September is National Recovery Month—a time to celebrate individuals in recovery and spread the messages that prevention works, treatment is effective, and people can and do recover.
For years, I have observed individuals with substance use disorders often get various degrees of support from their family—some helpful and some not. Although families want to provide healthy support, often they do not because of misinformation and misperceptions about the disease and the best way to handle it.
So, let's start over and take a look at what individuals in recovery really need from their family.
1. Understand that addiction is a brain disease.
There is a saying we tell those entering recovery: "You are not bad getting good, you are sick getting well." When people learn about addiction as a brain disease, they begin to see themselves not as a failed human being, but as someone who's behavior now makes sense.
Addiction is a brain disease that leads to loss of control of one's substance use, drives one to continue doing it—despite negative consequences—and is characterized by overwhelming cravings.
There is a tendency to want to punish the person with addiction and pass moral judgment. When we understand addiction as a disease, we are more likely to provide empathy and support versus condemnation and ridicule.
The family needs their own counseling and support. "But he is the alcoholic, why do I need treatment?" Family members are often filled with two types of emotions anxiety/fear and anger/resentment. They are fearful of the future, that things won't change, that things will get worse and if the person is sober that relapse will happen. They also have anger/resentment about all the pain that has resulted from the addictive behavior.
Additionally, they often struggle with trust. For years, they have likely heard half-truths, outright lies, discovered secret behaviors and experienced broken promises. Fear, resentment and mistrust impacts one's ability to provide healthy support. Exploring family treatment groups, individual therapy and support groups—such as Al-Anon Family Groups—is a good starting point to being to work through those issues.
2. Allow the recovering individual to decide what treatment works best for them.
Families often cope with their anxiety by attempting to control the person with the addiction. Al-Anon Family Groups teaches family members the "Three C's" about alcoholism:
• You didn't cause it.
• You can't control it.
• You can't cure it.
The recovering person must work their own program of recovery, not the program you want them to work. What family members can do is have a voice in the process but allow the recovering individual, with the help of their treatment team, make the final decision in what their program of recovery consists of.
3. Hold the recovering individual accountable and allow for natural consequences to occur, rather than rely on punishment or threats.
You can't scare someone into staying sober forever. No amount of threats can defeat addiction, it is a brain disease that takes a lot of ongoing hard work to overcome. A consequence is an agreed upon outcome that is appropriate to the situation and will result if certain expectations are not met. This helps hold the recovering individual accountable for their actions.
Example: "We have agreed that if treatment is not enough to help me stay sober, I will attend AA meetings on the days I'm not in group therapy," versus, "If you drink again, I'm divorcing you and taking the kids."
4. Understand that if relapse occurs, it does not mean the recovering individual is not trying.
Some statistics point to a 60-80% relapse rate. We teach people that there are three types of relapses, some can be fatal, some are pathological, and some can be therapeutic (when the person learns from the experiences and takes the lesson to make changes to prevent future relapses).
The family should have dialogue with the recovering individual about what happened and what they plan to do to learn from the setback to reduce future events from reoccurring.
The recovering individual should be working on a relapse prevention plan and a relapse plan. The relapse plan will indicate steps they need to take if they relapse. The family should be aware of this plan, to better provide support if a relapse occurs.
5. Provide validation and acknowledgement for progress.
Newly recovering individuals often are filled with guilt and shame. The family may not be ready to trust or forgive, but if they see effort, change or progress, they need to verbalize what they notice.
• "I appreciate that you are making an effort."
• "I can see this isn't easy for you."
• "I have noticed positive changes in your behavior."
• "I'm so proud of you."
• "I'm happy to see you taking care of yourself."
• "You are an inspiration."
When things go unsaid, the recovering individual often thinks, "my recovery doesn't seem to matter" and then, "if it doesn't matter, then why am I doing this?"
6. Rebuild the relationship on a foundation of honesty.
Recovering individuals are taught that in order to recover, they need to practice a program of rigorous honesty. They need to talk about things they are struggling with, cravings they are having and any setbacks that take place.
It can be scary for the family to hear about the ongoing struggles and frustrating to hear about a relapse, but those things need to be communicated without fear of judgment or punishment. If judgment and punishment are feared, the recovering individual will find it easier to resort back to practicing a life of dishonesty.
7. Understand that recovery is a process and not an event.
Just abstaining from an addictive substance doesn't automatically result in happiness or peace of mind. I have heard it said before that addiction is like a tornado that has destroyed your home. When the tornado has stopped, you look around and see a lot of work that needs to be done.
Recovering individuals must work on dealing with urges, mood swings, managing triggering situations, constructing a life that reduces their vulnerability to using, etc. Once they figure out how to live without the substance, their focus can shift towards repairing relationships, growing spirituality, working on other self-defeating behaviors and addressing past trauma. These things happen over time—not overnight. When the family understands this, they can have realistic expectations.
The road to recovery is challenging, but those challenges can be managed more effectively when the family understands the above ideas and utilizes them to provide the type of support that the recovering individual needs.
For more information about addiction and recovery treatment and resources, please visit the Pine Rest website.
Kevin Neuman, LMSW, CAADC is a fully Licensed Master Social Worker and Certified Advanced Alcohol and Drug Counselor at the Pine Rest Christian Mental Health Services' Retreat Clinic.
Courtesy of Pine Rest Christian Mental Health Services.
Photo courtesy of Compassionate Eye Foundation/Steven Errico.