Wednesday  22/11/2023

PHOTO: Mathew Macquarrie

Text: Anna Nagygyörgy, Viktória Farkas y Alejandra Misiolek 

Addiction involves a high degree of shame and stigmatization, and it often goes hand in hand with secrets, lies and loneliness. We can ask ourselves if “drinking alone at home is a symptom of alcoholism? Thinking of a “closet drinker” who drinks on their own, desperately tries to hide all bottles, gets rid of alcohol breath using candies, we have the false impression that substance use is something happening in isolation. 

However, we have to keep in mind that addiction also has a social nature, which is the main statement of the present blog post. Our cultural context, economic status and especially, our close relationships have a great impact on addiction formation, maintenance and recovery, apart from our personal characteristics and resources (1).

Impressive support for this statement is a neurobiological study where addiction is proven to be related to social dependency. In our brain, the pharmacological effect of consuming drugs and alcohol is substituting the effects of positive interactions with our loved ones. In other words, by consuming substances, our mood and gratification system changes in a very similar manner as when we have a warm hug or a pleasant talk with our friend (2).

Family and addictions: What is circular causality?

Having more and more evidence in the hands of professionals, addiction was no longer perceived as a disease of an individual but rather interpreted in the framework of family systems theory. Family can be understood as a system which consists of the family members who are connected to each other. They form a whole and have distinct boundaries to separate from the outside world and from each other (3).

If a family member has an addiction, it affects everyone else in the family, which doesn’t happen only in one way, but rather in a reciprocal way. There is a feedback loop that either alters or confirms the addictive behavior, and then a new sequence starts, and so on and so forth.

This phenomenon is also called circular causality, which demonstrates well why the family is considered as the unit of treatment, instead of just the individual (3).

Another important characteristic of families is the aspiration for balance between stability and change. This balance is intended to be reached by controlling others and by sticking to family rules, which leads to the maintenance of the status quo. In families where somebody has an addiction, it forms part of the status quo and the system resists change. In order to get out of this pathologic equilibrium, professional help might be needed (4).

Alcohol and relationships: Protective or triggering of addictions?

Moving on to intimate relationships, it seems to be widely accepted that being in a committed relationship and living together with your partner can serve as a protection from risky activities. Indeed, studies showed that getting married, especially in your twenties lowers alcohol usage (5).

However, being married doesn’t serve as a magic solution: people with substance use disorder experience more domestic violence and marital problems than non-consumers (1). n other words, relationship problems arise due to drugs. What’s more, alcohol is often used to cope with the stress that emerges from conflicts with the partner (5). The contradiction can be resolved if we involve the quality: a healthy relationship fosters a substance-free life, while a disruptive one promotes it.

Addictions in society: differences between consuming with or without a partner

An important aspect to pay attention to in intimate relationships is the problems due to drugs In couples, in the long run, there is a tendency to have similar habits of usage of tobacco, marihuana, or alcohol, which is partially because of the influence of the first, heavier user (6).

When there is a difference in consumption, there is a lower relationship quality, more conflict, higher chance for intimate partner aggression and risky sex. In this discrepant use, the non or lighter user often tries to regulate the heavier user in a destructive way, which leads to conflicts and decreases their satisfaction with the relationship. What’s more, those who are concerned about the other’s substance consumption may become users themselves to cope with the situation (6). With all this, we can understand why it is often said that alcohol destroys couples.

At the same time, a surprising result is that if the partner has a similar consumption pattern, it can mean protection against the previously mentioned negative relational consequences. For example, smoking marijuana together might be a common leisure activity where they experience greater intimacy. Nevertheless, it has to be addressed that common usage can be an additional barrier to reaching substance-free life (6).

How to overcome an addiction: the importance of your loved ones for recovery?

Controversially, the relationships can both encourage and inhibit recovery from addiction. Many people wonder what to do if their partner uses drugs. Sometimes it is inevitable to change social networks to initiate and maintain abstinence. This can mean stopping meeting the “drinking buddies”, but can also lead to the end of a romantic relationship if it is based on common substance usage (1).

And how to help your partner with addictions? In recovery, a partner can help a lot by providing emotional support and being responsive to the other’s needs through recovery. It is proven that if more emotional support is provided, there are better outcomes among smokers. However, if the addict person’s expectations for support are not met, there is a worse outcome. Also, it is good to remember that if the partner focuses on past failures instead of successes, the support is negative and less effective. Finally, a good idea when it comes to recovery is to prioritize the so-called “we talk” (using plural first person rather than singular first or second person “I and you”), which leads to greater success in alcohol treatment (6).

As we saw in the case of a family, the whole system is affected by addiction. For this reason, the family members’ reluctance to engage in therapy by saying “it’s not their problem” greatly hinders the healing. In relational therapy, an important aim is to destigmatize the addict’s family members and let the whole system see how the members also contributed to and maintained the addiction. Setting healthy boundaries among them and restoring accountability for both the person struggling with addiction and their family members are the main goals of therapy (3).

Sources:

• Pettersen, H., Landheim, A., Skeie, I., Biong, S., Brodahl, M., Oute, J., & Davidson, L. (2019). How Social Relationships Influence Substance Use Disorder Recovery: A Collaborative Narrative Study. Substance abuse: research and treatment, 13, 1178221819833379. https://doi.org/10.1177/1178221819833379
• Panksepp, J. (2014). Affective neuroscience: The foundations of human and animal emotions. Nota.
• Bufford, L.G., Lappan, S.N. Addiction and relational therapy: an efficacious approach. Curr Psychol (2023). https://doi.org/10.1007/s12144-023-04843-3
• McGinnis, H. A., & Wright, A. W. (2023). Adoption and child health and psychosocial well-being. In B. Halpern-Felsher (Ed.), Encyclopedia of Child and Adolescent Health (First Edition) (pp. 582–598). Academic Press. https://doi.org/10.1016/B978-0-12-818872-9.00115-1
• Armeli, S., Hamilton, H. R., Hammen, C., & Tennen, H. (2022). Romantic relationship status, stress, and maturing out of problematic drinking. Psychology of Addictive Behaviors, 36(1), 44–53. https://doi.org/10.1037/adb0000698
• Derrick, J. L., Wittkower, L. D., & Pierce, J. D. (2019). Committed relationships and substance use: Recent findings and future directions. Current opinion in psychology, 30, 74-79. https://doi.org/10.1016/j.copsyc.2019.03.002