Monday, October 22, 2007

Addiction Straight Talk

Straight Talk: Discussing Addiction with Children
Claudia Black, Ph.D.

Three nine-year-old boys are standing in a long line at Disneyland, waiting to get on one of their favorite rides. In conversation, one boy asks of the other, “When is your dad getting out of the hospital?” At this point several people in the line turn in curiosity to listen. Before the boy whose father is in the hospital has a chance to answer, the other boy says, “I didn’t know your dad was in the hospital, what happened to him?” The third boy responds, “Oh, he is sick. He has a disease, it’s called al-co-hol-ism.”

What I have learned over the years is that younger children more readily accept that their addicted parent has a disease, it makes sense to them. This boy’s response was reflected spontaneously, without embarrassment, totally accepting that his father genuinely has a disease. Why else would someone act like this? Children, prior to the age of nine or ten don’t need a lot of explanation. They accept that addiction is a disease with both physical and psychological ramifications. Of course those aren’t the words used, but they understand the “being stuck” aspect of addiction, or the allergy analogy. They comprehend that this isn’t just a disease that affects someone physically like most diseases. They see the change in personality and they grasp the inability to stop something once it is started.

A Good Rule of Thumb: When talking to young children, keep explanations to three or four sentences. Let them come back to you with questions.

Many years ago I wrote a book for children affected by parental substance abuse titled My Dad Loves Me, My Dad Has a Disease. The title came from the impact of a conversation I had with Alexis, an eight-year-old girl, whose father was alcoholic and in treatment. I was having an individual session with her and I asked her if she knew why her father was in the hospital. She looked at me as if I was stupid and quickly said, “Of course, he has a disease.”

This young girl was able to accept there was no other reason for her father’s behavior. He certainly wouldn’t choose to act like he does. Something had happened to him and he needed help to get well. She had been told that drinking made him sick, that it does that to some people, that it can change his personality so that he behaves in ways that are confusing, scary, and hurtful to him and others. She readily accepted that. Still looking at me as if she wondered what assistance I could be to her since I didn’t seem to know her father had a disease, she added, “But he still loves me.” Alexis fully believed this because in her case her father had provided positive parenting in her very early years and she got the message that he loved her.

It is possible to talk to a child of any age as long as age appropriate language and relevance are considered. With young children this conversation is more likely to be more brief and much more general. Parents often tell them that they are allergic to alcohol and when they drank they did things they wish they didn’t do. So now you choose not to drink. If children are aware of the drug use, you tell them that you made some poor choices and used drugs and then couldn’t stop on your own, or without help. If they have lived with it, or saw you many times when you were under the influence it is best to acknowledge it.

As true for chemical dependency these same principles can be applied to behavioral addictions. For example:
Like a latter-stage drug addict or alcoholic, compulsive gamblers live from fix to fix, throwing life away for another roll of the dice and deluding themselves that luck will soon smile on them. Their subjective cravings can be as intense as those of drug abusers. They show tolerance through increased betting and they experience highs rivaling that of a drug. Up to a half of all pathological gamblers show withdrawal symptoms that mimic a mild form of drug withdrawal, including churning stomach, sleep disturbance, sweating, irritability and craving. And like drug addicts, they are at risk of sudden relapse even after many years of abstinence. With the exception of sex addiction, the ability to generalize these guidelines is relevant to other addictive disorders. (For more direction in discussion of sex addiction, the author suggests you go to her website and look in the Special Interest section.)

I have worked with children as young as four and five years of age who can describe personality changes, even loss of control though they don’t use that language. Some poignant explanations of personality change and loss of control I have heard from young children have been, “Sometimes my mom is very loving toward me and really likes me, and then maybe later in the day she acts like a stranger to me.” “When my dad says he is going to the bar for one or two drinks, he just can’t do that anymore. It is sort of like eating potato chips, I eat the whole bag.” As adults we often underestimate how much children have witnessed and understood.

Other parents find that if their children did not witness the active addiction and only know their parents in recovery that it is best to be less specific about the addiction until the children are older and it has more relevance to the child’s life.

I have always been vague with my kids about just what I took, how much or how frequently I drank—but they know I drank a lot and chose to stop when we had our first son. I see them as boys who could idealize the partying way of life, and if it was good enough for their dad and he ultimately stopped, then they could rationalize it is okay for them and that they could stop.

Father of 2 sons

As children raised with addiction become older they are not so readily willing to accept the disease model as the answer for why or how you, their parent, behaved the way you did. If children have not had some formal education about addiction, they may very well think calling it a disease is a cop out. They may think you are trying to make excuses for your behavior, and blame it on something other than yourself. If you are met with that resistance, your job is not to convince them; your job is to simply share information.

When mothers are addicted, children of all ages are more apt to minimize and deny her addiction even more so than a father’s. Both a woman’s ability to hide her addiction and the stigma of being an addicted woman makes it easier for children to discount their mother’s addictive disorder.

In conversation be willing to be descriptive about the addiction. You’ll find children may listen more if you do the following things:

  • Tell your children the areas of your life in which you believe you were out of control, such as alcohol or drug use, spending and debting, or work.
  • Take ownership for your choices along the way and how you were ignorant about what you were doing.
  • Explain that you didn’t realize you could not stop and pretty soon you were rationalizing, denying, etc.
  • Give your children examples of the extent of your denial and rationalizing.Refer to how your addiction controlled your life by speaking of your preoccupation and denial.
  • Describe your change in tolerance and/or escalation to achieve the desired effect. Make the point that you continued your behavior in spite of adverse consequences—again demonstrating that your addiction had power over and against your good judgment and morality.
  • Tell them this is not what you envisioned when you started your addictive behaviors and that you had no idea how it was hurting the family, in spite of what were obvious signs.
  • Relate that you needed help to stop something that had become bigger than you.
  • Be more available to them, now that you are in recovery.

You do not need to cover every point in any one conversation. This is not necessarily the only conversation you will have; hopefully it may be a part of many conversations. What is paramount in these conversations is that children hear that they did not cause the addiction, and they can’t they control it.

You don’t have to convince your children of anything or convert them to your way of thinking, just share yourself with them.

The different choices in what and how much parents share with their children needs to be influenced by the age of the child, how much of the active addiction the child witnessed, and the parents’ relationship with the child

You will need to find your style and entrances into conversations of what is most meaningful with your children. While it is important to talk about addiction, be careful to avoid being too wordy, detailed, or intellectual in talking to children of any age. They don’t need, nor will they listen to a lecture, yet the information is invaluable if presented in a realistic and sincere manner.

While you can’t make up for the past in a few conversations, and you can’t completely protect your children from the enormous reach of addiction, you can move closer to becoming the parent your children need you to be and the parent you want to be.

Straight Talk is available at

It Will Never Happen To Me

It Will Never Happen To Me: An Introduction:

This is an except from Dr. Claudia Black’s best selling book, “It Will Never Happen To Me.” The book is available at

While hundreds of thousands of people are in recovery from chemical dependency, co-dependency, and adult child issues, our communities continue to be impacted by addiction. Heroin, cocaine, crystal methamphetamine, and marijuana use is rampant throughout our communities. But historically the number one abused drug is alcohol.

The National Association of Children of Alcoholics has reported 76 million Americans, about 43% of the U.S. adult population, have been exposed to alcoholism in the family. Almost one in five adult Americans (18%) lived with an alcoholic while growing up. There are an estimated 26.8 million children of alcoholics in the United States. Preliminary research suggests that over 11 million of these children are under the age of 18. Compared to children of non-alcoholics: They are more at risk for alcoholism and other drug abuse. They are more likely to marry into families in which alcoholism is prevalent. Thirteen to 25% of children of alcoholics are likely to become alcoholics. We also recognize clinically, that as adults, they experience a subset of behaviors related to shame based beliefs that create depression, victimization, rage, and a lack of meaning in their lives. While children from difficult environments often show much resiliency, for many, it is at a very high price.

When the term alcoholic, or addict, or chemically dependent is used, it often is referring to people who have neither the ability to consistently control their drinking or using, nor can predict their behavior once they start to drink or use, and /or whose drinking/using causes problems in major areas of their lives and yet continue to drink and/or use. This is a person who, in his or her drinking/using, has developed a psychological dependency on a substance coupled with a physiological addiction. It is someone who has experienced a change in tolerance to alcohol/drugs and needs to drink/use more to acquire the desired effect. They have a need to drink or use which progressively becomes a greater and greater preoccupation in their lives. At one time in their lives, they had the ability to choose to drink or use. In time, it became not a matter of choice, but a compulsion.

Many people are confused about chemical dependency because there is no one specific pattern of behavior. Addicts differ in their styles of drinking/using and the consequences of the addiction vary widely. Some drink daily; others in episodic patterns; some stay dry for long intervals between binges; some drink enormous quantities of alcohol, use other drugs, others do not. Some drink only beer; some drink only wine; while for others their choice is hard liquor. Still others will drink a wide variety of alcoholic beverages.

Although addiction appears very early in the lives of some people, for others it takes years to develop. Some claim to have started drinking addictively from their first drink; many others report they drank for years before crossing over the “invisible line” which separates social drinking from addictive drinking. While the focus of It Will Never Happen To Me will remain on families where alcohol is the primary drug that is abused, it is my hope the reader will see the similarities in other substance abusing families.

The commonalities will be in living with extremes, living with the unknown, or the fears. It is the living in a system where the addiction has become central to the family and the needs of the individual family members become secondary to the needs of the addict and his or her addiction.

Commonalities To Other Addictive Disorders
Since the original writing of It Will Never Happen To Me in the early 1980s, we have not only been more adept at recognizing multi drug abuse, we are recognizing what is referred to as process addictions and the fact that both substance and process addictions often co-exist and are interrelated. Such addictions would include gambling, spending, eating disorders, sex, love and relationship addictions.

The commonalities across addictive disorders are:

  • A pattern of out-of-control behavior, meaning that one is not able to predict their use once they engage in the substance or behavior, nor willingly stop their use
  • Negative consequences due to the behavior
  • Inability to stop, despite the consequences
  • An increase in tolerance and amounts of indulgence — the need to use or engage more to get the desired effect
  • Preoccupation — the anticipation of, involvement in, or reflection about their addictive behavior is the focus of their thoughts and feelings
  • Denial — minimization, rationalization, denial of their behavior as a problem permeates their thinking to the point of delusional thinking

To apply this to other behaviors, know that addictive obsession can exist in whatever generates significant mood alteration, whether it is the self-nurturing of food, the excitement of gambling, or the intoxication of alcohol or other drugs.

Irrespective of the substance or object of the addiction, the co-addiction behavior follows very common routes as well.

Typically, we see the co-dependent experience:

  • Loss of sense of self, how they feel, and what they need
  • Being obsessed with another person that facilitates not dealing with own life
  • Reacting to someone else’s behavior instead of from personal motives
  • Being all-consumed with another and putting own priorities on hold
  • Taking responsibility for other people, tasks, and situations
  • Engaging in denial system

The dynamics of the addictive system, be the addiction alcohol, prescription pills, cocaine, heroin, gambling or sex, etc. are so similar that the impact on children is also very similar. For children in the family, the combination of addiction and co-addiction results in neither parent being responsive and available on a consistent, predictable basis. Children are affected not only by the addicted parent, but also by the non-addicted parent (if there is one) and by the unhealthy family dynamics created as a consequence to living in an addictive system.

Commonalities To Other Families
One of the gifts of what we have come to learn about people raised in chemically dependent families is that it has offered extremely useful information for people raised in other types of troubled families as well. Whether or not you were raised in an addictive family system, It Will Never Happen To Me may very well offer a framework to understand your situation. We have long recognized that people raised with physical and sexual abuse strongly identify as if they were raised with addiction. Many times they were raised with both. People who were raised with mental illness, ranging from schizophrenia to depression, to raging parents frequently identify with adult child issues. People raised with parents impacted by chronic health issues, or physical challenges may identify.

Another reason for identification is to be raised by those who were raised with addiction (to be raised by adult children), who may not manifest an active addiction, but the thinking and behavior is often characteristic of addiction. The connecting thread between these different types of families is experiencing chronic loss that fuels emotional isolation, rigidity, or shame. Whatever the circumstances, when you come from a history of loss it is like being a first cousin to the person raised with addiction. Therefore if this information can benefit others raised in troubled families, this is an added gift.

The terminology was different than it is today. Today we seldom refer to someone as alcoholic, and recognize people are often addicted to more than one substance. And we use the phrases like “chemically dependent” or “addict” to recognize that irrespective of one’s predominant substance addiction that they need to refrain from the use of alcohol and other drugs. This has occurred for two reasons, the first being it was recognized that many alcoholics were actively addicted to at least one other substance; and secondly, that even if they did not show signs of a second addiction, they needed to refrain from the use of other substances because those other substances would often lead them to relapse to their primary or secondary addiction.

In the 1970’s, spouses and partners of the alcoholic were referred to as co-alcoholics. Today they are more commonly thought of as co-dependents, or co-addicts. Originally the prefix “co” was used to describe a marriage partner who had become increasingly preoccupied with the behavior of the addict and functioned in the role of a primary enabler. It now encompasses the dynamics of giving up a sense of self, or experiencing a diminished sense of self in reaction to an addictive system.

The only acknowledgement of the impact of children was in the professional journals citing the research about Fetal Alcohol Syndrome (FAS) and the genetic predisposition to alcoholism. The emotional or social impact was not discussed, and the phrase “adult children” or “co-dependency” non-existent.