To understand the addict’s family, let’s first look at families in general and how they function. In its most basic form, a family is a task-oriented group, with the primary purpose being the promotion of the health and welfare of its members.

Although families may be made up of any combination of members in relationship to one another, let’s look at a family that consists of two parents and several children living in the same house; the father is the primary wage earner, and the mother has primary responsibility for the day-to-day care of the children.

Roles in this family are clearly defined and mutually agreed upon. They are age-appropriate, with clear patterns of communication and clear boundaries. The parents have a healthy, mature relationship, and their emotional needs are met by each other or by other adults. They are therefore able to tune into and respond to the emotional needs of the children without having to take into account their own needs. The children’s role is to get educated and grow up. They do not have to be concerned about their parents’ well-being; it is a one-way relationship. There is a healthy intergenerational boundary.

By the same token, parents and children alike in this family allow each other to express themselves, to work out their own problems, and to have privacy. There are healthy interpersonal boundaries. Family members are free to experience and express the entire range of emotions that define their experiences in life, good or bad. They are free to pursue goals and interests outside the family, to be creative, and to give of themselves to others in the community.

There are three things to notice about this family: (1) it has a distinct task - raising the kids - that everyone agrees upon, (2) it has a well-defined and healthy structure that is geared toward completing the task, and (3) it has efficient ways of dealing with feelings and identifying and communicating physical and emotional needs. Because those elements are in place in the family, its members experience the home as a relaxing and renewing place to be, and they are therefore able to go out into the world as creative and productive beings.

Furthermore, when crises such as illness, death, or financial setbacks come up, the mechanisms are in place to deal with these additional pressures without straining the family to the breaking point.

Another phenomenon that we see in all types of families, as well as in many biological and sociological systems, is that of homeostasis, which means “staying the same.” Biological systems tend to stay the same, because homeostatic mechanisms keep them that way. For example, our body temperature generally stays about the same. If we become too hot, we sweat and cool off. If we become too cold, we shiver and warm up. On a psychological and emotional level the same principle applies. We tend to resist change. Sometimes choices that may at first seem self-defeating can be understood if we realize that the person making them was just trying to keep things on an even keel, consciously or unconsciously. Families also will resist change and will adapt in a variety of ways to any stresses that threaten to change the status quo. Sometimes these ways are helpful, but sometimes they are not.

While the family is trying to cope with the addiction, a lot of the changes that are made serve to keep the situation as stable as possible. In a family with someone who is recovering, there will also be a general resistance to change for the same reason. Anything that is different - whether it’s positive or negative - will be hard to incorporate into the family system if for no other reason than that it rocks the boat, which is uncomfortable.

Elizabeth Connell Henderson, M.D.

Glossary

Appendix A: Regulation of Addictive Substances

Appendix B: Sources of Additional Information