This article is by Thaddeus Camlin, PsyD and published by Practical Recovery

 

The aphorism ‘blood is thicker than water’ reminds us to prioritize family.  When it appears that people choose drugs and alcohol over family doubt reverberates through the deepest truths of human bonds.  We become so focused on how someone could choose drugs and alcohol over family that we miss the bigger question:  Why is someone in a position to choose drugs and alcohol over family in the first place?  Often, people are issued an ultimatum something to the effect of: “It’s us, or the booze.”  Rather than reflecting a corrosive character defect in the so-called “addict,” the answer to why people choose drugs and alcohol over family may instead lie, at least in part, at the hands of those who issued the ultimatum in the first place.

Anyone who ever issued an ultimatum to a family member likely believed, and were possibly told by “experts,” that such tough love tactics are the best way to help a loved one.  In reality ultimatums, especially in the context of addiction interventions, can be intensely traumatic and damaging to relationships.  Ultimatums are not consistent with supporting autonomy and healthy communication, two keys to helping a loved one overcome addiction.  People who are issued ultimatums in addiction interventions can feel that love from family is conditional upon being who family wants them to be rather than who they are.  Unconditional love and acceptance does not mean condoning all behavior, but it does underscore the importance of supporting self-determination and standing by family no matter what.

People with addictive behaviors rarely want all ties cut with loved ones.  If someone chooses to continue to drink after being issued an ultimatum, that person’s choice was to drink, the other person’s choice is whether to continue to engage the relationship.  Most people I work with desperately want relationships with loved ones and are heartbroken when loved ones cut ties.  Putting the responsibility for ending the relationship squarely on the shoulders of someone choosing to drink can intensify the feelings of shame that often fuel problematic addictive behaviors in the first place.  I’ve worked with many people who say things to themselves along the lines of, “I must be a horrible person, I keep choosing alcohol over my family.”  Such internal dialogue over days, weeks, months, and years takes a toll on self-worth and can contribute to further problems.

In addition to the pain people can experience when issued an ultimatum, family members can be left with powerful regret if ties are cut and loved ones spiral down to the deepest depths of despair where overdose and death are dangerously possible. Expressing concern, offering support, and not being taken advantage of are possible without choosing to sever all ties with a loved one who chooses to ingest psychoactive compounds despite concerns from family.

Families generally aim to help, and meaningful connection in relationships helps both prevent and heal addiction.  Yet, disconnection from loved ones as a catalyst for change remains a dominant practice in addiction treatment.  It is important for families to know that choosing to end a relationship with a loved one over continued engagement in alcohol or drug use can result in the opposite of their desired effects.

It is curious that the tactic of threatening to cut all ties with a loved one engaged in problematic addictive behavior only seems to apply to certain substances.  Tobacco is related to more deaths than all other substances, including alcohol, but who is threatening to end relationships with loved ones because they smoke cigarettes?  From the family’s perspective it is worth asking: Is an imperfect relationship with my loved one better than no relationship at all?

Asking why people choose drugs and alcohol over family is a flawed question because it puts all responsibility in a two-party decision on one party.  People don’t choose drugs and alcohol over family.  People choose to use drugs and alcohol, loved ones choose to cut ties over drug and alcohol use. For healing in relationships to occur it is usually crucial that all parties involved are willing to take partial responsibility.

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