Addiction & The Family: Unwritten Roles & Unspoken Rules

This blog post is the second in a series contributed by Rachel Evans, LMSW, of the Center for Recovering Families at The Council on Recovery and Ashley Taylor, MSW, LMSW, of Heights Family Counseling. Read the first post here.

When someone has a substance use disorder, the people within their close circle – whether it be family, friends or a combination of both – adapt to the associated behaviors. Many roles that these people embody contribute to the functionality of the system itself. There are a few adaptations of these roles, but the most common are the hero, the scapegoat, the addict, the mascot, the caretaker, and the lost child.

(For a breakdown of these roles and their impact on the system, read our blog post.)

While someone in the family unit might outwardly display particular character traits, there are also feelings that exist beneath the surface that are harder to recognize. Not every family system will reflect these roles, but oftentimes, these roles are displayed in some form or fashion. By taking on these roles, people within the system are able to assert some control over the outcome of their situation and maintain a sense of normalcy in a situation where one can feel a loss of control.

Addiction and family

In families that deal with substance use disorders, there are also unwritten rules that members abide by in order to prevent disruption within the system. These rules are: Don’t talk, don’t trust, and don’t feel. People within the system follow these rules to maintain the status quo. “Everyone in the system often begins to believe that their needs no longer matter,” says Rachel Evans, Family Therapist at the Center for Recovering Families. These rules are adaptations made beyond the roles that people within the family unit follow that help protect their goal, which is to manage life with someone struggling with a substance use disorder.

Family members can come to understand it like this: We don’t talk about the addiction. Secrecy allows the addiction to thrive. We cannot trust the person with a substance use disorder. Addiction often comes with inconsistent behaviors, so family members often learn not to trust their loved one, and often suppress their emotional experiences of the addiction. Because of these learned rules, recovery often begins with talking openly about the addiction safely, rebuilding trust, and identifying emotions in every family member.

If you or a loved one is struggling with a substance use disorder, or if you recognize any of these roles and rules in your own life, contact us today to inquire about counseling and treatment options.

Finding Recovery at The Council’s Luncheons

The Council’s beloved Annual Speaker Series is more than a luncheon: time and time again, it has served as the starting point in a person’s recovery journey.

It’s a big claim – and to the outside observer, may seem far-fetched. How could a luncheon be the doorstep to recovery? The answer lies in community. As one attendee explained, “My view on recovery was very narrow. I felt like a complete low-life alcoholic doomed to a life of despair, but when I walked into my first Council luncheon and saw the massive crowd of happy and seemingly normal and successful people, my vision changed.”

This centuries-old misconception of addiction as a moral failing has long contributed to the feelings of shame that work to keep people trapped in their disease. The Council’s luncheon is a bold declaration that it is okay to have this disease; it sends a message that recovery is possible and worth our best efforts for every individual. The Council’s luncheon delivers a radical shift in perspective and opens the doorway to possibility. Said one individual, “The Council’s luncheon broke the stigma for me of what an alcoholic was and what a glorious life in recovery could look like.”

The Council's luncheons
Every spring and fall, up to 1,000 members of Houston’s recovery and behavioral healthcare communities attend The Council’s luncheons.

The sheer size of The Council’s luncheons further strengthens this powerful message. One attendee remarked, “I sat in this room with 1,000 people who were there to support recovery. I had never seen anything like it. For the first time in my life, I felt the stigma of addiction lift. Here was a place free from shame and judgment. A place to share the stories of addiction, but more importantly to share the promises of recovery and the resources available to every person in Houston through The Council.”

Because if addiction thrives in isolation, community is the antidote.

Through community we can nourish recovery. A community of recovery can change despair to possibility; it can give us permission to replace shame with self-compassion; it can provide a lifeline of hope.

Since its inception nearly 40 years ago, The Council’s Annual Speaker Series has raised millions of dollars to support local families impacted by addiction; it has shared a message of hope for recovery; and perhaps most importantly of all it has created a community of individuals who can find strength in recovery, together.

If you know someone who needs to hear lived experiences of the power of recovery, invite them to our upcoming luncheon. They might just walk away changed.

Now is the Time to Address Co-Occurring Disorders

As Houston’s leading nonprofit provider of prevention, education, and outpatient treatment services for addiction and co-occurring mental health disorders, The Council on Recovery has helped thousands of people enter recovery and families heal. As a leader though, it is our obligation to do more than serve. We need to look to the future, embrace behavioral health innovations that are grounded in evidence, and inspire others in times of uncertainty.

Over the past year, The Council has led just such a charge, through the formation of The Center for Co-Occurring Disorders. The Center is a groundbreaking initiative designed to address co-occurring mental health disorders concurrently. When we launched The Center, we knew there was an urgent need for these services; we also knew that if we wanted this effort to succeed – and to last – we had much more to learn.

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Our history in the behavioral health field told us that our efforts had to be disruptive. There have been far too many efforts to treat co-occurring disorders that have fallen short because those involved held on to the status quo; others could not conceive of how to reconfigure the existing frameworks; still others sought a one-size-fits-all solution; and others focused solely on direct services without modifying the systems in which they operate.

We knew The Center had to be different.

Our first year was a time to envision, generate ideas, and challenge existing systems. Through this process, we recognized that the approach to treating co-occurring mental health disorders needs to be multi-dimensional and uniquely catered to the individual patient. Here’s what we accomplished in the first year of this initiative:

  • We assessed the readiness of The Council’s own treatment programs to address co-occurring disorders in our clients.
  • We formed an advisory board comprised of leaders from the health, psychiatry, addiction and IDD (intellectual and developmental disability) fields.
  • We launched a 6-part workshop series that trained medical professionals in Houston to understand and address co-occurring mental health disorders, free of charge.

And these are just the first steps. Moving forward we intend to incubate, test and adapt the best models of assessment, treatment and payment. We will continue to educate the medical community on various aspects of co-occurring disorders, including their connection to trauma and suicide. We will continue to empower and equip healthcare providers with the skills and tools necessary to effectively and compassionately help those in need.

The Impact of Addiction on The Family System

This blog post is contributed by Ashley Taylor, MSW, LMSW, of Heights Family Counseling and Rachel Evans, LMSW, of the Center for Recovering Families

When someone we love deals with addiction, wishful thinking tends to surround their recovery. We think to ourselves, “If this person just gets better, then everything else will fall into place.” No matter how desirable that outcome, substance use disorder is a systems disease that requires a systems solution. Substance use disorders not only affect the person suffering, but also the people closest to them.

“By the time people get treatment, the family system has often regulated around the addiction to maintain the status quo,” says Rachel Evans, family therapist at the Center for Recovering Families. “The addiction has become the locus of control.”

Everyone who is involved in the system has adapted in ways they might not even recognize in order to maintain a sense of normalcy and peace, while watching someone they love battle a difficult disease. Because of this, many families are exhausted by the time their loved one enters treatment. Regardless of the ways in which the support system has regulated itself around the addiction, the relationship between the person dealing with substance use disorder and their families can be an important one.

impact of addiction on family system

“The collaborative effort of treatment is very beneficial,” says Rachel. When appropriate, having family members present for treatment improves success rates, and treatment benefits both the person struggling with substance use disorder, as well as the family members. When it comes to recovery, it is crucial that everyone is willing to do things differently in order to set family recovery at the core of the system. Through family recovery, everyone is able to gather and understand different strategies for coping with the new way of life for this person, as well as unlearning potentially harmful practices that had been in use prior to the recovery process.

This help can take the form of family treatment, support groups such as Al-Anon and Nar-Anon, and even individual therapy. When an entire system is affected, addressing the entire system is the most effective treatment. This takes the responsibility off one individual and makes the process a collaborative one. In this way, the person going through recovery can feel more supported in their journey, and feel the love and encouragement from those closest to them.

The process of addiction recovery is rarely linear, nor does it only impact the person working to overcome substance use disorder. When addiction is viewed as a systems disease, it can be addressed throughout the whole system. By viewing this process in a more collaborative light, we are able to better support and understand the journey of our loved ones.

If you or a loved one is struggling with substance use disorder, call us today at 713.914.0556, or contact us through our website.

A Message to Those Affected by the Opioid Crisis

This blog post is authored by Mary H. Beck, LMSW, CAI, President & CEO of The Council on Recovery

Most of us are well aware of the opioid crisis facing our communities. We read the grave statistics about addiction and overdose deaths experienced by so many. Impassioned advocates call us to action, treatment specialists inform us on the most cutting-edge practices, legislators pass laws and allocate financial resources to combat this public health emergency. All of this is vitally important.

Yet we are facing a parallel crisis, which is tearing apart families and leaving people in severe distress – a crisis to which our communities are often blind: the trauma and grief experienced by family and friends of those struggling with addiction or who are trying to live in the wake of an overdose death.

Our loved ones die – it is a sad, painful truth. For years, many of us live in fear of this truth – knowing that when someone we love so deeply is suffering from a chronic illness, death may be the outcome. We cherish the moments of reprieve and hope for recovery. At other times, we are doing everything in our power to save them – we suffer in silence once they are gone.

This is true whether your loved one dies from cancer, heart failure, brain disease, and yes, addiction too. If you are feeling the pain of a loved one’s substance abuse or their death, you are not alone. Over 100,000 people have died of a drug overdose in the past year alone – leaving spouses, parents, siblings, and friends behind.

How did we get here?

Americans take 80 percent of all prescription painkillers in the world. New reports from the Centers for Disease Control and Prevention and the Houston High Intensity Drug Trafficking Area confirm that drug overdoses have surged since the onset of the COVID-19 pandemic, both in Houston and nationwide. The sharpest increases were deaths involving opioids, primarily illicitly manufactured fentanyl. In the last year, fentanyl related deaths in Houston increased by 40%.

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The extremity of this surge is a cause for grave concern for our team, but it only strengthens our resolve to partner with local leaders and community partners to tackle this issue comprehensively and systemically. This takes a multi-pronged approach – focused on education and awareness, providing intervention and treatment, opening doors to recovery, and when necessary supporting family and friends in their grief.

If you are one of the millions watching a loved one’s addiction spiral out of control, or if you have already lost a loved one due to an overdose, you deserve the same compassion and support others receive when they are grieving.  You need a place to turn, where your strength and courage are honored, while your grief and emotions are nurtured. The Council on Recovery is that place – a place to start when you don’t know where to turn and a place to heal.

If you, a loved one, or a client/patient is struggling with opioid use, contact us today, and we can get them the help they need. For more information on our opioid use services, download our flyer.

The Council Responds to the State of Emergency on Child and Adolescent Mental Health

The American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry and Children’s Hospital Association declared a state of emergency in child and adolescent mental health, citing the ongoing COVID-19 pandemic and the inequities that result from structural racism. The Council on Recovery remains steadfast in our goal to help any and every child and adolescent affected by substance use and other mental health disorders in the midst of these national crises.

Child and adolescent mental health had worsened in the decade before the pandemic, with suicide becoming the second leading cause of death among this population by 2018. This only intensified with the challenges children and adolescents faced in the last year and a half. Students lost consistent access to friends and adults supports. Many took on new responsibilities, including childcare, housework and part time jobs, putting added pressure on developing minds. Tragically, more than 140,000 children in the U.S. lost a primary or secondary caregiver to COVID-19, with youth of color disproportionately impacted.

child and adolescent mental health

With substance use disorders and overdoses continually skyrocketing across all demographics, we commend and support the proposals included in this state of emergency declaration, including but not limited to:

  • Increase federal funding dedicated to ensuring all families and children can access evidence-based mental health screening, diagnosis, and treatment to appropriately address their mental health needs, with particular emphasis on meeting the needs of under-resourced populations.
  • Improve access to technology to assure continued availability of telehealth to provide mental health care to all populations.
  • Increase implementation and sustainable funding of effective models of school-based mental health care.
  • Fully fund comprehensive, community-based systems of care that connect families in need of behavioral health services and supports for their child with evidence-based interventions in their home, community or school.
  • Promote and pay for trauma-informed care services that support relational health and family resilience.

“One thing we know is that children and adolescents are 100% our future,” says Alejandra Ortiz, LMSW, adolescent therapist at the Center for Recovering Families, “And it is our responsibility that they feel empowered and safe enough, physically and mentally, to take on the curve balls life can throw at them.”

The Council’s Center for Recovering Families offers assessment, counseling, education and support for children and adolescents. This can include parent consultations and coaching as well. To learn more about our Children & Adolescent Services, call 713.914.0556, or contact us through our website today.