Friday, February 3, 2012

What to Talk About When We Talk to Our Kids About Drugs

As a clinical social worker, who has spent almost three decades working with individuals with drug or alcohol problems, I've accumulated quite a collection of articles covering almost every aspect of substance abuse including those which focus on helping parents talk to their kids about the pitfalls and dangers associated with drinking and drugging.  And, sadly, because this topic remains just as pressing as it did then when I first started practicing as it does now, I thought I'd share some of the guidelines I've used with families over the years.

1.  Never, ever humiliate your child. Do your best not to "talk down" or be disparaging. You may be angry and upset, but hit the "pause button" before resorting to threats or remarks you may regret once having said them.  Remember, that toning down your reactivity is the surest way to open up new possibilities and dialogue. And you want to keep the conversation going.

2.  Never, ever confront your child while he or she is under the influence of alcohol or drugs (unless, of course, you think your child needs immediate medical attention).  It's important that when you have that talk that he or she is clear headed and sober.

3.  If your teenager is in emotional pain, let them feel it.  As a parent, I know there is nothing worse than watching your child struggle.  Our impulse is to rescue them.  However, if we don't let them struggle they will never learn how to manage for themselves and work through life's difficult patches.  This is not to suggest that we abandon them in their moments of need.  Rather, we can show them our love by letting them know that we have confidence and faith in their ability to solve their own problems.  Remind them that the pain is not there to punish them.  But is meant instead to show them where and when the healing can begin.  There is always another choice out there.

4.  As a parent, it's important to stay flexible but that does not mean be overly permissive.  You've got to have a bottom line. Your child needs to know, in no uncertain terms, what your limits of tolerance are.  How else can you maintain your integrity and reliability in their eyes?

5. Don't be a snoop. Be vigilant and on top of things, but don't micromanage or violate your child's privacy.  So avoid doing a reconnaissance of their room and reading their diaries.  It will only come back to bite you.

6.  The most common mistake parents make with their kids is to make threats they can't enforce.  Before establishing consequences for any kind of acting-out behavior, be sure you can follow through on them.  It's also a good idea to try and include your kids in the conversation as to what they think would make an appropriate consequence for them breaking or bending the rules.  And if two parents are involved they both need to agree on the mode of discipline that's to be enforced. That's crucial.  All too often parents are at odds with each other.  This kind of "splitting" only confuses kids and leaves them feeling as if no one is in charge.  And they're usually right.

7.  Don't vilify your child.  They're not a monster, although they can be acting like one.  Can you keep in mind that it's the drugs or alcohol which is distorting their behavior? Can you remember to tell them that you love them but hate what drugs are doing to them?

8.  Drugs and alcohol are powerful stuff and require "big medicine" to confront them, so if things begin to spin out of control don't try and go it alone. Get help.  If your child is at risk, don't hesitate to reach out and seek professional help.

(The inspiration for this list originates with the work of Dick Schaefer and his book, "Choices and Consequences:  What To Do When A Teenager Uses Alcohol/Drugs.)

Amy bows low at the feet of all her holy teachers.

Saturday, January 21, 2012

Couples and Recovery

As a psychotherapist, I've counseled and coached  couples for almost thirty years.  Their complaints run the gamut from "He leaves the toothpaste cap on the side of the sink" to "She's having an affair with my best friend."

But one of the thorniest and most painful of all issues which couples face remains that of addiction. It contaminates every aspect of a relationship and sucks the life right out of it.  A couple's world shrinks smaller and smaller as the addiction begins to dominate practically every aspect of their lives.  It doesn't take long before the non-abusing partner finds themselves organizing their life around the addiction and their addicted loved one.  The playing field between them is no longer level.  The "habit" holds all the cards.  Common sense would dictate that once the vicious cycle of addiction is broken, and the dependent spouse successfully abstains from drugs or alcohol and begins organizing their life around recovery, that peace would prevail and all would return to normal.  However, this is rarely the case.  Instead, what couples frequently experience is anger and resentment.  But why?  What's going on?

To better understand this seemingly paradoxical outcome, we first need to understand what occurs between couples when addiction is present.  Frequently, in a relationship in which one person uses and the other does not, spouses develop "over functioning" or "over responsible" and "under functioning" or "under responsible" styles and roles. Typically, the "over functioning" partner begins to assume more and more day-to-day responsibilities even if it means jeopardizing their own health and welfare to do so.  On the other hand, the "under functioning" spouse, who is abusing, increasingly neglects their commitments and obligations to their relationship and/or work.  The addict's orbit continues to contract into a smaller and smaller space in which there is room for only for two e.g., their habit and themselves.  Consequently, when caught in this downhill trajectory, couples become increasingly isolated and find that what ever future they have together has become suspended and frozen in time.

In my practice, I often hear the addict complain that their "over functioning" partner is a "nag" or "always on my case" while the sober partner retorts with how "irresponsible" and "untrustworthy" their partner has become )which in all likelihood they have).  What this dynamic describes is the distribution of power in a relationship which undergoes a seismic shit when sobriety enters the picture.  Most couples anticipate a smooth transition from addiction to recovery but, as I stated earlier, this is a common misconception and of of recovery's ironies.  Perhaps George Bernard Shaw, the renowned British playwright, said it best when he wrote, "There are two great tragedies in life. One is never getting your heart's desire.  The other is to get it."  The life lesson being that no matter how alluring a much sought after change may appear it, too has its downside. The once using partner who habitually occupied the one-down position in the relationship no longer finds themselves as the low man on the totem pole.  By virtue of being sober, they are now on equal footing or in a symmetrical alignment, so to speak with their partner.  Conversely, the sober spouse is no longer in the one up position.  Their "over functioning" stance is suddenly challenged.  The hyper vigilance which was required when living with an active addict is no longer necessary.

This period of readjustment can be scary and confusing for couples.  If the "over responsible" partner no longer has to hold everyone and everything together, what exactly should they be doing?  And, if the addict no longer has their addiction to keep them occupied what exactly do they do with themselves?  Sobriety requires that each partner redefine themselves not only in relation to themselves but with each other as well.  It can't be stressed enough that the early days of recovery are among the shakiest and couples are especially vulnerable as they  learn to adapt to its uncharted waters.  That's why it's important to advise coupes not to make any major life changes during that first year of sobriety.  Things need to decompress and even out first.

During the transition from addiction to sobriety, couples need to remember that recovery is a joint process which includes both parties. This is not to imply that each partner is responsible for the other's progress. However, it is important to remember that the once offending partner cannot be expected to shoulder all the weight for the couple's ensuing success or failure.  Their job is to stay sober one day at a time and to restructure their life around recovery. Concomitantly, their partner must undergo their own recovery as well.  They have emerged through a trail by fire, often traumatic, and need time to lick their wounds and heal, too.

And this is where a 12-step program becomes relevant. Just as Alcoholic's Anonymous is the cornerstone upon which an addict's successful recovery rests, Alanon is a crucial support for the "over responsible" spouse.  Alanon, which is geared towards those affected by a loved one's addiction, is essential because it not only provides education and information about chemical dependency, it also addresses the interdependency between the couple which is not conducive towards growth and well being.  The program teaches peo0ple how to differentiate between what is their responsibility and what is not. It proves lessons in limit setting and boundaries for those who do not know when and where to draw the line, so to speak.  As a wise teacher taught me, we all need to define a bottom line in order to preserve our dignity and integrity.

But regardless of whether or not one is part of a happy or unhappy relationship, the important thing to remember is that even the best of them is subject to a seemingly never ending process of distillation and resettling. The work is often difficult, painful and upsetting.  However, the promise of transformation and transcendence from what is to what can be remains nothing short of miraculous.

(For further reading on this subject, I recommend Claudia Bepko's and Jo Ann Krestin's "The Responsibility Trap" who originated the "over/under responsible" model from their inspiring work with couples and addiction.)

Amy bows low at the feet of all her holy teachers and to the teacher within.