Addiction and the family, addiction affects the family as much as it affects the individual. Both sides affect each other over time.
Addiction is also a family disease. The attitudes and behaviors of family members towards the member with a substance problem affect the course of treatment, and the addicted member's relationship with the substance affects the other members of the family. As a result of this mutual interaction, a system is formed in the family. The existence of this system constitutes a risk factor for the individual with addiction problem. For the treatment of addiction, all family members should be aware of their attitudes and behaviors that trigger substance use and create a new system that includes new attitudes and behaviors that facilitate the course of recovery. For this, family members need to change the way they communicate with the individual with addiction problems. Instead of criticism, personalization and you-language communication, they should adopt more constructive I-language and reflective listening approaches. Instead of giving advice to the member with substance use problems, family members should listen carefully and without judgment. The family member should be given the opportunity to talk about the problems they have with the user. However, strict and clear new rules should be set. The user should not be the one pulling the strings in the family. Family members should start implementing a treatment-centered program that will prevent substance use.
Seeing that the new system is reassuring and supportive for him/her, the individual with substance use disorder will start to see his/her family as a positive resource instead of the substance in solving his/her emotional problems.
Family / Marriage / Couple Therapies
Marital problems are one of the most disturbing problems in human life. Every marriage has some problems, but sometimes the problems become unsolvable, causing couples to experience deep disappointment and making it difficult for the marriage to continue. However, it is possible to stop this negative trend. Although couples can sometimes achieve this through their own efforts and by developing problem-solving skills, professional help is often required and marital therapy is needed. Family and couple therapy aims to identify problems and improve the interaction and communication styles between couples, children and other family members in order to end conflicts and ensure marital peace.
At what point is it necessary to seek family therapy?
Many couples may need help from time to time throughout their marriage. It is not necessarily necessary to be in a troubled marriage to seek marriage therapy. Although it is not yet common in our country, many couples with strong marriages receive marriage counseling or participate in relationship development programs in order to further improve their relationships or to prevent problems that may arise.
Conflicted, troubled marriages are different from the ups and downs of most people's marital lives. In these marriages, disappointment in the relationship does not just come and go, it is not an occasional feeling but a constant one, and people are deeply dissatisfied with their marriage or, in the case of unmarried couples, with their relationship. In such marriages and relationships, there are frequent and increasingly violent fights. Fights do not lead to solutions, they only create a sense of exhaustion. But the relationship in troubled marriages is not always quarrelsome. In some marriages there are no fights, but the relationship is not of high quality, the spouses are completely disconnected from each other; they stop doing things for each other and stop communicating completely, and things start to get worse in married life.
Frequent arguments without resolution, loss of positive emotions, loss of friendship, sex and vitality are all signs that the marriage is in trouble. If there is neglect, withdrawal, violence and a complete lack of connection, the marriage is in serious trouble and the risk of divorce is high. It is not necessary to be officially married to talk about marital conflict. Marriage/couples therapy may also be needed for such problems in serious long-term relationships.
What kind of problems in marriage require therapy?
In couples with communication problems, the relationship may go well for a while in the early romantic stages of the relationship. However, if couples are not ready for the long-term tasks in marriage, problems start to arise after a while. Studies of couples show that the risk of marital disharmony and separation is higher in the early stages of marriage. However, conflicts also increase after the couple has children and the children become teenagers or leave home. Problems in marriage usually arise from communication problems, alcohol and substance abuse problems, individual psychiatric problems, inadequate problem solving skills, domestic violence, extramarital affairs, different perspectives of couples on child rearing, cultural differences and sexuality.
Sometimes marital problems are a direct result of individual psychiatric problems. Some problems such as alcohol-substance addiction, personality disorders, depression, anxiety disorders, schizophrenia, affective disorders may disrupt the family balance. In these cases, treatment of the family member with psychiatric problems is a priority.
Marital therapy is also necessary in the treatment of sexual problems. Because sexuality and other parts of marriage are interrelated. Sometimes marital problems affect sexual life, while sometimes sexual problems affect the whole marriage. Research shows that sexual dysfunctions and marital problems are often, but not always, seen together. In sexuality, there is a relationship between two people, only in this relationship, unlike in daily communication, emotions are expressed not only verbally but also with the body, so a problem in this area cannot be solved without communication. Even if the sexual problem of the spouses is independent from other areas of the marriage, there needs to be harmony and cooperation between them in solving the problem, and this communication can be achieved through marital therapy.
Marriage therapies can also be used in the treatment of children's problems. Unrest and tensions between spouses directly affect children. Therefore, in order to treat a psychological or psychiatric problem in children, it is necessary to eliminate the problems in the parents' marriage. Research shows that children exposed to conflict between parents have more behavioral problems and emotional problems. Harmony and disharmony in the family affect not only the internal life of children but also their social relationships. Children look up to their parents as role models in communication and problem solving. Therefore, in order to make children healthy, it is necessary to make the marriage healthy. Even if the child's problem develops independently of the parents' marital relationship, the parents need to act together in the treatment process and this requires a good relationship and cooperation, which is where marital therapy can be helpful.
Consequences of a troubled marriage
A stressful marriage has a very negative impact on both parties. It leads to problems such as pain, suffering, anxiety, anger, violent tendencies and depression. If it continues, there are studies showing that it also has a negative impact on physical health. Children who grow up in marriages with intense conflict have been shown to have more problems than other children.
What is marriage therapy?
There are effective treatments for marital problems. Couples can make their marriages satisfying again if they decide to work on their relationship and put enough effort into it.
Marriage requires certain skills such as understanding oneself, understanding one's partner, knowing how to argue, problem solving and accepting differences. Sometimes ineffective, negative behavioral patterns in the family we grew up in can be carried into the relationship, and sometimes the normal difficulties of life can make it difficult to maintain a happy marriage.
In a sense, marriage therapy involves communication, going beyond blaming each other, discovering one's own role in family problems, and problem solving.to focus on what is important, to develop positive behavioral patterns, to understand the personality traits of others, and to learn to reconcile differences that can be reconciled and accept those that cannot be reconciled.
There may be ongoing problem areas between spouses, certain issues where discussions intensify. The aim of marital therapy is to help spouses become able to talk about these issues and find solutions. The therapy process keeps the spouses on a course of progress even as they struggle with difficult problems and prevents the relationship from reaching a dead end.
But my wife doesn't want to come to therapy!
Starting marriage therapy is not easy. Sharing the problems of a very private life, such as marriage, with a stranger is difficult for most people and the idea of discussing problems in front of a therapist can be unpleasant. Couples have tried and failed to solve problems on their own, and conversations often turn into unresolved fights, so there is a fear that this will happen in therapy. They may feel that therapy cannot help them solve their marital problems. Anxiety about what to expect may prevent the person from coming to therapy.
Marriage therapy progresses more easily when it starts with the joint decision of the spouses: "there is a problem in our relationship, what can we do to fix it". Because in such a beginning, a significant part of the problem has already been overcome. Even if the problem and its solution are not known, both parties are aware that there is a problem and they are willing to change. Being able to come to a joint decision shows that there is a certain level of communication between the couple. Unfortunately, such a start is not always possible.
Some people find it difficult to seek help for their problems because of social conditioning or their personality structure. Sometimes, as a result of conflict in the relationship, one partner refuses to come to therapy. A common mistake is to suggest counseling during a fight or at a time when the problem is most intense, when the negative emotions have not yet subsided. Suggesting counseling at the wrong time delays or prevents counseling altogether. When one of the spouses says "let's go to a therapist" during a fight, the other party often perceives this as a criticism or an accusation of "sick person" or "you are the problem" and becomes defensive and refuses to meet.
If your partner does not accept the suggestion to go to therapy, it would be good to try to understand why and repeat the offer after some time has passed. Speaking calmly in a more appropriate environment, being careful not to use accusatory and critical expressions, explaining that we do not see the problem only in the other person, that we also have a role in the conflict and that we are ready to take our own responsibility for change, and speaking in a way that will relax the spouse and attract cooperation will increase participation in therapy.
If, despite all your efforts and encouragement, your partner refuses to go to therapy, you can start doing something on your own. Of course, it is difficult to fix a troubled marriage on your own, but at least by talking to a marriage or family therapist you can see your own role in the problems in the relationship and resolve the conflict.You can be informed about what you can do in assimilating and improving the relationship, how to approach your spouse, and perhaps you can succeed in convincing him/her to participate in therapy with the support and guidance of the therapist. Sometimes, when one of the spouses starts to receive counseling and achieves an improvement in the relationship with the changes he/she has made in himself/herself, his/her spouse may see this improvement in their marriage and start to trust the psychotherapy process and may later agree to participate in the process.
How are family and couple therapies performed at NPISTANBUL Brain Hospital?
In marriage therapies applied in our clinics within the NP Group, regardless of the reasons why couples apply for therapy, their marriages are first evaluated in all aspects. During the evaluation process, the spouses are interviewed together and separately and both parties are asked to define the problem and the history of the problem from their own perspective. Each of them is asked for their suggestions and thoughts on the solution and their expectations from the therapy are determined. In this process, psychometric tests and some scales to determine the type and severity of marital problems are applied to each of the spouses in order to understand the reflection of their personality traits and existing psychiatric illnesses, if any, on the marriage. In joint sessions, the communication style of the spouses and how they interact with each other are observed.
There are many types of couple therapy. Cognitive behavioral, psychoanalytic, structural, experiential, pragmatic experiental, existential and other schools of therapy are applied according to the orientation of the therapist.
In order to bring about change in the relationship during the therapy process, the therapist may give some homework to be practiced from one session to the next. There are several benefits of practicing these homework assignments. On the one hand, spouses see that the problems they are experiencing can be controlled. On the other hand, it is important for them to see that the solutions and the real permanent changes do not come from outside themselves, that it is not about the methods applied by the therapy/therapist, but about the changes they make in their own behaviors, and it is important in terms of increasing the sense of trust in their lives.
The duration of therapy may vary depending on the type and intensity of the problem and the rate of change in the individual. The number of sessions is determined according to developments. The intervals are arranged by taking into account that the sessions should be long enough to allow the subjects addressed in the sessions to be put into practice, but short enough not to allow old negative habits to continue. In the beginning, the sessions are generally started once a week, and as progress is made, the therapy is terminated by opening the intervals and diluting them towards the end to ensure that the change continues with the efforts of the individuals themselves.
Family Information Meetings
Free family trainings are organized once a week at our hospital.
The aim of the trainings
Addiction is a disease that affects not only the individual but also the whole family. For this reason, recognizing the disease of addiction will enable you to support your relatives with more accurate methods. In this program where information about what you can do during the recovery process of your relatives is shared, you will find solutions to common problems together with other addicted relatives.
Content of the Training
- What is Addiction?
"What is addiction? What kind of a disease is it? How is recovery from addiction possible?" - Substances and their effects
This session includes information about addictive substances and their effects. - Impact on Family
"How do families experience this disease? How does it affect families? What can be done?" is a session where topics such as these are discussed. - Steps to Change
"How should families behave in addiction treatment? What are the appropriate methods?" is a session where topics such as these are discussed. - Communication
"How can you establish healthy communication with your dependent relatives? What are the appropriate communication methods? "is a session where topics such as these are discussed. - Frequently Asked Questions
It is a session to discuss appropriate methods to deal with situations that challenge you during the healing process.
Duration and Mode of Participation:
The Family Education Program is intended for spouses, parents and adult children of alcohol or substance users.
Family Education is not a closed group work. The training program consists of a total of 6 sessions and continues continuously once a week. Families can enter from any session they want and complete all sessions in this way. The structure of the sessions is organized accordingly. However, since the last session is organized to reinforce the knowledge gained in the previous two sessions, it is recommended that families follow the last 3 sessions regularly.
