Coping with a Parent with a Substance Use Disorder (2024)

Coping with a Parent with a Substance Use Disorder (1)

Son is upset with father who drinks.

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Parents and Addiction: A Complex Dynamic

When an individual struggles with a substance use disorder (SUD), the ramifications for their loved ones are almost inevitable. In fact, three of the 11 criteria for SUD diagnosis listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are directly associated with relational dysfunctions. For the individual struggling with the SUD, these criteria include failure to fulfill major role obligations at home, recurrent social and interpersonal problems, and social activities given up or reduced. A parent’s SUD is especially difficult for their children, who remain vulnerable and malleable during their development into adulthood. Unfortunately, when not properly attended to in a timely manner, the short-term consequences of this relationship have a lasting impact throughout their adult life as well.

From a trauma lens, such negative experiences in interpersonal relationships can lead to what is known as the small “t” trauma. Trauma refers to events or situations leading to experiences that are out of a usual range of stressors, which today are understood in terms of two groups, the big “T” (that is, war, physical or sexual violence, natural disasters) and small “t.” The latter refers to trauma with a more subjective and personal level of impact, such as relational strain, loss, and breakups.

To better understand this dynamic, therapists often draw from attachment theory, which speaks to the impact of earlier relational experiences on a person’s development. In recent years, some have even started speaking about addiction being an attachment disorder. Because of the many approaches associated with them, addiction disorders like SUD have slowly but surely become reputed as multidimensional systemic disorders, that is, addiction as a family condition.

The repercussions of addiction beyond the person struggling with it firsthand are evident when considering an addicted parent’s relationship with their child. For the child, the individual dysfunction and challenges involved with SUDs become a systemic issue that creates and maintains certain unspoken rules, which foster unhealthy attachment patterns. The book Treating Adult Children of Alcoholics, by Douglas H. Ruben, depicts these misguided “rules” in detail, but to name a few, they include:

  • Do not express your feelings openly.
  • Limit your communication with others.
  • Nothing you do is good enough, but we expect you to be perfect anyway.
  • You have to work to benefit others and you cannot be selfish.
  • Do as I say, not as I do.
  • Do not “play” or enjoy yourself.
  • Above everything else, avoid conflict.

Clearly, these rules are directly averse to what a child should be doing to achieve level-appropriate developmental milestones. Following any of the above guidelines can easily result in poor self-image, confidence, and lack of differentiation of self, leading to misaligned boundaries and other negative tendencies.

These issues lead to autonomy and independence problems, they inhibit the child from resolving the problem on their own, often being stuck in the cycle of guilt, shame, and blame, externalizing the problem. Examine this mindset: “The more other people are to blame, the less I can do to change things.” The person may feel liberated in the moment, but they can ultimately experience this loss of control in the long term.

Mending Damaged Relationships

Then, how can the adult children of addicted parents change? First and foremost, they need to reach internally. One technique they can use to accomplish this is called differentiation, which allows them the ability to delineate feelings from thoughts and subsequently, the self from others. They can then foster self-awareness about these past tendencies and understand the impact.

Once they have established this baseline, they can look externally to understand how SUDs affect individuals like their parents. For example, there is a huge difference between these narratives: “My parents were not there when I required their guidance.” Versus: “My parents were in a state that they were not able to provide the needed support for me.” As a family member, just knowing how addiction leads to neurological changes in reward circuitry—leaving the sufferer desensitized and distorting their values—can be helpful when challenging these maladaptive narratives. These adjustments in perception through understanding can begin the healing journey toward forgiveness and liberation.

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This state of liberation does not solve all problems. Frequently, it requires long-term work and joint efforts on the part of the parent and child to truly heal. This is where professional help can be reassuring, providing an impartial, knowledgeable perspective to mediate difficult conversations. Although resolving these issues can be done alone, resolving the issue through an interpersonal means—opening up to the parent and/or a mental health professional—is ideal considering the relational nature of addiction.

Once educated, the adult child should find an outlet through which they can validate their experiences. Often, this can be done by consulting with a treatment provider. Participating in support groups can also be meaningful. They allow the individual to learn from others who have been through similar challenges and to build on their progress by bonding over these shared experiences. This validation and increased understanding can normalize such experiences and provide great empowerment and motivation for people engaging in the new narrative of healing and recovery.

Coping with a Parent with a Substance Use Disorder (2024)
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