An interview with Michael Borowiak, MSW, LICSW, expert in treating families with complex challenges
How are families doing? What trends are you seeing with families?
The world is changing rapidly. Families have little time to adapt and respond. Families are doing the best they can to figure out and navigate these changing dynamics around them. We’ve seen this recently with schools, the way they are structuring education and trying to find ways to stay healthy and successful.
We are seeing a growing concern with families around substance abuse problems. For many, the stress of the last 18 months has led many to excessively drink or use other substances in an effort to cope with the difficulties.
What are some reasons people may seek family therapy?
People request family therapy when their primary relationships are not going well. This is common in families where addiction is present. When there is addiction present for a member of the family, parents may be struggling to be in alignment in how they are going respond and lead a child who may be dealing with an addiction. It may also be that other family dynamics and family conflict contribute to the need for an individual to seek solace in a substance. Also, in families in which a substance use disorder is present, members of the family often struggle to identify healthy boundaries with each other. Many people “over function” in a family system or “under function”. Family therapy assists each member in understanding healthy boundaries for themselves and for the other members of their family. Identifying and addressing the above dynamics can help a family to reduce the stress for each member of the family, including the person dealing with the addiction, so that the family system is more supportive of recovery.
How do you help them?
We create a safe place for families to heal and repair the unhealthy dynamics they currently experience. We help them identify ways out of the stuck patterns they are in. We often get requests for support from loved ones with a family member struggling with substances abuse, not knowing what to do. We can help them with strategies to address the concern, through therapeutic support or referral to a formal intervention.
Why is family therapy especially important for substance use recovery?
Family therapy is one of the most important and often underutilized ways of treating substance use disorders. Our medical system focuses on the individual struggling with this disease and rarely addresses the family dynamics outside of education. Substance use disorders affect everyone in the family. Each member is a co-sufferer of this disease. Family therapy helps address the underlying unhealthy relationship dynamics that may contribute to the addiction patterns and is a way for a family to get well.
A person struggling with addiction may go to treatment, do extraordinary work to improve themselves, and attempt to return to their family system excited about important improvements they’ve made, only to find his/her family is still angry and hurt from the behaviors brought on by the addiction. These families need help in repairing relationships, establishing healthy boundaries, ultimately learning how to be in healthier relationship with each other. Quite frequently, it’s important for the individual to continue therapy on their own as well.
Someone with a substance use disorder is typically not only dependent on the substance they are using, but also on the relationships around them that may perpetuate the addiction. Addiction creates hurt, shame, anger, embarrassment and isolation within families. It can cause trauma and other mental health challenges, as well as unhealthy enmeshment between family members. This has often been labeled codependence. Enmeshment or codependent behaviors are attempts by family members to create homeostasis in the system. Unfortunately, these attempts to stabilize the family often result in very unhealthy patterns that can compromise the wellbeing of family members. Family members may make excuses for the behavior of someone struggling with addiction in the hopes that this will help them recover, families may minimize the extent or degree the problem has evolved, and family members may create conflict in other areas in efforts to distract from the addiction behavior.
In treating this, all family members need a safe space to feel heard and understood and given space to heal between each other. In family therapy, we work on forgiveness, establishment of new boundaries, and trust. So often trust has been broken and there’s a need of support in resetting and maintaining it. Family members are also often anxious about the consistency of recovery, and they worry about relapse.
A family that comes together and begins to make changes in a healthy direction may positively impact the person struggling with the addiction. It’s important for families to know that there is hope. Things can get better. When addiction affects a family, it’s important for the whole family to get help or support.
Recovery is a family journey.