Welcome to the Family Program

1. Welcome to theFamily Program

2. Family Program An Overview:

3. Chemical Dependency is a symptomatic, treatable disease

4. Concepts for families to understand:

5. The Three C’s

6. I didn’t Cause it

7. I didn’t Cause it I can’t Control it

8. I didn’t Cause it I can’t Control itI can’t Cure it

9. The DiseaseModel of Addiction • A disease is any deviation from a state of health. • In 1956, the AMA acknowledged alcoholism as a disease. • Dependency has symptoms. • It is treatable and has a prognosis. • If you treat it as a disease, people get well. If not they don’t.

10. The DiseaseModel of Addiction • It has symptoms. • It is primary. • It is progressive. • It is chronic. • And left untreated it is fatal.

11. Blackouts Preoccupation Medicinal use Tolerance Unpredictable Personality changes Loss of control Using alone Withdrawal Hiding the Drug Rapid use Relief use Consequences Indefinable fears Physical & Moral Deterioration Symptoms

12. Blackouts Temporary loss of memory of what happened while using. A blackout can last a few minutes, hours, or days.

13. Preoccupation Excessive thought devoted to desired substance in place of other productive thought. Preoccupation indicates the top priority chemicals have in a person’s life.

14. Medicinal use Chemically dependent persons tend to prescribe for themselves, seeking relief from tension, pain, anxiety, or as an aid to sleep.

15. Personality changes The person behaves in a manner unlike themselves.

16. Loss of control Once a chemically dependent person takes the first drink or drug, the outcome is an uncertainty.

17. Hiding the Drug This can include being misleading about the amount consumed by hiding empty bottles and making strong mixed drinks.

18. Rapid use Large amounts in a short time.

19. Relief Use Rationalized use, “I deserve it” or “If you had my problems”

20. Consequences Hospitalizations, incarcerations, trouble with the law, loss of jobs-school-friends- family, financial, physical & death.

21. Indefinable fears Living in a state of constant anxiety and paranoid with no apparent reason.

22. Withdrawal Shakes, tremors, and other physical symptoms.

23. Physical & Moral Deterioration Chemically dependent persons experience physical life- threatening consequences and their behavior often becomes unthinkable at some point in their lives.

24. Primary • Dependency is not a secondary symptom of another disorder.

25. Progressive • The disease gets progressively worst over time. The dependent becomes increasingly physically, spiritually, emotionally and psychologically ill.

26. Chronic • There is no cure. Recovery from the disease is based on complete abstinence from all mood altering chemicals.

27. Fatal • The disease can only be arrested. If not, the person will die.

28. The Progression of the Disease

29. The Progression of the Disease • Phase I: Learning the Mood Swing Pain Euphoria N

30. The Progression of the Disease • Phase I: Learning the Mood Swing Pain Euphoria N

31. Phase I: Learning the Mood Swing Pain Euphoria N Learns that chemicals affect mood Creates a positive mood swing every time Learns to trust the chemical Learns to control the degree of the swing by regulating the quantity consumed

32. Phase II: Seeks the Mood Swing Pain Euphoria N Applies what was learned in phase I to social activities Uses the chemical at appropriate times and places Develops self imposed rules and adheres to them, i.e. :I don’t drink after 5 PM.” May suffer consequences Continues ability to control the times, quantities, and outcome of all chemical using experiences Social users remain in this phase. Victims of Chemical dependency advances to phase III

33. Phase III: Harmful Dependency Pain Euphoria N Begins to experience periodic loss of control over chemical use. Can no longer predict outcome once use begins. Behavior under the influence in conflict with person’s value system causing emotional pain. Spontaneous rationalizations arise and hide the emotional pain. This loss of insight becomes a growing delusion. Negative feelings about self remain unidentified and therefore are irresolvable. This results in a growing chronic emotional distress. Experiences growing anticipation and preoccupation with the use of the chemical.

34. Phase III: Harmful Dependency Pain Euphoria N Lifestyle changes and tends to revolve around using. Specific times to use are established and rigidly conformed too. Self imposed rules established in phase II are now regularly being broken. Tolerance increases causing the victim to create more ingenious ways to get, use, and keep the chemical. i.e. hiding and sneaking drinks. Projection of self-hatred on to others begins to occur. The dependent's whole life is deteriorating as chemical use affects health, spirituality, emotionality, and relationships.

35. Phase IV: Using to Feel Normal Pain Euphoria N

36. Phase IV: Using to Feel Normal Pain Euphoria N Using to feel normal has replaced Euphoria Blackouts occur frequently Tolerance decreases Physical addiction can occur Paranoid-like thinking is present Geographic escapes are made Spiritual bankruptcy Loss of desire to live

37. Family Session Write letters following format outlined in in the next two slides Information from letters will be shared at a family conference Call family member’s therapist to schedule conference at 920-231-0143 or 1-800-298-8170

38. Dear _______, I am writing this letter with love and support. Letter Format

39. 1st part of letter----write examples of examples of when the family member was drinking/using…give details of their attitudes, and behaviors…what actually happened and how you FELT about the situation. Letter Format

40. 2nd part of letter---write concerns you may have at this time. 3rd part of letter---your hopes for the future Letter Format

41. Sharing of this letter will take place during the family session, to be scheduled soon. Again please call therapist to schedule an appointment. Letter Format

42. Rules in the Addicted Family Don’t Talk Don’t Feel Don’t Trust

43. The Dependent’s use is the most important thing in the family’s life. For example, the addict is obsessed with maintaining supply, and the rest of the family is just as obsessed with cutting it off. While he hides the drugs, they search for them. While the addict stockpiles, family pours liquor down the drain.

44. The Dependent’s use is the most important thing in the family’s life. Like two football teams, their goals lie in opposite directions, but they are all playing the same game. They all plan their day around the dependent’s using hours. The addict tries to ensure nothing interferes with using, the family either frustrates plans, arranges to be at home to meet his demands, (or not to be at home to avoid his anger or possible embarrassment in front of friends).

45. The Dependent’s use is the most important thing in the family’s life. The dependent’s use is the overriding family concern around which everything else revolves.

46. Chemicals are not the cause of the family’s problems. At first the dependent and his family deny that the addict is abusing alcohol or drugs. Later the family denies the addict is dependent on chemicals. Finally, when dependency is glaringly evident, the family insists that it is only a complicating factor, not the root of whatever difficulties have lead them to seek help.

47. Someone or something else caused the dependency; the addict is not responsible. Here the addict’s tendency to project his/her guilt and blame (on someone else) gets crystallized into a “rule” that gets imposed on the rest of the family. The addict then redirects attention to the wife, children, job, or anything else to keep his/her using out of the spotlight. If the distraction is a person, then curiously that person often will accept the delusion and become overwhelmed with guilt and feelings of worthlessness.

48. Everyone in the family must be an “enabler”. When asked, family members are quick to say they would do anything to get the addict to stop. But unconsciously they are all helping him to continue–they are, in effect, “enabling” him. And everyone does their part to protect the addict, and in turn his dependency.

49. Everyone in the family must be an “enabler”. They alibi, cover up, take over responsibilities, and accept rules and quirks rather than rock the boat. Their actions are defended as love, loyalty, or family honor, but the effect is to enable the slow progression of the disease.

50. No one may discuss what is really going on in the family, either with one another or an outsider. Feeling threatened, the chemically dependent wants first to avoid letting outsiders know about family affairs and secondly to block family members from gaining access to new information and advice from outside that might undermine the family’s willingness to enable. A set of family rules evolves: don’t think, don’t talk, don’t feel.