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Is addiction a family illness?

It is understandable that the focus of addiction is primarily on the addict.  However, my work and experience has shown me that addiction tends to be an illness or condition that develops around profound problems within the family unit, or system. It is important that we find ways to consider the way the family interacts, the way the system as a whole works, and to see what changes can be made to that.

If we don’t think about the way the family relates to itself, and the behaviours and responses that move around the family system, then we may be overlooking vital parts of the problem.  This all too easily leads to further destructive behaviour and acting out on the part of the addict.

Yes, the addict needs to stop using.  But the family system may need attention too.  ASAP.

The family needs to consider how the addictive behaviour fits into and is part of the overall family dynamics.

Addicts tend to use, drink, drugs, gambling, sex, porn etc, to avoid difficult feelings.  The drug of choice masks feelings.

How do you determine if someone is an addict?

Look to the degree to which their lives are becoming unmanageable.

  • Are there money problems?
  • Are they racking up debt?
  • Falling out with people?
  • Losing jobs?
  • Selling things?
  • Having trouble with the police?

If signs of increasing unmanageability are there to see then the problem may be one of addiction and co-dependency.

It is often more helpful to be clear about the unmanageability than it is to say ‘well they aren’t drinking that much… they can’t be an alcoholic.’

Unmanageability is a key signal

Addictive behaviour tends to grab all of the headlines in the family conversation and pretty quickly the only subject is the addict.  The addict becomes identified as the problem.

There is no denying that when the addictive behaviour is happening it does use up a lot, if not all of the family resources, emotions, energy, time, money.  In the first place the addict needs to stop using.

If that can happen, if the cycle of destructive behaviour can be broken then there may come a brief lull in the storm. Grab it with both hands.

This is the point at which some attention can be turned to the family, to the other members of the system.

Addiction tends to go with co-dependent behaviour

What do we mean by co-dependency?  It is a complicated word and subject.  For the purposes of this blog, when I speak of co-dependency I am speaking of the way in which one person will derive satisfaction from consistently helping another vulnerable person.

The co-dependent person will put the addict’s situation first, helping them, creating unbalanced relationships that focus upon the need of the addict as a way of covering up the needs and deficits they feel themselves.  Co-dependency is a dysfunctional relationship in which one person enables another person’s addiction.

The payoff for the co-dependent person is that by putting the emphasis so much upon the addict, and the need to support and help the addict, the co-dependent person manages to avoid looking at their own problems and difficult feelings such as fear, unhappiness, guilt etc.

Being co-dependent, helping the addict, keeps you active, which makes you feel you are doing something constructive. But the real pay off is that it covers up your own difficult feelings.

  • What are you covering up while you are helping keep the focus on the addict?
  • What difficult feelings of your own become obscured in all of the action of supporting the addict?
  • What behaviour can you change?

These questions extend beyond the things that the co-dependent person does for the addict partner or parent or child.  It extends into the narratives and stories that the family become caught up in telling about the addict.

This pattern needs to be interrupted and changed

The co-dependent person needs to find a way to take responsibility for their part in the story.  They need to stop using; action, helping, enabling, just as much as the addict needs to stop drinking, taking heroin, gambling etc.

Finding a way to open up the problem in the family can be daunting. But it is necessary because if you leave these things to run along the lines that they are on, they are all too likely to end up in disaster.

Taking responsibility for our own part in the family system is essential

If we just keep doing the same things over again, and keep saying that the problem is all down to other people, to the addict, then our lives will never develop and allow us to create and grow into the people we can be.  Finding a way to open up what is going on in the family system may be the key to changing destructive addictive and co-dependent patterns.

Is addiction a family illness?

Toby Ingham

Toby Ingham is a psychoanalytic psychotherapist and supervisor based in High Wycombe in England. Toby works on both a short and long-term basis with people who are trying to work through a variety of situations. Sometimes these relate to a specific event such as CPTSD, bereavement, divorce or redundancy, sometimes relating to a more general problem or behavior. He blogs on a wide range of psychological themes.

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APA Reference
, . (2018). Is addiction a family illness?. Psych Central. Retrieved on March 24, 2019, from


Last updated: 3 May 2018
Last reviewed: By John M. Grohol, Psy.D. on 3 May 2018
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