Family Counseling

Rehab described addiction as a family disease: addict behavior impacts everyone in a household. Although addicts are very good at hiding the volume of drugs they consume in the early stages of addiction, eventually they get caught in the web of lies and cascading disasters that are byproducts of active-addict conduct. The stigma of drug abuse combined with the bewilderment of dealing with the irrationality of addiction lend themselves to shame, secrets, guilt, escalating fear and overwhelming anger. Communication is a casualty which must be addressed because returning to old patterns is adverse to sobriety. That’s why family counseling is so important at most rehabs.

Since addiction is a family disease, AA has always maintained that families need to work their own spiritual programs so all have tools to diffuse the inevitable conflicts that arise in family life, rather than let them fester. In family counseling loved ones learn about the disease, the program, and how to build their own programs to support sobriety rather than abet addiction. Families are universally urged to go to Al-Anon to learn how to stop enabling and how to take care of their own needs in the process.

One place family counseling starts is identifying the contradictory emotions rehab evokes: hope and fear. Hope that treatment will succeed, accompanied by fear that failure will plunge everyone back into chaos. Not-at-all gentle instruction on dealing with these conflicts honestly, fully, and fairly is an entry-point into learning a process for dealing with relationship grievances in sobriety.

These are very difficult lessons to learn. As a result, family counseling is extremely uncomfortable.

I, for one, hated it. It’s very painful to have to hear and appreciate the feelings, fears, and anger of long-suffering loved ones. But facing the guilt and shame sober is part of the learning process.

The tension in family counseling was always palpable, the result of the aggressive and unsparing questions the counselor was obliged to ask about how we’d stop lying to each other and start dealing with our problems as they happened and out in the open. She refused to let us waffle until she had answers to her upsetting questions to try to bridge the emotional gaps — chasms really — that open up in relationships involving drug addicts. (There’s a saying in AA: “Addicts don’t have relationships, they take hostages.”)

One touchy subject that routinely crops up is the alcohol and/or drug use of every family member. It’s very difficult for someone to stay sober if others in the household keep booze around and drink it regularly. For example, the wife of one of my fellow patients reported she continued to drink a bottle of wine every night after work, “to relax.” She eventually promised to give it up to support her husband’s sobriety, but only after a series of contentious challenges by the family counselor (and I didn’t believe her for a second).

Family counseling at rehab is just a start. open and honest communication has to continue after formal tretament. That’s one of the reasons all family members needed to work their own spiritual programs. Otherwise we’d lapse into old destructive relationship patterns. Honest communication was a skill that had to be practiced one day at a time, just like sobriety. We would all need continuing education. That meant immersion in AA for addicts and Al-Anon for families.

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