Tuesday, February 10, 2015

Here are my notes from my textbook reading on the subject of family systems and substance abuse this week. 

Ackerman (1983) states that the "key to surviving in an alcoholic home is adaptation" (p.16). 

We know that one of the developmental tasks of children is to learn to adapt to their surroundings. Therefore, the adaptation to a dysfunctional, chemically dependent system will create dysfunctional behaviors in children as they interact with outside systems and as they grow into adulthood.

No matter what your belief about the etiology of addiction, - biological, sociological, psychological - it clearly passes from generation to generation.

Many addictive families share common characteristics.  Secrecy (disengagement), for example is extremely important. Denial of the problem is also paramount. Family members will go to extreme measures to keep the secret and to avoid dealing with the issue of alcohol / drug use.

Characteristics of addictive families: 
1. Hypervigilance - constant state of fear 
2. Lack of trust 
3. Inability to identify and express feelings 
4. Highly vulnerable to shame 
5. Afraid of abandonment 
6. Communication is angry, hostile, and critical 
7. Intense love or hate 
8. Totally in control or totally out of control 
9. Either enmeshed or disengaged 
10 Partners are so interrelated they are inseparable emotionally, psychologically, & sometimes physically from each other or from their drug of choice 
11. Behaviors center around "If you love me, you will (or will not) ...."  

Mal-adaptive behaviors: 
1. Being over-involved 
2. Obsessing 
3. Attempting to control another's behavior 
4. Trying to gain approval of others 
5. Making great sacrifices for others
6. Repeating the same pattern seen in family of origin 
7. Seeking out abusers to marry 
8. Either totally dependent or totally disregards feedback of others 
9. Drawn into relationships with needy individuals 
10. Shields the abusing partner from unpleasantness 
11. Pattern of preserving balance becomes a coping mechanism 
12. Enabling - a form of protection - anything done to protect the chemically dependent person from the consequences of his behavior  - results from attempting to adapt rather than confronting

Research supports that substance abuse in families impairs a child's physical, social, and psychological development in a way that may lead to an adult with mental illness or substance abuse issues (McCrady, Epstein, & Kahler, 2004).

Children in these families are at high risk for the development of a variety of stress-related disorders including conduct disorders, poor academic performance, and inattentiveness.
Children in substance-abusing families are socially immature, lack self-esteem and self-efficacy, and have deficits in social skills.  Furthermore, because these children live in chronic chaos and trauma, they might develop long-lasting emotional disturbances, antisocial personality disorders, or chemical dependence in later life. Children may become addicted to excitement or chaos and may develop inappropriate behaviors such as fire setting or, conversely, may become the "superresponsible" child in the family, taking on parental roles.

Factors that impact the parental chemical dependence on children: 
1. The sex of the abusing parent 
2. The sex of the child 
3. The length of time the parent has been actively abusing 
4. The extent of the abuse/ dependence on the chemical 

Four family structures of alcoholic families: 
1. Functional - abuse is connected to social or personal problems
2. Neurotic enmeshed - stereotypical -
3. Disintegrated - separation occurs between the abuser and other family members.
4. Absent - permanent separation between the chemically dependent person and the other members.

Ackerman, R.J. (1983). Children of alcoholics: A guide book for educators, therapists, and parents. Holmes Beach, FL: Learning Publications.

McCrady, B. S., Epstein, E.E., & Kahler, C.W. (2004). Alcoholics Anonymous and relapse prevention as maintenance strategies after conjoint behavioral alcohol treatment for men: 18 month outcomes. Journal of Consulting and Clinical Psychology, 72(5), 870-878. 

Stevens, P., & Smith, R. (2013). Substance abuse counseling: Theory and practice (5th ed.). Boston: Pearson.

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