The seven stages of family recovery

The seven stages of family recovery

I’ve made some connections this week with The National Family Support Network in Ireland. They provide information, support and advice to family members living with substance misuse.  If you live in the UK, ADFAM do similar work here.

A study was undertaken in Ireland in 2007 by Dr Carmel Duggen, for the National Advisory Committee on Drugs (NACD). She looked at the ways people coped with a family member’s heroin use. She identified seven stages that family members go through, regardless of their economic or social background. It was found that going through these stages helped affected family members to move on from a role of a victim into a role of support and recovery. This applies to their own recovery, regardless of whether their loved one chooses to continue using substances or not.

This study identified seven different stages of how family members eventually come to manage heroin use within the family. This way of thinking is now applied to family members in a wider context who are living with a loved one’s drug or alcohol use.

There are lots of models to explain recovery and, as you probably know, the cycle of change is a fabulous one. I wrote a blog about it here. It really is a good idea for people living in this difficult situation to familiarise themselves with tools to use that can help.

The stages

 

Here is my interpretation of the stages in line with the Vesta Approach’s method of supporting family recovery.

 

Stage One: Unknowing

This is when families are not aware that a family has a problem with drugs or alcohol. Either that, or they don’t know the signs. As this period goes on, the substance use will usually worsen prior to the realisation that something is wrong.

 

Stage Two: Coping Alone

Once a family member finds out about the problem, They will often try and cope with the situation alone, trying all sorts of methods to help them to change. This is so hard to do when you are not a trained professional and when you worry about what people think or try to hide the problem. The best thing to do is to ask for help.

 

Stage Three: Desperately Seeking Help

Families at this point reach out for help from services as a reaction to their loved one’s substance use. This is difficult because they do not know where to go for help. In my experience, many families think rehab is the only answer and focus on help for the person using substances rather than themselves. Getting help for yourself is the best course of action because you cannot force your loved one to get help. Trust me, it doesn’t work.

 

Stage Four: Supported Learning

Family members begin to research addiction, substance use or the drug their loved one is taking. They may be starting to get some structured help and support for themselves. Families will start to learn about how to respond and not to react when their loved one uses their substance and learn new and effective strategies to cope. Strategies will always be unique to your situation.

 

Stage Five: Reclaiming the Family

At this stage, affected family members have engaged in support for themselves and begin to understand that they cannot change their loved one, they can only change themselves. NFSN say, ‘Part of this is separating the needs of the family and their own needs from those of the drug user. Families begin to separate the family dynamic from the drug dynamic and start to address the wider family needs.’ So, this is a case of practising the new strategies over a period of time, setting clear boundaries and giving own needs priority attention.

 

Stage Six: Supporting Recovery

Families have found the strategies that work for them and have learnt the skills to change the environment in which they live so that they can influence change and tip the balance so that drug or alcohol use becomes less attractive than sobriety. Strategies such as ‘rewarding your loved one when sober’ or ‘withdrawing when your loved one uses’, while, at the same time, providing love, support and encouraging their loved one to make better choices.

Stage Seven: Contributing

Once a family member is in a recovery process from their loved one’s substance use, they will be able to support others who are going through the similar experiences. I set up a mentoring programme in a previous project. The families can contribute by telling their own story and guiding others through the recovery process which is invaluable to those who are struggling to cope themselves.

 

Tell me in the comments what stage you think you’re at.

 

I can help

 

My service, The Vesta Approach, supports families affected by a loved one’s substance use. You can access confidential support from me wherever you are in the world. I will help you to get your loved one into treatment and lead a better life. I offer face to face sessions in the Manchester (UK) area or via Skype worldwide.

I also have an online therapeutic programme. Take a look at my services here

Follow me on Twitter and Facebook

I have a closed Facebook Group called Vesta Confidential. If you are affected by a loved one’s substance use, come and join me.

 

Sign up to my mailing list here to keep up to date with Vesta news and get my free Ten Steps to Family Recovery download.

 

Take care,

Victoria.

Dealing with aggression

Dealing with aggression

Recently, I’ve been thinking about aggression. I shared last year that I had been in a violent relationship in my twenties. It was a very difficult time, but, I learnt an awful lot from it. The main thing I learnt was that it is not acceptable for anyone to shout, hit, control or forcefully put themselves into a position of power, whether alone or in front of others.

In my professional life, I have completed a lot of training around domestic violence and also worked in organisational development where my team trained people in assertiveness and resilience. Knowing how to ‘do it’ and putting the skills into action around are emotions is a tricky challenge.

I’ll hold my hands up, when I was younger, I did not used to be as emotionally intelligent as I am now. I used to react to whatever feeling was going on inside me. If someone was annoying me I’d snap at them, if a situation annoyed me I would vent to anyone that would listen, if someone challenged my values, I would be absolutely raging!

Through my learning and self-development. I have worked on this and mantra is ‘respond, don’t react’. This applies to reacting to my own feelings as well as being on the receiving end of someone else’s. Trying to remember this mantra works well. Trust me!

 

Fight, flight or freeze

 

Our responses to experiencing stress, aggression or danger are fight, flight or freeze. I have examples of all three. Have you ever been in relationships with people that push your buttons and your values clash so much that when they argue with you, you can’t help but fight back? Does this get you anywhere? Maybe, in some circumstances where there is absolutely no other option and it’s a choice between life or death. Probably not in any other situation. This goes for arguing back too.

 

A man at Christmas chased me and my daughter in our car in a fit of road rage as I turned into a road and made him jump! It was one of those roads that appears to be wide, but when you turn into it, it’s really narrow- so it makes you jump when people turn in. As I turned into my street, I saw him behind me flashing his lights and beeping. As my daughter is four years old, I knew I had to protect her. After a on the spot risk assessment, I thought, there is no chance I’m going to pull into my drive. I carried on driving and called my husband. I drove for about a mile and a half hoping he would go, but he didn’t. Guess what? I ended up at a traffic light! It turned red. He got out and started yelling for me to wind window down. I knew I had to bring him down from his rage. With the window firmly closed and the car locked, I simply said, ‘I have my daughter in the car. My husband is on the phone. Please go away.’ Something in that sentence brought him down and he walked away.

 

We sometimes freeze when someone does or says something hurtful or embarrassing about us. I personally think that when this happens to me, it is about not being able to process what’s been said in the moment. We may not want to react inappropriately. ‘Freezing’ is how we would describe a deer in headlights. Animals freeze to try and prevent danger, such as an attacker from seeing them move. It is part of our instinct to do the same.

 

What is aggression?

 

Aggression is an inappropriate response to feelings of stress or someone or something perceived as a threat. It is where an individual believes they are standing up for themselves, but in a hostile way. This behaviour stems from not being able to see another person’s point of view, and often, not caring whether they have a view or not. An aggressive person’s views are right, ours are wrong. Life is black and white, there are no grey areas and quite frankly, they are not interested in hearing the our point of view.

 

Aggressive Behaviours

 

Aggressive behaviour is acted out in many forms, from anger, threats, bullying, shouting, punishing, coercion, control, verbal or physical violence, and conversion strategies to try and wear someone down.  People who regularly display aggressive behaviours can be authoritarian and genuinely believe it’s their way or the highway. They may have wider emotional or mental health issues going on, or be using substance problematically.

Friendships with aggressors are usually based around their perceived influence, fear and protection as opposed to friendships being formed because of commonalities and the enjoyment of someone else’s company. This is how cults and gangs are formed-by fear not fun.

 

Dealing with aggression

 

In the moment of an aggressive act, we will naturally have a fight, flight or freeze response. It’s instinctive. We are likely to complete a mini-risk assessment of the situation we are in.

Personal safety is paramount above any strategy whatsoever. If there is any threat of violence, get out of there. Walk away, run. Whatever you need to do.

Another mantra of mine is that ‘you can’t rationalise with someone who isn’t rational’. My advice is do not even try to engage in a conversation with someone who is not rational at that point. If they are drunk, angry or intoxicated in any way, do not bother to try any techniques. Leave them to it and speak to them when sober or calmer.

 

  1. Stay calm- have you ever had a good result from arguing back or retaliating? Probably not. So it’s best to avoid it!

 

  1. Empathy- are they having a bad day? Is the behaviour unusual? What’s actually going on for that person on that day?

 

  1. Take ownership- are you responsible for anything? Have you behaved aggressively yourself? Name it. I’m sorry I was talking during your presentation, but… (see point 5) We all make mistakes!

 

  1. Say something!- Only you can decide whether you say something in the moment or following an event. If someone just is not listening, forget it. Withdraw from the scene, but don’t forget about it. We often just let things go but in the long run, this passive behaviour will not get you anywhere. In the moment reponses are great, but not always appropriate or realistic.

 

  1. Respond, don’t react- Tell the other person how you feel. My favourite tool for this is I-messages. Frame it like this:
  • I feel… (state how you feel)
  • When you.. (state the behaviour)
  • I would like… (what you would like to happen instead)

For example,  “I feel upset when you shout at me. I would like it if you could wait until you feel calm to have a discussion about things in the future.”

It is a fact that NOBODY can argue with your feelings. They are yours and they belong to you.  This way will have more of an impact that yelling back at them.

 

  1. Establish triggers- if it is a loved one or someone you see regularly, working out what triggers them to aggressive behaviour is useful, so that you can plan ahead for future outbursts and how you will manage it. Look out for the red flags that are typical when their undesirable behaviours are triggered.

 

  1. Consider your values- what do you believe in? What will you or wont you accept? How would you feel if someone behaved this way towards your grandma, your best friend or your son?

 

  1. Consider the future of your relationship- violence is not acceptable in any forms. Aggression can be worked with, providing the individual is accountable and takes responsibility for their behaviour. If they do not, you do not have to accept it. Think about your options as you could reduce contact, cut ties, move out, only see in certain situations and so on.

 

I can help

 

My service, The Vesta Approach, supports families affected by a loved one’s substance use. You can access confidential support from me wherever you are in the world. I will help you to get your loved one into treatment and lead a better life. I offer face to face sessions in the Manchester (UK) area or via Skype.

I also have an online therapeutic programme. Take a look at my services here

Follow me on Twitter and Facebook

I have a closed Facebook Group called Vesta Confidential. If you are affected by a loved one’s substance use, come and join me.

Sign up to my mailing list here to keep up to date with Vesta news and get my free Ten Steps to Family Recovery download.

 

Take care,

 

Victoria.

How to stop ‘enabling’ someone’s substance use

How to stop ‘enabling’ someone’s substance use

When I first heard the term “enabling”, I felt really sorry for the people who were classed as the “enablers”. It felt to me like a negative label attributed to someone that’s trying their best, day in, day out, to help someone they love with a substance misuse problem. “How mean”, I thought!

Now, I’ve realised that my attitude to this was all wrong. Enabling actually means unknowingly “making something possible or easier”. The family and friends of people who use drugs and alcohol go through a wide range of emotions themselves and are not trained therapists, so end up trying anything and everything to help their loved one change. This is a perfectly natural thing to do!

When a loved one shows signs of recovery or a glimmer of their old self and behaviours, a relaxed and sympathetic approach ensues. As they move back into their ‘selfish’ drinking or drug using behaviours, angry reactions are to be expected. If they put themselves in danger, panic, or worry, desperate measures are called upon. It’s a rollercoaster of emotions every single day and if you’re in this situation, you’re just doing your best. See my blog on the cycle of change for more detail of the road to recovery.

 

What is enabling?

 

Disabling enabling is one of the four Vesta Programme principles. In my programme, we will tune you in to any ways in which you and others have perhaps been (unknowingly) making it a bit too easy for your loved one to drink or use drugs. Don’t worry! Everyone does this out of the love and care for their family.

In order for your loved one to change, we make a plan for this to stop these behaviours and replace them with better ones. Why? Because until you and others around your loved one stop “helping”, the chances of them stopping misusing drugs or alcohol are slim to none.

There is no judgement here. Enabling, helping or whatever you want to label it is a lovely, kind thing to do. It’s just not going to change anything.

 

Why does enabling matter?

 

If we want to influence substance misusing behaviour, there are a few things to consider. What does your loved one get out of their substance use? What do they like about it and what does it allow them to avoid? It’s important to think about these points as the benefits of their use. Secondly, what problems do drug and alcohol use cause them? What good things do they miss out on when they use or drink? These are the costs of their substance use.

If we focus on the problems that drugs and alcohol cause them, these are “punishing consequences” and include anything that makes them feel bad as a result of their substance use. Hangovers, missing work, shame, depression, aggression or health concerns. Each person will have different reactions to different consequences.

The important thing to remember is that in order to create change, the balance of the costs and the benefits of substance use needs to be shifted so that your loved one experiences ALL the natural consequences of their substance use. Your loved one needs to experience the full costs of their substance use.

If enabling takes place by anyone close to your loved one, they will continue to experience the more positive effects of their substance use. We need them to experience the negatives. It’s tough, but I can help you do this on the Vesta Programme.

 

Enabling behaviours

 

We’ve established what enabling is and why we need to stop doing it, but it’s important to understand what types of behaviour are enabling. It can be anything that reduces the painful consequences of their use, protecting them from other people’s judgements or reactions. Some examples of enabling behaviours are as follows:

  • Concealing a loved one’s substance use from family or friends
  • Paying off debts
  • Reparing damage to home or other posesisons
  • Defending them from criticism
  • Being around your loved one when they drink or use (regardless of your mood!)
  • Making excuses for them with work absence
  • Avoiding having your own life on order to help them

Can you recognise any? What might be the consequences of these behaviours for you and your loved one?

Remember that nobody is judging you here!

 

The benefits of disabling enabling

 

When we enable, we reduce the negative consequences of someone’s undesirable behaviour at a cost to ourselves. This means that instead of your loved one experiencing the cost of their own behaviour, you are! These costs manifest themselves physically, emotionally, financially and socially.

If you think about what has worked before while you have been helping your loved one in this way, what has changed? Not much?

Perhaps it’s time to try a new approach.

Instead of living like this, imagine what it would be like to free up some of your headspace and concentrate on you?

In the Vesta Programme, I will help you to assess each enabling behaviour and we will work on stopping these. We will assess how comfortable and safe you feel stopping these behaviours and alongside the other programme principles I will help you to recover from your loved one’s substance use, live a better life and get your loved one into treatment.

 

I can help

 

My service, The Vesta Approach, supports families affected by a loved one’s substance use. You can access confidential support from me wherever you are in the world. I will help you to get your loved one into treatment and lead a better life. I offer face to face sessions in the Manchester (UK) area or via Skype.

I also have an online therapeutic programme. Take a look at my services here

Follow me on Twitter and Facebook

Sign up to my mailing list here to keep up to date with Vesta news and get my free Ten Steps to Family Recovery download.

 

Take care,

 

Victoria.

Drugs, alcohol and mental health

Drugs, alcohol and mental health

Drugs, alcohol and mental health

 

I’ve worked with people who have problems with drugs and alcohol (I’ll refer to both as drugs for this blog) for over a decade. I had some brilliant training years ago around dual diagnosis. This term refers to people who have been diagnosed as having mental health problems at the same time as problems with alcohol or drugs.

 

Which problem was there first?

 

I believe that people use substances because of the consequences from using them, whether they are positive or negative, resulting in positive or negative consequences. Interestingly, a positive consequence includes the following:

  • What somebody likes about using drugs and alcohol (these are called positive reinforcers)
  • Things that drugs and alcohol helps them to avoid (these are called negative reinforcers)

This is where we can start thinking about mental health. If someone has mental health issues that are possibly undiagnosed or diagnosed, then substance use might help them to alleviate some of the negative ways they are feeling. We call this self-medication. So, the drugs are beneficial to them. In these cases, the mental heath issues may have been the problem that was either undiagnosed or not treated properly in the first place and then the drugs came along after.

We then move onto the negative consequences of drug use. These are:

  • The problems caused by taking drugs
  • The things that people miss out on because of drugs

When we think about the negative consequences of drug use and mental health, some typical problems that may be caused from drug use is that it can exacerbate mental health problems, so even if someone gets short term relief, their problems overall can increase through their drug use. Drugs can also cause mental health problems for people who have possible had no mental health problems prior to taking drugs. This can be due to many factors like sleep deprivation, hallucinations, anxiety, paranoia, stress and in some cases, drug induced psychosis, accidents, physical health problem- the list goes on.

How do we help people with a dual diagnosis?

 

When I’ve supported people who have problems with both mental health and drugs, it has been challenging trying to get them the help they need. This is because services in mental health often find it hard to treat people who are intoxicated with drugs. This makes sense, because it is tricky to assess someone who perhaps isn’t able to communicate all that well.

Drug and alcohol services can also have difficulty because if a person is self-medicating with drugs, once they are removed as a coping mechanism, we need to get the right support in place, the right medication if needed and the right therapies. The recovery journey needs very careful planning in partnership with all the required services involved.

We often think that once people stop using drugs, then life will be immediately better. Recovery doesn’t work like that. Stopping using drugs is just the start of that journey. Each recovery journey is individual to that person and they need to lead it themselves. This is why professionals and family members must understand the goals that a person with dual diagnosis wants to achieve themselves, rather than imposing this upon them. If everyone works together to meet these goals, then the individual is more likely to want to change. Read more here on recovery.

 

Support

 

There is a lot of support out there for anyone who is feeling unwell. There is also lots of work being done around breaking the stigma of accessing help for mental health and substance use. Asking for help is the best thing anyone can do if they need it.

Click here for some services who can help.

 

I can help

 

My service, The Vesta Approach, supports families affected by a loved one’s substance use. You can access confidential support from me wherever you are in the world. I will help you to get your loved one into treatment and lead a better life. I offer face to face sessions in the Manchester (UK) area.

You can also get help via Skype  and my online group therapeutic programme which I’ve launched this week! Take a look here

Follow me on Twitter and Facebook

Sign up to my mailing list here to keep up to date with Vesta news and get my free Ten Steps to Family Recovery download.

 

Take care,

 

Victoria.

 

Why you need help when you live with a person using alcohol or drugs

Why you need help when you live with a person using alcohol or drugs

Living with someone who has problems with drugs or alcohol is usually an all-consuming, emotional and relentless journey. You love them so you keep going and before you know it, every waking moment is spent thinking about them, their problems and how you can make it better. You haven’t even time to think about help for yourself. Sound familiar?

 

Your feelings are determined by what your loved one’s behaviour is like that particular day. Have they had a drink? Have they used? How much have they used? How will I find out? I’ll ring so and so. They’ve let me down again. The children are upset. Oh no, will there be another row? Might they get violent? How can I stop it?

 

I get it.

 

Are they really addicted?

 

You may be in a bit of denial or not so sure yourself that your loved one has a problem. Some people spend most of their time together with their loved one and friends using substances themselves so maybe you’re thinking have I really got room to talk? Everybody else does it. Maybe because they are not using every day then they can’t be an “addict?”.

 

Forget that word, “addict”, for now. I prefer the term, “someone who has problems with alcohol or other drugs”. It’s a bit easier to understand that if somebody is having problems in other areas of their life because of drugs or alcohol then they are having problems. These problems aren’t a one-off, and a number of aspects of life such as relationships, work, finances, health and so on may be affected. Something needs to change. Sometimes, this might be a friend or family member having a chat and helping them realise. Sometimes, they may be in denial or need some specialist help. This all depends on the individual, the amount of their substance being used, frequency and how long it has been going on. Unfortunately, nobody can make your loved one access support. You can only influence it. It is their decision to get help.

 

If your instinct is telling you that you loved has a problem and you also have evidence for this, then they probably have. It might also be completely obvious.

 

What is so hard about asking for help?

 

If you know your loved one has a problem, you can influence them to access treatment, but when it comes down to it, it is their choice. There are lots of treatment options for substance misuse which I can talk about another time. It is useful for you to know this, in case an opportunity arises for you to discuss this with them at a time when they are sober.

 

What we are never good at is asking for help or admitting we need this ourselves! Why?

 

There are loads of reasons. You might be so intently focussed on your loved one getting help that you don’t even consider yourself at all! Unsure about what support is out there for you? Perhaps you are worried about people finding out for all different reasons, like wanting others to just think you are living a “normal” life. Lots of powerful emotions like fear, anger, worry, shame, embarrassment, frustration and guilt, as well as not wanting to let our loved one down are barriers to accessing help.

 

These are all common feelings and thoughts of family members affected by a loved one’s substance use. You’re not on your own, have a look at the stats from ADFAM’s evidence pack which was published in 2012! ADFAM are amazing. Have a look here. 

 

Remember that your loved one choosing to drink is not your fault. NACOA have lovely words for children with parents who have problems with alcohol which I think are important for you to remember too:

I…

  • didn’t cause it
  • can’t cure it
  • can’t control it
  • can take care of myself
  • can communicate my feelings
  • can make healthy choices

 

I hope you can take some comfort in the fact that you are definitely not alone in your situation.

 

What next?

If you’re still here, you know that your loved one has a problem, we’ve considered some of the feelings and daily thoughts you might be experiencing and you know you’re not on your own.  So, what have you got to lose? I’m wondering if there is anything else stopping you from getting your own help.

 

I know from working with families affected by substance misuse for many years that there can also be a number of practical reasons why it is difficult to get help (as well as the above):

 

  1. Work may mean you can’t go for sessions during the day.
  2. Childcare- you might not want to leave your children with your loved one.
  3. Evenings may be taken up with other responsibilities, if not work.
  4. You might just be knackered all the time and not have the energy.
  5. What’s out there might not be your thing.
  6. Fear of leaving your loved one alone.

 

There is some help out there to suit everyone. You might think that once your loved one gets into treatment, you will get help too. Unfortunately, this is not always the case as your loved one needs to give consent for you to be involved in their treatment journey. If they don’t, you may not get support yourself. Some services do offer family services as part of their recovery process which is fantastic. Have a look yourself online and see what’s available for you in your area.

 

How the Vesta Approach is different

 

I set up The Vesta Approach because I know how difficult it is for some of you to even get out of the house. I offer my service face to face in Manchester, UK. Don’t worry though, as you don’t even need to go out to access my programme as I offer Skype sessions and soon, an online therapeutic programme. Read more here.

 

This service is for you. I will teach you how to respond differently to your loved one’s substance use in an evidence based programme that supports you to recover from your loved one’s drug or alcohol use, get them into treatment and improve your quality of life.

 

If you want to know more, sign up to my mailing list and receive my “Ten Steps to Family Recovery Guide” to give you a taster of the programme and my top tips to starting your recovery journey.

 

Remember that you are not alone so take that first step and have a look at what help is out there for you.

 

I can help

My service, The Vesta Approach, supports families affected by a loved one’s substance use. You can access confidential support from me wherever you are in the world. I will help you to get your loved one into treatment and lead a better life. I offer face to face sessions in the Manchester (UK) area. You can also get help via Skype  and my online group therapeutic programme which is launching in the next few weeks!

Follow me on Twitter and Facebook

Sign up to my mailing list here to keep up to date with Vesta news and get my free Ten Steps to Family Recovery download.

 

See you next week,

 

Victoria.