How Does a Family Navigate the First Year of Recovery
So how in the world does a FAMILY navigate a loved one’s first year of recovery from addiction (whether to drugs or alcohol)? Is it even any of their business? Can they share their concerns with their loved one or will that cause their loved one to relapse? What are they supposed to do, now?
These and so many other questions grip the family desperate for the nightmare to be over. Whether your loved one went through a residential treatment program, did it on their own with the help of a 12-step program, decided to stop drinking or drugging and get healthy through nutrition and exercise or engaged the services of a therapist specializing in addiction [in other words, there is no one, nor right way to do addiction recovery], the help for the FAMILY piece is often missing. This missing piece can often complicate a loved one’s early recovery, and it can most definitely hinder a family member from getting on with and enjoying their own lives – regardless of their loved one’s recovery.
What Can Families Do to Navigate the First Year of Recovery
Helping the ENTIRE Family Navigate the First Year of Recovery Is So Important
Just as there is no one, nor right way, to “do” addiction recovery, the same is true for family recovery. However, my years of experience and my own consulting work with families going through this, have demonstrated the following suggestions can be very helpful for all concerned.
Appreciate the “Familyness” of Addiction
This statement simply means that one person’s addiction has an impact on those who deal with that person on a repeated basis. These articles expand on this concept:
Behind Every Alcoholic or Drug Addict is a Family Member or Two or Three…
The Dance of the Family Disease of Addiction
Understand Addiction For What it Is – A Chronic, Often Relapsing, But TREATABLE, Brain Disease
For this, I suggest you browse through The Addiction Project website (produced by HBO in collaboration with the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Drug Abuse (NIDA) and the Robert Wood Johnson Foundation) and/or watch the following two videos:
“What is Addiction?” (an interview with Dr. Nora Volkow, Director of the National Institute on Drug Abuse)
“The Science of Relapse” (helps one understand relapse, triggers and preventative measures)
Some of the concepts you’ll want to confirm, include:
- Why understanding the key risk factors for developing the disease (genetics, early use, social environment, childhood trauma, mental illness, repeated alcohol or drug abuse) help explain how a person “gets” an addiction.
- Why the key characteristics of the disease help explain the difference between addiction and substance abuse.
- That a “dual diagnosis” is when a mental illness and an addiction are present – in other words, two brain diseases — and why both the mental illness and the addiction must be treated at the same time.
- Why treatment has to be a disease management model and not an acute treatment model and what is involved in healing / re-wiring the brain.
- How the brain changes experienced by the drug addict/alcoholic are the result of their brain disease and thus are the cause of their changed behaviors/”thinking” and how those changed behaviors/”thinking” influence the family members’ brain changes and visa versa. (see next section)
Understand the Brain, therefore the Physical and Emotional, Impacts on the Family Members
I wrote my latest book, 10th Anniversary Edition If You Loved Me, You’d Stop! for just this reason. To help the family member, the friend, the drug addict/alcoholic, the grandparent, the child… anyone who is trying to understand what’s happened and how in the heck you find a way out. [It’s a short book, too 
!] This post also gives a snippet of the impacts on the family: “The Health Consequences of Secondhand Drinking.”
Some key concepts you’ll want to confirm:
- Why the fight-or-flight system becomes chronically engaged and what are the physical and brain impacts of such.
- Understand the “don’t tell, don’t trust and don’t feel” aspects of living with an alcoholic/drug addict results in ‘brain training’ family members to expect lies, stealing, broken promises; to always be on high-alert (hyper-vigilant).
- Understand how chronically coping with the drinking/drugging behaviors/”thinking” wires fight-or-flight neural networks and given we do not “flight,” the kinds of responses we do employ – anger, anxiety, depression, manipulation – in order to stay safe (cope).
- Understand the normalcy and toxicity of a family member’s rage, resentments, expecting the worse – identify those that are applicable.
- Understand that change for family members is about stopping their reaction to emotions (the stress response triggers of the fight-or-flight system) as if they were fact; understand the concept of reacting (from Limbic System) vs. responding (from Cerebral Cortex).
- Understand that the family member’s brain changes change their behaviors/”thinking” and how those influence the drug addict/alcoholic and other members of the family.
- Understand that healing the brains of all family members takes time and why family members are unable to go along with the notion of letting bygones be bygones just because the drug addict/alcoholic has stopped using/drinking.
Many family members have found wonderful support through 12 step programs specific to family members, such as: Al-Anon | Ala-Teen and Nar-Anon.
Be Aware of Key Issues for Both “Sides”
The following are the often unspoken worries family members (whether it’s the addict | alcoholic or the non-addict | alcoholic) have as they begin the first year of recovery. It can be very helpful to address these in some sort of written agreement WITH the help of an addition’s therapist, Recovery Coach, treatment team member or some other neutral third party who understands the complexities of what a family is going through:
- what the drug addict/alcoholic should expect from family members (i.e., not to try manage their recovery and specifically what is meant by this)
- what family members should expect from the drug addict/alcoholic (i.e., to tolerate their fears and reactions and what is meant by this)
- what recovery will look like for all concerned (i.e., attending meetings, seeing a therapist, taking craving medications, daily exercise, working with a nutritionist, yoga or other meditation activities)
- what to do about the issues that fell by the wayside while the disease was active, such as credit, employment, living arrangements, transportation, school, custody
- relapse triggers for the drug addict/alcoholic (e.g., family member always asking questions, feelings of being watched, vibes of: “You owe me after all I’ve done for you!”…)
- relapse triggers for the family member (e.g., drug addict/alcoholic not following through on promises, not working their recovery, not taking responsibility for actions, not taking proactive steps to let the family members know what is going on)
- drug testing, medications, dual diagnosis treatments
- identify a code word family members can use when a difficult issue arises in order to acknowledge the tension but postpone discussion of the issue until in a safe setting
- decide how family members will express their feelings / concerns
- talk about sober living environments or recovery homes (SLEs) and associated costs
- decide what is off-limits (e.g., talking about or asking questions about the work that will be done in therapy, trauma issues, coping issues, anger, depression; postponing thoughts of major decisions, such as divorce until _______; etc.)
- discuss bottom-lines, e.g., “You use, and I will __________.” – make sure all know what has been done to put these into play if the boundary is breached
- decide what to tell extended family, neighbors, friends and the children
- decide how alcohol (or other substance / prescription medications) will be handled in the home and at family events
- consequences (in detail) if portions of the plan are not upheld
Know It Takes Time
It took time to get to this place. It will take time to get to a new place. We’re healing brains – the organ that controls everything a person thinks, feels, says and does; an organ that’s triggered into action by sounds, sights, touches and smells; an organ whose existing reactions are mapped – maps that need re-wiring. Check out Understand Brain Maps | Change a Habit | Change Your Life. But in the meantime, there are awesome opportunities to live moments in each day with joy and serenity. I’ll leave you with one last article, First Things First – When Recovery From Addiction Feels Overwhelmingly Difficult, Keep It Simple.
Feel free to email me at lisaf@BreakingTheCycles.com to schedule a call to answer specific questions. There is no charge for these initial “help” conversations.
Lisa Frederiksen
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An article well written and very thorough Lisa. Great tips for families of addicts/alcoholics to address post recovery. I like the concept of “unspoken worries”. So true. Thanks again for your wisdom!
Thank you, Lisa! I remember, myself, the unspoken worries were killer because it kept us all walking on eggshells – something we’d all been doing while the disease was active. I appreciate your comment!
Great overview with excellent resources for family members. I am a psychotherapist and author. In my work, I have seen many families overwhelmed with the addiction of a family member. Families find it difficult to access resources for their responses. This article gives a clear overview on how to deal with such overwhelming issues. Thank you for your work.
I so appreciate your comment, Cherilynn. As someone like yourself who works with families, it’s wonderful to hear you think it can help.
[…] wrote a post about all of this recently, which I titled, “How Does a Family Member Navigate the First Year of Recovery“. I covered five key suggestions in that post, namely that all concerned need to […]