Supporting Loved Ones - Part 1

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Is someone you love addicted?

Many people struggle to understand the behaviours and emotions of someone who is suffering from an addiction.

They often feel a sense of inadequacy at not being able to change the addicted person's behaviours, and a sense of hurt at being exposed to harm emanating from those behaviours.

This often makes it easier for the non-addicted person to wash their hands of even trying, and to choose instead to walk away... but this is not so easy to do if the addicted person is someone close to you whom you love and really care for.

So, what can someone affected by a loved one's addiction do to help the addicted person?

The answer is:  Plenty... but only if you take the time to think about what you are trying to do.

Before even trying to help someone you must first understand a few things about addiction. This particular section tries to explain exactly what these things are, starting with one which often confuses loved ones and consequently colours their reaction to addiction and to the addicted individual.

It can be summed up in a very simple phrase.

It's not about YOU... it's about THEM.

Addiction can be thought of as being almost a polar opposite of mindfulness. Instead of being aware of everything within them and around them, the addicted person pays heed only to what is within them, and even then only to a very small part of their being - their addicted part. Addiction manifests as total self-absorption in servicing neurological needs generated within the addicted brain.

The result is an apparent total selfishness on the part of the addicted person, and a seeming indifference to the concerns and wellbeing of others.

Yet this is rarely the actual case. The addicted person DOES still care about others - what they gradually stop caring about is THEMSELVES.

If you truly want to know about addiction then there are few better starting points than the works of Dr Gabor Mate. His central theory is that all addictions come about as a response to emotional pain and trauma.

In other words, addictions are a form of expressing pain through self-harm.

In many ways this makes sense. A common definition of addiction is that it is the inability to willingly desist from engaging in a particular behaviour despite knowing that it is ultimately harmful to yourself.

So, by continuing to engage in addictive behaviours you are knowingly harming yourself.

And by extension, harming others. Particularly those who care about you.

Addiction feeds off hurt. It becomes self-sustaining in that because it is brought about as a reaction to hurt it can reinforce itself by causing yet more hurt. The more hurt which an addicted person feels then the more drawn they are to engaging in the addictive behaviour which their brain has been trained to fall back upon as a default reaction to experiencing hurt.

We could perhaps describe this as circular re-enforcement of addiction, but there is an added  dimension which needs addressing. Every time someone engages in addictive behaviour they do so in the full knowledge that they shouldn't. That they are harming themselves, and also harming those around them. Yet the pull of their developing addiction is increasingly hard to resist. Each episode thus brings an increase in residual guilt, and a corresponding decrease in self-esteem. Which in itself acts to further entrench the addiction, as self-esteem is normally a protective barrier against engaging in self and collaterally harmful behaviours.

If we were to visualise the process of addictive reinforcement as a shape then rather than a two dimensional circle we should really view it as a three dimensional vortex. The further down the vortex one travels the greater is the pressure to commit to the addiction, and the less self-esteem is retained to act as a counter force to submitting fully to addictive engagement.

It becomes almost like a whirlpool which sucks the addictively engaged person ever deeper, spinning ever faster as they descend.

Which is where increasingly the effects that are visited on the addicted person's loved ones can become ever more significant, both as a method of maintaining addiction and as a way of generating further guilt. At the early stages of addiction many actions which loved ones may perceive as being directed against them, such as stealing money, lying, being insensitive and unresponsive, are actually more about the addicted person responding only to the in-the-moment demands of their own internalised addictive needs. But the longer the addiction is allowed to manifest then the ever decreasing level of respect which the addicted person has for themselves effectively throttles back the creation of further guilt and despair over actions carried out against themselves.

Put simply, if you stop caring about what happens to yourself then you stop feeling as much hurt over whatever does happen to you. Less hurt means less need to express pain, and less need to express pain means less need to self-harm through addictive engagement. Which basically means that the addiction risks rendering itself ineffective, or at least less influential. It risks burning itself out.

But even after an individual has effectively given up on themselves that does not mean that they stop caring about others. Harming themselves may no longer be an effective pathway for generating self-hurt but harming their loved ones can be a different story. The addicted part of the brain becomes wired to seek continual addictive engagement and as hurt triggers such engagement it finds ways of persuading the host to commit acts which maximise the generation of hurt.

It may sound as if we are talking more about a virus than an addiction through use of terms such as host but in many ways an addiction can be seen as functioning like a virus.As we will cover in the next article in this section there are physical changes which occur in the brain as addiction takes hold and these manifest within the consciousness as an imperative, a compulsion if you wish, to access addictive related rewards. This results in the mind of an addicted person actually working against their overall wellbeing and leads to an internal battle of will in which the addicted part of the brain tries to justify actions which are directly harmful as being logically reasonable. Indeed, not only does it use sophistry to persuade the addicted person to act in illogical ways but it uses its own subverted logic to further entrench behaviours it considers will lessen the opposition it encounters. An addicted mind truly is a conflicted and embattled mind, and like a virus the main purpose of the addicted part of the mind is to secure its own survival and continuation. This makes it very resistant to attempts from within to abstain or seek help. Very few addicts willingly seek help for themselves for this very reason, part of their mind simply will not let them.

This is why many addicted people find that they need to hit their own personal rock-bottom before they can begin to recover. While soever there is still scope to fall further then they cannot bring themselves to willingly stop falling, which takes us back to the definition of addiction being an inability to exert self-control even when individuals know it is in their best interests to do so. This is also why so few addicts reach out for help before they do hit a crisis point. Rather like a wildfire running out of fuel to burn it is only when addicted individuals do encounter their own nadir and have nowhere else to fall to that suddenly they discover the power within themselves to temporarily resist their addictive urges.

This is perhaps best illustrated in behavioural addictions rather than those with associated substance or chemical factors where induced physiological effects may take longer to wear off. Gambling addicts will often report that the only time they feel relief from their urge to gamble is when they finally run out of money, and therefore know that even if they wanted to they cannot gamble any more. They experience a sense of calm at knowing they have nothing more to give. This may only be a temporary state of remission - perhaps only as long as their lack of financial resources lasts - but it does offer a window of opportunity to start addressing the addictive conditioning that has formed in their brains.

This is also why the last thing a loved one should ever do if their loved one approaches them for help is simply give the addicted person the resources to address their immediate financial needs without first addressing their addictive needs.

Put quite simply - do not tell an addicted person to stop engaging in their addictive behaviour while simultaneously giving them the means to re-engage in their addiction.

This may seem a reasonable and compassionate thing to do but in reality it represents the ultimate expression of failing to properly understand addiction and quite simply DOES NOT WORK.

It undermines the space for change which not being able to respond to addictive urges creates. It also creates scope for generating even greater guilt in the person who has been "helped" as when they do inevitably relapse they feel responsible for an even greater burden of betrayal which then risks creating a barrier preventing them from admitting their relapse and seeking further help from their loved ones in future.

The key thing to remember about addiction is that it impairs the afflicted person's ability to control their own behaviours, which can mean that loved ones must intervene to impose their own external control over the addicted individual's ability to engage in self-harmful behaviours.

The first step to helping a loved one overcome addiction is therefore to generate a space where they can feel separated from any immediate pressure to feed their addiction - by removing anything that can be used to feed that addiction - and to then use the window of opportunity this creates to explore treatment options.

In many cases this will involve depriving the individual of access to financial resources and imposing the sort of restrictions on their personal liberties which most families and loved ones will feel very uncomfortable in doing. The unavoidable truth is that the implicit trust which has formed over the lifetime of their relationship will have to be suspended, or at least greatly tempered, until both sides can build a new framework of trust based around updated mutual understanding. Not trusting someone does not mean that you no longer love them, but finding oneself in a situation where trust can no longer be given or taken for granted will inevitably be hard to endure.

This suspension of trust can be extremely onerous and waring on those seeking to help their loved ones but it should be remembered that the person they are trying to help is still basically the same person they have always known. The feelings for each other which pre-existed any addiction will still be there. The actions and behaviours they have come to expect from their loved one in any given situation will still hold true. Their personal values will not have radically changed.

While this person may have acted almost like a total stranger it must always be borne in mind that they are not a stranger - they are someone they know intimately who has been suffering long term hurt with no pathway to release other than through self-directed harmful and destructive behaviours. 

What is really needed, for everyone involved, is not to focus overly on draconian restrictions but rather on creating an environment where all parties can be encouraged to speak openly about their feelings and emotions. The primary goal is to reach mutual understanding. Without this there is very little chance of a lasting and successful reconciliation. Or indeed of lasting abstinence from addictive engagement.

Once again this is not something which will likely come easily to those involved. Addiction is primarily a coping strategy gone wrong. If open sharing of emotions and feelings was a regular part of an existing relationship then it would be hoped that there would already have been a pathway to sharing and expressing hurt which did not leave the individual seeing addictive engagement as being a preferred coping strategy to simply talking things out.

The whole process of starting to open up about addiction, the harms caused, the reasons why, the emotions involved, and the broken trust and betrayal involved, will be an intense experience for everyone. Things will undoubtedly be said on all sides which will be painful for others to hear. A lot of guilt and doubtless some recrimination will be present. It will therefore be a time where the addicted individual may experience increased levels of pain and guilt, thus tempting them to resort to their existing escape strategy by re-engaging with their addiction. Should this indeed happen those seeking to offer support should try to bear this in mind and not jump too hastily to conclusions that this represents a further act of disdain, rejection, or deliberate insensitivity aimed towards them. If nothing else it ought to be a timely reminder of the extent to which the individual is still in thrall to their addiction led coping mechanisms.

For this and other reasons it may be a good idea to postpone in-depth discussions with the addicted person until these can take place outside of the normal home environment. So, away from objects, routines, and external inputs which may trigger confrontation - or which offer scope for relapse. 

There is a risk that once away from the immediacy of addictive pull, and the sense of despair that it engenders in the addicted person, that the willingness on both sides to engage in what will be emotively charged and uncomfortable conversation may wane. In order to prevent this being the case it may be wise, while the immediacy of crisis, and acknowledgement of the need to accept intervention, is still uppermost in all parties' focus, to reach an agreement that both sides will cooperate in making time to fully discuss the issues and situation they find themselves in. 

This could mean involving a trained mediator of some sort, an addictions or mediation counsellor, perhaps, but it could also simply involve taking a few days away in a neutral location where there is the opportunity to balance difficult conversations with activities which have previously proven to be mutually enjoyable and calming. Taking a holiday together, for example, could be a suitable option.

Apart from hopefully reminding everyone of the good parts of their relationship this can also provide a welcome distraction from many of the existing triggers which fire the afflicted person's need for engaging in addictive responses. It can be a safe space for all involved, away from every day pressures and allowing for less emotive and more rational discussion to take place. It can also act as a reminder to the addicted individual of the good things in life which they have been missing out on due to their intense addictive focus and can begin to reintroduce a concept of hope for the future which will undoubtedly have been absent in the despair induced by their addiction.

As has already been said the primary objective is to gain better understanding between everyone involved, and regardless of what has happened there is no value to be gained from engaging in a blame game. What is absolutely not needed is an escalation of guilt. Quite the opposite in fact.

Which is why we return to the original message of this particular point.

When it comes to understanding a loved one's addiction you must always bear in mind that, despite any evidence to the contrary, their behaviour is not about you, or deliberately targeted at you, it is entirely about them. They are the addicted person. If they do appear to be deliberately harming you then this is in all likelihood a sign that they are no longer able to inflict meaningful harm against themselves and are instead using those they love the most as proxy targets for their own expression of hurt. They are harming you because harming you in turn harms them.

Looking beyond any immediate response on your part it should be recognised that addiction is the end result of an unhealthy coping strategy resulting from some underlying emotional pain. As such true recovery can only be assured once the root cause of this pain is exposed and fully addressed. But in order to allow the process of discovering the source of the pain to effectively begin it is first necessary to lessen the hold which addiction has on the afflicted individual.

To use a clinical analogy this is a bit like a medical practitioner stabilising the patient and treating the exposed wounds. ER for the addicted.

Sometimes all this needs is to make it known that they are free to talk openly about their emotions - in other words that they have an alternative route to releasing inner pain.

In other situations it involves making it physically impossible for the individual to easily engage in addictive behaviours. The controlling approach, so to speak.

Another common approach involves discovering a substitute activity which is less harmful, or even beneficial, to the individual. This might mean encouraging activities which both boost self-esteem and generate pleasure engagement. Exercise is a prime example, but other feel good activities can involve helping others through volunteering, or taking a more active role in family activities - e.g. supporting their own children in school or leisure pursuits.

But whatever approach you take towards supporting your loves ones please do not confuse stabilising the symptoms and putting management and avoidance strategies in place as being the end goal. 

Addiction does not develop overnight, and nor does recovery happen instantly. 

Discovering and preventing addictive behaviour is not the same as curing addiction. Treating the addiction is not the same as treating the cause. The only guaranteed way for doing that does indeed involve building understanding of what addiction is, and how it influences individual behaviour, but ultimately any lasting cure will only come from the addicted person being able to delve deep into their own inner self in order to identify the source and reasons behind their underlying hurt. 

This is not something that can be done for them. They have to achieve it for themselves. If only to make sure that they really do get to the root of the problem, rather than simply taking someone else's word for it. If they do not believe at a subconscious level that they have worked it all out then quite bluntly they won't have worked it out. It will still be there, and still be a potential fracture point for their future wellbeing.

Having to let the addicted individual do most of the "heavy lifting" does not mean that you as a loved one cannot help. Having a trusted person or trained professional along for the journey will help focus the search and help provide a safer space for the individual to explore and revisit what will unquestionably be painful memories and experiences.

As a loved one, trying to do the best for an addicted person does primarily center around creating a safe and unthreatening environment in which they can begin to heal.

To conclude this introductory section we end with a simple reminder: Please always bear in mind that in most cases addiction is a coping mechanism which has gone massively wrong. It is perhaps the ultimate (but one) example of a cure becoming worse than the illness it was meant to alleviate but with sufficient understanding and patience any situation can be improved.

Things can get better.

In the next section, the Addicted Mind, we will look at what is actually happening inside the brain of the addicted individual. What is occurring on a neurological level, and also how the addicted part of the person's mind will act against them to keep them addicted.