FAMILIES IN RECOVERY
by Stephanie Brown
Early recovery was a self-obsessed time for us. Our children had a "recovering Dad" and a "recovering Mom," but who was taking care of them? No one. I will be forever grateful for sobriety, but I have a profound regret that we abandoned our children in the service of our own recoveries.
- a father in the Family Recovery Project
THE FAMILY RECOVERY RESEARCH PROJECT
What is the process of recovery for the family? What happens over time when one or both parents stops drinking? Are there stages, similar to those identified for the individual? What is the impact of this major change on the family and on individuals within? What is the impact of sobriety on children?
In 1989, Dr. Brown and Dr. Virginia Lewis began The Family Recovery Project at the Mental Research Institute in Palo Alto to ask these basic questions. For over ten years, the project reviewed couples and families who weretogether for at least five years during active drinking and were still intact in recovery (length of total abstinence ranging from 79 days to over 18 years). They examined the process of change by length of sobriety within three domains: the environment, the system and the individuals within. What did they learn?
THE KEY FINDINGS
Family recovery is a developmental process, with abstinence marking a positive beginning rather than an end. Recovery is a difficult, painful process of radical change that is never easy and rarely smooth for anyone involved. Without knowledge about what to expect, including the paradox that what is normal and necessary to long-term positive change is also disruptive and even traumatic in the short run, the impact of such turmoil can cause further damage.
- The four stages of recovery -already defined for the individual- hold true for the family: Drinking, (now called Active Addiction), Transition (the move from drinking to abstinence), Early Recovery (the stabilization of abstinence with new learning, much uncertainty and constant change), and On-going Recovery (when massive change has been consolidated and the family is guided by the organizing norms, values and beliefs of recovery).
- The environment, or context, of the actively addicted family is traumatic and harmful to children and adults. It remains unsafe and potentially out of control into Early Recovery which may last as long as three to five years. In Ongoing Recovery, the environment is safe and not thrown off track by the difficulties and crises of normal life.
- The system of the actively addicted family is restrictive and closed. Healthy individual development is sacrificed to preserve the pathological system.
- The unhealthy actively addicted family system must collapse as the family enters recovery, permitting attention to shift from the system to the individuals. Many families do not accomplish this collapse, or they donot survive it. Because there is so much disruption with abstinence, and so much turmoil caused by the collapse of the system, many families break up, seeing that things have gotten worse, not better. Our data explain how outside support networks (12-step programs, treatment centers, therapists) provide a "holding environment" for all members of the family, a scaffolding for the actively addicted family system that has collapsed. Families utilize these outside supports to weather the difficult changes of the first three to fiveyears. It may be five to ten years before a stable, strong sense of healthy family is secure. Change like this does not occur from inside the family in the vacuum created by abstinence. It requires external guidance andsupports. Yet conventional treatment wisdom often leans in the opposite direction: much of family therapy is aimed at bringing individuals together, to focus on a "we." Our work demonstrates the importance of an individual focus during the early period. There is sometimes an unrecognized dark side: children may be neglected as parents focus exclusively on their individual recoveries and abdicate parenting responsibilities. We think it will be surprising to many that children experience a "trauma of recovery" in addition to the horrors of drinking. It is grim news to learn that children may feel worse, not better, just like their parents, and they may experience physical abandonment as well as continuing psychological isolation due to their parents' recovery.
THE TRAUMA OF RECOVERY
Data on the process of family recovery shocks us with mixed news: Yes, recovery is positive; the end of the drinking is extremely important and lays the necessary foundation for in-depth change. But that process of change, which we have called the "trauma of recovery," is difficult.
We must face the fact that what is essential for parents may be inadvertently damaging for their children, but only if we deny it. Once we acknowledge this reality, we can address the holes in our treatment programs so we may better protect children AND support parents in their recoveries. We can also focus on the absolute need for support structures outside the family, which we are calling "community systems," and on the need to expand our ideas of prevention to include recovery. Our current theories and practice for the professional treatment of addiction and the family leave people hanging without necessary knowledge and support.
WHY DO WE NEED TO KNOW?
Why do we need to understand recovery? Our findings challenged the most fundamental professional beliefs about the treatment of addiction and how people change, particularly the continuing emphasis on brief interventions with the addicted individual alone and the assumption that deep lasting change can be accomplished quickly. When the focus of attention is expanded past the crisis stages of active addiction and acute treatment for the individual, and includes the environment and family system in addition to the addicted person, a radically different model of developmental change becomes possible.
KINDS OF INTERVENTIONS
What kinds of interventions can be helpful at what stage of recovery? Couple and family therapy in the early period of abstinence can provide education about the normal process of recovery: the turmoil and disruption to be expected, the need for parents to focus on themselves as individuals, and the importance of maintaining or learning parenting responsibilities, both concretely and emotionally. Parents need guidance in focusing on themselves without further neglecting or abandoning their children, keeping a watchful eye on children's reactions and needs.
Couples and families with stable recovery can benefit from more intensive therapy, depending on their particular needs and circumstances. Family members can then turn their attention to relationships within the family without threatening their own progress, or forcing a return to old, unhealthy family interaction patterns.
We expected an outcry against our research because we recommended additional "treatment" and unlimited "continuing care" rather than less treatment, or even none. We believe that much of this care can be provided by volunteers who offer education, support, and the sharing of their experience as "mentor families" through an extension of the "apprentice model" of the 12-step programs.
From the time I was 6 until I was 10, my mother was in and out of treatment for her alcoholism. I went to Alateen because my parents needed me to go. I told myself that what was happening wouldn't be important to my whole life, that all of this was not traumatic. Now I know I was living in a vacuum, which gave me nothing to hold onto. I was tuned out for most of this time. As I listen to them talk today, I know why. They weren't there for a long, long time.
-An ACOA listening to her parents tell the story of their recovery
This family talked about the process of coming back together. As their individual recoveries progressed, the environment became safer, and a new healthy family could develop.
When and how this happens depends on many factors unique to each family. Sometimes kids are very young when parents begin recovery; there is time for a healthy family to form before children grow up and leave.
Or, kids may be teens or young adults who are on their way out when recovery jars the family system. These adult children, having grown up with drinking and the turmoil of early recovery, are now coming home — emotionally — to join this healthier system and repair the bonds of attachment with their parents. Much of the developmental work that should have occurred during childhood and adolescence can now take place... and does.
Family recovery does happen. It takes time.