Changing Focus

Meet Debra Jay—author, clinical interventionist, and addiction counselor. In 2008, Jay coauthored Love First: A Family's Guide to Intervention, a breakthrough book for families hoping to get a loved one into treatment. In 2014, Hazelden Publishing released Jay's newest book, It Takes a Family: A Cooperative Approach to Lasting Sobriety. In it, Jay draws from wisdom born of experience—her own as an addiction professional and that of countless families she's helped along the way.

Isn't treatment for the addict the end goal families need most?

Treatment for the addict is a starting place for the rest of the family to begin healing. Families need help in their own right. When an intervention is done properly, family members rally together and are educated about the disease of addiction and supported in taking action against addiction. I've seen families come together in unbelievable, amazing, beautiful ways through an intervention. The family is able to set the anger aside and move into empathy. Then their loved one goes off to treatment, the family is left on their own, and nothing more changes for them. Most alcoholics and addicts coming out of treatment have a recovery plan, but families are left to figure things out for themselves.

What kinds of things do families need to change?

Families are profoundly affected by the disease of addiction, but they don't realize the extent. More than anything, family members need help in recognizing and changing the fear-based behavior patterns they've developed in response to the disease of addiction. They have been living in crisis mode and, as a result, have developed some unhealthy survival skills that carry over into all other areas of their lives. These survival skills become behavior patterns, or what's called "character defects" in Twelve Step language. Some of the more common behaviors include the need to control others, perfectionism, hanging onto resentments, or behaving like a martyr. These are ways we learn to protect ourselves from pain. Peel back each of these behaviors and you'll find the same thing: fear. Families who live with addiction live in a state of fear, behaving in ways to keep themselves safe—not understanding that those survival behaviors further perpetuate the fear.

How does the family get out of that cycle of fear?

There are simple, practical strategies families can put into action to build a circle of support for each other. I call it "Structured Family Recovery." It begins when family members learn to take the focus off of the addict and, instead, begin to focus on their own behaviors. More than anything, families worry about relapse. Everyone's focus is on the addict. This has been the pattern. For months or years leading up to treatment, the family has been in crisis and watching the addict like a hawk, fearing whatever the next consequence might be. During treatment, all attention is on the addict, too. And after treatment, everyone's attuned to the addict's every move, terrified at the prospect of relapse. But families can change their focus and work in a collaborative way to not only reinvent their relationships but also be of support to one another, which reduces the probability of relapse.

So, you use the term "circle of support" to describe a family?

The circle image came to me in working with a young man whose family was at a loss after years of experiencing his mother's struggle with addiction to opiates. His mother would go to treatment, stay sober for a while, and then relapse. Each time she relapsed, he said it felt like his family was standing outside a circle, turned inward, and all pointing at his mother in judgment. When his family finally got help for themselves, he described it as standing inside the circle—holding hands, working recovery together. That's what Structured Family Recovery feels like for the family: You're all in it together, including the recovering alcoholic or addict, each taking personal responsibility for yourselves and at the same time supporting one another.