Addiction research should give more attention to the relatives of addicts
Addiction research should give more attention to the relatives of addicts
Bad Brückenau, May 2015 – The families of addicts need just as much help as the addicts themselves. However, unlike addicts, families hardly find adequate support because their roles in the addiction context are not adequately assessed and differentiated. To quickly, they are put in the box of co-dependent persons who need the dependence of the addict in one way or the other and eventually —intentionally or unintentionally—additionally fuel the addiction by what they do or don’t do. This point of view which has been established for decades, is disputed among professionals. The therapists of My Way Betty Ford Klinik have committed themselves to provide information on addiction and dealing with addiction and to sensitize the public for the condition.
Since the term “co-dependence” was coined, it has been used in an undifferentiated, generalizing manner. There is no generally accepted definition of the term in addiction research and the approach was never empirically validated. The concept tends to assign a co-responsibility and independent clinical profile to the family members of addicts, first and foremost to their life partners. Still today, most of the recommendations for families are based on this approach. However, support offers for families cannot be generalized. Yes, the families of an addicts are affected by the addiction and suffer from an above-average rate of stress-related conditions such as sleep disorders, burnout, depression, anxiety and psychosomatic disorders including eating disorders. Particularly affected are the children. They are at an increased risk of developing behavioral problems and substance-related disorders later in their lives. In addition, they often start substance use at a young age.
Hence, the situation of families deserves a just as customized approach as the treatment of addicts and the dynamics between a couple or in the family must be taken into consideration. Family-related factors are more important for the development of a child than the consumption behavior of an addict. Going to the meetings of one of the Al-Anon groups—self-help groups for families of alcoholics—can be helpful for relatives and also provide temporary relief by being able to talk about the problem. However, recommendations exchanged at group meetings should not necessarily be considered as being effective in general. On the contrary: In the initial phase of the Al-Anon movement, the groups worked on the assumption of co-alcoholism as an illness.
The therapists of Betty Ford Klinik are convinced that this approach to co-dependency can no longer be maintained. Their view is broadly supported by researchers and clinicians. In their survey article “Family Members of Addicts—The Explanatory Value of the Concept of Co-Dependency” published in the periodical “Sucht”, Michael Klein of the German Institute for Addiction and Prevention Research in Cologne and Gallus Bischof of the Center for Integrative Psychiatry at Lübeck University, draw the following scathing conclusion: “Ultimately, we see that—in terms of providing adequate, effective help for the partners and families of addicts—the concept of co-dependency has been counterproductive and an obstacle for research during its entire history. Families of addicts in general and partners of addicts in particular can probably be helped much better in the future if this concept is abandoned and a differentiated approach based on psychological and social medicine models is used and emphasized in healthcare policy in the future.”
Practical counseling of addicts in matters of everyday life is challenging and even therapists are pushed to their limits because the mostly irrational behavior of addicts is difficult to understand. Being overwhelmed by the circumstances and worried about the addict, relatives mostly tend to act intuitively. We see all shades of coping mechanisms, from full procurement of the drug to complete rejection. Therefore, relatives need to identify their specific problems, dependencies and entanglements, as in the case of other problems between partners and within families, and not hide behind the obvious addiction of the other. This is not about making everything your own fault but about looking at the interactions with each other. Both sides must develop more self-awareness as well as relationship awareness. The process can only be successful, if mutual projections and attributions of guilt are avoided.
My Way Betty Ford Klinik in Bad Brückenau gives families of at-risk and addicted persons the following general guidelines. These are our recommendations for help and self-help:
- Get information, seek advice and help.
- Join a group with people who have the same problems as you do (self-help group).
- Accept that addiction is an illness.
- Point out the addiction problem and the necessity to get help to your family member in a calm and neutral, yet firm manner, without blame and reproach.
- Show empathy and understanding, listen attentively instead of doing the talking and just providing good advice.
- Ask why the substance is used and, together, weigh the pros and cons of substance use.
- Don’t expect immediate happy sobriety.
- Take the addict seriously in his attempt to live without alcohol or without the substance—also the manner in which he tries to become healthy again.
- Encourage him to do new activities, be supportive if he wants to change his behavior.
- Don’t let yourself be discouraged by relapses . Discuss the relapses in you group.
- Stop trying to control the addicted family member.
- Learn and exercise to no longer get tangled up in psychological games of accusations, attacks or protest .
- Create a relaxed atmosphere for yourself and for your family member.
- Get to know your own problems, needs and desires better.
- Develop your own interests and design your life in a positive way.
- Maintain and develop personal autonomy.
- Develop trust and a calm manner.
A reasonable approach includes the partner in the therapy of the addict without necessarily declaring him as co-dependent. This so-called behavioral therapy for couples uses techniques which affect both the addict, the partner and the mutual relationship. The following techniques are worth mentioning as they can help relatives:
- Problem solution training
- Communication training
- Development of problem-solution abilities of the couple
- Development of a positive exchange in the relationship
During treatment at My Way Betty Ford Klinik already, the therapist develops a follow-up plan close to home together with the patient. Whenever possible, the family should be integrated in the plan. The follow-up plan serves to sustainably consolidate the therapeutic success and is set up in close cooperation with local physicians and therapists.
My Way Betty Ford Klinik is available with advice for patients and, with their consent, also for their relatives, even after discharge. You are welcome to contact us personally, over the phone or via the internet.
Despite the enormous information and counseling needs of relatives, only a small portion of patients uses the offer of a meeting with the family, even at Betty Ford Klinik. Against the background of their daily work experience, the therapists of Betty Ford Klinik therefore call for early and differentiated help and support measures, adjusted to the individual circumstances of the partners of addicts. While addicts have been able to take recourse to a variety of offers for help, their partners, parents and children have often been looking for support unsuccessfully. The competence of available sources of information such as newspapers or the internet cannot be verified. This is also a challenge for the healthcare system: researchers and addiction treatment centers must be enabled to integrate relatives to a greater extent in a customized therapy approach. Limiting addiction therapy to the addict is short-sighted. The way relatives of addicts have been treated in the addiction context, stigmatizes them by using the inadequate term “co-dependency” .
Profile of My Way Betty Ford Klinik:
My Way Betty Ford Klinik in Bad Brückenau is the leading addiction treatment and substance withdrawal center in Germany. The intensive therapy program is unique in Germany and is targeted at private patients and self-payers. 36 single rooms are available to accommodate patients. Absolute discretion is our top priority . The competence team of our center is committed to the goal of accompanying their patients on their way to a fresh start in life, equipped with new abilities and without addictive substances. Our therapists have longstanding experience in the treatment of addiction and, for many years, have been offering further training for general physicians treating patients with addictions. Against this background, the management of the center has decided to promote the information of the public on topics such as dependence, detoxification and withdrawal and to sensitize for the condition.
My Way Betty Ford Klinik opened its doors in 2006 quickly acquired an excellent reputation throughout Germany. Our therapy concept is based on the successful therapies used at the Betty Ford Center in California, USA.
My Way Betty Ford Klinik® GmbH
Fon: 0800 / 55 747 55