A Shared Space for Healing: Family Therapy for Addiction

In her song “Drinkin’ Problem,” Lori McKenna describes the effects of a “drinking problem” in excruciating detail:

I can’t hardly get out of bed, I can’t hardly clear my head

Of last night’s spinning, smokey memories

I call in sick to work, I tell ‘em my whole body hurts

Yeah, I think this drinkin’ just might be the death of me.

Towards the end of the song, we realize that the singer is not a drinker; instead, these ill effects are due to her partner’s drinking:

I swear that every bottle you bring home

Leaves me feeling that much more alone…

No, I never touch the stuff, but, honey, I’ll tell you what

You can’t count all the ways it touches me 

As McKenna’s song graphically illustrates,  the tragedy and disruption accompanying compulsive or destructive behaviors or the use of substances can devastate individuals, families, and loved ones. People with addiction may neglect caretaking, vocational, and other responsibilities; they may withdraw emotionally, lash out verbally or physically, and get in legal trouble. Family members may experience painful anger, hurt, loneliness, and anxiety and have problems functioning. They often live in despair of meeting their needs or fear what may happen next. Loved ones may even develop unhealthy coping behaviors; others may unwittingly enable addiction, often out of the desire to avoid conflict.  

But just as they suffer from addiction, family members can be crucial to healing. The love, compassion, and insight of loved ones can powerfully influence the recovery of those with addiction. Family therapy, often used in conjunction with other interventions, can help families break cycles of behavior that are a part of addiction and provide a forum for relationship healing.

Here is what families can expect from family therapy when addiction is involved:

A Focus on the Family as a Whole

In the face of crises such as addiction, families often focus on one or more family members as “the problem.” The family therapist will instead focus on cycles of behavior and communication that sustain negative behaviors and interactions and emphasize each family member’s resilience and strength.

A Forum for Everyone

Family members often have conflicting views about the nature and extent of the family’s problems. Some may think there is “no problem” and that other family members are “exaggerating;” others may maintain that people in the family are “in denial.” Rather than taking sides, the family therapist will help family members clarify their thoughts and feelings and hear others’ thoughts and feelings. 

Young children, too, may be able to participate. While it may not be appropriate for them to take part in every session, therapy can be a place for them to share their feelings about the impact of addiction through words, art, or activities. 

A Focus on Patterns of Interactions

Family therapy starts with the premise that problems, including addiction, are not only centered within individuals but also in the interaction between them. The therapist will help family members examine patterns of behaviors and communication that sustain addiction and other problems and work with families to modify them to generate healing and understanding.

An Emphasis on Strengths and Solutions

Families entering therapy may rightly fear that the therapists may pin the problems on them as the “addict” or “enabler.” Family therapists will develop a forum for people to address challenging issues. Still, they will also identify and amplify each member’s strengths and the aspects of relationships that are supportive and healing, thus reducing defensiveness, raising morale, and charting a path toward positive change. 

Support for Effective Communication

When addiction is present, families often engage in blame in an attempt to express feelings and solve problems. Family therapists help family members to reduce blame, acknowledge others’ points of view, and express their thoughts and feelings with “I-statements.” With the therapist’s help, phrases such as “You never listen to me” may express themselves as “I know I can be tough with you at times, but I’m worried, and I want you to hear me.”  

A Space for Healing

As McKenna shows, addiction can devastate family relationships. Toward the song’s end, she points a way out: 

The book I’ve been reading says we need to work this out. We need to talk about our problems if we got ‘em.” 

Family therapy can be a tool not only for helping individuals beat addiction but can provide a place to talk to heal wounds and rebuild supportive, caring relationships.

-Posted by Jonah Green

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