Addictions: Treating the Family Struggling with Sobriety

In the last section, we discussed the label of "enabler", and ways in which family members can reframe their role to better help their own health and that of the addict.

In this section, we will discuss the ‘collapse’ stage of recovery. In my experience, the three most important points to consider when discussing the collapse stage are, letting go of long-standing routines and rituals, letting go of old attitudes and behaviors, and the fear of ‘walking backwards’.

I find that one of the hardest things for families in early recovery to do is to let themselves and their family "collapse".  I use the term ‘collapse’, because for many families, this is how it feels for them to let go of the past and begin building a new life together.  As you are aware, this is extremely frightening for most family members of addicts. As you will see with Jen, family members have organized their lives around the addiction, sometimes for many years.

The Collapse Stage - 3 Important Points

♦ # 1 - Letting Go of Routines & Rituals
For Jen, the first important aspect of the collapse stage was letting go of long-standing routines and rituals. Jen, 16, had been living with her mother Pam’s alcoholism since junior high. Jen and her mother had developed set behavioral routines and rituals which allowed both of them to live in denial of the depth of Pam’s problem.

Jen stated, "it’s like we had this little play we performed.  She comes home at 1am, drunk, sometimes pukes on herself.  I get mad, yell. She cries and yells at me. Then I feel bad, clean her up, put her to bed. The next morning, she makes me breakfast and we both smile and laugh, like it didn’t happen. It’s always the same, but what else can I do?"  Do you agree that the family creates internal and external triggers that lock the addict into using behavior, and the co-addicts into controlling behavior?  As you know, for recovery to be successful, this way of life needs to end, or ‘collapse’.

♦ # 2 - Letting Go of Old Attitudes & Behaviors
The second important aspect of collapse for Jen was letting go of old attitudes and behaviors. As we discussed, for the family members of the addict, behaviors and attitudes focus on control, and how well the family members can defend themselves.  

Jen stated, "I never know what to say to Mom to get through to her.  If I try explaining, she just gets nasty.  Once she actually told me if I shut up and wore some makeup to cover my pimples, I might finally get a boyfriend and have someone else to nag!  That really hurt.  Why try to talk to her any more if she’s going to come back at me like that?  I’d be stupid to just invite her to attack me again. It’d be best if I just focused on keeping her from drinking herself to death, and keeping her from getting in and hurting me any more than she already has!"

Clearly, Jen’s attitudes revolved around minimizing damage and control, rather than a sense of love and family.  Are you treating a Jen who has given up support and community in favor of defending him or herself?

♦ # 3 - The Fear of ‘Walking Backwards’
In addition to letting go of long-standing routines, rituals, attitudes, and behaviors, a third important aspect of collapse for Jen was the fear of ‘walking backwards’. Jen stated, "you know, you tell me I should stop playing these games with Mom. That’s like telling me, ‘ok, now blow up your house,’ without telling me where the hell I’m going to live afterwards!" Thinking about this dismantling process made Jen feel like she was being asked to ‘walk backwards’ through life.

Jen told me that she felt terrified when facing letting go of the rituals she had established with her mother Pam. Jen stated, "ever since I can remember, I’ve been my mother’s mom. I cleaned her up if she comes home smashed and gets sick on herself. Friday night was my night to sit and pray for her to come home safe. I can’t remember a night out with friends. Hell, I don’t have friends. Everything focused on taking care of Mom. Now you’re telling me to go focus on my own life. What life? If I don’t look out for her, who will? I hate this ‘let go’ stuff. You say it so easily. Do you have any clue what you’re asking me to do?"

Jen’s personality and identity had been defined by how well she cared for Pam’s addiction for as long as she could clearly remember. I explained to Jen that the fear she was feeling was normal and understandable.

In her group therapy, kids from other addicted families decided to have a slumber party in Jen’s honor. I thought this would be an excellent way for Jen to begin learning how to be 15, and letting go of her caretaking role. Pam offered to go to an extra meeting and stay the night at her sponsor’s home to make it easier for Jen to go. However, Jen was still fearful of leaving her mother for the night.

♦ 4-Step "Breathe out the Old, Breathe in the New" Technique
I asked Jen to try the "Breathe out the old, breathe in the new" technique with me. 
Step 1: First, I asked Jen to think about what the words ‘old’ and ‘new’ meant to her. Jen decided that ‘old’ meant spending Friday night waiting for her mother, and ‘new’ meant spending Fridays out with friends.
Step 2: I asked Jen to close her eyes, and imagine breathing out an aspect of the old, for example fear that her mother would not come home.
Step 3: Next, I asked Jen to imagine breathing in a new feeling, movement, or sensation of the new- like laughing with friends.
Step 4: I continued the breathing technique with Jen for a few minutes, then asked her to try it at home when she felt uneasy about the slumber party.
Would introducing a cleansing breathing technique be beneficial for your Jen?

In this section, we have discussed the three important aspects of the ‘collapse’ stage of recovery. These are, letting go of long-standing routines and rituals, letting go of old attitudes and behaviors, and the fear of ‘walking backwards’.

In the next section, we will discuss the entry into family recovery in its early stages. We will specifically discuss the four aspects of parallel recovery. These are, rebuilding is slow, personal examination, the family is still divided, and parallel recovery is only partial recovery.
Reviewed 2023

Peer-Reviewed Journal Article References:
Ashford, R. D., Brown, A. M., Ashford, A., & Curtis, B. (2019). Recovery dialects: A pilot study of stigmatizing and nonstigmatizing label use by individuals in recovery from substance use disorders. Experimental and Clinical Psychopharmacology, 27(6), 530–535.

Church, S., Bhatia, U., Velleman, R., Velleman, G., Orford, J., Rane, A., & Nadkarni, A. (2018). Coping strategies and support structures of addiction affected families: A qualitative study from Goa, India. Families, Systems, & Health, 36(2), 216–224.

Eddie, D., White, W. L., Vilsaint, C. L., Bergman, B. G., & Kelly, J. F. (2021). Reasons to be cheerful: Personal, civic, and economic achievements after resolving an alcohol or drug problem in the United States population. Psychology of Addictive Behaviors, 35(4), 402–414.

Hodgins, D. C., Kim, H. S., & Stea, J. N. (2017). Increase and decrease of other substance use during recovery from cannabis use disorders. Psychology of Addictive Behaviors, 31(6), 727–734.

Robbins, M. S., Feaster, D. J., Horigian, V. E., Rohrbaugh, M., Shoham, V., Bachrach, K., Miller, M., Burlew, K. A., Hodgkins, C., Carrion, I., Vandermark, N., Schindler, E., Werstlein, R., & Szapocznik, J. (2011). Brief strategic family therapy versus treatment as usual: Results of a multisite randomized trial for substance using adolescents. Journal of Consulting and Clinical Psychology, 79(6), 713–727.

QUESTION 8
What are the three important aspects of the collapse stage of recovery? To select and enter your answer go to Test.