By Terence T. Gorski

In many cases the addict is the first family member to seek treatment.

Other family members become involved in order to help the alcoholic get sober.

Many family members refuse to consider the fact that they also have a problem that requires specialized treatment.

These family members tend to deny their role in their addicted family and scapegoat personal and family problems upon the addicted person. They develop unrealistic expectations of how family life will improve with their loved one getting abstinent.

When these expectations are not met, they blame the addict for the failure, even though he or she may be successfully following a recovery program.

Their attitudes and behaviors can become such complicating factors in the addict's recovery that they can contribute to the process of relapse and even "set-up" the addict's next "episode of use."

On the other hand family members can be powerful allies in helping the addict prevent fully engaging the relapse process.

Relapse Prevention Planning utilizes the family's motivation to get the addict sober. As family members become involved in relapse prevention planning, a strong focus is placed upon co-addiction and its role in the family relapse process.

Family members are helped to recognize their own co-addiction and become actively involved in their own treatment.

Addiction is a family disease that affects all family members, requiring everyone to get involved in treatment. The addict needs treatment for addiction. Other family members need treatment for co-addiction.

Co-addiction chronic and follows a predictable progression. When persons in a committed relationship with an addicted person attempt to control drinking, drug use, or addictive behavior (over which they are powerless), they lose control over their own behavior (over which they can have power) and their lives become unmanageable.

The condition of co-addiction manifests itself in three stages of progression.

Early Stage: Normal Problem Solving and Attempts to Adjust

The normal reaction within any family to pain, to crisis, and to the dysfunction of one member of the family is to do what they can to reduce the pain, ease the crisis, and to assist the dysfunctional member however possible in order to protect the family.

These responses do not make things better when the problem is addiction, because these measures deprive the addicted person of the painful learning experiences that bring an awareness that his/her addiction is creating problems.

At this stage, co-addiction is simply a reaction to the symptoms of addictive disease. It is a normal response to an abnormal situation.

Middle Stage: Habitual Self-Defeating Responses

When the culturally prescribed responses to stress and crisis do not bring relief from the pain created by the addiction in the family, the family members TRY HARDER. They do the same things, only more often, more intensely, mores desperately.

They try to be more supportive, more helpful, more protective. They take on the responsibilities of the addicted person, not realizing that this causes the addict to become more irresponsible.

Things get worse instead of better and the sense of failure intensifies the response.

Family members experience frustration, anxiety, and guilt.

There is growing self-blame, lowering of self-concept, and self-defeating behaviors.

They become isolated. They focus on the addict's addictive behavior and their attempt to control it. They have little time to focus on anything else. As a result they often lose touch with the normal world outside of their family.

Chronic Stage: Family Collapse and Stress Degeneration

The continued habitual response to addiction in the family results in specific repetitive, circular patterns of self-defeating behavior. These behavior patterns are independent and self-reinforcing and will persist even in the absence of the symptoms of addictive disease.

The things the family members have done in a sincere effort to help have failed. The resulting despair and guilt bring about confusion and chaos and the inability to interrupt dysfunctional behavior even when they are aware that what they are doing is not helping.

The thinking and behavior of the co-addict is OUT OF CONTROL, and these thinking and behavior patterns will continue independent of the addiction.

Recovery from co-addiction means learning to accept and detach from the symptoms of addiction. It means learning to manage and control the symptoms of co-addiction.

It means learning to focus on personal needs and personal growth, learning to respect and like oneself. It means learning to choose appropriate behavior. It means learning to be in control of one's own life.

RELAPSE PREVENTION FOR THE FAMILY

What can family members do to reduce the risk of their own relapse and the risk of relapse in the recovering addict? They can become informed about the addictive disease, recovery, and the symptoms that accompany recovery.

They must recognize that the symptoms of post acute withdrawal are sobriety-based symptoms of addiction rather than character defects, emotional disturbances, or mental illness.

At the same time they must accept and recognize the symptoms of co-addiction and become involved in Al-Anon and/or personal therapy as they develop plans for their own recovery.

All members of an addicted family are prone to return to self-defeating behaviors that can cause them to become out of control. An acute relapse episode can occur with an addict or a co-addict family member.

Like addicts who develop serious problems even though they never use alcohol or drugs, the co-addict often becomes dysfunctional even though the addict is sober and working an active recovery program.

RELAPSE WARNING SIGNS FOR CO-ADDICTION

( below is a partial list of behavioral warning signs in a recovering family environment)

1. Situational Loss of Daily Structure. The family member's daily routine is interrupted by a temporary situation such as illness, the children's schedule, the holidays, vacation, etc. After the event or illness, the significant other does not return to all of the activities of his or her recovery program.

2. Lack of Personal Care. The significant other becomes careless about personal appearance and may stop doing and enjoying small things that are "just for own personal enjoyment." The person returns to taking care of others first and self second or third.

10. Defensiveness. The co-addicted person may not totally approve of some of his or her own actions, but when challenged about them will openly justify the actions in a sharp or angry way.

6. Compulsive Behavior. The significant other experiences episodes during which he or she feels driven to do more. Whatever has already been done does not seem to be enough.

9. Return of the Tendency to Control People, Situations, and Things. As the co-addicted significant other feels less control over life, he or she begins openly to try to control and manipulate other people or situations. The addicted person may be the prime target, but does not necessarily have to be.

25. Failure to Maintain Interpersonal (Informal) Support Systems. The co-addict stops reaching out to friends and family. This may happen very gradually. He or she turns down invitations for coffee, misses' family gatherings, and no longer makes or returns phone calls.

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About Terry Gorski

Terence T. Gorski is an internationally recognized expert on substance abuse, mental health, violence, & crime. He is best known for his contributions to relapse prevention, managing chemically dependent offenders, and developing community-based teams for managing the problems of alcohol, drugs, violence, and crime. He has extensive experience working with employee assistance programs (EAP) and has special expertise in working with emergency professionals including fire, medical, and law enforcement. He is a prolific author and has published numerous books and articles.

www.tgorski.com

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