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Section 4
Addiction: Placing Blame on Family

Questions 5 & 6 | Test | Table of Contents

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In the last section, we discussed the caretaking trap. The caretaking trap involves family members feeling they have no choice, avoiding pain and seeking pleasure, feeling guilt and shame, and being well-intentioned.

In this section, we will discuss the mirroring of symptoms in the addict’s family, and the four character defect personality types: the caretaker, the perfectionist, the procrastinator, and the rageoholic.

♦ Mirroring of Symptoms
During the course of addiction, addicts and their family members begin to mirror each other. The disease of addiction changes both in surprisingly similar ways. The decline of the family’s physical, mental, emotional, and spiritual health runs parallel to the addict’s deterioration due to their drug.

As you know, addiction to any substance causes a somatic illness, directly affecting the body organs and tissues. Family members of addicts often suffer psychosomatic illness; their emotional changes directly cause changes in their organs and tissues. As you know, these are not changes that are "all in the family’s heads"; they are real physical symptoms caused by mental and emotional changes.

Many of these physical and emotional problems are the same problems suffered by the addict. Common problems occurring both in the addict and the family members include hypertension, anxiety, irritable bladder, peptic ulcers, and gastritis. These health problems caused by the stress of having a relationship to an addict are very serious, and can in fact be fatal. Do you have a client who needs to be reminded that their psychosomatic illness is as serious as a somatic illness, and needs to be addressed?

I find that family members of addicts are also prone to somatopsychic disorders; changes in the body which change the way an individual thinks and feel. Depression is a good example of this condition. Living under ongoing stress, such as living with an addict, results in high levels of the hormone cortisol. Cortisol physically affects the brain, leading to depression. An alcoholic’s body, fighting the toxic effects of alcohol, also releases high levels of cortisol, leading to depression in the same way.

In my experience, the emotional states of addicts and their family members also begin to mirror each other. Both experience feelings of anger, resentment, withdrawal, distrust, dishonesty, anxiety, depression, and untrustworthiness as a result of fear. Both addicts and their families try to control their fear with character defects. These defects are so well practiced over time that they become a relationship worldview. Family members of alcoholics often unknowingly seek out relationships with people who fit their character defects.

Marie, age 43, told me "I’ve been married four times to four alcoholics. After each divorce I’d swear I’d never marry another alcoholic. Then I’d find this great guy, we’d get married, and it was only after the blush of the honeymoon wore off that I discovered I’d married another alcoholic. It’s taken doing this four times for me to realize it’s not all about them; it’s about me too."

I find the hardest thing for most family members of addicts to admit to is untrustworthiness. They can easily see how the addict is untrustworthy, but they see themselves as taking care of everything, as the responsible ones. It is hard for these family members to understand that it is not "taking care of everything" that is the problem, it is the way their learned character defects cause them to do it. Each character defect is a breach of trust; it is not intentional, but the emotional contortions necessary for surviving a family member’s addiction result in these behaviors.

4 Character Defect Personality Types
♦ 1. Caretakers
Earnie Larsen describes four ways family members become untrustworthy. The first are caretakers. A caretaker needs a ‘baby’ to take care of, so they tend to do things that keep others from growing up. Caretakers, also, as you know, called enablers sometimes subtly and unknowingly sabotage an addict’s recovery to keep them in the caretaking pattern. As you know, if someone else is taking care of the addict, there is no reason for the addict to take care of herself.

♦ 2. Perfectionists
Perfectionists are untrustworthy by constantly sending out the message that others need to do better. Perfectionists are never content, and treat mistakes like they are the end of the world. These individuals degrade others by letting everyone know they are not performing up to the perfectionist’s expectations.

3. Procrastinators
Procrastinators breach trust by making promises to do things, and consistently backing out. They are terrified of commitment. Procrastinators try to please everyone all the time, even if it means not telling the truth. When asked "what do you think", the procrastinator will answer "It doesn’t matter. Whatever you think is fine by me." Procrastinators are untrustworthy because they are always avoiding responsibility.

4. Rageoholics
In addition to caretakers, perfectionist, and procrastinators, rageoholics use anger to control others. Feeling superior makes them feel safe, and they tear others down to build themselves up. Sometimes a rageoholic will play the role of the martyr, accusing others of taking advantage of them. Rageoholics are untrustworthy because they can always find a rationalization for why someone else is to blame, and rarely hold themselves accountable.

Children growing up with an addict in the family adopt these same character defects. They begin life at a disadvantage, but their developing character defects usually go unnoticed. Emily, the wife of an alcoholic, told me about her 13-year-old daughter. "Julie is so responsible, and she’s always on the honor roll. She’s perfect… she acts just like a little adult, helping me around the house." Emily did not realize that Julie was becoming a perfectionist, spending all her energy pleasing others, and rarely asking for what she needed.

Julie was also playing the hero role, as described in Section 4, carrying the weight of her father’s alcoholism and trying to bring respectability to the family through her actions. I told Emily that Julie was likely to marry an alcoholic to continue the role she had learned to play. Julie was also likely grow up to be plagued by feelings of inadequacy, never letting other people close enough to really know her.

4-Part "Trust Yourself First" Exercise
I asked Emily to work through the "Trust Yourself First" exercise with me. I asked her to answer four questions, and rate herself on a scale of 1-10, with 1 representing "not at all" and 10 representing "all the time".

Part 1 - How well do you honor your needs? Do you sleep when you’re tired, eat when you’re hungry, or take a break when you’re feeling stressed?
Part 2 - When you make promises to yourself, do you keep them? If you promise yourself that you’ll spend a quiet evening alone reading a book, do you cancel when an unexpected invitation comes along?
Part 3 - Can you trust yourself to make tough choices? For example, would you walk away from a relationship that weakens your self-esteem, or from a job that pays the bills but leaves you feeling unfulfilled?
Part 4 - Do you stand up for yourself when someone steps over your boundaries or acts in inappropriate ways? Can you tell a friend that it’s not okay to criticize or tease you?

After answering these questions, I asked Emily to rate her level of trustworthiness, and to journal about the changes she needed to make to become more trustworthy. We agreed that she would start by making a weekly appointment with herself to have a cup of tea by herself on her porch.

In this section, we have discussed the mirroring of symptoms in the addict’s family, and the four character defect personality types: the caretaker, the perfectionist, the procrastinator, and the rageoholic.
Reviewed 2023

Peer-Reviewed Journal Article Reference:
Church, S., Bhatia, U., Velleman, R., Velleman, G., Orford, J., Rane, A., & Nadkarni, A. (2018). Coping strategies and support structures of addiction affected families: A qualitative study from Goa, India. Families, Systems, & Health, 36(2), 216–224. 

Corrigan, P. W., Watson, A. C., & Miller, F. E. (2006). Blame, shame, and contamination: The impact of mental illness and drug dependence stigma on family members. Journal of Family Psychology, 20(2), 239–246.

Eddie, D., White, W. L., Vilsaint, C. L., Bergman, B. G., & Kelly, J. F. (2021). Reasons to be cheerful: Personal, civic, and economic achievements after resolving an alcohol or drug problem in the United States population. Psychology of Addictive Behaviors, 35(4), 402–414.

Farmer, R. F., Seeley, J. R., Gau, J. M., Klein, D. N., Merikangas, K. R., Kosty, D. B., Duncan, S. C., & Lewinsohn, P. M. (2018). Clinical features associated with an increased risk for alcohol use disorders among family members. Psychology of Addictive Behaviors, 32(6), 628–638.

Pimentel, P. S., Arndorfer, A., & Malloy, L. C. (2015). Taking the blame for someone else’s wrongdoing: The effects of age and reciprocity. Law and Human Behavior, 39(3), 219–231.

Rusby, J. C., Light, J. M., Crowley, R., & Westling, E. (2018). Influence of parent–youth relationship, parental monitoring, and parent substance use on adolescent substance use onset. Journal of Family Psychology, 32(3), 310–320.

QUESTION 5
What are the four character defect personality types of family members of addicts?
To select and enter your answer go to Test.

QUESTION 6
What are the four questions involved in the "Trust Yourself First" Exercise?
To select and enter your answer go to Test.


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