. What Stephen Porges calls social engagement (the horizontal axis in the bottom of the diagram) represents the nervous system in a state of calmness. The body is warm, relaxed and present. At social engagement, the cortex has optimal functioning with optimal capacity to catch a lower brain impulse, pause and consider potential scenarios that may result if the impulse is or is not acted on, and make an informed decision. But when there is a stimulus—like concern over an addicted loved one’s behavior—and the person lives with this stressor for an extended period of time, the baseline of social engagement moves up (as in the diagram 1).
In Diagram 2, note that the baseline of social engagement increases on the vertical arousal part of the scale in response to an ongoing stimulus in the environment (such as behavior of the addicted individual).
Here’s an example. Imagine you have a loved one newly in recovery, and you feel hopeful about their recovery. But they were supposed to be home from work an hour ago. You are becoming concerned and anxious. You think about the last time they tried sobriety. Your self-talk (thinking) can create a story that doesn’t have a happy ending. Maybe you think they stopped off at a bar. The focus of your attention stays on the story even though you do not know if it is true. Almost imperceptibly, tension increases in your jaw and your arms. Your speech may become more rapid. In this escalated state of the nervous system, the cortex’s capacity to function optimally is decreased. That is, you may be less able to catch a lower brain impulse, pause to consider potential scenarios, and make an informed decision. You call your loved one, get their answering machine, and leave a message letting them know your concerns and feelings. Over time, your nervous system and thinking processes have become conditioned to respond to worst case scenarios thinking as a way to prepare for addiction problems.
Diagram 3 shows the thinking process in this example when the nervous system is activated. Based on a past belief, we become worried or frustrated and take an action with no control of the outcome. Our lack of control leads to challenging feelings about our situation, which reinforces our belief system. This leads to more negative thoughts, and the cycle repeats. In the very broadest sense, when our thinking process is caught in this cycle, it is an addictive pattern that, over time, leads to less and less self-control.
There are also other problematic outcomes of significance related to the elevated baseline of social engagement in the nervous system. The person who spends long periods of time in a constantly activated state may not recognize that they are in an activated state. Instead, it eventually becomes normalized and may become a part of the person’s identity. The focus of attention is habitually focused outward. They may have little awareness of body sensations from the activated nervous system, and they may also have less awareness of the impact the stress is having on them.
As Diagram 4 shows, with an elevated baseline, the same level of activation results in dangerously near overwhelm and the state of freezing. Through this process, the baseline of your nervous system has slowly, almost imperceptibly, increased. Your ability to fully relax in your own body doesn’t happen like it used to, and you may not even notice.
The slow, progressive, almost imperceptible process of the baseline of the nervous system increasing is similar to the slow, progressive, almost imperceptible process of addiction. In some ways, they reflect one another.
As humans with nervous systems created for survival, we have a natural response to focus on differences rather than similarities. That is especially true when we are in highly activating environments like families with addiction. This is a physiological response, which is not the fault of any family member. But understanding this intellectually and practicing regulating your own nervous system when you need it most are two very different things. To best use addiction in the family as an opportunity to transform your family, you need cognitive understanding, behavioral practice, and the ability to get some coaching when you need it. Proficiency increases in time to become.
At any stage of addiction or recovery, The Family Recovery Solution™ can increase understanding, offer resources and provide guidance for everyone in the whole family who wishes to participate. This process can be summarized in three words: Recognize, Resource, Restore.
Recognize: At the end of this phase of the process, the participating family members will understand the roles and behaviors that contribute to addiction and healing and will have identified areas of vulnerability for potential change.
Resource: At the end of this phase of the process, the participating family members will have had opportunities to practice resourcing and communicating in day-to-day interactions, ideally, having gained competence and resiliency with new skills.
Restore: At the end of this phase of the process, family members have practiced, tweaked and integrated new tools into the new family structure to best navigate connections and live into their own new family vision.
As family members start this process, old patterns will be viewed through new lenses. Life may look and feel quite different. When an activating event occurs—like another addiction related incident—it is natural for the body to go back to old ways of coping in response. It is also natural for you to move back into old roles. Each person’s experience of this will be different. With the guidance of TFRS, people engaged in the process towards healing lead and guide the whole family into a change process. Honoring one’s own experience and that of others is crucial. Through resourcing, support is provided and/or suggested that best meet the needs of individuals and the family. Practice and integration is ongoing throughout TFRS.
Research suggests that when recovery is a family process, long-term success rates are much higher and relapse rates are much lower than when recovery is not a family process. TFRS is unique in that it meets a family in any stage of addiction or recovery. When TFRS is used before the addiction gets to chaotic levels, the first phase, Recognize, is a gentle and persistent wakeup for everyone in the family, allowing them to see the invisible structure, change behavior, patterns, and roles, and potentially form a plan for the future.
TFRS can also be used in conjunction with intervention, can be a support network for the family while their loved one is in treatment, can be helpful at discharge, and can even be effective when family patterns have not changed even though the addicted member has been in abstinence for many years. To use the team approach to the fullest, TFRS builds a group of professionals around families that want change to align intention and treatment, have regular communication as a team, and coordinate as needed. Family System theory states that when one person in the family changes, the system will change. But when multiple people in the family change, the system change happens much quicker. And that means that family members have enhanced opportunity to become more functional, and potentially use this as an opportunity for transformation.
If there is addiction in your family and you would like to learn more about how you can initiate a process that interrupts the family’s addictive patterns and guides the family towards healing, contact us at www.thefamilyrecoverysolution.com, Twitter, Facebook, or Linkedin at TFRSolution, or email at firstname.lastname@example.org.