Understanding How Enabling, Family Roles, & Behavior Affect Addiction and Mental Health Treatment Outcomes
What Enabling Provides a Family System
A person enables for various reasons, often having little to do with the person suffering from a substance use disorder. Most people understand enabling a substance user often takes away their ability to face consequences. The question is not so much what is enabling providing for the substance user, but rather what is it providing to the enabler?
Family Focused Strategies for Addiction and Mental Health Intervention
Addiction Affects Family Members Differently Than You May Think
When a loved one begins to use drugs or alcohol, their relationships with others begin to change. Everyone reacts to addiction in their own way. However, a substance use disorder often brings more problems and devastation into the home. Is it the family member with the substance use causing the chaos and confusion? Could it not also be the family member’s attention to the substance user that is causing the maladaptive roles to form and the resentments with one another that follow?
At Family First Intervention, we understand how difficult it can be to see what has happened within the family system. One of our many goals is to educate those affected by addiction and help them see how the whole family shifts and why.
How Does Addiction and Mental Health Lead To Dysfunctional Family Roles?
If I were to ask a room full of people who or what is the problem, they would almost inevitably say the addict or alcoholic and their behaviors. Although that is undeniably true, is it the only problem? Family members’ underlying resentments and anxiety cause them to be as frustrated as, if not more frustrated, with the primary enabler and others within the system. This often causes the other family members to fight and be at odds with others’ views and suggestions. The primary enabler can cause an internal struggle for the attention, affection, and approval that has been almost entirely given to their loved one with the addiction. The family often makes it about the alcoholic or drug addict, creating a diversion from some of the internal problems that need to be addressed. Misplaced emotions, resentments of others, lack of education, acquired maladaptive coping skills, coupled with a lack of communication between family members, are often the culprit. As a result, family members take on counterproductive roles within the family system to help them through. Families who are flooded risk being unable to change effectively and unbiasedly due to misplaced emotions. This is often why just “talking to them” about stopping their addiction fails utterly. This approach does not address the big picture or the underlying family problems and only scratches the surface.
Family First Intervention has identified some of the most common reasons that a substance use problem affects a family system, even in previously healthy households:
- Substance use disorders cause family members to take on maladaptive coping skills and become flooded in their ability to make rational, effective decisions.
- Substance use disorders turn family members against one another. Family members start to acquire reasons to avoid helping their loved ones. There is often something gained by holding onto certain family roles, such as the hero or the enabler who seeks to remain feeling needed in the relationship.
- The family system often approaches the problem from the direction of the substance use being the primary problem. Our research shows it is far more effective to address and repair the damage to the family system before help can be offered effectively.
- Family members avoid confrontation and the fear of rejection. Creating Ambivalence and Confrontation is proven to be the most effective method to move a substance use disorder client through the stages of change when applied therapeutically and professionally.
- Family members frequently find objections to solutions offered. This is often due to unresolved and misplaced emotions. Some family members unconsciously avoid the steps required to help their loved one in order to hold onto the new family patterns of confusion and chaos.
- The longer maladaptive family roles are left unaddressed, the more damaging and lasting an impact they can have on the entire family and their loved one.
- Family members often blame the addiction as the cause of the family problems when the problems more frequently stem from the family members reacting to other family roles.
An intervention is not about how to control your loved one with a substance use or mental health disorder; it is about learning how to let go of believing you can.
Family Roles, Enabling, and Addiction Guide: An Addiction Treatment Resource for Families
Use the Index to Jump to a Role
THE SUBSTANCE USER
The Substance User & The Codependent Family System
The substance user is the creator of chaos and drama. Families are often worried about confronting the substance user, as they frequently believe it will make them worse. Over time, the substance user is in charge of the family’s daily thoughts, concerns, and operating basis. Families will make more excuses for the substance user than the substance user will make at an intervention. The family system is not prepared for the turbulence and volatility of the substance user, and once the enabler enters the mix, the whole family falls apart. Another essential characteristic of the substance user that the family must understand is their motive. The job of the substance user is to hurt others emotionally. The reason behind this is that the substance user, at the current time, is incapable of owning any of their problems, as they believe it is always someone else’s or some other thing’s fault. Their job is to make you understand the why of all their heartache, and for you to see them as a victim of your doing.
“The Primary Role of the Substance User is to Create Chaos and Drama.”
THE ENABLER
The Enabler & The Codependent Family System
The Enabler role can apply to any member of the family system who makes it possible for the addiction and mental health to continue. Although every family will take on a primary enabler, there are often many enablers in an unhealthy family system. Here are the two focus points to make the enabler role as simple as possible. First, the enabler provides comfort. Avoiding discomfort is the number one priority for an intended patient. Comfort is why the intended patient does not get help. The other point addresses what the enabling is doing for the enabler and why. The enabler comforts the intended patient for the same reason the intended patient uses substances; there is a reward. When the dust settles and the loved one is in treatment, the family system will start to repair itself only with rigorous family recovery. What will be realized later is that the other family members have or had a bigger resentment with the enabler than they did with the substance user. The phenomenon results from the others needing the person who has become an enabler. The enabler chose to focus all their attention on one person, the one with a substance use or mental disorder. The result is that the others act out a family role. All the roles you are about to read about and watch a video on have one thing in common: fighting for the attention of the enabler who has diverted all their attention to the intended patient.
“The Primary Role of the Enabler is to React to the Chaos and Drama.”
THE MARTYR
The Martyr & The Codependent Family System
The martyr is the forever victim, and enablers become martyrs. A spouse or partner who is in a relationship with a person who has a substance use or mental disorder often becomes a martyr by default. A martyr is one of the most challenging family roles to get past when setting up an intervention. The martyr will cry the loudest for help and make all the excuses that no help is available or will be effective. As professionals, we often leave the spouse out of the decision-making process and only include them in the intervention. If this approach is not taken, the martyr will almost always pass on the idea of helping their loved one who needs addiction and mental health treatment. They may even tell the intended patient about the upcoming intervention. The martyr is so good at wearing this mask that they have convinced everyone that they will do whatever it takes to help their loved one, while shooting down every idea. Families often do not believe us when we explain that we should exclude the martyr from the decision and be specific about when we should include them in the intervention. The martyr is more worried about what will happen to them if the intended patient gets better and their whole identity is forced to change.
“The Primary Role of the Martyr is to be a Victim of Circumstances and to make Excuses for Themselves and the Intended Patient.”
THE HERO
The Hero & The Codependent Family System
Everybody wants to be the one to save the day, and everyone sees themselves as “a hero” in their own way. The role of “The Hero” in the family system is slightly different. This person is an overachiever and often attempts to undermine the intervention and recovery efforts because they think they know better. The Hero believes, “I’m going to be the one who fixes this, I have to be the one who fixes this.” The hero sees that the loved one with a substance use or mental disorder is receiving all the attention for destructive behavior. The hero attempts to draw attention from the enabler by doing the opposite of what the substance user does and becomes a perfectionist.
“The Primary Role of the Hero is to Draw Attention to Themselves from the Enabler. The Hero is a Perfectionist and Must Feel in Charge of the Solution.”
The Scapegoat
The Scapegoat & The Codependent Family System
If something is not working, do something different; if it is working, do more of the same; this is what the scapegoat does. The scapegoat is aware that the loved one with a substance use and mental disorder is getting all the attention. They see the hero is unsuccessful in using perfectionism to draw attention from the enabler. They believe acting out in negative behavior will draw the same attention from the enabler.
“The Primary Role of the Scapegoat is to Draw Attention to Themselves from the Enabler. The Scapegoat does this by acting opposite to the Hero.”
The Lost Child
The Lost Child & The Codependent Family System
The lost child realizes that overachieving and underachieving do not suffice to draw attention from the enabler. The lost child isolates and attempts to disappear from the family, if you will. Most believe they do this because they do not want to be bothered; that is not true. They do this to see who really cares and who will find them. The lost child would love the enabler and others to show them they care. At times, the lost child will throw a curveball when found by attempting to push others away; this is merely a test. The lost child is trying to see how far one will go to show them how much they care. What is interesting about the lost child is that this role is always present in the substance user. This is why interventions work. The substance user’s lost child is waiting to be found and for the family to show them that they care. Their pain is that nobody cares, and this is not true. We understand it is hard to show love for some after the destruction they have caused. Remember, the substance user is trying to inflict pain on those whom they feel are the cause of their pain, whether that is true or not. Recovery is seeing what you did to put yourself in your position and not taking the inventory of others.
“The Primary Role of the Lost Child is Not to be Lost, it is to Draw Attention from the Enabler and be Found”
The Mascot
The Mascot & The Codependent Family System
The Mascot is a little different than the others. They are not trying to compensate by acting opposite to others, nor trying to be found by engaging in isolation. The mascot attempts to repair the broken family by implying that everything is ok or better than it actually is. The mascot often tries to inject humor into the family to divert attention from the current tragedy occurring right in front of everyone. This role is not helpful because it causes future problems for the mascot, and it actually works in the present time… a little. The Mascot does provide comfort, and that comfort is counterproductive to addressing the issue. The mascot can create an illusion that things are better than they actually are.
“The Primary Role of the Mascot is to Create an Illusion of Normalcy in the Family. Humor and Diversions are the Coping Mechanism of Choice”
When Family Members Prevent a Loved One With a Substance Use or Mental Disorder From Getting Help
Families do not realize what they are doing or why. Families do not want to hear that they may be the reason why things are not getting better. Families do not mean harm by what they are doing, and they are doing it. When family members are on the phone with us discussing the situation, you hear it clearly, even though they do not. The hardest thing for us to hear is when a family decides they will address the problem a certain way, and we know it will only make things worse. When we explain why that is not the best solution for families, they believe we are only trying to sell them something. When we are trying to help you, we hear it. The substance user has trained every one of the family members on how to behave. The substance user prepares you for the call to our office. It is amazing how we hear the family making all the excuses for themselves and their loved one. It is so apparent to us and so unrealistic for the family. It is a delicate tight rope we professional interventionists must walk. If we try to point it out, we’re salesmen. If we don’t point it out, we validate you continuing the way you are going.
When we speak to your family, we often suggest that you only include a few in the decision to do an intervention and then include the others once you have committed to the process. Families usually see this as a sales tactic rather than us trying to exclude destructive family roles that are not interested in us or anyone else taking away their security blanket. We know and understand family systems theory. Families do not believe that it applies to their family, and what we say only applies to others, not them.
“The most formidable challenge we professionals face is families not accepting our suggested solutions. Rather, they only hear us challenging theirs. Interventions are as much about families letting go of old ideas as they are about being open to new ones. Before a family can do something about the problem, they must stop allowing the problem to persist. These same thoughts and principles apply to your loved one in need of help.”
Mike Loverde, MHS, CIP
No One Chooses Their Roles or Behaviors Intentionally
The roles stated above happen over time. Most people we speak with are unaware of why or what they are doing. Some get angry or defensive at the mere suggestion of exploring their role. It is these roles, developed over time, that largely perpetuate the family problems and provide less want or need for the substance user to change or the family to change themselves. Most family members believe they are being helpful and their current beliefs are valid, normal, and possibly one day effective. While the family is held in these roles, the substance user accelerates by creating a diversion. The addiction destroys the family system, leaving many unaware of what is happening. The attention is frequently on the substance user and infrequently on the family. What ends up happening is that the family is fighting one another and is at odds because nobody is on the same page. Some enable, some try to impose their beliefs on others, trying to prove their stance, and others may “wipe their hands” of the situation altogether. When all come to the same agreement, guided by a professional, solutions become clearer and easier to execute. It is helpful to identify and repair the family system that may be preventing the substance user from seeking help.
The closer a loved one is to the alcoholic or addict, the less likely they are to be emotionally capable of formulating proper judgment. Emotionally attached family members are often flooded and unable to correct the problem internally. It almost always requires a third-party perspective from the balcony. If a family expects their loved one to surrender to professionals for a new perspective, it may be helpful for those affected to follow a similar course of action. It can be very difficult to know who is helping and who is hurting without an expert’s input. That’s why working through the problem with the help of an intervention specialist is so vital. Emotionally driven decisions and those made in a flooded emotional state can be difficult to deliver effectively. Those members affected by the addiction are almost always unable to simultaneously be the counselor and the family. There is far too much going on, making it near, if not entirely impossible, to see the forest for the trees.
When Families Change, So Does the Addiction and Mental Health
It is important for family members to know what they are up against. This includes identifying family roles and behaviors that may affect positive outcomes. Knowing what a substance use disorder is and how a family becomes consumed by it allows for better judgment and decision-making. In any other aspect of medical conditions and care, most families would allow themselves the opportunity to learn from professionals. With addiction, it is often not the case. Families who surrender and become aware of how the addiction and their behavior are impacting the rest of the family are the first step towards achieving the goal of positive change and wellness.
Related Resource: A Complete Guide to Addiction Recovery for Your Loved One
What a family expects or waits for from the substance user is often what is needed for themselves. A person who suffers from a substance use disorder almost never sees the need for positive change if the family system surrounding it prevents it. While most families are waiting for them to ask for help or reach a bottom by way of consequences, it is the family that can unknowingly be standing in the way or reaching an emotional bottom themselves. It is difficult for a family to see that some of the ways they have been going about correcting the problem could actually fulfill an unconscious need within themselves. Nobody plans this; it just happens.
