Saskatchewan Alcohol and Drug Services Provincial Working Group

FAMILIES & ADDICTIONS COURSE

A family is like a mobile: each persons actions affect the others.

Reprinted with permission from THE ADDICTIONS FOUNDATION OF MANITOBA October 2003

Saskatchewan Alcohol and Drug Services Provincial Working Group

VISION STATEMENT
We are a committee of Provincial representatives committed to providing networking, leadership, support and consistency by developing, enhancing and evaluating services.

WORKING WITH FAMILIES SUBCOMMITTEE

The purpose of the subcommittee was to develop a model of providing clinical services to family members based on best practice evidence. As part of the work of the subcommittee, the manual Families and Addictions Course, Addictions Foundation of Manitoba, September 2000 was selected as a resource for the use of Saskatchewan addiction personnel when working with family members. The manual is congruent with the Saskatchewan approach to services for family members and with the principles of working with families as outlined by the subcommittee in their report to the Provincial Working Group, September 2003. The manual incorporates current research and materials for working with families affected by the substance use of a family member. The subcommittee recommends it as a resource to be used in conjunction with the document Saskatchewan Alcohol and Drug Services: Motivational Assessment Process for Family Members, April 2002. The subcommittee gratefully acknowledges the permission granted by AFM to reproduce this resource and trusts it will prove useful to Saskatchewan addiction personnel.

The subcommittee welcomes feedback on use of the manual. Feedback may be directed to: The Provincial Program Support Unit 2003 Arlington Ave. Saskatoon, SK S7K 2H6 Telephone: (306) 655-4510 Fax: (306) 655-4545 Email to g.madill@saskatoonhealthregion.ca

Saskatchewan Alcohol and Drug Services Provincial Working Group

FAMILIES & ADDICTIONS COURSE

A family is like a mobile: each persons actions affect the others.

Reprinted with permission from THE ADDICTIONS FOUNDATION OF MANITOBA October 2003

FAMILIES AND ADDICTIONS COURSE

Purpose
To provide participants with a knowledge base of the addictive process in family systems and the recovery needs of family members.

Objectives
Upon completion of this course, participants will be able to: identify the characteristics of an addictive process describe the survival behaviours and roles that are adopted by family members affected by an addictive process describe how to conduct an initial family meeting identify recovery needs and goals for all family members

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TABLE OF CONTENTS
The Addictive Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
Definition of Addictions Five Characteristics of Addiction Definition of Co-dependence The Iceberg (A Unifying Model of Dependence and Co-dependence) Core Beliefs of Addictive Thinking The Dragon Named Shame The Faces of Shame Guilt and Shame Three Processes of Addictive Thinking Three Rules Addictive Thinking and Resulting Behavioural Roles

The Addictive Process and its Impact on a Family System . . . . . . . . . . . . . . . . . . . . .15

Definition of a Family System with an Addictive Process Assessing the Family Dynamics Healthy Versus Addicted Family Systems Understanding Family Roles Three Generational Genogram

Recovery Needs and Goals . . . . . . . . . . . . . . . . . . . . . . . .25

Stages of Recovery for the Family

Appendices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29
Boundaries Working with Family Roles Sculpting a Family Sculpting Shame Structured Family Intervention Recovery Genogram Construction

Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47
Print and Video

Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49

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THE ADDICTIVE PROCESS

Addiction destroys love as well as freedom. In the presence of our addictions were not free to ask what we really desire.
Sam Keen

Definition of Addiction
The Addictions Foundation of Manitoba currently uses the following definition for addiction. Addiction refers to an unhealthy relationship between a person and a mood or mind-altering substance, experience, event or activity, which contributes to life problems and their re-occurrence. (adapted from T. Kellogg) List as many substances, activities or processes that you can think of that could become addictive:

Definitions of Co-dependence
Co-dependence is a dysfunctional pattern of living which emerges from our family of origin as well as our culture, producing arrested identity development, and resulting in an over-reaction to things outside of us and an under-reaction to things inside of us. Left untreated, it can deteriorate into an addiction. (Friel and Friel, 1988) An absence of relationship with ones self. (T. Kellogg,1985) List some examples of co-dependent thinking and behaving:

Five Characteristics of Addiction

Addictions have five factors in common: 1. A compulsion to look to someone or something outside of self for safety, security and self-esteem. 2. Preoccupation with that substance or process to the extent that attention is diverted from other important priorities. 3. Loss of control over the use of the addictive substance or behavior. 4. A tendency to continue the behavior in the face of adverse consequences. 5. Significant personal losses or major life consequences.

Co-dependence
Co-dependence occurs: When we have an absence of relationship with self if we are not aware or conscious of who we are, what we feel, what we think, what our values are, etc.. (If we dont know these things about ourselves, we can never share them with another person.) When our behaviour is determined by someone elses. When others rely on us to maintain their destructive behaviors and addictions. When we are subordinate to others and thereby not true to our own feelings.

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UNIFYING MODEL OF C0-DEPENDENCY AND ADDICTIONS

Relationship Addictions

Ingestion Addictions

Depression/Anxiety

Gambling

Co-dependency (Identity & Intimacy Problems)

Guilt

Unconscious Experience (internal processes)

Shame

Fear of Abandonment

Adapted from Friel & Friel, 1988

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Process Addictions

Conscious Experience (external behaviours)

Stress-Related Disorders

Three Processes of Addictive Thinking

I am not O.K. the way I am. There is a void that needs to be filled. There is something or someone external to myself that will fill this void. My happiness is dependent on finding this substance, possession, person or activity.

Three Rules
There are three unspoken rules in a family system with addictive process. They are: DONT TALK (no honest communication) DONT TRUST (no openness about problems) DONT FEEL (no expression of feelings)

Core Beliefs of Addictive Thinking

I dont know who I am without him/her/it. (co-dependency identity & intimacy problems) I have a vague sense that something is wrong. (guilt) I am a bad, unworthy person. I am not good enough the way I am. (shame) I dont need anybody. I will not survive if you leave me. (fear of abandonment)

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ADDICTIVE THINKING AND THE RESULTING BEHAVIOUR ROLES

Roles:
Addict Dependent Offender Under responsible Distancer Immature Victim

Core Beliefs:
I am bad I do not deserve Others are more important I cant trust anyone

Roles:
Co-addict Co-dependent Victim Over Responsible Pursuer Psuedo-Mature Offender

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THE DRAGON NAMED SHAME

FACES OF SHAME
Physical Features
warm face lowered eyes down-cast head

Shame as a Natural Human Emotion:

Shame is an emotion which gives us permission to be truly human. Shame tells us our limits. Shame tells us that we need something from someone other than ourselves. Our shame tells us we are not God. Shame is the psychological foundation of humility.

muscle tension flushing neck and chest faltering energy

Mental Features

self-criticsm belief that others agree with personal devaluation negativity expectation of ridicule and disdain thoughts compound shame disassociation

Shame as a State of Being:

Shame can be transformed into a state of being which takes over ones whole identity. To have shame as an identity is to believe that ones being is flawed, that one is defective as a human being. Shame is an inner sense of being completely diminished or insufficient as a person. It is the self judging the self. A pervasive sense of shame is the ongoing premise that one is fundamentally bad, inadequate, defective, unworthy or not fully valid as a human being.

Shame-bound Family Systems:

A shame-bound family is a family with a self-sustaining, multigenerational system of interaction with a cast of characters who are (or were in their lifetime) loyal to a set of rules and injunctions demanding control, perfectionism, blame and denial. The pattern inhibits or defeats the development of authentic intimate relationships, promotes secrets and vague personal boundaries, unconsciously instills shame in the family members, as well as chaos in their lives, and binds them to perpetuate the shame in themselves and their kin. It does so regardless of the good intentions, wishes and love which may also be part of the system. (M.A. Fossum & M.J. Mason, 1986; J. Bradshaw, 1988)

Behavioural Features

addiction withdrawal perfectionism criticism (blaming others) rage

Spiritual Features

crisis at the very core of existence disconnection from our true selves loss of sense of communion with others loss of connection with higher power

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GUILT
How could I have done that!

SHAME
How could I have done that!

Guilt:
a painful feeling of regret one has about behaviour that has violated. I did . . . . . I didnt . . . .

Shame:
an inner sense of being diminished or insufficient as a person. I am . . . . . I am not . . . .

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SOURCES OF SHAME

Sources of Shame in Family of Origin

deficiency messages parental rejection physical and sexual abuse family secrets parental perfectionism

Sources of Shame in Our Culture

pressure to succeed conformity: focus on image and appearance prejudice and discrimination institutional shaming

Parental Rejection

abandonment betrayal neglect disinterest

How we Shame Ourselves

automatic thinking habitual withdrawal isolation perfectionism self-hatred

Deficiency Messages

You are not good. You are not good enough. You dont belong. You are not loveable.

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MAJOR RULES OF SHAME-BOUND SYSTEMS

Always do the right thing be good, strong, right, perfect make us proud.
Preoccupation with standards that keep changing.

Always be in control.
Use whatever you have to in order to stay in control.

Never talk about it.

And never talk about your problems.

Stay out of touch with feelings.

Feelings are not expressed openly.

Dont rock the boat. Do not communicate directly. Dont be selfish. Its not okay to play. Do as I say not as I do.

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HEALING SHAME
Develop a caring relationship with someone who is trustworthy.

Shame is healed in group.

(Prolonged individual counselling may perpetuate shame.)

Name it.
(Recognition.)

Claim it.
(Stop the inner abuse.)

Tame it.
(Neutralize to counteract the toxic effects.)

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THE ADDICTIVE PROCESS AND ITS IMPACT ON THE FAMILY SYSTEM

THE GOLDEN EAGLE

A man found an eagles egg and put it in the nest of a backyard hen. The eaglet hatched with the brood of chicks and grew up with them. All his life the eagle did what the backyard chickens did, thinking he was a backyard chicken. He scratched the earth for worms and insects. He clucked and cackled. And he would thrash his wings and fly a few feet into the air like the chickens. After all, that is how a chicken is supposed to fly, isnt it? Years passed and the eagle grew very old. One day he saw a magnificent bird far above him in the cloudless sky. It floated in graceful majesty among the powerful wind currents, with scarcely a beat of its strong golden wings. The old eagle looked up in awe. Whos that? he said to his neighbour. Thats the eagle, the king of the birds, said his neighbour. But dont give it another thought. You and I are different from him. So the eagle never gave it another thought. He died thinking he was a backyard chicken.
Anthony de Mello The Song of the Bird

ASSESSING THE FAMILY DYNAMICS

Structure
Structure is the way the family is organized. It includes five components: rules, roles, rituals, hierarchies and boundaries. (Jacob, 1987). RULES: Rules are the stated and unstated guidelines for family function that become established and fortified by repetition. They express a familys core beliefs and values as well as a familys defenses. (Brown, 1999) ROLES: Role is the function performed by someone or something in a familiar situation, process or operation. Roles are expressed through repetitive behaviours and interactions with other family members. (Brown, 1999) RITUALS: Rituals are customs or family procedures that establish and maintain a familys identity and contribute to cohesiveness. (Brown,1999). HIERARCHIES: Hierarchies are ordered subsystems within the family that are defined by function and task. For example, parents are at the top of the hierarchy and hold most of the responsibility for maintaining the familys survival. BOUNDARIES: A boundary is a border, an imaginary fence or line of demarcation between individual family members, between subgroups within a family (parents/children, boys/girls,etc.) and around the family itself. (Christian, 1997). Boundaries represent our sense of ourselves and our perception of how we are different from others physically, intellectually, emotionally and spiritually.

Process
COMMUNICATION: Communication is the exchange of information between family members. (Brown, 1999) INTERACTIONAL PATTERNS: Interactional patterns refer to the dynamics of family members. Think of these dynamics as a dance (Brown, 1999). Imagine that the family is like a mobile. When one part of the mobile moves, all other pieces are affected.

Definition of a Family System with an Addictive Process

A family with an addictive process is one in which the environment or context of daily life becomes dominated by the anxieties, tensions and chronic trauma of active addiction. The substance or activity becomes the central organizing principle of the family system, controlling and dictating core family beliefs and influencing all aspects of behaviour, as well as cognitive and affective development. (Adapted from Brown & Lewis, 1999)

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HEALTHY VS ADDICTED FAMILY SYSTEMS

Healthy Rules
clear, consistent discussed negotiable

Addicted
unclear, contradictory random, capricious Dont feel Dont trust Dont talk locked into one role stunts development source of shame Hero, Scapegoat Lost child, Mascot, Co-dependent, Addict Victim, Rescuer, etc. non-existent or unpredictable dreaded, associated with the addiction role reversal role confusion improper balance of family power, financial and emotional burden blurred intrusive/enmeshed violated rigid/wide-open indirect unclear ineffective shaming covert

Roles

free movement between roles facilitates growth source of pride

Rituals

regular, reliable, treasured

Hierarchies

parental responsibilities remain with parents stability, security freedom to be a child clear autonomous respected flexible direct clear effective self-esteem enhancing overt emotional closeness relaxed atmosphere spontaneous openness, moderation mature, reflective trusting own perceptions interpretations, beliefs

Boundaries

Communication

Interactional Patterns

emotional distance tense atmosphere cautious defensive, extreme impulsive, out-of-control mistrust of perceptions, interpretations, beliefs questions what is normal

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UNDERSTANDING FAMILY ROLES

Sharon Wegscheider-Cruse
You may recognize from your own experience the roles that follow. They occur in all troubled families, even occasionally in healthy families during times of stress. The chronic pain of the family with addiction leads to adoption of roles which are more rigidly fixed and are played with greater intensity, compulsion and delusion. Family members adjust to the pain by hiding their true feelings behind predictable behaviour patterns. We are talking about behaviour, not people. The role is not calculated behaviour it is subconscious and its goal is to preserve the family system. Each role grows out of its own kind of pain and has its own symptoms, offers its own pay-offs for both the individual and the family, and ultimately exacts its own price.

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THE HERO

his is an adult role assumed by a child in the family whose job is to provide self-worth, hope, pride and success for the entire family. This child assumes this role because one or more of the parents is not emotionally available due to their own dysfunction.

Internalized Messages
I will not feel for myself. I must feel for others. I will not upset the family or others. I will take care of everyone, everything. I cant afford to make mistakes.

Feels: miserable, inadequate, hurt, confused,

angry, afraid, unworthy of success, guilty.

Everyone thinks this way. I should be able to handle everything, anything. Im okay if I do good.

Appears
Looks good Good natured Popular Has it made Successful All together Considerate Responsible

Ill never give up. Im responsible for everything. I really dont need anything, anyone. I wont ask for help because I should know. I will not have fun, if I dont work, it doesnt count, I wont exist. If I do play, I must win. I will try anything to please you, because you must approve of me. On the outside I will adapt, on the inside I will trust no one. You can depend on me. I will grow up fast.

High achiever

Non-emotional Over-committed

Over-involved

Works hard for approval 9 years old going on 30

Compulsive caretaker Obedient

Rigid about rules Intellectual Secretive

Others come first

Intolerant of non-achievers

Never satisfied with achievements Goals remain forever beyond today Quiet martyr, seldom shows anger with words, but it leaks through into behaviours Achievements attempt to make up for lack of parental nurturing

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THE SCAPEGOAT

his role is designed to provide a focus of attention away from the real source of family dysfunction and to provide a target for all of the pain the family members feel.

Internalized Messages
Ill show you. I dont need anyone. I dont value anything you value. I wont know what is inside me. I wont feel. I dont care. I will never belong.

Feels: angry, fearful, lonely, hurt, rejected, hateful, jealous.

It will never be okay. You cant hurt me.

Appears
Counter-hero Bad kid, the heavy Irresponsible Goof-off Gets in trouble

I wont connect. Youll never get it right with me. Ill get even. The books will never balance. I can never win at your game anyway so Ill play it my way. I trust my friends, not you. I wont succeed. I can never do enough.

Doesnt seem to care Withdrawn from family Relies on peers to provide belonging/needs Starved for attention Among the first to use chemicals, become sexually active Angry Born mad Defiant Low achiever

Dishonest

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THE LOST CHILD

heir role in the family is to offer the family relief from the problematic situation that having another child in the dysfunctional system would cause. They offer this relief by becoming invisible.

Internalized Messages
I am invisible. I dont count. The only one who will be there for me is me. I have no worth. I have no self. I dont exist. I wont be involved at all. I wont be seen or heard, ever.

Feels: bad about self, hurt, angry, lonely, inadequate. Appears

Shy The loner Takes care of self Independent Often over/underweight Aloof Withdrawn

I have to get sick in order not to die, Mom and Dad will then rally around me. Im afraid of everything, the world is so big. What I can control is me, no one can get in unless I let them.

Avoids stressful situations

Finds comfort in privacy of self Keeps a low profile Creates an imaginary reality where everything is perfect and safe Treasures pets, things Placates Conforms

Controls by passivity Secretive Early sexual activity

Super-organized Stress-related illnesses

Early suicidal ideation Lacks skills for intimacy Greatest chance of being labeled schizophrenic

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THE MASCOT

heir role in the family is to bring good feeling to the family system. They are to provide comic relief, fun and humour to an otherwise grim environment.

Internalized Messages
If they laugh, they must like me. I will stay little and cute. I will adapt and put myself aside. I aim to please, Ill make you feel good about yourself. I laugh instead of cry. No one will ever like me if I am serious, they wont take me seriously. Im helpless, I cant think, I cant decide.

Feels: fearful, insecure, confused, lonely,

anxious, tense.

Appears
Super-cute Precious Parents like to show them off Does anything that will gain attention Develops stress-related illnesses Manipulates and controls Poor concentration Poor learner

Please dont be mad at me. I can fix it up with a little humour. I am responsible for it. I have to keep moving or no one will notice me.

Hyper-active, often medicated Charming Dishonest

Seldom taken seriously Inappropriate use of humour i.e. timing, targets Judged and treated as immature, thus development is retarded

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THREE GENERATIONAL GENOGRAM OF FAMILY WITH ADDICTIONS

Scandinavian strong work ethic English Baptist hot bed of emotions

Be Be

alcoholic

Rigid Rules big boys dont cry dont feel work is most important

Rigid Rules children should be seen and not heard dont feel dont talk cover up

alcoholic military service

Walt

workaholic doctor

violent arguments

Peg

alcoholic

Dick

Pam

Robert

Cindy

Candy

alcoholics

ACA

alcoholic

workaholic

brain damaged AA Al-Anon Church

failure overeater couldnt save the marriage covered up for Robert chose recovery after failed marriages

bartender at 13 was defiant, angry no faith in myself intimacy difficulties alcoholic later recovery

fixer protector of younger and parents over achiever actor ACA group

dreamer fantasy world avoided home dont talk experienced recovery issues more than addiction issues

The Subby Family

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RECOVERY NEEDS AND GOALS

The real voyage of discovery consists not in seeking new landscapes but in having new eyes.
Marcel Proust

Like footsteps or a shadow, losses do not go away. Recovery asks that they be acknowledged and assimilated.
Patty McConnell, 1986

STAGES OF RECOVERY FOR THE FAMILY

Brown & Lewis, 1999

STAGE ONE: DRINKING

FAMILY FOCUS: denial of alcoholism denial of loss of control of drinking TASKS: building therapeutic alliance challenging denial acknowledging realities of alcoholism focusing on alcoholic behaviours and distorted beliefs

STAGE THREE: EARLY RECOVERY

FAMILY FOCUS: more congruent with primary tasks of therapy if each family member is committed to recovery fragmented and defensive if one partner is in recovery and the other is not TASKS: to continue to learn abstinent behaviours and thinking continue focus on individual recovery integration of new attitudes, behaviors and thinking stabilize individual identities begin to work the 12 steps detachment, family focus guided by individual needs re-establish and maintain attention to children maintain parenting responsibilities establish supports outside the family

STAGE TWO: TRANSITION

(includes end of addictive behavior and beginning of abstinence)

FAMILY FOCUS: predominately defensive to contain an increasingly out-of-control environment to hold existing system together to maintain denial and all core beliefs that sustain it shift to abstinence TASKS: to break through denial to realize that family life is out of control to begin and continue a challenge of core beliefs to allow the addicted system to collapse to shift focus from system to individual to begin detachment and recovery for individuals to enlist outside support to learn new abstinent behaviors and thinking to learn and practice relapse monitoring to re-establish attention to children

STAGE FOUR: ONGOING RECOVERY

FAMILY FOCUS: more congruent with the primary tasks of therapy if family members maintain commitment to recovery fragmented and defensive if one partner is in recovery and another is not or if neither partner is in recovery TASKS: to continue abstinent behaviour to continue to expand individual identity to maintain individual programs of recovery to add a focus on couple and family issues to deepen spirituality to balance and integrate combined individual and family recoveries to explore and work through issues of ACOA, childhood and adult traumas

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A DEVELOPMENTAL MODEL OF RECOVERY FOR THE FAMILY

Brown & Lewis, 1999
DRINKING Drinking
Intensification of chronic and acute trauma; danger Unsafe Unsafe Moving from unsafe to safe In a state of collapse; hitting bottom; tightening of defense; rigidity; brittle, dangerous Unhealthy Unhealthy Collapse of system; vacuum; trauma of recovery; shift to external focus and support Moving toward stability; still can be chaotic; hope, mixed with tension, anxiety; continuing trauma of recovery Safe Stable, healthy new system; organized by recovery principles (Type I); capacity for self and system focus, I and we, without sacrifice of either; possible family story Stable, split organization (Type II) Chronic and acute trauma; chaos, crisis dominated; beginning trauma of recovery

TRANSITION Abstinence EARLY RECOVERY

ONGOING RECOVERY
Stable, predictable, consistent; not organized & dominated by crisis or trauma; supports abstinence; comfortable, secure

ENVIRONMENT

Chronic, acute trauma; tension, anxiety, chaos, inconsistency, unpredictability, hostility, pervasive shame, guilt, emphasis on control

Unsafe

SYSTEM

Alcohol is the central organizing principle governing pathological and pathogenic family homeostasis; the family is dominated by defensive accommodations to pathology; tight, rigid boundaries; polarized relations; adaptation

Recovery organizes the system (Type I); split organization (Type II); no recovery organization (Type III); emphasis on separation continues; parallel lives focused on external support and attachment; foundation of new system underway Stable healthy or moving toward health

Produces pathology; normal tasks of family development arrested; emphasis on shortterm stability in which pathology is normalized

Capacity for couple focus, but not organized around recovery; healthy or not healthy

Unhealthy Sacrificed to preserve endangered system; dominated by trauma; defenses against surrender; cracks in denial; despair, defeat Shift to individual focus, which has priority over system; shift to external help, attachment to recovery; time of intense dependency; feelings of depression, anxiety, abandonment, confusion, fear, dominance of impulse Focus on alcohol; recovery; intense education; less dominated by impulse; new identity; still confusion; perhaps depression, anxiety; intense self-examination, self-development

Stable, dry (Type III); no systems change; likely unhealthy Stable individual recovery; behaviour, identity secure; capacity for interpersonal focus, combine I and we Spiritual development; shift from external control to internal (Higher Power); intensive self-examination, development through 12-step program, therapy, religion

INDIVIDUAL DEVELOPMENT

Attachment based on maintaining pathological, pathogenic beliefs, behaviour, and affect to maintain system; sacrifice of individual development to systems preservation

Type I Couple: Both partners are actively working recovery programs. Type II Couple: One partner is actively working recovery and the other is not. Type III Couple: Neither partner belongs to a recovery group.

STAGES OF RECOVERY FOR THE FAMILY

Brown & Lewis, 1999

Drinking

Transition

Early Recovery

Ongoing Recovery

Environment

System

Individual Development

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APPENDICES

A young Indian boy went to the village shaman. The boy was troubled and said to the elder, Help me. There is a war inside my heart. Part of me wants to travel east, and another part wants to travel west. What do I do? The old man nodded. The boys problem was a familiar one. Within each man, the shaman said, lives two dogs. Both dogs are strong and fight for the mans heart; one to go east, and one to go west. The man chooses which dog will win by deciding which dog he will feed.
Author Unknown

BOUNDARIES
Boundaries are our sense of ourselves and our perception of how we are different from others physically, intellectually, emotionally and spiritually. Boundaries exist for our protection. Our boundaries are not fixed; they change with what we feel and the people we are with.

Physical Boundaries

Intellectual Boundaries

We get to know our physical comfort zones through our physical boundaries. When we have healthy physical boundaries, we can determine how and when we want to be touched, and who we will allow to touch us. It means we give that right to others. Physical boundaries are most often violated by physical violence, incest or neglect. Children who are touched inappropriately by parents must deny their discomfort and repulsion in order to survive the abuse in a family. If a father makes sexual advances toward his daughter, shell probably learn to ignore the sensation of her skin crawling, her stomach tying in knots, and have to hold her breath in order not to feel. Our bodies and emotions tell us when someone is violating our space. But many children with alcoholic parents learn to distrust their senses and their emotions. They often ignore bizarre events and treat crises as if they were normal. Physical boundaries are violated by physical violence, incest and neglect.

A healthy intellectual boundary lets us trust how we view the world. It allows us to know what we want and need, and helps us to sort out our desires from those of others. A flexible intellectual boundary lets us accept information from the outside world and look at it before we make it ours. Intellectual boundaries are blurred by parents who too tightly control their childrens perceptions. Often, children who become dependent on their parents to think for them dont develop intellectual boundaries. This kind of relationship encourages dependency and discourages responsibility. Intellectual boundaries are violated by messages that say appearance is everything, good times are enshrined/bad times are forgotten, you are crazy if you think something is wrong here.

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Emotional Boundaries

Spiritual Boundaries

Emotional boundaries are formed early in our life and are greatly influenced by the nature of the bond with our parents. Emotional boundaries protect us with an internal shield, helping us determine where emotions are ours and letting us deflect emotions that are not ours. When we have healthy emotional boundaries, we can honestly determine our feelings about any situation, person, place or thing. If we take responsibility for expressing our emotions and notice the impact of our behaviour on others, we have healthy emotional boundaries. Typically, when parents are irresponsible with their feelings, their children will become irresponsible with theirs. If a father repeatedly rages uncontrollably at a child, that child will inherit feelings of rage and shame. The only way a child avoids this is to have an emotional boundary. Unfortunately, young children do not immediately possess boundaries. If the father were to explain to the child that his rage was his own and had nothing to do with the childs behaviour, perhaps this boy or girl would develop an emotional boundary. Emotional boundaries are violated by role reversal, emotional incest, shame and humiliation and enmeshment.

A spiritual boundary gives us the sense that we are not earthly beings trying to become spiritual, but spiritual beings in human form. This spiritual boundary allows us to believe there is a Power in the universe greater than ourselves. A healthy spiritual boundary lets us embrace our humanness. When we grow up with the notion of a Higher Power who loves us unconditionally, we feel that we can make mistakes and well still be loved. Infants are not born into this world hating themselves. Healthy children are able to give and receive love. It is the mutilation of our spiritual boundary that causes us to fall out of love with ourselves and disconnect from our Higher Power. Boundary confusion is also a problem. Where do I end and where do you begin? What am I responsible for and what are you responsible for? The tendency is for adult children in many situations to become responsible for everything. If something goes wrong, somehow it was their fault. This can result in the person being in a constant state of guilt and anxiety, striving even harder to make things work. Many adult children enter the helping professions and experience problems with clients, becoming over involved and not drawing a clear line between the counsellor/ client relationship. This is emotionally and physically draining and these people (counsellors, nurses, teachers) often suffer from stress resulting in burn out.

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BOUNDARIES
Rigid boundaries (too strong) Diffuse Boundaries (too weak) Flexible boundaries (healthy)

Rigid

Flexible

Diffuse

Intergenerational Boundaries
Dad Mom Dad Mom Dad Mom

Children Rigid

Children Flexible

Children Weak

Family Boundaries

Rigid

Flexible

Diffuse

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WORKING WITH FAMILY ROLES

ROLE Chemically dependent NEEDS IN COUNSELLING
Intervention

Chief enabler

To be listened to with understanding and compassion Establishment of trust (an ally) Redirection from problems and issues to feelings Release of feelings, especially rage Basic information re: family systems and intervention Honest feedback re: role behaviour and consequences Group participation Focus on own needs Appreciation of good qualities (who they are rather than what they do) Establishment of trust Basic information re: family systems and intervention Honest feedback re: role behaviours and consequences Permission to maintain role until improved self-esteem allows movement Group participation Impeccable honesty Genuine caring Active listening to hurt, anger, self-hate Respect Education re: the characteristics of addiction Strong continuing emotional support Sense of belonging Feedback on behaviour with no hint of blame Practical guidance in resolving life problems Group participation Warmth, openness Caring Patience Gentle drawing out of isolation Teaching of relational skills To be noticed, individual qualities identified Group participation Quiet, relaxed atmosphere Consistency Assurance that they are okay and have value Information on things about the family that he/she needs to know Professional help for emotional problems, learning disabilities Group participation

Hero

Scapegoat

Lost child

Mascot

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SCULPTING A FAMILY
Sculpturing is a most useful tool in assisting persons to understand the dynamics of relationships, as well as to experience nonverbally their internal processes and emotions. Basically, sculpturing is putting people in physical postures that best demonstrate a given situation. You can sculpt any relationship you want to work with. To do a sculpture depicting the dynamics of family where there is addiction, chronic illness, secrets or extreme rigidity, the following method may be used: Before proceeding, invite participants to volunteer for a role that is/was not their own (i.e. a first-born could choose to be a middle child, the spouse of an addict could choose to be the addict, etc.). This opens the opportunity for participants to experience what it is like to be in another persons place. Invite one participant to take the part of the identified problem (i.e. be the bottle of alcohol, the gambling, the secret, the workaholism, etc.). Invite this person to stand in the center of the room. Props, such as chairs, may be used in sculptures. If applicable, the use of alcohol as the problem often speaks to the group members, as many come from backgrounds where there was alcoholism. Invite another participant to be the addicted person have them choose what sex they wish to be have them place themselves in relation to the problem, asking them how close they would see themselves. Other group members may make suggestions. There is no right or wrong way of doing this. Wherever they place themselves becomes a starting point for teaching. Next, invite another participant to take the part of the spouse or partner of the addict. As before, have them place themselves in relation to the problem and person, etc. Now, add (one by one and in birth order) four persons to represent the children in the family. Once this sculpture is complete, ask each participant, starting with the person with the identified problem and working down to the last child, the following questions: What is is like for you right now being in the place you are? How are you feeling? How do you see your relationship with each of the other members of the family? The teaching will come from the participants themselves. The facilitator, with knowledge of the role within such a family (hero, scapegoat, lost child, mascot, enabler), can build upon what is presented by the individuals involved. There is no correct way to do the sculpture. However the sculpture is made, the input from the participants will show the dynamics of the family. The facilitator encourages observations and questions from other group members who are not in the sculpture. Some things to note are: who is close to whom who is far away who is pointing a finger are there coalitions who is below who is above any observations on looking at the family

In bringing the sculpture to a close, invite participants for any other comments or observations. Thank them for their participation and invite them to become themselves again. Participants will have a tendency to move into the dynamics of their own feelings of origin, or current family. They are encouraged to stay with their present experience in the sculpture, as time will be given following the sculpture for them to reflect on their own families. A good way to move from the sculpture is to have individual group members reflect with specific questions on their own role in their family of origin and its effect on their lives today.

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The great thing about a family sculpture is the flexibility it provides for the facilitator to take from the experience of the participants and teach whatever dynamics of family systems is appropriate. The facilitator needs to trust the process and the participants knowledge and intuitive sense of the dynamics of addiction in families. No two sculptures are exactly alike, as are no two families. In general, the systems look alike and each family has its own particular personality. Trust the process and be prepared to be surprised!

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SCULPTING SHAME
Explain to the participants that we wish to do an experiential exercise which will be to sculpt the emotion shame from their own personal perspective. Request that the group arrange themselves in pairs in various places in the room, but where everyone will be able to see each other. This exercise works best if all participants take part and if there is an odd number then one group can have three people. Once the group is divided into pairs, ask them to decide among themselves who will be the artist/sculptor and who will be the clay. Ask the artists to request permission from the clay if they wish to touch them physically. Now instruct the artists to place their clay in a position that depicts shame in their minds. Wait and allow for questions, or circle through the room and encourage individuals. After the artists complete their task, ask the clays to hold their positions for a moment. Approach different sculptures and ask the individuals portraying them: What does it feel like to be in this position? Does any part of your body hurt? What can you see with your eyes? Who can see into your eyes? Allow different sculptures to explore their feelings. Be the observer with the group of artists as to what other features become obvious while in this shame position. Now ask the clays and the sculptors to reverse so that the other person is able to portray their experience of shame. Explore the same types of questions, encourage people to reflect on their experience of the clay and on the experience of the artist.

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STRUCTURED FAMILY INTERVENTION PROCESS

Because many addicted persons do not hit bottom on their own, in the 1950s the Johnson Institute in Minneapolis developed a method of raising peoples bottom by confronting them with data concerning their use. Historically, intervention in the addictions field has been a process of confronting an addicted person and convincing the person to enter a treatment program. Over the years, the Addictions Foundation of Manitoba has modified the Johnson method to move the focus from the addicted person to the family system. Moving from a sense of confrontation towards one of invitation, family members enter into a process of education which leads to an awareness of the dynamics of addiction in their family system. The family and its individual members, as well as the addicted person, are invited into recovery. In simple terms, intervention is described as to step in. It is concerned people coming together to face their own reality. Having processed their experience, they may decide to present this reality, in a receivable way, to the person in the family who is experiencing an addiction. Because the family members have taken the time to work through their own issues and dynamics, any meeting with the addicted person becomes an experience of sharing their grief at the loss of relationship, rather than a negative confrontation. Family intervention is a process, not an event. It is based on the belief that addiction is a family issue which calls for intervention and treatment for the entire system. Empowerment of any family member, or any constructive change in family patterns or functioning, means that intervention has occurred. Intervention is appropriate at even the earliest stages of the addiction to reduce suffering and long-term effects on the family. Some of the advantages of a systems approach to family intervention are: It helps the family to understand why individuals act the way they do. It forces everyone to think in relational patterns. It reminds the family that change in one part of the system affects the whole. It helps the family to understand resistance and, therefore, to honour it. It eases the notion of blame. It helps all to think of the problem within the broader context, including biological and social differences. It values experience and honours the fact that the true expert on the family is the family itself. The goals of the family intervention process are as follows: To work with the strength and health of the family to increase motivation for family recovery. To convey the whole family message. To empower the family to change patterns that work against family recovery. To encourage family members towards long-term support. To facilitate entry into a treatment or mutual support program for all family members, including the addicted person. To address the common fallacies held by families in an addictive process. For example: Family members dont need help.

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 The one using or acting out must want to quit the family has nothing to do with it. Treatment cures the addiction problem. When addictive use or behaviour stops, family problems stop. There are six principles of intervention which are essential if the family decides to proceed to a meeting with the identified person: There must be concerned persons if a structured intervention is to occur. This process is not about hidden agendas, such as getting back for past misdeeds, venting of anger and frustration, etc. One of the reasons family intervention takes time and process is to allow family members to process and move through their own issues. The data presented at a structured intervention must be specific and clear. Generalizations, vague statements that include you always, moralizing, preaching, etc. have no place in an intervention. Intervention is about presenting information in a manner that can be heard by a person who is usually defensive and out of touch with reality. The care and concern of family involved in an intervention meeting is usually what the identified person remembers as significant. Individuals in an addictive family system tend to hold emotions in until a tolerance break occurs and there is blaming and venting or anger and frustration. The addicted person does not perceive this as coming from a sense of caring. A family who takes the emotional, psychological, spiritual and social risks involved in addressing the issue directly does so because of love and caring. The intervention meeting is a time for them to share this caring and concern directly and honestly. Intervention statements must be nonjudgmental. Through time and process,

the family members have addressed the issues of defensiveness and self-protection they have needed to function in a system with addiction. In recognizing their own behaviours and reactions, they often move to a more clear understanding of addiction. They are more able to separate the person from the behaviours and stay simply with the clear data, refraining from lectures and moralizing. For an intervention meeting to be effective, the family must have a plan of action. Rarely, in the life of the addicted person, is there a concrete plan of action to address the issue. Physicians say: You should do something about your drinking. It is the rare occasion when this is followed by a referral to an addiction professional or agency. The family says: Do something about your drinking or else. Rarely is this followed by a clear, specific request for recovery. What is different in an intervention meeting is that the family has developed a clear, specific plan for the addicted person to get professional help (i.e. We have a time and place and professional help available.) Family intervention really is family intervention, and the plan of action for family members and the family unit comes in their new behaviour. Throughout the entire process,family members have been looking at the effects of addiction on themselves and their family, they have looked at their beliefs, defence mechanisms, roles, rules, communication and interaction. They have looked, and most of them have seen, how their lives have been externally referenced, how they have lost parts of themselves in trying to change what was not in their power to change. Having seen their lives more clearly, they want to make changes changes for themselves and for their own well-being. In the initial method of structured intervention, the focus was on a bottom-line for the addicted person. In a family intervention, the focus is off the identified person and on individual and family health. A family

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members commitment to their own health and recovery usually has consequences for the addicted person, but its not about the identified person its about all family members and the system. Family intervention takes time, it is a process. It is very helpful if the initial meetings can be multiple family groups. This provides an opportunity for families coming from isolation to address the dont talk, dont trust, dont feel rules that have usually developed in the system. Often, it is easier for them to see the dynamics of another family than to see the dynamics of their own. Ideally, this is done in a minimum of four, two to three hour sessions. Many families decide at this

time to move on with their own lives, entering recovery programs of their own. Others decide to do their own recovery while proceeding towards a structured intervention. Regardless of the path taken by a family, debriefing sessions are appropriate at the end of this particular process. The role of the facilitator in the family intervention process is to provide information to the family; to facilitate the exploration of their family system; to model trusting, talking and feeling; to chair the structured intervention if the family so requests; to make appropriate referrals and to affirm the strength, courage and resilience that brought them to the process.

One of the spin-offs of the structured intervention process is that participants learn a simple way of communicating within their own family system which can also be used in other areas of their lives where difficult information needs to be shared. The process of making an intervention statement can be used by those who are learning new ways of communicating (i.e. learning to talk to one another.) The simple structure is as follows: CARE I care about whats going on I value our relationship Im concerned about Im worried about What I saw (see) What I feel about it How I am behaving in response Ive decided to look at I need to It would be helpful to me if Would you consider

CONCERN SPECIFIC DATA MY RESPONSE COMMITMENT TO SELF INVITATION TO JOIN ME

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RECOVERY
The goal of recovery is recovery of each person in the family. In the past, it has been assumed that only the addicted member needs recovery and that the system goal is to preserve the couple or family unit. Recent research indicates that focusing on the preservation of the family system can insure the maintenance of the addictive process. The collapse of the addicted family system is a necessary part of recovery and is facilitated by encouraging family members to focus on their own personal growth process by redirecting their energies away from the addicted member. The dependent member needs to redirect his/her energies away from the mood-altering substance or activity and towards health through a rehabilitation program and 12-step recovery work. Family members are encouraged to pursue their own healing through affected persons programming and 12-step recovery work. Often, family members of a dependent person will be the first from an addictive family system to seek help for themselves, and it is not essential for the dependent person to choose recovery in order for the family members to choose recovery. Ideally, all recovery occurs in a group setting where unconscious issues around shame may be explored and healed with witness. Brown and Lewis (1999), who interviewed couples and families in various stages of recovery from alcoholic family systems, remain strongly committed to the belief that recovery is dependent on dissolution of the system from the inside. The need for the family system to collapse is central to their whole theory of recovery. It is the collapse of the family structures and defense mechanisms that protected and maintained the drinking that clears the ground for the transformative process of recovery. As one family said, Youre not just putting your life back together; its a new life. (p.19, Brown & Lewis, 1999). They discovered that seeking outside help (treatment programs, 12-step groups, therapists, religious affiliation) facilitates the collapse of the unhealthy system and provides stabilization during recovery. Brown and Lewis were able to define four stages of the recovery process for the individual and also for the family. The stages include: & Drinking Transition (hitting bottom abstinence) Early Recovery Ongoing Recovery

Transition and Early Recovery stages can last as long as three to five years. They refer to three domains for therapists to use to assess the family in recovery: environment, system and individual development. Environment refers to the experiences of daily, routine family life. A question one might ask to assess this is: Is this a safe place, physically and emotionally? System refers to how the parts relate to the whole. Questions one might ask are around defensiveness, rigidity, respect for autonomy, how responsibilities are shared, etc. Individual development refers to progress through 12-step recovery, security in personal identity and ability to engage in interpersonal relations. Friel and Friel (1988) describe the recovery process using the following basic principles: 1. 2. 3. 4. Recovery is a process. Recovery cannot be done alone. Recovery is painful. Recovery means changes in how we feel, how we act, and in what we believe. 5. Recovery means getting out of our roles. 6. In recovery, we recover choices. 7. Recovery requires transcending paradoxes (i.e. letting go of black and white thinking). Sharon Wegscheider-Cruse (1981) suggests that the goals of all family members at the primary stages of recovery are the same:

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1. To let down the wall of defensiveness. Feelings of high pain are often sealed off from self and others. Caring and attentive listening is often the best tool in assisting persons to move through such defenses as delusion and denial. 2. To let the pain emerge. It is essential that family members be allowed to identify and feel their feelings fully in an atmosphere of acceptance. 3. To begin to experience some positive feelings. Having moved through the painful feelings, family members will gradually come to life again, recognizing that feelings are life. 4. To accept the family issue and ones own part in it. As part of the system, all family members have become part of the problem. An admission of this is essential to further recovery work. 5. To make a personal commitment to an Ongoing Recovery program for the family and for themselves. A personal commitment is required to take the initiative for continuing care.

Claudia Black suggests that one approach to recovery is through addressing the three major rules in families with addiction: dont talk, dont trust, dont feel. Talking about their own personal experience of life without fear of condemnation or lack of validation is important. For many family members, feelings of disloyalty arise as they begin to share their family secrets, but as long as the secrets remain, the addictive process continues. Beginning to identify personal needs and to articulate them is a part of the recovery process. Learning to communicate in a clear manner is often completely new for families. Lack of trust is an issue that permeates the family, particularly the couple, during the early stages of recovery. Recovery of trust begins with trust in self trust in ones own perceptions, beliefs, intuitions, intellect, feelings, value, experience and boundaries. In the initial stages of recovery, family members await a relapse, often resorting to old familiar behaviors around over-responsibility even while the dependent person is making healthy life choices (Bepko,1985). In this Transition phase, confusion in roles is problematic for all family members as old roles

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do not fit anymore and new ones have not yet been learned comfortably. A child may react strongly to a parents appropriate exertion of authority, experiencing new parental limits as demeaning. (Brown & Lewis 1999). In families where only one parent embraces recovery, there can be continued chaos, confusion and dissolution of the system and a less likely chance of system recovery. When both parents embrace recovery, children can have great difficulty with the drastic change in reality. What was denied before the drinking is now the acknowledged focus of everything (Brown & Lewis, 1999). Children of parents in Transition are at risk of further neglect as their parents have to pursue individual work intensely in order to maintain recovery goals. According to Brown and Lewis, children need the same kind of support that their parents are receiving. This includes education about alcoholism that is appropriate to the childs age, and opportunities to share their own feelings about what has been and is happening. In Early Recovery, Brown and Lewis describe people as settling into new identities as an alcoholic and co-alcoholic and settling into abstinent behaviors. They state this is primarily a period of intense education and support for new behaviors, as well as attention to the self and individual growth. One partner may still be ahead of the other, a difference that may cause severe conflict or a growing distance. Brown and Lewis noted that individuals who each have a focus on the self report the greatest satisfaction as a couple in this stage: they are busy and are no longer looking to the partner for self-fulfillment. This distance can be interpreted as marriage failure by the couple or the counsellor, but most often it is part of the normal process of recovery. Many couples report that the stage of Early Recovery can last from three to five

years while they develop stability, predictability, consistency and confidence in recovery. The couple relationship remains secondary to the individual focus, even though the couple may be very involved with each other. The Type I couple (both partners embracing recovery programs) experience living parallel lives where attachment to outside support takes priority. For the Type II couple (one in recovery, one not), the growth of one partner threatens the other partner and conflict is frequent. Brown and Lewis noted that children may remain frightened of the changes as they experience the joy of sober parents but still feel abandoned as the parents pursue their recovery programs. The Type III couple (abstinence but no recovery) report they feel like they are still living with an alcoholic in the house. Brown and Lewis report that the couples they interviewed in Ongoing Recovery described this stage as a period of calm with stability, predictability and consistency. These couples state they have come to realize that recovery is not an outcome but an ongoing process. The researchers describe the family in Ongoing Recovery as settled into a new structure with equity between partners, clear rules and roles, appropriate boundaries between parents and kids, open and honest communication, and having the ability to enjoy the realities of separateness and togetherness. They also took note of the Type II and Type III couples where recovery was uneven between partners or where recovery did not move beyond abstinence. Type II and Type III couples experience considerable pain as the conflict of living with two different realities is relentless. Growth is impeded and intimacy is obstructed by tension and mistrust. In families where both partners have embraced recovery programs, children are given a second chance. Parents are able to acknowledge feelings, talk about realities, valid past experiences and be empathic to their children. In couples where the recovery is uneven, children will continue to be affected by the conflict and will have developmental delay due to their vigilant focus on their parents.

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CONSTRUCTING A GENOGRAM

Male

Marriage with date shown

Female

Divorce or separation Unknown Sex

Adoption

Common-law union

Still-born Sex unknown

1980

1962

Death with date shown

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EXAMPLES OF GENOGRAMS

Children of a marriage Eldest recorded first

Twins and siblings

Remarriage

M. D.

M.

M. D.

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DISTANCES GENOGRAM SYMBOLS

CONFLICT. The parties do not get along well. They are uncomfortable with each other, and there is tension (high or low) and nonverbal or open disagreement most of the time. CLOSE. Two people are caring, supportive and loving to each other. VERY CLOSE. Two people have a special relationship characterized by overinvolvement (enmeshment). They are very dependent upon each other and neither has a clear, separate identity; they are not emotionally separate from each other. DISTANT. Emotional distance is evidenced by people who go out of their way to avoid or ignore each other. An indifferent attitude prevails. CUTOFF. A definite breach has occurred and two people are estranged from each other. There is unresolved emotional attachment denied by separation, withdrawal, running away, isolation or refuting the still intense connection. There may be no contact, but there is still a very strong tie to a person. ENMESHED AND CONFLICTUAL.

Father

Mother

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RESOURCES

Two monks were returning home in the evening to their temple. It had been raining and the road was very muddy. They came to an intersection where a beautiful girl was standing, unable to cross the street because of the mud. Just in the moment, the first monk picked her up in his arms and carried her across. The monks then continued on their way. Later that night the second monk, unable to restrain himself any longer, said to the first, How could you do that?! We monks should not even look at females, much less touch them. Especially young and beautiful ones. I left the girl there, the first monk said. Are you still carrying her?
A Zen Story

PRINT & VIDEO RESOURCES

Print * Bratton, Mary. A Guide to Family Intervention.
Health Communications Inc., Pompano Beach, FL. 1987. ISBN 0-932194-52-4 Potter-Efron, Ronald & Potter-Efron, Patricia. Letting Go of Shame: Understanding How Shame Affects Your Life. Harper & Row Publishers Inc., New York, NY. 1989. ISBN 0-06-255411-5

* Bepko, Claudia with Krestan, Jo Ann. The

* Richard, Dr. Ronald W. Family Ties That Bind:

A Self-Help Guide to Change Through Family of Origin Therapy. International Self-Counsel Press Ltd., North Vancouver, BC. 1987. ISBN 0-88908-655-9 Satir, Virginia, Banmen, John, Gerber, Jane, Gomori, Maria. The Satir Model: Family Therapy and Beyond. Science & Behavior Books, Inc., Palo Alto, CA. ISBN 8314-0078-1

Responsibility Trap: A Blueprint for Treating the Alcoholic Family. The Free Press, New York, NY. 1985. ISBN 0-02-902880-9

* Brown, Stephanie, Lewis, Virginia. The Alcoholic

Family in Recovery: A Developmental Model. The Guilford Press, New York, NY. 1999. ISBN 1-57230402-2

* Christian, Sandy Stewart, MSW (ed.). Working with

Groups on Family Issues. Whole Person Associates Inc., Duluth, MN. 1997. ISBN 1-57025-124-X Dayton, Tian, Ph.D. The Drama Within: Psychodrama and Experiential Therapy. Health Communications Inc., Deerfield Beach, FL. 1994. ISBN 1-55874-296-4

* Treadway, David C. Before Its Too Late: Working

with Substance Abuse in the Family. Penguin Books Canada Ltd., Markham, ON. 1989. ISBN 0-393-70068-2

* Wegscheider, Sharon. Another Chance: Hope and

Health for the Alcoholic Family. Science & Behavior Books, Inc., Palo Alto, CA. 1981. ISBN 0-8314-0059-5 Wegscheider-Cruse, Sharon, Higby, Kathy, Klontz, Ted, Rainey, Ann. Family Reconstruction: The Living Theatre Model. Science & Behavior Books, Inc., Palo Alto, CA. 1994. ISBN 0-8314-0083-8 Wegscheider-Cruse, Sharon, Cruse, Joseph R. & Bougher, George. Experiential Therapy for Co-dependency. Science and Behavior Books, Inc., Palo Alto, CA. 1990. ISBN 8314-0075-7

* Edwards, John T., Ph.D. Treating Chemically

Dependent Families: A Practical Systems Approach for Professionals. Johnson Institute, Minneapolis, MN. 1990. ISBN 0-935908-56-0 Foster, Carolyn. The Family Patterns Workbook: Breaking Free from Your Past & Creating a Life of Your Own. The Putnam Publishing Group, New York, NY. 1993. ISBN 0-87477-711-9

* Friel, John, Friel, Linda. Adult Children: The Secrets

of Dysfunctional Families. Health Communications Inc., Deerfield Beach, FL. 1998. ISBN 0-932194-53-2

Videos * Pieces of Silence by Robert Subby * Its Not My Problem by John Bradshaw
Compulsive Relationships: The Players and Personalities by Claudia Black and Terry Gorsky Relationship Building: Achieving Intimacy by C. Black and T. Gorsky Relationship Styles: Compulsive, Apathetic and Healthy by C. Black and T. Gorsky

* Friel, John, Friel, Linda. An Adult Childs Guide

to Whats Normal. Health Communications Inc., Deerfield Beach, FL. 1990. ISBN 1-55874090-2

* Fossum, Merle A., Mason, Marilyn J. Facing Shame:

Families in Recovery. W.W. Norton & Company, Inc., New York, NY. 1986. ISBN 0-393-30581-3 Muller, Wayne. Legacy of the Heart: The Spiritual Advantages of a Painful Childhood. Simon & Shuster, New York, NY. 1992. ISBN 0-671-76119-6

* Healing the Family Within by Robert Subby

*Available from the Saskatchewan Health Resource Centre

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BIBLIOGRAPHY

Flight from the Shadow

There was a man who was so disturbed by the sight of his own shadow and was so displeased with his own footsteps that he determined to get rid of both. The method he hit upon was to run away from them. So he got up and ran, but everytime he put his foot down there was another step, while his shadow kept up with him without the slightest difficulty. He attributed his failure to the fact that he was not running fast enough. So he ran faster and faster, without stopping, until he finally dropped dead. He failed to realize that if he merely stepped into the shade, his shadow would vanish, and if he sat down and stayed still, there would be no more footsteps.
Chuang Tzu

BIBLIOGRAPHY
Black, Claudia. It Will Never Happen to Me. Denver: MAC, 1981. Bradshaw, John. Healing the Shame that Binds You. Deerfield Beach, FL: Health Communications Inc., 1988. Brown, Stephanie & Lewis, V. The Alcholic Family in Recovery: A Developmental Model. New York: Guildford Press, 1999. Friel, John & Friel, Linda. Adult Children The Secrets of Dysfunctional Families. Deerfield Beach, FL: Health Communications Inc., 1988. Jacob, T. (Ed.). Family Interaction and Psychotherapy: Theories, Methods and Findings. New York: Plenum, 1987. Kellogg, Terry & Harrison, Marvel. Broken Toys, Broken Dreams. Amherst, MA: BRAT Publishing, 1990. McConnell, Patty. A Workbook for Healing Adult Children of Alcoholics. San Francisco: Harper & Row, 1986. Wegscheider-Cruse, Sharon. Family Reconstruction: The Living Theatre Model. Palo Alto, CA: Science and Behavior Books, Inc., 1994.

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