What are the Benefits of Family Therapy in Addiction Treatment?

Addiction is often conceived of as a problem that an individual has. To an extent, this is true. However, in many cases, the problem of addiction is much larger and more complicated than this. No person exists in a vacuum; everyone has friends, family, and loved ones impacted by their choices. This is true, even when someone is at odds or separated from their family. In many cases, substance abuse issues can cause great rifts or pain in the relationships the addicted individual has with others.

This can look different in different situations. In some cases, individuals struggling with addiction may live with family members, spouses, and/or children in their homes. The relationships of the addicted person with those in the home can become problematic very quickly. Even when someone lives alone or with friends, the relationships with those around him are important.

When we talk about “family” here, it is useful to understand that this does not just refer to those related by blood. For family addiction therapy, the term “family” can refer to immediate and blood-related family members, close friends, mentors, in-laws, or anyone else who has a familial relationship with the addicted person.

Unhealthy Behaviors

When it comes to addiction and the family, some behaviors or patterns are very unhealthy or dangerous, most notably codependency and enablement.

• Codependency: The behavior of codependency occurs when the addicted individual and someone close to them has adapted their relationship in a dysfunctional way in response to addiction. Sometimes this will manifest as constant fear or worry by the loved one for the addicted individual to the point that it disrupts the loved one’s life; this can also manifest in the form of denial, low self-esteem, unhealthy behavior such as over-eating or shopping; additionally, this may show up as changes in mood that are dependent on the addicted individual.[i]
• Enablement: When it comes to these behaviors, it can sometimes be difficult to distinguish between enabling and helping. In many cases, it may not be unclear. In general, enabling relates to assisting someone addicted to things that they would normally do for themselves or allowing them to avoid consequences that they would normally receive. Helping, on the other hand, generally relates to things the addicted individual with things they would not or could not do by themselves. The line between these is difficult, and it can often be helpful to consult a counselor or wise family and friends for assistance in making significant decisions.[ii]

Benefits of Family Therapy

• Improved Communication: Communication between one who is addicted and their family can be a difficult process. Addiction can cause each person to say and do things differently than they would otherwise. Family therapy provides a safe context in which healthy communication can happen. The counselors who lead family therapy sessions are trained to facilitate and encourage honest but loving communication between those struggling with substance abuse and their loved ones.
• Awareness of Family Dynamics: In many cases, the dynamics and relations between the person addicted and their family can go unnoticed. Changes in the ways people relate can happen subtly and quietly. In the context of family therapy, however, there is an opportunity for the nature of the relationships and the family dynamics to be more clearly revealed. Sometimes there are unhealthy ways of relating, including codependency or enabling tendencies that neither is aware of initially.
• Clarification of Ways to Get Help: Family therapy can also provide a place for both the addicted and their family members to receive help and find ways of receiving help. Many of the struggles relating to healthy relationships involve both persons needing help and either not getting it or not knowing how to get it. The person addicted may know they need help but will often be wrong in understanding what and how they need help. Many times, family members and loved ones desire to help and support the addict, but they do not know-how. Even more unnoticed, however, is that often the family members themselves need health. There will be physical and mental exhaustion, among other consequences, that come with supporting and dealing with someone who is addicted.
• Establishment of Boundaries: Beyond these things, family therapy is beneficial for helping those addicted and their families as they set to establish effective and useful boundaries. This is important to help avoid the negative behaviors of codependency and enablement. When boundaries have not been set appropriately, the result is negative for both parties. Boundaries can sometimes feel restrictive or feel like we are not helping our loved ones who struggle with addiction, but the reality is that the boundaries are for the good of the addicted. There is a difficult but important balance that must be found between having empathy, loving, and supporting the addict and allowing them to continue in their behavior without experiencing the natural consequences.
• Opportunities to Safely Share Feelings: Because of the difficult nature of substance abuse and the guilt and shame it often brings with it, addressing feelings can be extremely challenging. For the one who is addicted, often the feelings may be repressed or avoided. When they are not avoided, they can surface as overwhelming shame and embarrassment. When confronted, this guilt and shame can manifest by anger and hurt, sometimes including making the one confronting the addict feel guilty for bringing it up. These are natural but harmful things. For the family member trying to help a loved one, there are often feelings of being taken for granted, of exhaustion from constantly supporting the loved one or providing for the home without the loved one. Addressing this with someone in the midst of addiction is, at the very least, difficult. Family therapy can help in these situations by providing a safe context and a wise, trained professional to guide and support the discussion.
• Chances to Build Trust: Finally, family therapy can provide opportunities to build trust. The reality is that addiction causes a lot of fractures in relationships, and trust is often eroded and damaged very quickly. For obvious reasons, this is not the place where we want relationships to stay. The hope is for restoration and reconciliation. This requires the rebuilding of trust. Family therapy, often by addressing the things listed above, can help begin this process of building trust and restoring relationships.[iii]

Sources:

• [i] Lesser, Ben. “Substance Abuse and Codependency.” Dual Diagnosis. https://dualdiagnosis.org/codependency-substance-abuse/. Accessed 5/21/2021.
• [ii] T., Buddy. “How to Stop Enabling an Alcoholic or Addict.” Verywellmind. https://www.verywellmind.com/how-to-stop-enabling-an-alcoholic-63083. Accessed 5/21/2021.
• [iii] Edited by Dan Wagener. “Family Therapy for Substance Abuse & Addiction Treatment.” American Addiction Centers. https://www.recovery.org/treatment-therapy/family/. Accessed 5/21/2021.