Importance of Family Therapy

Importance of Family Therapy

Ishita Akula M.Phil (Clinical Psychology)

Family is often our first source of contact with the outside. We all belong to a family. Be it adopted, biological foster, or a group of individuals living together. Family shapes the individual infinitely. It forms the child’s personality, communication patterns, and the lens through which the world is viewed from.

Therapy is a dreaded word by most of the population. Therapy is often mistaken as talking to someone about how you feel. However, psychologists and counselors know the depth of it. Our job as MHPs is to be an advocate for counseling and therapy as well as clear any myths and misconceptions about it.

The family becomes the focal social unit through which the child learns about society, well-being, values, how to form relationships, and how to live their life.

Healthy families give birth to healthy adults. Unfortunately, not all families are functional and healthy in their way of living. Such families often raise dysfunctional adults. While one cannot choose the kind of family they are born into, one can certainly end the cycle of dysfunctional families. Moreover, even healthy families go through dysfunctional and harmful patterns which might need some resolution.

In such cases, Family therapy is the way to go!

What is family therapy?

Family therapy or family counseling is a form of treatment that is designed to address specific issues affecting the health and functioning of a family. It can be used to help a family through a difficult period, a major transition, or mental or behavioral health problems in family members (“Family Therapy”, 2014). Family therapy is beneficial to help resolve family issues and maladaptive transgenerational patterns. Facing issues that have created resentments, misunderstandings, and estrangement can help restore balance and the well-being of the family in therapy.

The goal of family therapy is to bring clarity to all relationships and to foster repair and closeness if family members choose. Family therapists believe that problems exist between people, not within people.

Such therapies could improve the relationship and bonding between siblings, parents, spouses, children, etc. Such therapies promote healing and solving family issues by involving in open discussions and other activities.

Goals of family therapy

  • Enhanced communication and problem solving
  • understanding of family patterns and dynamics
  • Foster empathy for each other
  • Conflict and anger management
  • Bringing the family together after a crisis;
  • Creating honesty, trust & support between family members;
  • Teaching better ways to manage stress and crisis
  • Instill forgiveness in family members
Importance of family therapy in addiction recovery

Studies reveal that the 12-month prevalence of Alcohol Use Disorder in India in the year 2010 was 2.6% and that of alcohol dependence was 2.1%. In 2012, 33.1% of all road traffic accident deaths were attributable to drunk driving. Around 62.9% of all deaths due to liver cirrhosis were attributable to alcohol use. It shows that addiction is widespread in the Indian population.

Globally, 50% of the deaths are caused by liver cirrhosis, 30% of the deaths are because of oral and pharyngeal cancers, 22% of the deaths are caused by inter-personal violence, 22% of the deaths because of self-harm, 15% of the deaths caused by traffic injuries, 12% of the deaths because of tuberculosis (TB) and 12% of the deaths caused by liver cancer were attributed to alcohol consumption.

Addiction can significantly affect families by impairing the functioning, health, and overall well-being of every family member—for those suffering from substance abuse and those who are not, too. Just as problems within the family can influence addiction, a supportive family environment can play an important role in the recovery process.

It becomes important that other members of the family take up roles and responsibilities to support the person who is undergoing recovery. The family shall understand the nature of addiction and how it impacts the behavior of the person who is addicted to a drug. This helps in supporting their recovery endeavors.

When the family isolates the addicted person, it only complicates the recovery. During family therapies, the therapist or the counselor offers advisory notes on how important it is to help the addicted person feel loved and heard during the recovery phase. This prevents them from getting back to drugs.

It is common to be angry, frustrated, and distressed about having a person who is addicted to drugs and has a dishonest attitude of theirs. But opening up hearts and sharing mutual feelings shall help the person regain confidence and trust from family members and thus prevent a relapse after recovery.

Families endure disruption to their routines and undergo stress and anxiety when a member is addicted to drugs or other substances. The family gets fragile and dysfunctional leading to distortions. In family therapy for addiction and substance abuse recovery, the entire family comes together in working out ways for a family member to help recover from addiction or substance abuse.

Beyond solving relationship issues and addiction problems, family therapy could solve other issues relating to stress, depression, family conflicts, financial complications, eating disorders, and other mental health problems and disorders.

Effect of Substance Use on Family

Substance abuse has several effects on the family members which are very unhealthy.

  • Negative emotions – As a result of the substance abuse, the family regularly deals with emotions like anger, resentment, anxiety, concern, guilt, and embarrassment. Continuous experience of such negative emotions might lead to mental health disorders in the members.
  • Safety – In some cases, the safety of family members may be put at risk by a person’s substance abuse. Children or spouses may also feel the need to obtain legal protection due to fear of their loved one’s actions.
  • Responsibilities – Certain family members inherit too many responsibilities or responsibilities that are not age-appropriate. This can cause children or spouses to become overwhelmed, anxious and resentful.
  • Communication –When a family member is abusing drugs, communication within the family unit is often negative and positive interaction is very limited. In addition, the needs, concerns, and wants of the family members other than the substance abuser may be overlooked.
  • Damaged Relationships –Substance abuse produces damaged relationships that can continue on through generations.
Coping with Addiction in the Family: Unhealthy Behaviors

Families often cope with addiction in unhealthy ways, such as by living in denial about the addiction or by following behind their loved one, picking up the pieces. Their lives may be taken over by the addiction wherein they spend time either getting help for it or covering up their mistakes.

The types of behaviors often noticed are Codependency and Enabling behaviors. These behaviors not only contribute to the addiction but also make recovery quite difficult or in the worst cases, impossible.

Codependency

Codependency is seen in imbalanced relationships where one person enables another person's self-destructive behavior such as addiction, poor mental health, immaturity, irresponsibility, or under-achievement. It often results when someone has to adapt to dysfunction in the family system. Codependent behaviors are learned thoughts, attitudes, and behaviors that lead to neglecting your own needs and desires in favor of being obsessively concerned with a loved one’s problems.

Codependent behaviors include:
  • Worrying constantly about your loved one’s drug abuse and the consequences of the addiction
  • Feeling responsible for solving their problems
  • Lying to others about a loved one’s substance abuse
  • Having very low self-esteem as a result of neglecting your own physical, spiritual and emotional needs as you focus solely on your loved one
  • Engaging in your own unhealthy behaviors that help you cope with reality, such as over-eating, excessive shopping, or obsessive Internet use
  • Basing your mood on that of your loved one
Enabling

Enabling behaviors keeps someone from dealing with the negative consequences of their actions. Not dealing with these consequences gives the impression that their behavior is somehow acceptable.

Enabling behaviors include:
  • Using drugs or alcohol with a loved one to help keep trouble at bay
  • Keeping your feelings inside in order to keep the peace with your loved one
  • Accepting your loved one’s justifications for substance abuse
  • Lying to others for them
  • Protecting loved one’s image by minimizing the consequences of the addiction, such as by making excuses for them or taking care of their responsibilities
How Children May Cope with Addiction in the Family

Children may develop their own set of unhealthy coping skills in response to addiction in the household and the chaos and uncertainty it inevitably brings. Many children blame themselves for a parent’s substance abuse and may strive for perfection to avoid upsetting the delicate balance in the household. Conversely, they may withdraw for the same reason.

Children who witness or fall victim to physical, emotional, or sexual abuse may develop post-traumatic stress disorder and suffer from related nightmares, insomnia, and flashbacks. They may withdraw socially due to a lack of social skills or the fear that someone may find out the truth, and they may suffer from anxiety born from an unstable living environment or from a deep-seated fear of losing their parent to the addiction.

Benefits of Family Therapy for Addiction

Due to the above effects and costs, it is important to involve the family in the recovery process. Some benefits gained by people in treatment and their families are:

  • A better understanding of the nature of addiction and recovery: Done with the help of psychoeducation. The family is taught the biological, social, and psychological factors involved in addiction. This helps in demystifying the myths, misconceptions, and prejudice that the family might carry.
  • Becoming aware of family dynamics: Addiction and Substance Use are affected and maintained by multiple factors. Family dynamics can be a major predisposing and enabling factor. Being aware of these dynamics as well as ways to resolve them will help the overall addiction process
  • Improving communication: For successful recovery, the familial environment should be conducive. Improved communication is essential especially when the family lacked appropriate emotional involvement.
  • Sharing feelings: During active addiction, family relationships go for a toss. Family members may be angry but unable to express it, they may fear relapse. It takes time to learn how to recognize, balance, and express these feelings.
  • Setting boundaries: This is an important step for everyone in the family involved. The recovering addict as well as the caregivers need to establish appropriate boundaries to ensure that there isn’t any threat to their recovery and mental health.

Learning self-care: In addiction treatment, the focus is on the person with the addiction. During family therapy, a parent or spouse may learn that they need help, too. They may be directed to try Al-anon or other mutual help groups in addition to finding an individual therapist

At Samarpan, Family therapy can take different forms in the addiction treatment process. It typically involves the whole family meeting together with the focal therapist, but sometimes only part of the family meets, or in atypical cases, each person might meet individually with a therapist. Each session lasts about an hour and may look different, depending on the family’s unique needs. For instance, an entire session might be devoted to talking about each person’s feelings and concerns, while another meeting may involve education on effective communication and improved listening to reduce misunderstandings.

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