Addiction affects the family in many ways

 Spiritual effects: isolation, neglect of core values, stressed family ties, shame
 The addict feels abandoned and isolated. He or she begins to disregard societal rules. This tends to separate the family into divisive segments (warring camps). The deterioration of the core values and self-esteem results in feelings of shame and fear of discovery.

 Emotional effects: self-focused, exaggeration of feelings, psychological defences, loss of self-esteem, lack of intimacy
 Emotionally, the family may be as dysfunctional as the addicted person. Denial is as strong in the family as it is in the addicted person and it contributes to enabling behaviour. Some of these processes are unconscious and; therefore, not available for the family to accept.
 Frustration and pain leads to exaggeration of feelings (explosive behaviour). The family knows that it is different and defends itself through psychological defences (denial, rationalization, and minimization). The frustration and futility of trying to appear “normal” contributes to loss of self-esteem. Enabling is a form of self-deception and an emotionally exhausting activity.

 Physical effects: domestic violence (physical, emotional, sexual), increased use of health care services
 Domestic violence can occur in well-educated, professional families. The physician who is addicted may be the perpetrator. However, in a moment of conflict, family members may be violent toward the physician or other family members. The following warning signs of domestic violence may be present: (1) feeling stressed and unsafe in the relationship, (2) feeling afraid of, threatened by or physically harmed by a family member, (3) “walking on eggshells” around the family member, and (4) feeling cut off from the outside world.
 Family members who live with alcoholics incur the risk of spouse and/or child abuse through violent acts and extreme psychological trauma. As a result of the potential tension and anxiety in the family involving drinking behaviour or drinking-related behaviour, the total family is likely to be above average users of medical care.
 With effective treatment, family members of alcoholics decrease utilization of medical services.

 Social effects: withdrawal from community, distrust/dishonesty. embarrassment, maintain appearances, financial difficulties
 These personality changes are a result of emotional disturbance engendered by the addictive process. Some of these changes in personality become apparent quickly, while others evolve over a long period of time. Most of these changes are not apparent (or ignored) by the family.
 Economic declines (move, change schools, change jobs) may occur. Withdrawal/avoidance of community public exposure occurs.

Copyright rdocis 2007