Elizabeth Donnellan is a professor at Kaplan University College of
Social and Behavioral Sciences. She holds certification as a field
traumatologist, licensed in both the mental health and addiction fields.
In addition to more than 14 years of college teaching experience,
Donnellan has professional experience as both a direct care provider and
an administrator, including with school counseling (K/12), substance
abuse/addictions treatment, mental health counseling, rape/crisis
counseling and traumatology. Donnellan contributed this article to Live
Science's Expert Voices: Op-Ed & Insights.
Imagine the powerful aroma of coffee or chocolate — an aroma so
enticing that it completely distracts your attention. Your mouth waters
as the desire intensifies to drink that cup of coffee or eat that
chocolate bar. In this scenario, a simple sensory message (e.g., smell)
changes your thoughts and actions, probably without your realizing it. A
powerful change in the brain occurs from the release of chemicals, which focuses your actions on
finding and devouring the coffee or chocolate. Your desire is
all-consuming — so much so, that you cannot focus on anything else. This
same process occurs in the mind and body of people who are addicted to
drugs or alcohol, except that they feel the urges about a thousand times
more strongly than the above example. Worse, their bodies have become
chemically dependent on the presence of that drug or alcohol and without
it, cannot feel "normal."
Over time, they become accustomed to finding, using and recovering from
the drug. These activities dominate the greater part of the day and
redirect their focus away from relationships, work and daily
responsibilities. This shift in activity changes a person's life
relatively quickly, without their intent or awareness. While the path to
treatment can be quite different for each individual, it usually
includes leaving hurt family members behind. Often, these family members and friends struggle to provide support while
simultaneously coping with feelings of betrayal, anger and fear. It can
be a confusing time for family members and friends.
Educate yourself: Basic addiction science
Knowledge about the addiction process can help you understand how someone becomes reliant on alcohol or drugs. This information is important to an understanding of why achieving sobriety can be such a struggle for some people. Once you know, it is easier to provide informed support to your loved one without being afraid of the changes that he or she will undergo during treatment. Two great resources include guidance from the National Institute on Drug Abuse and information available from The Association for Addiction Professionals (NAADAC).
Support yourself: Counseling and support groups
Not all treatment programs are able to offer family counseling. However, family members often have complicated emotions related to the loved one's addiction and former actions. When people are addicted to drugs or alcohol, their focus is on the addiction and not on the well-being of family and friends. This can leave family members with anger towards the loved one particularly if he or she lied or stole to accommodate the addiction.
Taking care of your mental and emotional health as a caregiver is important to your own recovery during this time. Support groups such as Al-Anon (alcohol), Alateen (teens only) and Nar-Anon (narcotics) provide free support groups for those who live with someone in treatment or recovery. Sharing stories and feelings in a confidential setting with those who have similar experiences can be therapeutic. If possible, during this time, family members should also get some counseling to readjust to the loved one's sobriety.
Complicated road: Understand extended problems
Many family members and friends do not understand the extended problems that addiction creates for their loved ones. Often, these individuals need stable housing, financial support, medical attention, steady transportation and peer support (e.g., AA/NA or peers). It is helpful to realize that one treatment goal is self-sufficiency. Partners or spouses might have been shouldering all of the family responsibilities in the past out of necessity. Allowing the loved one to share in those responsibilities will help him or her develop confidence.
Sometimes it is very difficult for family members to share responsibilities because of a lack of trust. In these cases, family/couples counseling is an important step toward building a healthier relationship.
Set boundaries: Honor family members
Together as a family, set boundaries so that everyone understands what is or is not acceptable. Boundaries create a framework of acceptable behavior for all members of the house (not just the loved one's struggle with addiction) and help support a healthy family. According to research by William White published in 2009, rules should include the use of direct communication, telling the truth, accepting each other's faults and not using drugs or alcohol in the house.
This is important during the first stages of recovery when the loved one is still grappling with physical and psychological cravings. The structure of boundaries removes the uncertainty of what is expected from each member of the family. Over time, the boundaries can change as the needs of the loved one and family members change. Visit PsychCentral and the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) to learn more about how to support yourself, your family and your loved one.
Using these strategies, family members, friends and the recovering patient can build — or rebuild — healthy relationships. Addiction treatment takes time to work, and for some people, a lot of time. Patience, love, direct communication and acceptance of the difficulty of recovery are the best ways to support those you care about most.
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