The treatment of alcoholism and substance abuse involves looking at many facets of a client. The goal of effective treatment planning is to keep the treatment plan and goals individualized and measurable. For many clients, this involves issues such as anger management, resolution of guilt and shame, and becoming involved in actively working a 12-Step Program of recovery. Others express a desire to address family issues as well.

As a member of society, there are rules that we are expected to follow. These rules exist to aid in the functioning of a society. In an alcoholic family, there are rules as well; rules serving the same function. However, these rules are not typically written down, and they seem to have evolved through a system of trial and error. These rules are most often referred to as "Don't Talk, Don't Trust and Don't Feel." Over time, a code of silence develops, and the disease is simply not discussed. This disease many times causes erratic and inconsistent behavior, and a trusting environment cannot be established among its members. Addicts also falsely learn the art of manipulation will get them what they want, and they become so highly skilled they lose all sense of honesty in their relationships with people. Finally, the members of this family learn to stuff or repress their feelings of anger, sadness and fear, and they then only express those feelings which do not rock the boat.

This pattern is often difficult to interrupt, and it is only when the client enters treatment that the family is afforded a chance to examine their own life rather than focusing on the behaviors of the alcoholic. It is at this time that family members are encouraged to attend Al-Anon or Families Anonymous in order to begin their own program of recovery.

As a part of an individualized client treatment plan, there are assignments or tasks given by our counselors for the clients to complete. Many tasks in treatment and recovery need to be written, whether it is a fourth step, a client's goodbye letter to his/her addiction, or a letter from the client's family. Here is one such letter:

My son asked me to write a letter telling how his substance abuse affected me. This is not something I looked forward to doing because it was a long and very painful period of time. There are times when I freely talk about it to people I am comfortable talking to. However, putting my thoughts into a concrete format is something I have not yet done. I've thought about what to write, but for the most part this is an impromptu effort.

STRESS!!! This is the one word that keeps coming to mind when I recall the events that have occurred. It affected me on all levels of my life. We all deal with stress coming from all directions around us, but this stress was soul deep and had no end.

Hardest to deal with was emotional stress. Everything that went wrong was an emotional injury. Earlier things like breaking curfew, poor grades, problems at school gave way to lying, stealing, police contact, probation, more stealing, and finally senior year running away from home while still a minor. My life was an emotional roller coaster that rode waves of anger, tears, depression, love and hate. I tried to stabilize my life by controlling my child as well as the rest of my family. It did not work. Step One--We are powerless over drugs and the lives of others. Thank you Families Anonymous for this first and most important step, but for more than a decade and a half I've been Mom and Mom fixes things. Why couldn't I fix this?

Of course stress affected me physically. When my child left home the first time I became a physical wreck. Eating was meaningless and falling asleep was nearly impossible. Unfortunate for me was the fact I could not seek support from friends and secondary family members. The simple truth was I was too embarrassed to talk about it.

This led to stress on a social level. I withdrew from my friends and family. Not only could I not share my problems with them, I could not trust my son at home alone. I felt I had to be home to guard my home. Worst of all were the arguments with his Dad. No doubt we were hurting terribly, and at times each other's support, but too many times differences in opinions, actions and reactions only caused more stress.

Mental stress. I could not think clearly because I was too close to the problem. I fell into all the traps: denial, codependency and that issue of control to name a few. The hardest thing to admit is that I was my son's enabler. It is a family disease. It saddens me to know how many suffer because of it. Thankfully we are getting better, and I pray it continues.

As addiction professionals, we focus on the effects of the substance abuse on the client. However, as the above letter illustrates, addiction does seriously affect the family as well. The above letter closely parallels the progression of the disease in the client; varying degrees of stressors and/or conflicts cause a constant 're-balancing' act on the part of the family, or any relationship.

Sharon Wegscheider-Cruse (The Family Trap - 1976) likened the chemically dependent family to a mobile, that changes position but always maintains connections with each part. If one part of that mobile is set in motion, the rest of the mobile will adjust to maintain some sort of equilibrium. If a chemically dependent client continues his/her use, the rest of the family system must adjust itself to maintain thesame sort of equilibrium.

As clients enter treatment for their disease, or as family members contact Serenity House to help their family members, we communicate to the family that there is hope, that there is a way out. Henry Tews, the President/CEO and founder of Serenity House has written a pamphlet entitled "Help Me Save The One I Love", which outlines the struggles of a parent who wants to help those overcome by their addiction. Many times during the week, this pamphlet is mailed to family members to aid in their recovery from this enabling disease. Other suggestions that are given include Families Anonymous and Al-Anon, both of which are modeled after AA--a group fellowship of peers sharing a common problem.

There is a sign in the hallway at Serenity House, a sign that is a constant reminder to me of what we are doing. It says "Welcome to Serenity House - You are no longer alone." The mother who wrote the above letter felt alone in her struggles; our clients report feeling alone in theirs as well. Upon entering Serenity House, however, the clients are no longer alone. If the above letter sounds like your experience, or the experience of a friend, please contact me at 630-620-6616, ext. 118, and I will send a copy of Henry's pamphlet to you.