1. ©2010 McGraw-Hill Higher Education. All rights reserved. Chapter 6 Parenting Impact on Alcohol/Drug Use and Abuse

2. ©2010 McGraw-Hill Higher Education. All rights reserved. Parent-Child Bonding Primary relationship that greatly influences behavior Poor bonding impacts: – Development – Self-concept – Social and interpersonal relationships – Achievement – Identity

3. ©2010 McGraw-Hill Higher Education. All rights reserved. Hypothesis regarding adolescent abuse Overinvolvement hypothesis Functional hypothesis

4. ©2010 McGraw-Hill Higher Education. All rights reserved. Overinvolvement Hypothesis The overinvolvement hypothesis is that one parent (frequently the mother) is overly involved in the adolescent’s life to compensate for the lack of availability by the other parent.

5. ©2010 McGraw-Hill Higher Education. All rights reserved. Functional Hypothesis The functional hypothesis is that the adolescent’s substance abuse distracts the family from focusing on other familial problems, such as marital discord, infidelity, and parental abuse of alcohol/drugs.

6. ©2010 McGraw-Hill Higher Education. All rights reserved. Abandonment Depression An affective disorder with six key elements: 1. Rage [Homicidal] 2. Suicidal depression 3. Panic 4. Feeling of hopelessness and helplessness 5. Emptiness and void 6. Guilt (Source: Masterson, James. “Psychotherapy of the Borderline Adult – A Developmental Approach”, 1976)

7. ©2010 McGraw-Hill Higher Education. All rights reserved. Characteristics of Shameful Experiences 1. Unexpected exposure; being judged on a vulnerable aspect of oneself 2. Feeling as if there is a loss of choice 3. Feeling out of place, flawed, defective, or inadequate 4. A threat to the core of one’s identity 5. Mistrust in ability to perceive things properly; unsure of self in making decisions or relating to people

8. ©2010 McGraw-Hill Higher Education. All rights reserved. Characteristics (continued) 6. Trust of self and others is jeopardized; boundaries are distorted; and physical, emotional, and/or sexual violations may occur 7. Difficulty in assessing what is reality 8. Feeling helpless, powerless, and trapped, with no way out (Fossum and Mason 1986)

9. ©2010 McGraw-Hill Higher Education. All rights reserved. SHAME Shame Based System 1. No Hope 2. Inescapable 3. Exterior based Feedback Based System 1. Hope – choice 2. Can make amends 3. Will feel better later Definition: Self looking in on self, finding the self lacking. Feeling exposed “see” in some public way and wanting to cover – feeling hunted. (Source: Facing Shame: Families in Recovery, Fossum and Mason)

10. ©2010 McGraw-Hill Higher Education. All rights reserved. Affect / Shame Binds anger + shame = rage anxiety + shame = panic fear + shame = terror sadness + shame = depression depression + shame = despair despair + shame = suicidal thoughts suicidal thoughts + shame = suicide attempt

11. ©2010 McGraw-Hill Higher Education. All rights reserved. Affect / Shame Binds cont’d hurt + shame = pain pain + shame = trauma (deep or chronic pain) trauma + shame = phobia phobia + shame = loss of reality unavailability + shame = lack of trust of others lack of trust of others + shame = paranoia paranoia + shame = loss of reality

12. ©2010 McGraw-Hill Higher Education. All rights reserved. Obstacles to Reaching Parents & Family Denial Skepticism – Incongruence Assumption that things will be OK Distorted, depressed view of life Fear of being labeled Fear of loss of confidentiality Narcissism of parents Lack of energy/time of parents Lack of credible messages – cultural/racial Lack of concern/respect for experts Lack of awareness of community resources Need for services for basic survival Cultural mores Distrust of the system

13. ©2010 McGraw-Hill Higher Education. All rights reserved. Other Obstacles to Reaching Parents & Family Rejection Sensitivity – Can’t avoid failure/rejection – it is “how long” does it take to recover from defeat Procrastination, rumination – motivation & change Despair – “Universal and permanent causes for misfortune” Lack of hope – depression Shame versus pride Recognition that alcoholism and drug addiction are family diseases

14. ©2010 McGraw-Hill Higher Education. All rights reserved. A Balanced or Healthy Family System (Fossum & Mason) Includes Hope Choice Ability to make amends

15. ©2010 McGraw-Hill Higher Education. All rights reserved. Characteristics of Parental Imbalance (Kempher) Increased alcohol, drug and/or nicotine dependence Increased marital conflict Increased parental absenteeism

16. ©2010 McGraw-Hill Higher Education. All rights reserved. Compassion Definition: recognizing and being sensitive to others suffering as well as one’s own suffering Can counteract shame A noble ascription (the common good not just about me) is: We are all in this together. The most resistant people in families to get to counseling are……fathers.