When your loved ones gather around the holiday table this season, the elephant in the room may very well be the newly recovering addict or alcoholic in your life.
Everyone involved may be walking on eggshells, unsure of what to say or how to act. Addicts and alcoholics leave a lot of damage in their wake, and no one is more aware of that than the individuals themselves. Whether the recovering addict in your life is fresh out of drug and alcohol treatment or has turned over a new leaf and started attending a recovery program in your community, they probably feel like there’s a spotlight on them at your holiday gatherings.
As the parent, spouse, or sibling of those persons, you may even have questions yourself. After all, you’ve probably worried and fretted and talked for weeks, months, and years to your family support system about the problem … but how do you talk about their recovery? What do you say? How do you explain it to Aunt Rhonda or Grandma Betty or any of the other relatives whose only reference point about addiction and recovery is that “drugs are bad.”
Deep breaths. We’ve got some suggestions that may not only break the ice but lead to a productive conversation with everyone involved that helps you get through the holidays – offering love and support to the recovering addict in your life and opening a dialogue for family members to be able to do the same.
It’s OK to Talk About It
One of the biggest concerns loved ones may have about how to interact with a recovering addict in the family is whether or not the subject should even be broached. While decorum and diplomacy are certainly encouraged, it is perfectly acceptable to acknowledge that elephant in the room. It’s probably rare that the problem was top secret, so now that it’s being addressed, why should the solution be?
Recovering individuals are taught through treatment, 12 Step programs, and therapy that talking about their addiction opens the door to healing. And talking about it can lead to a better understanding of what it is and what it is not on the part of family members who want to help but don’t know how.
“It’s crucial that we all be as vocal as possible when it comes to addiction – because whether we’ve had our own struggles or witnessed the illness in someone we love, we can all play a role in breaking down the stigma,” writes Caitlin Flynn for the website Bustle [1]. “Being more open and outspoken about addiction could be lifesaving, which is part of why we all need to make a conscious effort to talk about it – even when it’s painful, uncomfortable, and raw.”
Of course, it’s essential that those conversations stem from a place of respect: “Certain labels are charged with negative connotations,” according to an article on the website Healthline [2]. “They reduce the person to a shell of their former self. Junkie, tweaker, drug addict, crackhead – using these words erase the human with history and hopes, leaving behind a caricature of the drug and all the prejudices that come with it.”
It’s a delicate subject, to be sure – and before you encourage Grandma to ask questions, you should certainly talk to the recovering addict in your life about whether he or she is open to such discussions. Chances are, they want to help dispel misinformation and educate the family members they love, but they might just want to get through Christmas dinner without feeling like they’re on Dr. Phil’s couch … and that’s OK, too. As with all of these suggestions, it’s important to let the recovering addict in your life steer any such conversations … but that means talking to them about it beforehand. Ask them what their needs are and how you can best help to meet those because those conversations will prove to be the most beneficial.
It’s OK to Feel What You Feel About Your Recovering Addict
Addiction can wreak havoc on members of the immediate family. Writing for the website National Association for Children of Alcoholics, Dr. Tian Dayton sums it up [3] this way: “Family members can become subsumed by the disease to such an extent they lose their sense of normal … trust and faith in an orderly and predictable world can be challenged as their family life becomes chaotic, promises are broken, and those they depend upon for support and stability behave in untrustworthy ways. Both children and adults in this family may lose their sense of who and what they can depend upon. Because the disease is progressive, family members seamlessly slip into patterns of relating that become increasingly more dysfunctional.”
Needless to say, addicts and alcoholics can lay waste to family dynamics, and the aftershocks from their behaviors while they drank and used, can reverberate throughout the holiday season. Even family members with no direct connection to addicts and alcoholics may feel a sense of shame that their addicted relative’s actions have somehow besmirched the family name. It’s important to take stock of these emotions before planning a holiday gathering, however, to avoid a potential tempest that ends in more harm than healing.
This step will, of course, entail communication with those who have been affected – and, in so doing, ensure that their feelings are valid. In other words, if the recovering addict in your life once stole and pawned Uncle Joe’s tools while he or she was getting high, Uncle Joe may still be dealing with feelings of betrayal and hurt – and that’s both normal and understandable. Your role isn’t to assuage Uncle Joe’s feelings, convince him not to feel those things, or make apologies or excuses for the addict in your life.
You can, of course, point out that there are self-help programs and family therapists available to help Uncle Joe process those emotions. Family therapy, incidentally, can be beneficial across a broad spectrum of religions, cultures, and dynamics, according to a paper written for the Substance Abuse and Mental Health Services Administration [4]: “In family therapy, the unit of treatment is the family, and/or the individual within the context of the family system. The person abusing substances is regarded as a subsystem within the family unit – the person whose symptoms have severe repercussions throughout the family system. The familial relationships within this subsystem are the points of therapeutic interest and intervention. The therapist facilitates discussions and problem-solving sessions, often with the entire family group or subsets thereof, but sometimes with a single participant, who may or may not be the person with the substance use disorder.”
There’s also the 12 Step family groups Al-Anon and Nar-Anon, but in the event, Uncle Joe hasn’t availed himself of those resources, your job isn’t to encourage him to go. In this particular example, your goal is to validate what he feels, give your recovering addict a head’s up, encourage both to be civil around the dinner table, and let your loved one’s recovery program help him or her work through the relationship with Uncle Joe.
Yes, Addiction Is a Disease
Rarely have illnesses like addiction (Substance Use Disorder) and alcoholism (Alcohol Use Disorder) been so denied by so many people as legitimate medical conditions. It’s important, however, to note that the American Medical Association declared alcoholism as a disease in 1956 and classified addiction as such in 1987. These days, the National Institute on Drug Abuse, the American Psychiatric Association, the American Psychological Association, the American College of Physicians, the National Association of Social Workers, the American Hospital Association, the American Public Health Association, and the World Health Organization all classify addiction and alcoholism as legitimate medical conditions. Because it doesn’t look or present as what we think of as a typical “disease,” it can be difficult to accept that concept.
However, the American Society of Addiction Medicine defines it [5] as well as anyone: “Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.”
Without getting into a lengthy discussion of the complexities of addiction as a neurological disease, it may be easier to convince family members who don’t believe through information provided by the National Institute on Drug Abuse (NIDA) [6] and other websites dedicated to laying out the science behind the disease model. Keep in mind: While it’s easy to make sweeping generalizations about addiction when it’s a nebulous concept, it’s more difficult to do so when the addict is sitting across from deniers at Christmas dinner. An uproarious debate is probably not conducive to holiday cheer, however, and it may be easier to keep the peace by saving that debate for another time and place.
Yes, It’s More Common Than You Think
There’s been an expansion of dialogue surrounding addiction and alcoholism in recent years, but there’s still a stigma associated with both that keeps them shrouded in shame. As Dr. George Koob, director of the National Institute on Alcohol Abuse and Alcoholism, points out [7], “A common misperception is that addiction is a choice or moral problem, and all you have to do is stop. But nothing could be further from the truth.” That doesn’t stop the myth from persisting, however, and when it’s someone in your family who’s afflicted, it can often feel like a source of embarrassment.
Consider: According to the 2013 National Survey on Drug Use and Health [8], “In 2013, an estimated 24.6 million Americans aged 12 or older – 9.4 percent of the population – had used an illicit drug in the past month. This number is up from 8.3 percent in 2002.” In other words, if you gathered 11 people you know in a room, more than one would have used drugs in the previous month. According to the survey, the number of drug users varies according to the substances themselves:
- 8 million people reported being current users of marijuana;
- 5 million reported currently using cocaine;
- 595,000 reported using methamphetamine; and
- 7 million people or more than 10 percent of the population of Americans ages 12 and older, reported driving under the influence of alcohol at least once during the previous year.
While it may seem like a unique problem to your family, it most certainly is not. And while that may not be any consolation to Aunt Martha or Grandma Irene, there’s some solace to be found in the fact that plenty of other people are struggling with how to make sense of a disease that can seem incredibly arbitrary and unfair … and seems to be broadening its reach. Consider: The U.S. Surgeon General released a report in 2016 [9] that while one in seven Americans will battle a substance use disorder in their lifetimes, only 10 percent are getting the help they need to overcome it.
No, “Disease” Is Not an Excuse for Recovering Addicts
One of the hurdles of accepting addiction as a disease is that it’s such a complex illness to describe. As Dr. Nora Volkow points out in a piece for the NIDA [10], “To explain the devastating changes in the behavior of a person who is addicted, such that even the most severe threat of punishment is insufficient to keep them from taking drugs – where they are willing to give up everything they care for in order to take a drug-it is not enough to say that addiction is a chronic brain disease. What we mean by that is something very specific and profound: that because of drug use, a person’s brain is no longer able to produce something needed for our functioning and that healthy people take for granted free will.”
However, the neurological factors that remove the power of choice are difficult to explain, and for family members with no knowledge of drugs or addiction or alcoholism, it may be unlikely they’ll ever accept the disease concept – because to them, labeling it as a disease means that the recovering addicts can then blame their hurtful actions and words on an illness. It’s as if they view the disease model as tacit approval to act in an unseemly and dishonorable way and give a shoulder shrug afterward … but that also demonstrates a fundamental misunderstanding of the principles of recovery.
Take, for instance, some of the 12 Steps, which are the basis for numerous addiction recovery programs. Step 5: “Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.” Step 6: “We are entirely ready to have God remove all these defects of character.” Step 9: “Made direct amends to such people wherever possible, except when to do so would injure them or others.” Step 10: “Continued to take personal inventory, and when we were wrong, promptly admitted it.”
The entire 12 Step process is one of acceptance of personal responsibility, changing behaviors, and righting past wrongs. While those Steps may deviate slightly depending on the context of the recovery program, they are a universally accepted path to healing and wellness that’s the exact opposite of an “excuse.”
It’s Not Your Fault
Writing about her book “The Only Life I Could Save,” author Katherine Ketcham penned a visceral and powerful point of view for The Washington Post [11]: “While the questions family members of addicts ask may differ, the feelings of guilt and shame are universal. Guilt for what we did or didn’t do, said or didn’t say. Shame for our imperfections and limitations because even with all our endless expressions of love and concern, we couldn’t wrestle our children free of this demon of addiction. No matter how hard we fought, the addiction always seemed to win, leaving us alone with our anger, frustration, fear, helplessness, and hopelessness.”
It’s understandable that parents and familial figureheads want to take on the guilt of addiction. As the caretakers of their families, those individuals feel a sense of responsibility whenever something bad befalls those in their care – and because addiction is such a complex issue, it’s all too easy to assume that their parenting skills must somehow be at fault. Rabbi Richard L. Eisenberg, writing for the website Forward, puts it succinctly, however [12]: “No one fully understands the causes of addiction. But this I do know: the causes are complex, and it is too tempting to attribute addiction to bad parenting. Parents don’t turn their children into diabetics. Or asthmatics. Or schizophrenics. Or addicts.”
It’s OK to be angry. It’s OK not to understand. But it does no one – yourself or the recovering addict in your life – any good to assign blame where it doesn’t belong. “Don’t blame yourself,” writes Gary Morgenstein for the website Partnership for Drug-Free Kids [13]. “Drug addiction is an illness. Don’t blame yourself or your child for that.”
Watch Those Expectations
There’s a saying in the rooms of recovery that “expectations are premeditated resentments.” During the holidays, it’s all too easy to fall prey to them and assume that the recovering addict in your life will follow a certain path that you have laid out for him or her. That’s a path that can lead to conflict, however.
As Carole Bennett, the author of “Reclaim Your Life: You and the Alcoholic/Addict” writes for Huffington Post [14], “You need to be bold enough and strong enough to let the alcoholic/addict’s recovery unfold as it is meant to, not as you want it to. This is an important start in reining in your expectations, and in doing so you will be ahead of the curve. Your expectations should not be part of the alcoholic/addict’s life as they have nothing to do with you and whether you are doing the ‘right thing or not.'”
Expectations, Bennett points out, can set the recovering addict in your life up for failure. They’re already treading potentially treacherous waters in early recovery anyway, but to put expectations on them to meet certain standards – to get a job, to pay back certain debts, to make amends to family members – is setting them up for possible failure. It’s not that they can’t or won’t meet those expectations … but what if they don’t do so within the time frame you expect them to do so? It can lead to disappointment on your part and hurt feelings on your part, and Bennett writes, “It’s possible that the alcoholic/addict will sense this and realize that they are the reason for this sorrow. If they start to lose faith in themselves as well, this may create added pressure and possibly fuel a downward spiral. They may think, “What difference does it make? I can’t do anything right, for once again, I have failed my family and friends by not satisfying their expectations or mine.'”
Rather than you or your family members laying out for the recovering addict what you expect of them, why not instead ask them what they need? Follow their lead, support where you can, and, most importantly, manage whatever expectations you may have – for your sake and for theirs.
Recovering Addicts Need to Go To a Meeting
If there’s one thing that causes some consternation at family gatherings involving a recovering addict, it’s when that individual excuses himself or herself to slip out the door to attend “a meeting.” Given the suspicious disappearances and unexplained absences from previous holiday events and family functions, it’s understandable that Grandpa Joe or Uncle Ken view “meeting attendance” with some skepticism. After all, they may ask you, what the hell is a “meeting?”
Simply put, it’s a support group of other addicts and alcoholics who come together to hold one another accountable, support one another through tough times, and celebrate with one another when times are good. Whether it’s a traditional 12 Step program like Alcoholics Anonymous or Narcotics Anonymous, an alternative program like SMART Recovery or Refuge Recovery, or a religious-based program like Celebrate Recovery, the logic is the same: Like-minded individuals do better when they come together for a singular purpose.
For newly recovering addicts, meeting attendance can be a critical component of their newfound sobriety. Traditional 12 Step programs recommend 90 meetings for the first 90 days because repetition and muscle memory are necessary to help still-healing brains achieve some sort of balance. It’s worth pointing out to Ken and Joe, of course, that the recovering addict in the family didn’t take a day off from getting high, so why should they take a day off from staying clean and sober?
If your recovering addict needs to go to a meeting, don’t just “let” them – encourage them. Science, after all, backs up the inclusion of 12 Step meetings in a successful recovery program:
- A 2009 study in the journal Addiction found that “Participants exposed to the 12-Step directive condition for facilitating AA involvement reported more AA meeting attendance, more evidence of active involvement in AA and a higher percentage of days abstinent relative to participants in the treatment-as-usual comparison group.” [15]
- A 2017 study of adolescents found that 12 Step therapy showed equally positive results as Motivational Enhancement Therapy and Cognitive Behavioral Therapy. [16]
- The American Society of Addiction Medicine states that 12 Step recovery is “still a tried-and-true proven approach … (that) addresses the psychology of the person with addiction as well as the individual’s spirituality–his/her values, his/her connectedness to others, and his/her willingness to engage with others and humbly ask for help.” [17]
Yes, Relapse Is a Possibility
They say to plan for the worst and hope for the best, right? Such a witticism may seem like sage advice, but it can also lead to you and other family members living in a constant state of alarm that the recovering addict in your life may relapse.
Is relapse possible? Absolutely. The circumstances of an individual’s drug and alcohol use, the treatment they receive, and the support they have for recovery can all determine whether long-term sobriety is sustainable, but as the National Institute on Drug Abuse points out, “the chronic nature of the disease means that relapsing to drug abuse is not only possible but also likely.” [18] However, it’s important to note that relapse is a relative term that can range from a one-time slip to a full-blown descent back into the mouth of madness. And by comparison, relapse rates for drug addiction are on par with other chronic illnesses: 40 to 60 percent, compared to 30-50 percent for diabetes and 50-70 percent for hypertension and asthma.
Most importantly, the NIDA states [19], “Treatment of chronic diseases involves changing deeply rooted behaviors, and relapse doesn’t mean treatment has failed. When a person recovering from an addiction relapses, it indicates that the person needs to speak with their doctor to resume treatment, modify it, or try another treatment.” Reputable drug and alcohol treatment programs are constantly evaluating and modifying their therapeutic approaches to rehabilitation, and 12 Step programs remain bedrock sources of support for those who avail themselves of their availability.
Is relapse possible? Yes. Should you live in fear of it? Absolutely not. Does it mean that recovery is a failure? Not at all. Is it a setback? A temporary one, but as the Basic Text of one 12 Step program points out, “a relapse may be the jarring experience that brings about a more rigorous application of the (recovery) program.”
No, Things Won’t Go Back to the Way They Used to Be …
… but they can be even better. It may be a hard pill to swallow (no pun intended), but as the University of Pennsylvania Health System points out [20], addiction, like diabetes, “can be managed successfully with proper treatment. But treatment is lifelong. It’s chronic, it’s progressive, it’s characterized by relapses … and if untreated or mistreated, it can and will result in death.”
However … the treatment numbers are promising: “70 percent of alcoholics who stay engaged in treatment for a least one year achieve lifelong sobriety. With drugs, it’s between 50 to 60 percent.” But even more than that, treatment – via therapy, 12 Step recovery, religion, or any self-improvement regiment – can change lives. Recovery promises a “new way to live,” not that a recovering addict can get his or her old life back. Going “back to the way things used to be,” as some family members might lament, is simply turning back the clock to a time when the problem was swept under the rug, not discussed, and pretended that it didn’t exist.
Clearly, that strategy has failed – the family dynamic and the individual in your life who suffers from the disease of addiction. “The way things used to be” is and should be off the table, but that “new way to live” can mean grand changes on a positive scale – for the recovering addict and for his or her family.
It takes time, it takes effort, and it certainly takes support, but a better understanding of these 10 things will help get you there.