In many cases the addict is the first family member to seek
treatment. Other family members become involved in order to help the alcoholic
get sober. Many family members refuse to consider the fact that they also have
a problem that requires specialized treatment. These family members tend to
deny their role in their addicted family and scapegoat personal and family
problems upon the addicted person. They develop unrealistic expectations of how
family life will improve with their loved one getting abstinent. When these
expectations are not met, they blame the addict for the failure, even though he
or she may be successfully following a recovery program. Their attitudes and
behaviors can become such complicating factors in the addict’s recovery that
they can contribute to the process of relapse and even “set-up” the addict’s
next “episode of use.”
On the other hand family members can be powerful allies in
helping the addict prevent fully engaging the relapse process. Relapse
Prevention Planning utilizes the family’s motivation to get the addict sober.
As family members become involved in relapse prevention planning, a strong
focus is placed upon co-addiction and its role in the family relapse process.
Family members are helped to recognize their own co-addiction and become
actively involved in their own treatment. Addiction is a family disease that
affects all family members, requiring everyone to get involved in treatment.
The addict needs treatment for addiction. Other family members need treatment
Co-addiction chronic and follows a predictable progression.
When persons in a committed relationship with an addicted person attempt to
control drinking, drug use, or addictive behavior (over which they are
powerless), they lose control over their own behavior (over which they can have
power) and their lives become unmanageable.
The condition of co-addiction manifests itself in three
stages of progression.
Problem Solving and Attempts to Adjust
The normal reaction within any family to pain, to crisis,
and to the dysfunction of one member of the family is to do what they can to
reduce the pain, ease the crisis, and to assist the dysfunctional member
however possible in order to protect the family. These responses do not make
things better when the problem is addiction, because these measures deprive the
addicted person of the painful learning experiences that bring an awareness
that his/her addiction is creating problems. At this stage, co-addiction is
simply a reaction to the symptoms of addictive disease. It is a normal response
to an abnormal situation.
Middle Stage: Habitual Self-Defeating Responses
When the culturally prescribed responses to stress and
crisis do not bring relief from the pain created by the addiction in the
family, the family members TRY HARDER. They do the same things, only more
often, more intensely, mores desperately. They try to be more supportive, more
helpful, more protective. They take on the responsibilities of the addicted
person, not realizing that this causes the addict to become more irresponsible.
Things get worse instead of better and the sense of failure
intensifies the response. Family members experience frustration, anxiety, and
guilt. There is growing self-blame, lowering of self-concept, and
self-defeating behaviors. They become isolated. They focus on the addict’s
addictive behavior and their attempt to control it. They have little time to
focus on anything else. As a result they often lose touch with the normal world
outside of their family.
Chronic Stage: Family Collapse and Stress
The continued habitual response to addiction in the family
results in specific repetitive, circular patterns of self-defeating behavior.
These behavior patterns are independent and self-reinforcing and will persist
even in the absence of the symptoms of addictive disease.
The things the family members have done in a sincere effort
to help have failed. The resulting despair and guilt bring about confusion and
chaos and the inability to interrupt dysfunctional behavior even when they are
aware that what they are doing is not helping. The thinking and behavior of the
co-addict is OUT OF CONTROL, and these thinking and behavior patterns will
continue independent of the addiction.
Recovery from co-addiction means learning to accept and
detach from the symptoms of addiction. It means learning to manage and control
the symptoms of co-addiction. It means learning to focus on personal needs and
personal growth, learning to respect and like oneself. It means learning to
choose appropriate behavior. It means learning to be in control of one’s own
RELAPSE PREVENTION FOR THE FAMILY
What can family members do to reduce the risk of their own
relapse and the risk of relapse in the recovering addict? They can become
informed about the addictive disease, recovery, and the symptoms that accompany
recovery. They must recognize that the symptoms of post acute withdrawal are
sobriety-based symptoms of addiction rather than character defects, emotional
disturbances, or mental illness. At the same time they must accept and
recognize the symptoms of co-addiction and become involved in Al-Anon and/or
personal therapy as they develop plans for their own recovery.
All members of an addicted family are prone to return to
self-defeating behaviors that can cause them to become out of control. An acute
relapse episode can occur with an addict or a co-addict family member. Like
addicts who develop serious problems even though they never use alcohol or
drugs, the co-addict often becomes dysfunctional even though the addict is
sober and working an active recovery program.
RELAPSE WARNING SIGNS FOR CO-ADDICTION
( below is a partial
list of behavioral warning signs in a recovering family environment)
1. Situational Loss
of Daily Structure. The family member’s daily routine is interrupted by a
temporary situation such as illness, the children’s schedule, the holidays,
vacation, etc. After the event or illness, the significant other does not
return to all of the activities of his or her recovery program.
2. Lack of Personal
Care. The significant other becomes careless about personal appearance and
may stop doing and enjoying small things that are “just for own personal
enjoyment.” The person returns to taking care of others first and self second
The co-addicted person may not totally approve of some of his or her own
actions, but when challenged about them will openly justify the actions in a
sharp or angry way.
Behavior. The significant other experiences episodes during which he or she
feels driven to do more. Whatever has already been done does not seem to be
5. Return of the Tendency to Control People,
Situations, and Things. As the co-addicted significant other feels less
control over life, he or she begins openly to try to control and manipulate
other people or situations. The addicted person may be the prime target, but
does not necessarily have to be.
6. Failure to
Maintain Interpersonal (Informal) Support Systems. The co-addict stops
reaching out to friends and family. This may happen very gradually. He or she
turns down invitations for coffee, misses’ family gatherings, and no longer
makes or returns phone calls.
About Terry Gorski
Terence T. Gorski is
an internationally recognized expert on substance abuse, mental health,
violence, & crime. He is best known for his contributions to relapse
prevention, managing chemically dependent offenders, and developing
community-based teams for managing the problems of alcohol, drugs, violence,
and crime. He has extensive experience working with employee assistance
programs (EAP) and has special expertise in working with emergency professionals
including fire, medical, and law enforcement. He is a prolific author and has
published numerous books and articles.
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