Addiction & The Family: Unwritten Roles & Unspoken Rules

This blog post is the second in a series contributed by Rachel Evans, LMSW, of the Center for Recovering Families at The Council on Recovery and Ashley Taylor, MSW, LMSW, of Heights Family Counseling. Read the first post here.

When someone has a substance use disorder, the people within their close circle – whether it be family, friends or a combination of both – adapt to the associated behaviors. Many roles that these people embody contribute to the functionality of the system itself. There are a few adaptations of these roles, but the most common are the hero, the scapegoat, the addict, the mascot, the caretaker, and the lost child.

(For a breakdown of these roles and their impact on the system, read our blog post.)

While someone in the family unit might outwardly display particular character traits, there are also feelings that exist beneath the surface that are harder to recognize. Not every family system will reflect these roles, but oftentimes, these roles are displayed in some form or fashion. By taking on these roles, people within the system are able to assert some control over the outcome of their situation and maintain a sense of normalcy in a situation where one can feel a loss of control.

Addiction and family

In families that deal with substance use disorders, there are also unwritten rules that members abide by in order to prevent disruption within the system. These rules are: Don’t talk, don’t trust, and don’t feel. People within the system follow these rules to maintain the status quo. “Everyone in the system often begins to believe that their needs no longer matter,” says Rachel Evans, Family Therapist at the Center for Recovering Families. These rules are adaptations made beyond the roles that people within the family unit follow that help protect their goal, which is to manage life with someone struggling with a substance use disorder.

Family members can come to understand it like this: We don’t talk about the addiction. Secrecy allows the addiction to thrive. We cannot trust the person with a substance use disorder. Addiction often comes with inconsistent behaviors, so family members often learn not to trust their loved one, and often suppress their emotional experiences of the addiction. Because of these learned rules, recovery often begins with talking openly about the addiction safely, rebuilding trust, and identifying emotions in every family member.

If you or a loved one is struggling with a substance use disorder, or if you recognize any of these roles and rules in your own life, contact us today to inquire about counseling and treatment options.

The Impact of Addiction on The Family System

This blog post is contributed by Ashley Taylor, MSW, LMSW, of Heights Family Counseling and Rachel Evans, LMSW, of the Center for Recovering Families

When someone we love deals with addiction, wishful thinking tends to surround their recovery. We think to ourselves, “If this person just gets better, then everything else will fall into place.” No matter how desirable that outcome, substance use disorder is a systems disease that requires a systems solution. Substance use disorders not only affect the person suffering, but also the people closest to them.

“By the time people get treatment, the family system has often regulated around the addiction to maintain the status quo,” says Rachel Evans, family therapist at the Center for Recovering Families. “The addiction has become the locus of control.”

Everyone who is involved in the system has adapted in ways they might not even recognize in order to maintain a sense of normalcy and peace, while watching someone they love battle a difficult disease. Because of this, many families are exhausted by the time their loved one enters treatment. Regardless of the ways in which the support system has regulated itself around the addiction, the relationship between the person dealing with substance use disorder and their families can be an important one.

impact of addiction on family system

“The collaborative effort of treatment is very beneficial,” says Rachel. When appropriate, having family members present for treatment improves success rates, and treatment benefits both the person struggling with substance use disorder, as well as the family members. When it comes to recovery, it is crucial that everyone is willing to do things differently in order to set family recovery at the core of the system. Through family recovery, everyone is able to gather and understand different strategies for coping with the new way of life for this person, as well as unlearning potentially harmful practices that had been in use prior to the recovery process.

This help can take the form of family treatment, support groups such as Al-Anon and Nar-Anon, and even individual therapy. When an entire system is affected, addressing the entire system is the most effective treatment. This takes the responsibility off one individual and makes the process a collaborative one. In this way, the person going through recovery can feel more supported in their journey, and feel the love and encouragement from those closest to them.

The process of addiction recovery is rarely linear, nor does it only impact the person working to overcome substance use disorder. When addiction is viewed as a systems disease, it can be addressed throughout the whole system. By viewing this process in a more collaborative light, we are able to better support and understand the journey of our loved ones.

If you or a loved one is struggling with substance use disorder, call us today at 713.914.0556, or contact us through our website.

A Message to Those Affected by the Opioid Crisis

This blog post is authored by Mary H. Beck, LMSW, CAI, President & CEO of The Council on Recovery

Most of us are well aware of the opioid crisis facing our communities. We read the grave statistics about addiction and overdose deaths experienced by so many. Impassioned advocates call us to action, treatment specialists inform us on the most cutting-edge practices, legislators pass laws and allocate financial resources to combat this public health emergency. All of this is vitally important.

Yet we are facing a parallel crisis, which is tearing apart families and leaving people in severe distress – a crisis to which our communities are often blind: the trauma and grief experienced by family and friends of those struggling with addiction or who are trying to live in the wake of an overdose death.

Our loved ones die – it is a sad, painful truth. For years, many of us live in fear of this truth – knowing that when someone we love so deeply is suffering from a chronic illness, death may be the outcome. We cherish the moments of reprieve and hope for recovery. At other times, we are doing everything in our power to save them – we suffer in silence once they are gone.

This is true whether your loved one dies from cancer, heart failure, brain disease, and yes, addiction too. If you are feeling the pain of a loved one’s substance abuse or their death, you are not alone. Over 100,000 people have died of a drug overdose in the past year alone – leaving spouses, parents, siblings, and friends behind.

How did we get here?

Americans take 80 percent of all prescription painkillers in the world. New reports from the Centers for Disease Control and Prevention and the Houston High Intensity Drug Trafficking Area confirm that drug overdoses have surged since the onset of the COVID-19 pandemic, both in Houston and nationwide. The sharpest increases were deaths involving opioids, primarily illicitly manufactured fentanyl. In the last year, fentanyl related deaths in Houston increased by 40%.

opioid crisis image

The extremity of this surge is a cause for grave concern for our team, but it only strengthens our resolve to partner with local leaders and community partners to tackle this issue comprehensively and systemically. This takes a multi-pronged approach – focused on education and awareness, providing intervention and treatment, opening doors to recovery, and when necessary supporting family and friends in their grief.

If you are one of the millions watching a loved one’s addiction spiral out of control, or if you have already lost a loved one due to an overdose, you deserve the same compassion and support others receive when they are grieving.  You need a place to turn, where your strength and courage are honored, while your grief and emotions are nurtured. The Council on Recovery is that place – a place to start when you don’t know where to turn and a place to heal.

If you, a loved one, or a client/patient is struggling with opioid use, contact us today, and we can get them the help they need. For more information on our opioid use services, download our flyer.

Recovery is for Everyone: A Recovery Month Message from our President & CEO

This blog post was contributed by Mary Beck, LMSW, CAI, President & CEO of The Council on Recovery

Friends,

This National Recovery Month, we celebrate and honor our friends, family members, coworkers and colleagues who are in recovery from addiction and other mental health disorders. Recovery is not a single finish line; it is a daily, lifelong commitment to better oneself and reach one’s full potential in the face of chronic substance abuse and mental health conditions. Such an effort can be difficult for anyone, but 75 years of service to our community has taught us this – with adequate resources and support, recovery is possible for everyone.

The theme of this year’s Recovery Month is “Recovery is for Everyone: Every Person, Every Family, Every Community.” In this year of growth and change for our organization, this theme reminds us of our commitment to welcome everyone to recovery by lowering barriers to recovery support, creating inclusive spaces and programs, and broadening our understanding of what recovery means for people with different needs and experiences.

Lowering barriers to recovery

To fulfill our vision for a community in which substance abuse is no longer a major problem, we must be willing to offer our services to all who need them. Serving the diverse community of Houston means understanding the various needs of people from differing backgrounds, as well as the unique barriers to recovery they may face.

Whether that means providing virtual services, combatting shame and stigma that still exist with substance use disorders and related mental health conditions, or offering an extensive range of treatment services to meet each person’s individual needs, our team is dedicated to helping all Houstonians who need us.

Creating inclusive spaces and programs

Addiction is an equal opportunity destroyer, which means the opportunity of recovery can and should transcend race, gender, age, sexual orientation, creed, wealth, and any other label. Addiction and other mental health issues can affect anyone at any time, yet we know that those most affected often are afraid and uncertain or unable to access services necessary for recovery. Through our comprehensive service offerings, wellness opportunities, and compassionate, diverse team of addiction professionals, we strive to create an inclusive environment that celebrates our differences and unites us in a common goal of recovery for our entire community.

Broadening our understanding of recovery

Creating inclusive spaces for healing also requires understanding that recovery is not a single, defined process, neither is it limited to those with substance use disorders. The reason there is no universally agreed-upon definition for recovery is that the journey of recovery looks different for everyone. According to SAMHSA, recovery is “a process of change through which people improve their health and wellness, live self-directed lives, and strive to reach their full potential.”

Our understanding of the effects of substance use, as well as its relation to other mental health conditions, has greatly improved in the past few decades, along with our approaches to treatment and recovery support. Through initiatives like our Center for Co-Occurring Disorders, we are working with trusted organizations across Houston to broaden our understanding of addiction and recovery to treat those who need our help more effectively.

If you or someone you love is struggling with substance use or another mental health condition, we welcome you to begin your own recovery journey today. Call us at (713) 914-0556, or contact us through our website, and our intake team can connect you with the help you need.

The Impact of Family Roles on Addiction

This blog post is contributed by Lori Fiester, LCSW-S, MAC, CIP, CDWF, Clinical Director for The Council on Recovery

Have you ever wondered why some families seem to have roles in their family? I’m not talking about the roles of mom, dad or siblings, but roles people assume throughout their lives. As a therapist and an adult child of an alcoholic, I’ve been aware of my role in the family, both at work and in relationships. I’ve often joked that I didn’t become a social worker because I like people, but because I was born into this role. I am the hero child! And I worked hard to be that way… until it stopped being functional.

family roles

Family roles can happen in a family system where there has been upheaval, but they are usually solidified if that upheaval becomes a chronic occurrence, like in addiction. Basically, the family system strives for equilibrium.  Equilibrium is what holds the family steady. Family members slip into their roles to re-establish equilibrium when faced with anxiety. For instance, when one member is struggling, usually the system helps that one member gets back on their feet, and the system returns to normal.  When addiction occurs, the anxiety becomes chronic, and the roles are then utilized until eventually they become part of our behavior pattern – all in the name of equilibrium. 

Frequently observed family roles:


The addict is the one who is addicted to a substance and is the person the family revolves around to unconsciously provide equilibrium.

The enabler or caregiver is most likely the significant other. That role entails making sure everyone is happy and ensuring the addict suffers no consequences. Enablers often lose themselves in the lives of others.

The hero ensures that the everyone in the family looks good by overachieving, overdoing, and perfection.

The joker keeps the family laughing, which helps distract the members from the pain and suffering.

The lost child’s job is really to stay out of the way and not create any concern for the family or cause further distraction.

The scapegoat is similar to the joker, which is to provide distraction for the family through rebellion and drama.

If you or a loved one is struggling with addiction or a related mental health disorder, The Council can help you and your whole family to break these roles and recover together. For more information, or to get help, call us at 713.914.0556 today or contact us here. Telehealth options are available.

How Can We Fix Texas’ Mental Healthcare Crisis?

This blog post is co-authored by The Council on Recovery’s President & CEO Mel Taylor, MSW, and Executive Vice President Mary Beck, LMSW.

Substance use is a primary driver of readmission to the hospital and/or criminal justice systems.  If we addressed substance use disorders in conjunction with mental health disorders, the number of people in need of care would significantly decrease. Yet time and again, substance use is viewed as a secondary concern and not as a confounding disease affecting the majority of people with a mental health disorder.

As we read Alex Stuckey’s three-part series How Texas Fails the Mentally Ill, we were met with a mix of emotions. On the one hand, it is heartening to see a light being shined on this decades long travesty – a crisis that strips people of their dignity and basic human rights; that tells people they have to wait, homeless on the streets or in jail to get the care they desperately need. On the other hand, it is concerning to see the pronounced blind spot regarding co-occurring mental health and substance use disorders that exists among healthcare providers, behavioral health providers, policy makers, and the community at large.

According to the National Institute on Drug Abuse, multiple national population surveys show that about half of those who experience a mental illness during their lives will also experience a substance use disorder and vice versa. And the coronavirus pandemic is only making matters worse. A recent study conducted by The Recovery Village asked 1,000 American adults about their use of drugs and alcohol in the past month, and 55 percent reported an increase in their alcohol consumption in the past month, with 18 percent reporting a significant increase. When asked what prompted their substance use, respondents cited stress, boredom, and an effort to cope with anxiety or depression.

At The Council on Recovery, we’ve watched this dynamic intensify over the past year, with more clients struggling with relapse, suicidal ideation, and overdose. So what can be done? First, we must acknowledge and embrace the fact that the mental health care system is in disarray, and if co-occurring substance use disorders continue to be discounted and dismissed, it is unlikely that outcomes will improve.

Beyond that, we know that we cannot overcome this crisis if fragmented policies and underfunding continues. Texas needs a comprehensive analysis and long-range plan for the entire system, led by behavioral health experts who equally represent substance use and mental health disorders. The plan must study leading-edge best practices for the treatment of co-occurring disorders. Most importantly, it must identify multiple financing options that incentivize public and private providers – as well as payers – to participate in the plan and to provide best practice care.

Last fall, The Council on Recovery launched The Center for Co-Occurring Disorders as just such an initiative.

This multi-partner Center will explore and document current best practices, conduct evaluation on models of care, and identify and advocate for financing options. Led by The Council, other partners include The Harris Center for Mental Health and IDD, Harris County Psychiatric Center, Baylor College of Medicine and Harris Health, as well as a psychiatrist in private practice and community members with lived experience.

Over the last 75 years, The Council has witnessed the changes in the landscape of behavioral health care unfold in real time, along with the devastating consequences. In the wake of the pandemic, the oncoming tidal wave of mental health and substance use disorders will undoubtedly inflict even more suffering on the individuals trapped within our broken system.

But we can turn the tide.

Initiatives like The Center for Co-Occurring Disorders can help to educate the public, policy makers, and behavioral health professionals about the crisis in our mental health system. Together we can advocate for legislative priorities that support these efforts. Because doing nothing is not an option.

If you or someone you love is struggling with substance use or a co-occurring mental health disorder, contact The Council today. We offer telehealth services to all who need it, regardless of their ability to pay.