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Fight the System! Addiction and the Family Systems Model

The illustrious British poet, John Donne, once wrote that no man is an island and, as it turns out, no woman is an island either. We are all both the creation and the creator of the social environments in which we live. We shape the lives of the people around us, just as the people around us shape our lives.

Perhaps no social structure has as great an impact on who we are, what we do, and how we perceive ourselves as the social structure of the family unit. This is probably not surprising: the image of the troubled neurotic lying on a psychologist’s couch lamenting their childhood is a cultural commonplace. The phrase “mommy/daddy issues” is a sitcom standard.

As is usually the case, there are profound truths underlying the humor. So many, in fact, that the effort to understand the effects of the family dynamic on individuals has consumed psychological interest for decades. This effort has given rise to a critically important concept in the field of psychology. It’s called the “family systems model,” and it may well be the key to unlocking the mechanisms of your addiction, to bringing yourself and the ones you love to a new level of health and healing.

What Is the Family Systems Model?

In essence, the family systems model is predicated on the idea that a family is more than simply a collection of discrete individuals who happen to share a name and a history. Rather, according to this theory, the family is far greater than the sum of its parts. It is a unit, rather than an amalgamation of separate and unique persons. Above all, it is a system that shapes and defines those in the system through their interactions with others in the system.

In other words, according to this model, the personality, behavior, and even the identity of each individual family member are determined by their relationship with all other family members. Thus, within this system, we have predictable roles specific members are assigned and expected to play, such as the overachiever, the martyr, the saint, and the screwup.

Often, we internalize and act out the identity the family system ascribes to us without even realizing it. We learn (again, often unconsciously) to conform to these prescribed roles within the family unit in order to enable other family members to perform their particular roles. Each family member is a node in the system, playing their prescribed role to maintain the system, functioning in the old, predictable pattern, even if that pattern is fundamentally dysfunctional.

Family Systems, Identity, and Addiction

In essence, the family systems model holds that, in myriad ways, our identities are not wholly our own. Rather, our sense of self, and the worldview and behavior patterns that result from this self-identity are a function of our family dynamics, both for good and for ill. This means that family relationships in particular and the family unit, in general, can either undermine or support positive identity-formation and healthy functioning overall (1, 2). Indeed, the research suggests that family dynamics can be profoundly influential across all life domains, from shaping one’s career choices to informing medical decisions (3, 4, 5).

Given the singularly potent influence of the family on how we see ourselves and on what we do, it’s perhaps not surprising that both addiction and recovery are often deeply intertwined with the family structure.  For example, in a study of more than 800 individuals experiencing drug addiction, Zeng and Tan (2021) found a negative correlation between family functioning and relapse (6).

In other words, the researchers found that the more functional the family unit was, the lower the risk of relapse. On the other hand, as dysfunction within the family unit increased, so, too, did the likelihood of relapse.

Relationships and Recovery

At the center of this relationship between addiction, recovery, and the family system is the question of self-identity and the impact of self-concept on one’s sense of self-efficacy and self-esteem (6, 7, 8). The research suggests that robust psychological capital, which includes a strong sense of personal empowerment, a positive self-regard, and perceived social support can increase one’s resiliency, improve coping skills, and reduce the negative impacts of family dysfunction on addiction behaviors (7, 8, 9).

The challenge, however, is that the family unit is often an individual’s greatest source of psychological capital.  In a study of the effects of family intimacy on both relapse tendency and psychological capital, Zeng et al. (2021) found that high levels of intimacy between family members were associated with reduced relapse risk and increased psychological capital (10). At the same time, the researchers also found that one’s ability to forge and maintain intimate relationships within the family unit was largely a function of one’s level of psychological capital (10). In other words, the closer you are to your family, the more likely you are to stay clean and feel good about yourself.

However, if you don’t feel good about yourself, it’s difficult to cultivate healthy family relationships. This speaks to the mechanisms through which a dysfunctional family system can not only wreak havoc on your sense of self but can also contribute to substance misuse, addiction, and relapse as an unhealthy strategy for coping with the depression and anxiety that often accompany family dysfunction (13).

Given the profound and complex interconnections between relationships, identity, and behavior within the family system, it might at first appear as if the cycle of addiction and family dysfunction can’t be broken. Fortunately, this is far from the case. In fact, the evidence demonstrating the efficacy of a family-based recovery strategy is immense and growing (11, 12). The research indicates that family interventions often don’t just benefit the target patient but the entire family unit, principally by helping each individual forge a healthier sense of personal identity which, in turn, fosters more positive and productive relationships with the other family members (14, 15). The result is a family system that fosters healthy self-differentiation while also supporting healthy interpersonal dynamics. The family system becomes one that fosters intimacy, support, and psychological capital rather than breeding disorder, dysfunction, and codependence.

When you are in recovery, transforming the family dynamic in this way is often essential to your long-term sobriety. Because the family system is so intimately connected with our sense of self, you are unlikely to be able to forge a sober identity without redefining your role within the family unit and your relationships with your family members (16, 17, 18). To be sure, this process is not likely to be quick or easy. After all, family dynamics emerge because they serve a purpose, even if that purpose isn’t necessarily healthy or productive.

But there is some level of comfort and familiarity in even the most dysfunctional family dynamic, which is why the process of moving toward health takes time and commitment. Your family members may be disconcerted by and resistant to the change, particularly at first. After all, they have become accustomed to the old you and, as the family systems model shows us, they have likely unconsciously shaped their own identities around and in response to your addicted identity. That means that when you begin to change, to forge your new healthy, sober sense of self, they too must change. They can no longer define themselves through your addiction, they must find their own role to play in the family system beyond that of rescuer, victim, or judge.

Even more importantly, the entire family needs to be committed to becoming relationally healthier, as a unit and as individuals. This is the reason why family-based counseling is of such paramount importance in the recovery program. It helps you and your loved ones develop healthier patterns and to create a sense of self outside of the context of addiction and codependency.

How Bayshore Can Help

At Bayshore, our caring team of addiction recovery specialists strives to support our clients in achieving health, healing, and wholeness in every aspect of their lives. A particularly important facet of this is promoting healthy family relationships. As such, we offer both individual and family counseling, education, and support. Contact Bayshore today to discuss how our experts can help you and your loved ones achieve sobriety and enjoy mental, physical, and emotional wellness, both as individuals and as an intimate family unit.

At Bayshore Retreat we have extensive knowledge in treating substance abuse and co-occurring mental health issues. We understand that Mental Health Disorders can be the root cause of substance abuse. We use the latest scientific research and holistic approach for drug and alcohol addiction treatment.

References

  1. Baldwin, S., Malone, M., Sandall, J., & Bick, D. (2018). Mental health and wellbeing during the transition to fatherhood: a systematic review of first time fathers’ experiences. JBI database of systematic reviews and implementation reports, 16(11), 2118–2191. https://doi.org/10.11124/JBISRIR-2017-003773
  2. Hasanah, U., Susanti, H., & Panjaitan, R. U. (2019). Family experience in facilitating adolescents during self-identity development in ex-localization in Indonesia. BMC nursing, 18(Suppl 1), 35. https://doi.org/10.1186/s12912-019-0358-7
  3. Dillaway H. E. (2007). “Am I similar to my mother?” How women make sense of menopause using family background. Women & health, 46(1), 79–97. https://doi.org/10.1300/J013v46n01_06
  4. Mahon E. (2017). How Do You Find a Nursing Identity Within a Family Legacy?. Clinical journal of oncology nursing, 21(5), 637. https://doi.org/10.1188/17.CJON.637
  5. Beatie, B. E., Mackenzie, C. S., Funk, L., Davidson, D., Koven, L., & Reynolds, K. A. (2021). Caregiver identity in care partners of persons living with mild cognitive impairment. Dementia (London, England), 20(7), 2323–2339. https://doi.org/10.1177/1471301221994317
  6. Zeng, X., & Tan, C. (2021). The Relationship between the Family Functioning of Individuals with Drug Addiction and Relapse Tendency: A Moderated Mediation Model. International journal of environmental research and public health, 18(2), 625. https://doi.org/10.3390/ijerph18020625
  7. Zeng, X., & Wei, B. (2021). The relationship between the psychological capital of male individuals with drug abuse and relapse tendency: A moderated mediation model. Current psychology (New Brunswick, N.J.), 1–10. Advance online publication. https://doi.org/10.1007/s12144-021-02325-y
  8. Yang, C., Zhou, Y., & Xia, M. (2020). How Resilience Promotes Mental Health of Patients With DSM-5 Substance Use Disorder? The Mediation Roles of Positive Affect, Self-Esteem, and Perceived Social Support. Frontiers in psychiatry, 11, 588968. https://doi.org/10.3389/fpsyt.2020.588968
  9. Yang, C., Xia, M., Han, M., & Liang, Y. (2018). Social Support and Resilience as Mediators Between Stress and Life Satisfaction Among People With Substance Use Disorder in China. Frontiers in psychiatry, 9, 436. https://doi.org/10.3389/fpsyt.2018.00436
  10. Zeng, X., Lu, M., & Chen, M. (2021). The relationship between family intimacy and relapse tendency among people who use drugs: a moderated mediation model. Substance abuse treatment, prevention, and policy, 16(1), 48. https://doi.org/10.1186/s13011-021-00386-7
  11. Liu, S., Zou, X., Huang, X., Liu, Y., Lu, Q., & Ling, L. (2019). The Association between Living Status Transitions, Behavior Changes and Family Relationship Improvement among Methadone Maintenance Treatment Participants in Guangdong, China. International journal of environmental research and public health, 17(1), 119. https://doi.org/10.3390/ijerph17010119
  12. McCrady, B. S., & Flanagan, J. C. (2021). The Role of the Family in Alcohol Use Disorder Recovery for Adults. Alcohol research : current reviews, 41(1), 06. https://doi.org/10.35946/arcr.v41.1.06
  13. Moses, T., Lundahl, L. H., & Greenwald, M. K. (2018). Factors associated with sedative use and misuse among heroin users. Drug and alcohol dependence, 185, 10–16. https://doi.org/10.1016/j.drugalcdep.2017.11.035
  14. Mulvale, G., Green, J., Miatello, A., Cassidy, A. E., & Martens, T. (2021). Finding harmony within dissonance: Engaging patients, family/caregivers and service providers in research to fundamentally restructure relationships through integrative dynamics. Health expectations : an international journal of public participation in health care and health policy, 24 Suppl 1(Suppl 1), 147–160. https://doi.org/10.1111/hex.13063
  15. Calatrava, M., Martins, M. V., Schweer-Collins, M., Duch-Ceballos, C., & Rodríguez-González, M. (2022). Differentiation of self: A scoping review of Bowen Family Systems Theory’s core construct. Clinical psychology review, 91, 102101. https://doi.org/10.1016/j.cpr.2021.102101
  16. Hughes K. (2007). Migrating identities: the relational constitution of drug use and addiction. Sociology of health & illness, 29(5), 673–691.
  17. Stokes, M., Schultz, P., & Alpaslan, A. (2018). Narrating the journey of sustained recovery from substance use disorder. Substance abuse treatment, prevention, and policy, 13(1), 35. https://doi.org/10.1186/s13011-018-0167-0
  18. Gibson, B., Acquah, S., & Robinson, P. G. (2004). Entangled identities and psychotropic substance use. Sociology of health & illness, 26(5), 597–616. https://doi.org/10.1111/j.0141-9889.2004.00407.x
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