Module 3 Facilitator Supplements
ATOD Screening

Seeing the New Realities

It is important for mental health specialists (MHS) to begin to see and act upon new realities in children's (and clients') lives, many of which can be hidden-hidden risk factors and pain which can lead to alcohol, tobacco, or other drug use, and hidden stages of actual alcohol and drug problems.

The following information focuses more on factors that may affect children's lives, but are important when reviewing and assessing any potential ATOD problem and selection of prevention strategies. The following comments are specifically geared to children, but are relative to any assessment of any client when looking at their past histories.

...Societal changes have placed additional responsibilities on school and mental health personnel, who are often the critical components in children's lives. The children that educators and counselors see every day are increasingly at risk of becoming involved with alcohol, tobacco, and other drugs. Any child can become involved, but some are more vulnerable because of risk factors such as those discussed previously.

One important risk factor that often puts a child at particular risk is a parent who is an alcoholic or drug user. These children can be at four to five times greater risk of becoming involved with alcohol or other drugs; and as many as one out of five* children in any classroom could be living in a chemically dependent family. (*U.S. Department of Education, Drug Free Schools and Community Program).

But these children remain hidden behind a rigid code of silence-"Don't tell! Don't feel! Don't trust!" Educators, counselors, and mental health specialists need to hear through their silence, because schools and other social environments can either help these children or inadvertently add to their pain by reinforcing the rigid roles they play to cope with their situation.

The following pages will provide more information on the chemically dependent family. We encourage you to review these materials and supplement your training program with any additional information that will be relevant to your caseload.

Rules in the Chemically Dependent Family



Source: Robert Subby, Lost in the Shuffle, the Co-dependent Reality, Health Communications, Inc., Pompano Beach, Florida, 1987.

Rules are a necessary part of maintaining order in life . . . and we could not live without them . . . I want to raise questions about how those family rules are used and misused . . . and to draw attention to the consequences of the crazy-making family rules we live by.

Rule 1: It's not okay to talk about problems. We learn the no-talk rule from what our parents say ("don't tell others about what goes on in this house") and what parents do (parents don't talk about problems although tension may be hanging heavy in the air). We learn to avoid our problems. When we can't talk about things that bother us, we are likely to act them out, and things get worse.

Rule 2: It's not okay to talk about or express our feelings openly. Because of cultural expectations, Americans are restrained about expressing true emotions. We just aren't supposed to talk about some emotions. In the dysfunctional family the emotional blocking is even a greater problem. We don't go into feelings, we don't explore them, and we don't talk about them. ("Keep that up and I'll give you something to cry about.") As well, we get that message in more subtle ways such as when a frightened child tries to crawl into a parent's lap. The parent becomes tense and uncomfortable with his/her own feelings and can't deal with the child's feelings. The parents can handle closeness as long as it's at arm's length.

Rule 3: Don't address issues or relationships directly. Communication is done indirectly, with one person acting as messenger between two others (triangulation) . . . issues are about "you and me and the __________." Children have little power over adults, yet they are burdened to "fix things up" between non-communicating parents. This communication produces confusion and guilt for everyone. When it explodes, the children believe they are the cause of their parents' problems.

Rule 4: Always be strong, always be good, always be perfect. In the dysfunctional family, an ideal is created about what is good and right and best . . . and is far removed from what is possible and realistic. We end up punishing ourselves and others because our expectations are not met. Being okay and feeling together inside requires that we maintain control over things on the outside. Letting go is frightening. Love is dependent on what we do, not on who we are.

Rule 5: Don't be selfish. We learn to view ourselves as wrong for placing our needs before the needs of others. Normally, there are times in life when it makes good sense to take care of ourselves first. If we believe our own needs are wrong, then we will never be able to ask directly for those needs to be met. We learn to manipulate to get personal needs met or we learn to take care of others. Without somebody to take care of, we feel we have no purpose or worth. Guilt and shame are strong, dominating feelings. We continue to let ourselves be used, then feel resentful, bitter and angry, and still our needs aren't met.

Rule 6: Do as I say . . . not as I do. This rule teaches us not to trust. If we are taught by our parents to be honest, then see our parents being dishonest, we become confused and suspicious. We stop trusting and begin to count only on ourselves. What we see is inconsistency. What we know is that the only certain thing is that nothing is for sure. In The Road Less Traveled, M. Scott Peck writes that the rule "Do as I say, not as I do," is one of the most destructive messages parents can give their children. We tell ourselves and others that it is important to be true to ourselves, but in reality we are not. We are thinly disguised hypocrites. We do not do as we say.

Rule 7: It's not okay to play. In the dysfunctional family, the world is a very serious place. Life is seen as difficult and painful. We work twice as hard as everyone else to feel okay. Having a project or some crisis to deal with gives us a sense of purpose. We believe that what we do is a measure of who we are. Identity and self-worth are linked to a job. The longer we deny our need to play, the more we suffer. We abandon ourselves, but blame others for our inability to be spontaneous or genuine.

Rule 8: Don't rock the boat. Every family is a system and each person has a role. The rules help each person know his/her part. Stability is one of the positive results of healthy family rules. All systems have a self-adjusting mechanism, a desire for homeostasis. The family adjusting to change is a health quality. In families where there are lots of unresolved issues such as alcoholism, chemical dependency, physical or sexual abuse, the system also seeks to maintain a type of balance, but the balance it seeks to maintain is an unhealthy one. The system seeks to maintain itself and the rules don't allow for healthy change. "Don't rock the boat" is the master rule. It is the rule that rules.

Roles in the Chemically Dependent Family



SOURCE: Adapted from Project SAEFP, The Society of Teachers of Family Medicine, 1991.



References

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Colgrave, S. (1988). By way of pain. Rochester, Vermont: Park Street.

Fossom, M. and Mason, M. (1986). Facing shame: Families in recovery. New York: W.W. Norton and Company.

Friesen, V. (1979). On shame and the family. Family Therapy, 6(1), 39-58.

Harper, James. W. and Hoopes, M. L. (1990). Uncovering shame: An approach integrating individuals and their family systems. New York: W.W. Norton and Company.

Hoskins, R. (1989). Rational madness. Blue Ridge Summit, PA: Tab Books.

Kasl, C. (1989). Women, sex and addiction. New York: Ticknor and Fields.

Kaufman, G. (1985). Shame: The power of caring, (Revised edition). Boston: Schenkman.

Lewis, H.B. (1987). The role of shame in symptom formation. Hillsdale, NJ: Lawrence Erlbaum Associates.

Nakken, C. (1988). The addictive personality. New York: Harper and Row.

Simon, S.B. and Simon, S. (1990). Forgiveness. New York: Warner Books.

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Young, M. (1992). Training counselors to work with addicted populations: A comparative study (unpublished dissertation). West Lafayette, Indiana: Purdue University.