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Ask a Psychologist: When a Family Member Is Struggling with Addiction


How to ask for help, and how to move forward

by Shara M. Brofman, Psy.D.

Ask a Psychologist: When a Family Member Is Struggling with Addiction  | A Practical Wedding

Q:Hey APW,

I’m getting married in August (yay! yikes!) and am seriously struggling with a family conundrum. My older brother is an addict and has been in and out of relapse over the last four years. It has been an extremely difficult time for my family, as like most addicts he has repeatedly lied to us and done other unspeakable things to lose mine and my parents trust. In the last month or so things have taken a turn for the worse and he continues to lie and likely use drugs. He’s always been on the invite list, because, well, he’s my brother. However, the closer it gets to the wedding the more anxious I become about the situation and the more stressed out my mother gets. It is problematic because if I uninvite him—which I wouldn’t even begin to know how to do, or have the guts to do, then my parents will be stressed about what to tell extended family members and friends when they ask why he isn’t there. On the other hand, what if he comes and is strung out and makes a scene? With only six weeks before the wedding I realize I’ve got to figure it out soon. Do I make ultimatums to him that he has to have a clean drug test in order to come to the wedding? Do I sadly hope that he can’t get it together financially to make it from the West Coast to the East Coast? Do I flat out tell him he can’t come?

Yours,
Desperately seeking advice from APW families with substance abuse issues

A:Dear Desperately Seeking Advice,

Addiction can be a devastating disorder for the people who struggle with it, as well as for their families. It’s not easy to manage this in the midst of preparing for your wedding. But substance abuse also affects a large number of people, which means that there is a tremendous amount of information out there about how people and their families can recover from addiction. And there are many stories of success in recovery. You are already handling this well in asking for help, and in thinking about different ways to move forward.

Addiction is a biologically based illness that significantly changes the brain, particularly in terms of its reward center, as well as its ability to think clearly, make decisions, and control impulses. As the National Institute on Drug Abuse website points out, anyone can become addicted to drugs. And as tolerance and dependence develop, the drug is craved not just to achieve a high, but to avoid the severe withdrawal symptoms. So, a person’s life can quickly become organized around obtaining and using the drug. This is important to keep in mind, because it helps to gain perspective on the challenging behaviors that often accompany addiction and negatively impact relationships, including becoming unreliable, lying, and stealing. These behaviors can wreak havoc on families’ lives, but they are rooted in a biologically based disorder, which needs psychological treatment and/or medical care.

Like recovery from many illnesses, recovery from addiction requires people and their families to balance responsibility and acceptance. In planning your wedding, you are responsible for thinking about what you want and need to feel comfortable and happy on that day, while also staying realistic about potential obstacles. So, first of all, make sure that you are taking care of yourself. This might mean seeing your own therapist, going to a self-help group for families of people with addiction (by yourself or with family), or trying family therapy. Remember that addiction is a common disease, that you are not alone in having a family member struggling with it, and that there are many resources out there to help.

To help answer your question, I talked to my colleagues, Romy Reading, Ph.D., and Nora Moore, Psy.D., New York City psychologists with expertise in addiction. Weddings are wonderful celebrations, and they also create family pressure, both of which can trigger relapse, explain Moore and Reading. If your brother is going to attend the wedding, Reading and Moore suggest creating a safety plan. You, friends, or family can set parameters in advance to plan for potentially challenging situations on the wedding day. For example, you might assign someone who knows your brother well to support him and escort him out if necessary, or you may decide what information you want to share, and with whom. If you do decide that your brother should not attend the wedding, Reading recommends that you talk to him about it as soon as possible, and that you continue to have an ongoing, collaborative family dialogue, rather than focusing on ultimatums or obtaining drug testing.

While you’re thinking about the wedding day, don’t forget to also think more long-term about the future and your family relationships. Your brother needs help. If he is already in treatment, he may need a more intensive setting. And he may also be able to recover. “A wedding is a special day, but it is just one day out of your life,” notes Moore. “Think about what kind of relationship you want with your brother, and start there. Have you talked to him about your concerns? Can you work with him to come up with a plan so that, should he come, both of you will feel comfortable? It’s possible that you decide together that it’s best for him to not come, not because you don’t trust him, but because you are a sister supporting her brother in his struggle to recover from addiction.”

In the comments section of my July post about coping with a parent’s depression, there was an interesting discussion about stigma toward mental illness, but not towards medical illness. Moore agrees, “If your brother had a medical condition that prevented him from coming, would it be as stressful to explain? Addiction is not a failure in character, but an illness, and focusing on keeping up appearances can have negative consequences.” So, as for the question of what other people will think, choose what you want to explain, and to whom. Lean on the people you are closest to for support. Choose how much energy you want to put into worrying about what everyone else thinks (recommendation: none). And honor your wishes to create a beautiful, meaningful wedding day for you, your partner, and your families.

For more information on treatment, research, and resources for people with addiction and their families, visit the National Institute on Drug Abuse website and Faces and Voices of Recovery.

The information provided in Ask a Psychologist is intended by Dr. Brofman and APW to serve as general advice and guidance for all readers. The advice herein does not constitute a clinical recommendation or relationship, and Dr. Brofman and quoted mental health professionals do not take clinical responsibility for this information. Ask a Psychologist does not take the place of a confidential clinical consultation with a trained mental health professional.

Shara M. Brofman, Psy.D.

Shara Marrero Brofman, Psy.D., is a psychologist who values all things practical. She studied Child Development at Tufts University and worked in case management and clinical research before earning her master’s and doctoral degrees in Clinical Psychology from Rutgers University. Dr. Brofman practices in New York City and has special interests in women’s and reproductive mental health. She can be contacted at drsharabrofman at gmail dot com. Photo by Smitten Chickens.

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  • Ann Marie

    {hugs}

    We had this situation as well at our wedding, and I too was really concerned that one of our close relatives, who was a longtime drug addict, would make an enormous scene if he managed to come. When out of the blue, he announced that he had in fact procured a plane ticket to come to our wedding, we panicked.

    But it turned out just fine. We lucked out that he woke up and cleaned up his act, starting right before our wedding. He attended and everything was fine. No scene, no drugs, and we didn’t have to issue any ultimatums. (Unfortunately though he did relapse about 6 months later, and is now in treatment again.)

    We did make sure to seat him with relatives who would be able to keep a handle on him, and made sure that he was never alone, so that he couldn’t go out and buy alcohol. I don’t know if that helped, or if the wedding gave him a reason to be sober, or what it was, but we were so blessed to have that one day with him without his demons.

  • Jules

    In this case, I think anything you choose is an acceptable option since you’re clearly a compassionate sister that is worried about him on the whole and on your wedding day. With my brother, I have to remember to keep my guard and boundaries in place until he proves himself worthy of deserving trust again. I don’t feel guilty about any actions that I choose to take as a result (haven’t seen him in over 2 years, only send him cards for birthdays, etc…).

    Scenario 1: He comes and makes a scene. You have a plan in place to have him escorted out by other friends/family. Could be stressful on you and parents, but you also don’t have to uninvite anyone. Since it seems he is spiraling, it seems unlikely it will go smoothly (?).

    Scenario 2: You make ultimatums. He either fails and doesn’t come, fails and lies (comes anyway), doesn’t ever take a test and lies, passes and comes…This seems like a bad option. I know my brother would just lie to get what he wants.

    Scenario 3: You tell him he simply can’t come and that you will celebrate together later. I think the bit about “deciding together” that he won’t be there is wise if you can get him to go down that path in a conversation. If he is still in denial about it being a problem, that may be unlikely.

    I wouldn’t worry about what to tell others as a factor in what to choose. Is his addiction well-known to the people who would ask? Could you say for “health reasons” he’s unable to join you/not healthy enough to travel right now? I would never dream of pointing out the absence of a key family member on a wedding day…

    • Ann Marie

      > I would never dream of pointing out the absence of a key family member on a wedding day…

      In our situation, plenty of relatives knew exactly what was going on, and so wouldn’t have needed to be told anything, and everyone else wouldn’t have expected him to be there, because his addiction had kept him away from family gatherings for years. We didn’t plan to bring it up at all, and a simple “oh, he’s living in and couldn’t make it” would suffice if anyone asked directly.

      • Jules

        ….Oh, duh, why didn’t I think of that? My brother lives miles and miles away and “couldn’t make it” would be the obvious choice.

        • Eh

          I agree, keeping it simple and vague is a good idea. My BIL and his family didn’t come to our wedding (unrelated to addiction, but related to his wife’s mental health issues and a family feud). My MIL was very concerned about what other people would say and how she would react if someone asked her where he was so she came up with the line “Something came up and they weren’t able to attend”. Since they lived in the same town where the wedding was held I pointed out to her if she told people that then they will think that something serious happened (e.g., someone died). Luckily all the people that needed to know he wasn’t there already knew the situation and no one asked where he was. In the end, their kids ended up having lice so even if they wanted to come to our wedding either my BIL or his wife would have probably needed to stay home anyways.

  • Amy March

    Well, let’s think about that worst case scenario. He comes and makes a scene. Someone escorts him out. Everyone chatters awkwardly. The DJ plays a new song, perhaps your father says something along the lines of “please everyone let’s not less this disturbance get in the way of the party”, smiles, and takes you in his arms for a dance, giving you some recovery time and signaling to everyone else that they should carry on as well. Will your family agree to that plan? If brother makes a scene, we will all just focus on moving forward? Addiction is hard, but it’s also common. I think your guests will be more understanding than you think.

    • MizEm

      I think this is a solid approach. I attended a beautiful wedding last fall where a similar thing occurred. A couple of the groom’s brothers arrived uninvited. No big deal–the bride and groom let them stay. Later in the night, the brothers became drunk and caused a scene. Most guests did not even notice, they were so busy rocking out on the dance floor. The family addressed the issue and moved on. The celebration continued without missing a beat. While I remember this moment, what I remember MORE is the lovely day we all had together and the sweet family formed by this union. And I doubt anybody thinks less of the couple for welcoming family members, though uninvited, to stay.

  • lottie

    A good friend of mine in a comparable situation chose not to invite her brother to her wedding, and that was fine. It probably worked because her parents supported the decision (or at least didn’t question or push it and went along with it), so I do think family buy-in is important whatever you choose to do. Ultimately it’s your decision, but to the degree you can get everyone who matters on the same page, it will probably help.

  • anon

    I have a question that is tangentially related: does anyone here have experience dating a recovering addict? I recently met a guy who is very open about the fact that he’s a recovering addict, has been clean for 5+ years, and seems on an upward trajectory. Moreover, I’ve enjoyed spending time with him and there has been some fun flirtation. But…it also scares me. I don’t have a ton of personal experience with addiction, but I have friends with experiences comparable to the letter writers, with siblings and parents who struggled with addiction and by all their accounts, it’s been hard, really hard, and relationships have suffered tremendously. At the same time, addicts can be good people and who am I to cut off a potential relationship because of someone’s past (I mean, this could come into someone’s future too, and feel like it comes out of nowhere. At least I know I’m dealing with an addict)? But then again, I don’t know that much about this person and what harm he’s caused others and….basically, I’m really torn about pursuing this, and would love any thoughts, advice, questions (to ask, to think about) from those who may have experience with dating or relationships with addicts. thanks!!

    • Amy March

      “Who am I to cut off a potential relationship because of someone’s past?”

      Yourself. You don’t owe him or anyone a romantic relationship. Absolutely explore what addiction and recovery can mean and involve, but concerns about someone’s past are a perfectly acceptable reason not to pursue something. If that makes you feel guilty, try looking at it from his point of view. Does he deserve pity from someone with concerns about addiction or joy from someone with no concerns who sincerely views recovery as a good thing? That person doesn’t need to be you.

      • La’Marisa-Andrea

        Exactly.

      • La’Marisa-Andrea

        I will add this: everyone comes with some sort of baggage, if you will, and we get to decide what kind we want to deal with. I come from a family with several addicts, including my father, who has been in recovery for 20+ years but he’s in recovery from opiates and there is ALWAYS a risk of relapse bc it literally rewires your brain and you’re never the same again. I have seen firsthand and lived firsthand the consequences of my father’s addiction (and see it in other family members) and I absolutely could not ever be romantically involved with an addict. If something were to happen and my husband developed an addiction problem, I can honestly say that’s definitely on the dealbreaker table. I do not have the emotional fortitude to deal with that nor I don’t want to.

    • Emily

      I haven’t dated an addict, but I am the child of an alcoholic and have many friends in the AA and NA community.

      5 years is a long time to be in recovery. This person has accomplished a lot and done a lot work on themselves. This is not someone who is detoxing or working through the basics of recovery. They are probably mentoring other addicts and taking on leadership roles in the recovery community. They are still an addict, but they aren’t acting like an addict anymore. I think you could probably learn a lot from someone who has dramatically turned his life around and stayed sober for five years.

      On the flip side, relapse is always a danger. Statistically it is just not that common to recover from addiction.

    • Violet

      While it’s true as written above that anyone can biologically become addicted to drugs or alcohol, it’s not true that everyone is equally likely to do so. In part, openness to trying drugs is usually the first step (excepting people who are drugged against their will, as does happen). In terms of questions to ask, a conversation to find out how things began for him may be relevant to figure out if there are some personality differences that may be an issue, even if the addiction itself (which sounds really well-managed) is not. As you say, just like non-addicts, addicts can be good people. Let’s assume he’s a good person (whatever that means; and as we have no reason to believe he’s not). But what you really need to know is if he’s a good fit for you.

    • KC

      Do you know anyone who knows him/has known him for quite a while? Because independent confirmation that he has in fact been 5+ years clean would be kinda nice. I also agree that getting more info seems like it would be reassuring (or, if not, would give you enough information to be more confident in saying that this particular ride is not for you).

    • Hope

      Speaking from my own experience of having been married to an addict, I would think long and hard before going in to this relationship. I managed several years of my husband’s active addiction before we divorced but I never wanted to introduce children to the situation. It takes a lot of trust that someone has recovered fully to decide you could bring children into the equation.
      Even if you equate addiction with a physical illness that might have a relapse, there are people who choose never to have children because of the impact a relapse in the disease would have on the child. I would be extremely hesitant but you’re the one who knows this guy, not me.

      • anon

        Thank you for all of these perspectives and questions and thoughts. I think the key takeaway may be that this is someone worth getting to know better but not rushing into things. I have independent confirmation that he’s been sober for as long as he says he has been, he’s definitely involved in the recovery community/mentoring others, and has been frank about his past (not all the details, but I wouldn’t expect someone to tell me everything upon first meeting, and he seems open to talking about it). At the same time, there are definite reasons to be careful and deliberate and ask a lot of questions before pursuing anything. thank you all!!

  • Kaitlin

    We had a similar situation with my husband’s sister (his only sibling). He worried about inviting her and her causing a scene and he also worried about the ramifications of not inviting her. Up until the end of our engagement he was going back and forth on whether or not to invite her. I told him it was his decision and I would support him either way he chose. Even if she did show up and cause a scene, we would deal with it and move on because no one was going to get us down on our wedding day. Ultimately right before the wedding we saw her and she caused a lot of problems that weekend. It solidified his decision. He worried what people would say or how to respond if they asked about her. Ultimately very few people mentioned it and to those that asked about his sister we just said, unfortunately she couldn’t make it and left it at that and no one questioned it further. I am sad for him, that she wasn’t there but ultimately I think it worked out for the best. Her presence would have caused my husband and his family a great deal of stress that weekend, instead everyone was able to relax and enjoy themselves.

  • Satsuma Caravan

    I totally see where you’re coming from with the concern that your brother might possibly make a scene. However, another equally likely outcome for drug users is that they’d “hide away” for most of the wedding (e.g. go to a different room from the main party, hang out with the band or people who don’t know them well, avoid relatives & close friends who might ask questions that are hard and embarrassing to answer)…

    You’d be much better-placed than anyone on this forum to know how your brother usually handles big parties with relatives, new in-laws, friends, and anyone likely to trot out the big questions, “So, how do you know the bride or groom? And what do you do for a living?”. But if you think he’d want to avoid answering a non-stop deluge of questions like that (which just about everyone knows will be asked!), then you can most probably count on him trying to become the “invisible man” all night and avoid making much of a scene.

    Good luck & hugs!

  • Gina

    I think everyone agrees nowadays that addiction is a disease. However, it manifests itself a lot differently then a physical disease–i.e., you could expect your brother to have some physical limitations at your wedding if he had a physical disease, but you wouldn’t have to worry about him making a scene. So how this disease affects you is fundamentally unique. And that means that you get to choose how you want to handle it. My main piece of advice is: Whatever your choice, do not let anyone guilt you for it.

  • Cathi

    You know how APW has this mantra along the lines of “weddings don’t change who people are”? How if your BFF is chronically late before she was your MOH, she’s probably going to be chronically late to all of your wedding stuff? I think the same thought can reasonably be applied to the addicts in our lives, even if their addiction does add an element of unpredictability. I think if someone battling addiction is usually fine (other than the specific times they are using) then they will probably be fine at your wedding. But if they are prone to causing scenes, especially when they’re feeling neglected as not the center of attention, then they will probably cause a scene

    My husband’s little brother, among many other issues, has substance abuse problems which has resulted in him acting in a lot of horrible, violating ways. But he’s also a really nice guy who, deep down, loves his family and honestly doesn’t *usually* cause scenes. He tends to get into trouble when left to his own devices. He’s usually good around family when in groups, and he usually takes genuine pleasure in seeing the people he love be happy. So even though he had access to (and drank a lot of) alcohol at both my own wedding and their dad’s wedding the following year, he did just fine.

    He hasn’t done fine in other situations–he’s in jail, again–but he was not-fine in the usual situations and ways.

    • Hope

      I think Cathi makes a great point about knowing how the addiction plays out in different circumstances.
      My ex was best man in his brother’s wedding whilst in the midst of drug addiction. He was in the hospital a couple of days beforehand and missed the rehearsal dinner, as he had in the past also missed family events. But his addiction had never manifested in causing a scene and on the wedding day he was there, social as can be, lying to cover his addiction but not causing a problem for anyone. For my in-laws this worked out and he is in the wedding pictures despite the torrid circumstances.

  • anon

    I struggled with this issue leading up to my wedding as well. I wasn’t sure if I should invite my mother, and I asked a lot of people for advice.
    Two realizations helped me cope:
    1.) I can’t control my mother’s drinking. Any plan that relied on me influencing whether or not my mom would drink was going to hurt me and fail. A lot of the damage that family members of addicts earn come from efforts to control the addict. We cover for addicts,twist ourselves into knots trying to prevent than from getting their fix, or we pause our own lives to help them scrape by. All of these are loving but misguided acts.

    2.) I can set a good example for my mother. I want her to seek help, so I sought help for my own problems. I want her to stop self-medicating and tackle her demons, so I tackle my demons. I want her to respect the recovery process, so I respect the recovery process, even if that means having a dry rehearsal dinner, because I know that someone fresh out of rehab might not be able to handle stressful social event where free alcohol is served.

    In the end, I realized that I knew what to do about my mom, but I was grieving the absence of a sober mom during the wedding planning process, so even though I knew what to do I kept asking as if to remind others ” Hey my mom is an addict and it sucks and it’s not fair.”

    So hey, your brother is an addict and it sucks and it’s not fair. I wish your sober brother could be at your wedding.

  • Anon

    We also have a family member who has addiction issues who may be attending the wedding. We’re not worried that he’ll cause a scene, but have been considering what to do about cards, if she attends.
    We’re probably not going to do a card box, but may have some other designated area for cards. I’m also planning to have a designated card collector to scoop the cards after the cocktail hour, and give them to a designated family member.
    We’re not sure if the addict family member would steal cards or not, but we’d like to avoid temptation if possible. Just another two cents to think about if you’re planning with addicts around!

  • Aubry

    I just wanted to pipe up on the question of what will my parents say if people ask awkwardness. Just say “He couldn’t make it” *insert other person’s polite response* “Yes, it’s too bad” *Smiles* and move along. Sometimes when you know this big heavy piece of knowledge it seems like everyone will pry you for answers, but really people generally know that if you offer a intentionally vague answer and refuse to go deeper they need to leave well enough alone.

    Good luck, it sounds like this sucks right now. I’ve had experience will addiction and in once instance I had to cut a long time friend out of my life, and in another my family member is making an amazing recovery. He is years sober, going to university with a great GPA, and has a loving girlfriend who is not involved in the community he used to be a part of. I hope that everything turns out for the best with your family, whatever that means.

  • Mandertron

    “…focusing on keeping up appearances can have negative consequences.”
    So true! It took me 29 years to figure that one out. The anxiety of inviting a family member who is too ill to truly be there for you might not be worth the photographs.

  • http://anniecardi.wordpress.com/ anniecm

    As someone who’s had similar family drama and been around friends’ similar family drama, I can say that your extended family and friends may already know that your brother is dealing with some major issues and know better than to ask about him at your wedding if he’s absent. Or, if he’s present and causes a scene, they’ll know that he’s dealing with addiction and, well, things happen. I know I always stressed WAY more about what other people would think when it came to my own family. When it’s someone else’s family, there’s way less judgment.