Friday, July 10, 2009

Addiction as Disease Does Not Equal Get Out of Jail Free

Sometimes family members have a hard time with the idea that addiction is a disease. When this is the case, it often has to do with the issue of responsibility. Sometimes family members believe that "disease" is equated with a "get out of jail free card" or not being held responsible. This is not the case.

An addict has responsibility for choosing recovery over choosing to stay in the illness. They have responsibility to do whatever is necessary to maintain sobriety after they have interrupted the addiction cycle by quitting drinking, using, or engaging in addictive behaviors like gambling addiction or sexual addiction. They also have responsibility for the inappropriate and devastating behavior that they engaged in during the active addiction.

One of the overarching tasks and goals of early recovery is to take responsibility for that recovery and for the devastation caused by the addiction. This is important in order to gain insight distorted by denial and other defense mechanisms, to gain a new direction in life, and in developing the living skills that are needed to recover.

Family members are naturally "irked" by the idea that the addict gets off the hook for their behavior because they have an illness. The truth is that they are not being held not responsible. They are responsible for their behavior. Family members are equally responsible for their own behavior, in the maladaptive family dynamics that occur in the addiction context.

Spouses and parents often try to solve the problem of the addict's addiction for a very long time before the addiction is correctly identified. They often end up enabling the addict, by their very problem solving attempts. These family members usually tolerate intolerable behavior and situations over a long period of time, lose themselves in the process, and yet depend on the addict to step up and make it all alright.

Even sober or abstinent, the addict cannot make it all alright. The family member has often invested all their time, energy, and other resources in the development, nuturance, or reclamation of the addict, and has neglected themselves in the process.

In reality, family members are responsible for their own choices, decisions, and behavior in the addiction process--just like the addict.

One of the things that happens in the family dynamics of addiction is the circular blaming that each engages in. The addict often blames the family members for the problems that occur in the family, in their lives, and the family member often believes them. The family member typically feels compelled to engage in inappropriate caretaking or coercion of the addict, trying to get them to straighten up. There is a direct parallel between the compulsion to fix the addict and the addict's compulsion to "use". The family member often gets to the point where they blame the addict for their own choices, saying "I had to do ____ because he did _______".

The reality is that both had choices and responsibility for those choices each step of the way. Addiction negatively affects everyone in the family. No one escapes unscathed.

The good news is that each person involved in the scenario can recover, regardless of whether the other does. This, again, is based on choices and responsibility for one's own choices.

There is no doubt that the inappropriate behavior of the addict hurts the family members. The dishonesty, the inability to be emotionally present, or the inability to engage in adult responsibilities with emotional maturity is often part and parcel of addicts in their addictions. Family members are justifiably angry about the addict's behavior. If they have much insight into addiction, they are understandably concerned about the continuation of that behavior.

Recovery is a process that occurs over a long period of time. When the addict enters recovery by stopping the compulsive consumption of their drug of choice, things can begin to get better. However, abstinence is only the very, very, very beginning of recovery. There is much work to be done.

Family members also need their own recovery process. Family members do not recover by being a non-involved bystander or by continuing to invest in the addict's vs. their own recovery. Any person's recovery is contingent upon their taking responsibility for that recovery. Relationships can recover as each works on their own issues.

Spouses get to choose whether or not they are willing to remain in a relationship with uncertain recovery outcomes. Relapse is a common symptom of all addictions, and all chronic illnesses. Sometimes spouses decide that they have had enough and choose not to remain in the relationship. In some cases that could be the most responsible action they can take in caring for themselves.

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