For family members, life with an addict or alcoholic can be harrowing and exasperating in equal measure. At best a using addict (a term which includes alcoholics), will be unreliable and unavailable to loved ones. At worst addicts lie, steal and turn into a person unrecognisable to their families, all of which causes untold emotional pain. Unsurprisingly family members have often descended into their own mental and physical break-downs as a result of long term coexistence with a using addict. The secrecy, shame and silence that surround addiction enormously contribute to the difficulties family members face, and inhibit people from accessing help.

However, times are changing and the range of services available for family members today is far greater, as is the understanding of addiction’s impact on their lives. Once an addict enters a new life in recovery and is able once again to live as an independent human being, family members also often experience vast positive shifts in their own psychology.

In 2018 a study conducted by Alcohol Research UK, surveyed 1565 people who had an alcoholic within their family. The participants of the study were 48.1% parents, 23.6% partners or ex-partners, 10.3% children, 8.7% siblings and 1.3% friends. Of these people, 71.9% had received help for emotional or mental health issues. I have pulled out some of the statistics mentioned within the study which I believed best depicted the alcoholic’s impact on family members[1]:

  • 55.1% of respondents reported having debts during their family member’s active addiction, compared to 44.0% during recovery
  • 27.7% of respondents reported that they couldn’t pay their bills during their family member’s active addiction, compared to 17.6% during recovery
  • 31.7% were victims of family violence during their family member’s active addiction, compared to 10.5% during recovery
  • 4.7% were perpetrators of family violence during their family member’s active addiction, compared to 0.9% during recovery
  • 8.7% of respondents were fired or suspended from work while their family member was in active use, compared to 4.0% when they were in recovery
  • 59.2% of respondents got positive work appraisals while their family member was in active addiction, compared to 89.9% during recovery

This data highlights the far reaching ripple effect of alcoholism for those surrounding the active alcoholic and the recovered alcoholic.

Throughout the nineteenth century the family was viewed as unhelpful to the addict’s recovery and often blamed for their addiction. For genetic and environmental reasons, family members were largely seen as the cause of an addict’s inability to remain clean and sober after having been rehabilitated[2]. The spouses of addicts were treated without compassion and their own suffering viewed as ‘personal psychopathology, rather than normal adaptations to a disorder both baffling and devastating.[3]’ These views seem archaic and typical of inhumane historic approaches to mental health. Nonetheless, the finger of blame for the disease of addiction’s incurable nature was pointed at codependency amongst family members and their enabling behaviour long into the twentieth century. Today psychologists agree that there are many reasons why an addict will continue to use substances even when they have lost jobs, their homes and when loved ones are departing from their lives. The most incomprehensible aspect of addiction is the perpetual relapse after an addict has experienced a period of time clean and sober.

Family members ‘enable’ when they prevent the addict from feeling the consequences of his/her behaviour. For example, many addicts live with partners or parents because they are unable to pay for their own accommodation and food. The addict’s family realises that if they do not provide a roof over their head then they will become homeless because they are incapable of looking after themselves. This situation is tragic as the addict is powerless over his disease but is usually a huge drain on the wellbeing of the family, requiring support but able to offer little in return for the love and practical help received. Codependency occurs when a family becomes habituated to the new, unhealthy home life.

When an addict recovers family members sometimes struggle to adjust to the sober, independent addict as the support and care are no longer required. ‘Family therapists have borrowed the biological term homeostasis to refer to a family’s tendency to maintain stability or equilibrium. When the individual seeks treatment or successfully completes treatment, families can fight to maintain that homeostasis, and dysfunctional behaviours can remain.[4]’ It usually takes a long time for an addict’s family members to grow with the new dynamics and expectations which result from an addict recovering. This reconstruction is gradual not least because the family have witnessed many relapses and need to trust that this recovery will not be short-lived. Drs. Stephanie Brown and Virginia Lewis found that the ‘emotional turbulence within the family produced by addiction continues well into the first three to five years of recovery.[5]’ Family members need to feel needed and loved in a new dimension, now that they no longer have the ‘dependant’ addict.

The Martha Washington Society founded in 1842, was America’s early recovery mutual aid support group. It created societies for wives and created junior groups for children. By 1951 when Al-Anon was founded, the powerful, therapeutic value of mutual support groups was clear. Al-Anon grew out of AA, for those whose lives have been affected by an alcoholic loved one. Evidence of the effectiveness of support groups can be seen in the growth of Al-Anon and Alateen. Each week thousands of Al-Anon meetings are held in 133 countries and today it is used by family members of addicts affected by any substance abuse. Many other support groups exist, run by private bodies, social services and charities.

Over the past twenty years, a family oriented approach to treatment has evolved. Treatment services emerged which combined therapy for parents and children. These centres offer parenting training, family therapy and seek to decrease the likelihood that the children of today’s clients will repeat substance abuse behaviour as they move into their own adolescence and adulthood. In this new approach to rehabilitation family members are viewed as advocates of recovery. Whilst each individual must find their own path to peace in their own time, nonetheless, communication between family members can be advantageous for recovery. It is the stigma of addiction in our society and the silence around its impact on all involved, which often prevents healing. Therefore speaking about what has happened is fundamental for changes and improvements to relationships. The word recovery for family members implies a retrieval of what was lost through substance abuse (e.g., trust, financial security, intimacy, laughter). For other people, whose family members have died through addiction, the term recovery means the long process of grieving and healing.

However, lives can be rebuilt. Family members in recovery stress the importance of keeping their own growth and recovery separate from their advocacy role in support of the addict. Advocacy is important because of the demoralisation and anger families often experience through repeated episodes of recovery initiation and relapse. The involvement of loved ones can accelerate the healing process for everyone. Communication with professionals and in support groups is also vital. Families need the knowledge that there are permanent solutions to addiction and that there is hope. Through telling their stories of survival, forgiveness and reconciliation, they can provide authoritative antidotes to the hopelessness that frequently pervades our society’s perception of addiction. Through all of these processes time heals and healthier lives can be reconstructed for family members. As the addict is rehabilitated and becomes a different individual, family members can also find new focus and growth.