“Addiction Is a Family Disease.” What Does That Even Mean?

addiction is a family disease

The statement that addiction is a family disease is driven a lot by the age-old debate of “Nature vs. Nurture.” Genetic and environmental variables are at hand with the disease of addiction. The family plays a huge role in the nature vs. nurture concept as family is literally where our genetics come from and the environment we are raised in.

With that in mind, I often hear clients say, “Well, my family was great, and I had no trauma, so my family has nothing to do with my disease.” While that can often be true, it doesn’t automatically remove the family system from having a role. On the other hand, from the families of our clients, I often hear “I’m not the one with addiction, they are, it’s their problem and there’s no need for me to work on anything.” While it might also be true, they’re not the one with the addiction, this does not exempt them. They also need to do some work because addiction affects everyone, not just the addict.

Even in the most ideal family systems we can still learn maladaptive ways of coping through our family. It is usually not from malicious intent or even a conscious thought.  Most families are not thinking “If I don’t teach them how to cope, then their life could get destructive and that would be great.” Rather, families often just want their loved ones to stop experiencing fear, sadness and/or anger, but when they step in to sooth and comfort, they often teach avoidance and distraction. This usually occurs through giving them food, toys, candy, putting on the show they want to watch, letting them go play, giving more time on the video game, etc., all while not realizing we just taught them they need something external to fix something internal.

Then there is generational trauma, generational shame, family roles, family messaging, family secrets, family boundaries, or lack thereof, and the role those play in the family systems nature and nurture. With all that in mind, we have to look at the disease of addiction as a family disease in which everyone needs healing, effective coping, healthy communication and appropriate boundaries. All of that is simple in theory, but the actual application is where it gets challenging.

At Makana, we build from the attachment module I discussed in my last blog and then look deep into family dynamics to see how the family functions as a system. Often, we can see the roles in family systems present with the client’s role in the community within a few days. We use that present experience to see how the past shapes the present and manifests, because everywhere I go there I am. After recognizing the role the client takes on, we look at the family system and messaging that have placed and kept them in that role. We then look at generational systems to see how that has possibly been passed down by previous generations.

Once clients have a better understanding of how the family system has played a role in their struggles and strengths, we can then help the client identify where the healing for them, and ultimately their family, can start. It’s unfortunate, but often unresolved trauma has been experienced directly and indirectly by our clients through their family systems. While it happens, trauma doesn’t always automatically mean abuse, neglect, abandonment, etc.  Trauma can be anything that has changed a persons’ view self, others and/or the world in which beliefs and functioning were created and implemented to prevent this trauma from reoccurring.

It is with these family traumas in mind that our family dynamics module has a trauma-informed care approach we gear the healing from this module towards reframing these beliefs that have kept the family system stuck in a trauma response. In this reframing we teach the client not only how to recognize these family messages and roles so they can know the unhealthy functioning these beliefs perpetuate, but also how to redevelop these beliefs to be more realistic, healthy and functional.

Then we identify the client’s and family system’s resilience so they can see that their family system has the potential to heal and grow. We teach them this through examining boundaries, communication and needs within the family system and for self. To put it simply, many struggles in a family system with boundaries and communication come from unmet needs. These unmet needs usually include support, connection, feeling seen and heard, understanding and safety/trust. When these needs aren’t met, we usually go about getting them met in unhealthy and/or disruptive ways, or we go deep into forms of avoidance and numbing as to escape the experience of these needs not being met. However, when the family system can identify and reframe negative beliefs, practice healthy communication, appropriate boundaries and effective coping, these needs are usually met which leads to a functional family system.

Ultimately, a healthy and functional family system limits the triggers and stressors that can instigate or perpetuate the cycle of the addiction, making this one less thing a person will get high or drunk over. In summary, family is a part of both nature and nurture which can contribute to the development and continuation of addiction, therefore why “Addiction is a family disease.”

Written by: Joe Roller, LPC, LCDC