Undoubtedly, we devote the most attention to the family life of people addicted to alcohol at the stage of in-depth therapy, when working on guilt and reparation.
The family plays a special role in everyone’s life. Firstly, because in the process of upbringing, the family environment has a huge impact on the development of individual characteristics. Secondly, the family is the most important area in which the individual operates, a place where he fulfills his needs and desires, individual and social goals. The quality of family functioning is therefore of key importance to human life satisfaction: online rehab services – https://dopalist.com/
The goal of any family therapy is to bring about change. The essence and content of this change are determined differently, depending on the theoretical approach, i.e. on ways of understanding the mechanisms of family functioning and the therapy process.
In the area of our interactions there is a family with an alcohol problem. This is considered a family in which at least one person drinks in a way that brings other members numerous financial and emotional damage, while providing many life problems.
Of course, for there to be any positive change in the alcoholic family, we do not need to take care of all its members. However, when talking about improving or improving the family life of alcohol addicts, we must make it clear that not much is happening systematically in drug treatment in this matter. Rather, it happens “by the way.” Meanwhile, this is probably one of the most important elements of recovery. Let’s look at what we propose in this area and what are theoretical assumptions.
S. FAMILY HISTORY
The S. family came to the clinic in 1998. after the husband caused a car accident in the city center under the influence of alcohol. Earlier, when the husband began to drink more, the wife sought help in the Mental Health Clinic (she took medication briefly).
The family consists of four people. Ryszard is 45 years old, he has secondary education, works in an office, where he keeps financial records. He’s addicted to alcohol. 47-year-old Jolanta has a university education, she works as a librarian in high school. There is still a 16-year-old daughter in the family (studying; smart, talented, open) and a 21-year-old son who stays away from home (he studies in Warsaw, he comes home rarely once a month; he is often sick; he is taciturn, introverted) .
Currently, the financial situation of the family is at a minimum. Jolanta is trying to earn some extra money.
Ryszard comes from a working-class family, has two brothers, one of whom is also probably addicted. His father was a railwayman (he didn’t drink). Ryszard sees his family as good. He felt safe in her.
Jolanta’s father was a professional soldier. Jolanta is the oldest child. She changed her place of residence several times because of her father’s position. No one in her family abused alcohol. He describes his father as weak, his mother ruled at home and decided everything.
Ryszard and Jolanta got married after a year of acquaintance. Roland was a shy man, so he often drank to give him courage. Earlier, Jolanta didn’t bother. In the following years, drinking incidents intensified, creating tensions in the marriage, but the interventions undertaken by Jolanta did not have an effect (requests, quarrels). At the same time, the woman believed her husband’s explanations for justifying his drinking. Over the years, she was less and less willing to participate in meetings at which her husband was present after drinking publicly ridiculed her. Increasingly, she focused on whether Ryszard would return from work drunk or sober. Financial problems arose. During this period, Jolanta often fell into depression, alternately tearful or aggressive towards her husband. She claims that she could not understand what was happening to her and what was happening in her family.
During this period, Roland had a seven-year romance with another woman. Jolanta found out about him two years ago, at the time of her lover’s suicide. Ryszard was desperate and expected compassion and understanding from Jolanta. She rebelled against it only a year after that woman’s death. She hoped that since she was dead, “everything would work out.” Roland drank on the other hand. Jolanta took over most of her duties, had the money and took extra work, because she was short of life (drinking was very expensive). She moved away from her husband , do not sleep with each other.
Children reacted differently to this situation. The daughter got into conflict with her father, the son withdrew and remained inactive.
After reporting to the clinic and making a diagnosis, Roland began addiction therapy, while Jolanta started co-addiction therapy. Roland’s treatment was interrupted every 2-3 months with alcohol incidents. After another such incident, the man was referred for treatment in a stationary withdrawal center. Ryszard explained his drinking with life under stress resulting from the necessity of catching up, caused by drinking, arrears at work. Treatment in the ward was a period when family members gained hope for change. Jolanta became cheerful and talked about forgiveness if Ryszard didn’t drink. For a moment she focused more on children, especially her daughter (the suspicion that the girl was taking drugs turned out to be unfounded).
After Ryszard’s return from therapy, he returned seemed strengthened, confirmed in his belief in his addiction, Jolanta began to feel much worse. She slept badly (shortly), she felt sore muscles, she was prone to cry, she talked about appearing fears. At home, they didn’t talk about Ryszard’s disease and betrayal. And this subject, especially Jolanta, felt hurt, deceived. However, the spouses declared their willingness to be together.
PHASES AND OBJECTIVES OF WORKING WITH THE FAMILY
The phases (after A. Dodziuk) that the family may undergo during the period of abstinence by the alcoholic are:
The family’s phase of hesitation is mainly focused on alcohol, marriage matters are becoming a minor issue.
The phase of relief the family is satisfied with the fact that they do not drink, they do not see the need for change in marriage.
The phase of revealing the difficulties is inevitable, taking into account everything that happened in the family during the drinking period, also the conflicting expectations of family members.
A phase of constructive changes may appear as a result of family members working on themselves, acquiring new skills, as well as a better view of their own family situation.
From the therapy point of view, the phase of revealing difficulties and diagnosing emerging problems is important in order to determine the direction in which the family is going.
A goal must be set for change to occur. Let’s start with the general objectives that the family faces (after JC Czabała, “Family in Therapy”): satisfying the different, individual needs of family members (including drive, emotional, social and economic), and implementing various social tasks (including upbringing of children, transfer of cultural values) These goals cannot be achieved until they become common to family members. Agreeing on shared goals, albeit based on individual needs and imagination, is a condition for a well-functioning family. It must also be determined how how these goals will be achieved. This requires the following arrangements:
adjusting the ways of achieving goals to the individual properties of individual family members: physical (e.g. illness, disability), intellectual, personality traits or temperament.
creating an optimal family structure (type of roles, rules regulating role performance and defining relationships between persons performing different roles). The structure of the family depends on the changing goals adopted by the family, on the individual properties of individual family members and finally on the social and cultural conditions in which it operates,
adaptation of the ways of achieving the objectives to the external conditions in which the family lives (material, legal, cultural).
Of course, a family with an alcohol problem faces the same process. It lasts from the very beginning, also for the period of drinking. It is especially intensified when treatment is started by an alcoholic (or other family member), when goals must be redefined and agreed ways of achieving them.
The specific problems faced by alcohol families stem from (after A. Dodziuk): no change in the functioning of family members after stopping drinking, no new rules of coexistence and a new system of roles, unresolved problem of reparation, avoidance of factual conversations about the disease, conflicting expectations , usually undisclosed, problems related to meeting the need of belonging and the need for one’s own identity in the family, difficulties in communicating, problems related to regaining contact with children (sometimes by both spouses), sexual problems.
Each of them can be reported by both husband and wife. However, addiction therapist has problems with settling:
Is the problem reported by the patient a problem in his family, or is it due to the mechanisms of the disease (especially illusion and denial)?
Is the time to report a problem appropriate to start working on it (due to addiction or co-addiction therapy)?
What changes must occur (therapy progress) in the spouses before family therapy can be started? (Is recognition of addiction sufficient? Should a wife terminate co-addiction therapy?)
Is it possible to treat the family before acquiring the ability to communicate, recognize their own needs and make up for other deficits?
How to work on solving problems in the family?
Answers to these and other questions must also be related to the decision whether we consider family addictions as a “symptom” (according to system theory), or whether we treat other elements (problems in the family) that appear (are reported as a symptom) ) after or during addiction psychotherapy.
It seems that according to the knowledge of the essence of addiction and the assumptions of strategic structural psychotherapy, treating alcoholism as a symptom and attempting to conduct family therapy instead of rehab are not only a waste of time (we meet with the patient’s mechanisms), but they can even be harmful.
Therefore, when conducting family therapy, alcohol history should be taken into account, although, perhaps, the main focus should be on solving the problem with which the family is currently reporting, using methods adopted depending on the therapist’s orientation.