Chapter 5
Substance Abuse and Family Systems
Chapter Objectives
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Describe families as systems.
Describe the need for the entire alcoholic/addict
family system to seek recovery.
Explain the use of the term imbalanced instead of
dysfunctional when describing maladaptive family
behavior.
Describe the family roles in an alcoholic/addict
family system.
Identify rules, values, motto, communication,
drugs of choice, and functions of drugs in a rigid,
ambiguous, overextended, and distorted family
system.
Chapter Objectives
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Identify and describe the survival roles in an
alcohol/addict and imbalanced family system
(Wegscheider-Cruse model).
Define enabling behavior and give examples
of each of the five types of this behavior.
Identify the stages of family recovery in an
alcoholic/addict family system.
Families as Systems
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Looking at the family as a system is
imperative in addressing the problem of
alcohol/drug dependence and addiction.
 To effectively treat the alcoholic/addict,
the rest of the family system also needs
treatment.
Family Rules
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In an alcoholic/addict family system there
is the “no talk, no feel, no trust” rule.
– Talking
• may cause more problems
– Trusting
• usually leads to disappointment
– Feeling
• is too painful, and expression of feelings is not
allowed because it might cause more trouble.
Imbalanced versus Dysfunctional
The term “dysfunctional” is frequently a
shame-based, negative label, with a
negative emotional tone.
 Replace “dysfunctional” with “imbalanced”,
for this is what we truly are looking at – an
imbalance in the individual, and family
members’ lives.
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Imbalanced versus Dysfunctional
The term “imbalanced” gives hope that
there is help and a way to better manage
the system.
 There are different types of imbalance in
family systems.
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Rigid
Ambiguous
Overextended
Distorted
Rigid Family Systems
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Rules – strict interpretation of the rules with no
exceptions.
Values – things are always right or wrong.
Motto – “do it right, or else”
Communication – linear, hierarchical.
Drugs of choice – Alcohol and/or heroin,
sedative hypnotics, narcotic analgesics.
Functions of drug – Suppress feelings, stay
numb to the trauma in this family system.
Ambiguous Family Systems
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Rules – we have rules but we don’t enforce
them. Rules can be changed.
Values – forever changing, based on situation.
Motto – “keep peace at all cost; avoid conflict.”
Communication – mixed messages that are
confusing.
Drugs of choice – alcohol and/or heroin,
marijuana, hallucinogens.
Functions of drug – suppress feelings of
discomfort, kill pain, shut out or distort reality.
Overextended Family Systems
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Rules – be productive, get busy, stay on the
move.
Values – look good, achieve, willpower, feelings
are for wimps.
Motto – “we can achieve anything we set out
minds to.”
Communication – feelings are not expressed,
decisions based on what will please parents.
Drugs of choice – cocaine, methamphetamines,
stimulants
Functions of drug – keep on working/doing
Distorted Family Systems
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Rules – don’t let outsiders know we are crazy.
Values – maintain illusion of normalcy.
Motto – “aren’t most families like ours?”
Communication – mixed messages; limited
common perceptions of situations.
Drugs of choice – alcohol, hallucinogens,
marijuana, inhalants.
Functions of drug – distort reality, which is
already distorted, to try and make sense, or no
sense, of it.
Wegscheider-Cruse’s Survival Roles
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Survival roles describe the coping
mechanisms members use to survive in a
dysfunctional family
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Chief enabler
Family hero
Family scapegoat
Lost child
Family mascot
Chief Enabler
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Assumes primary responsibility for
chemically dependent family member.
 Major enabling approaches
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Avoiding and shielding
Attempting to control
Taking over responsibilities
Rationalizing and accepting
Cooperating and collaborating
Family Hero
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The achiever, the responsible child, the
good child, the model child.
 Often the firstborn, who escapes the
dysfunctional aspects of family through
personal achievement.
 Achieves for the family and ignores
personal feelings, values, and goals.
 Is vulnerable to alcohol/drug problems
and/or problems in interpersonal
relationships.
Family Scapegoat
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Diverts the family members away from the
real issues in the family and the painful
emotions of these issues.
 Is blamed for all of the family problems.
 Often acts-out in school and at home,
exhibits antisocial behavior and
substance abuse due to underlying anger
and resentment.
Lost Child
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Primary function is to allow the dysfunctional
family – especially the parents – expend less
energy.
Often identifies with the pain of parents and
siblings and wants to decrease the pain by not
contributing to the problem.
Denies feelings and needs, frequently
disconnecting emotionally and physically from
the family.
Are at risk for suicide.
Family Mascot
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Diverts attention away from family issues and
pain.
Uses humor, silliness, and self-disparaging
ineptness.
Discounts a sense of self as a price to pay for
calm in the family.
Feels unworthy of love, unless able to
alleviate someone’s pain.
Stages of Family Recovery
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The family goes through similar stages as
the alcoholic/addict in breaking through
their own denial systems and grieving the
losses, and pain of living in an
alcoholic/addict system.
Stages of Family Recovery
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The five stages of grieving (DABDA):
– Denial
• Will not acknowledge that something is wrong.
– Anger
• Keeps family from talking about problems/issues.
– Bargaining
• “If you will stop abusing alcohol/drugs, I’ll . . .”
– Depression (or Feeling)
• Feelings come to the surface and are easily
accessed forcing the family to seek help.
– Acceptance
• Family recognizes that they have a problem.