Toughest hurdle to overcome is denial

It is often difficult for the family to admit something is wrong

Telling your drug-addicted child he or she isn’t welcome at home unless they get treatment or abides by the house rules is painful for any parent.

“But it may be the critical move that eventually saves a child’s life,” said addictions expert Dr. Ted Kardera. “It’s the kind of statement that may precipitate someone getting into recovery and getting over denial.”

Addiction is a progressive, fatal disease, Kardera said. “With drugs you don’t have the luxury of 20 years. You’re looking at five to 10,” he said.

A parent who wrestles with whether to tell a child to leave home fears their child might not survive on the street or might die of an overdose. “But by continuing to support the child a parent may be enabling him or her,” said Kardera, a specialist in addiction medicine for 20 years.

He is a member of both the American and Canadian societies of addiction medicine and is one of two physicians at the Cedars addiction-treatment facility in Cobble Hill. He has also been involved with the physicians’ support program, assisting doctors with addictions and chairing the interventions committee.

Kardera explains that telling a child he might have to leave home is never a first step; it is a desperate measure that comes “towards the end of the process.”

First comes denial. “Parents say there is nothing really wrong, their son or daughter is just going through a bad patch.” More and more evidence piles up. Marks fall at school, behavioural problems abound, confrontations increase. In an effort to set things right, parents remove privileges, impose curfews, seek advice from doctors and counsellors, maybe put kids in treatment.

Family schisms develop. One parent says yes, another says no, and kids play both sides against the middle. “There is so much disruption you can’t believe it. This disease destroys lives, families, relationships.”

He advises that firm, loving guidelines should start early, but even if they are imposed later, the situation will start to change when parents become guilt-free and can say: “We’re responsible to him, but not for him. He suggests parents look into Al-Anon, a support group for friends and relatives of drug or alcohol abusers.

Some parents blame drug abuse on genetics or peer groups, but Kardera says that’s academic. The bottom line is: Accept it, deal with it, get on with helping the child.

And he, like most other counsellors, doesn’t use the term “tough love,” which refers to a program founded in 1979 by two Pennsylvania therapists. But whatever the terminology, the idea is to set boundaries with compassion.

When it works, it’s because the denial breaks down. “Denial is the hallmark of addiction,” he said.

The addict says: I’ve got it under control, it’s not a problem, and continues the abusive behaviour, whether it’s drugs, sex, work, gambling, alcohol — in spite of negative consequences.

Often the family is in denial, too. One parent sees the problem, the other doesn’t. One refuses to give the child money, the other sneaks it to them. They say, “My son can’t be an addict” because that reflects on them. Suddenly, too late, parents realize their child is addicted and living a dangerous lifestyle.

So where should they draw the line? “That’s the $64,000 question and there is no right answer,” Kardera said.

When and where parents take a stand depends on their tolerance and perhaps their egos. “It’s a process many of us struggle with. When is parenting normal and when is it pathological?” Kardera asked.

It can take courage to be firm, Kardera said. “Children may be furious, full of hate because you forced them to do something. But when you see them move from anger to acceptance and back to love, it is very, very powerful. That’s the shift that makes it all worthwhile because you have re-established family relationships.”

Dr. Gabor Maté bristles at the mention of “tough love” because it sounds adversarial and controlling.

“It’s either love or not,” he said, but quickly added that loving kids doesn’t mean parents have to “put up with crap.”

“I’m not talking about people being pushovers — if my kids steal from me I call the cops — but the real issue is not about setting boundaries, but having a connection with the child.

“The most important thing is not what parents do, but who they are in relation to the child. Am I punitive and vindictive when I ask them to leave? Or am I saying: ‘You have to go because I can’t live with this.’ That’s love, not hostility.”

He said no drug-addicted child is sick in isolation. It’s a family problem. Somehow the child’s needs were “significantly unmet” at some point. Not because parents meant any harm, but because their connection was inadequate.

“It’s not the parents’ fault, that’s where language goes wrong — but the whole family has to heal,” Maté said.

The more help parents get, the more compassionate they can be, instead of being stressed out and reactive.

Why are children vulnerable to drugs? Why can’t they say no?

Because the drug is doing something important, giving them emotional pain release, oblivion, a connection with others, Maté said. “It’s not a police problem. It’s a family problem. Hold onto your kids.”
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source: Times Colonist, http://www.canada.com/victoriatimescolonist