Addiction and family: addiction affects the family just as much as it affects the individual. Over time, both sides influence each other.
Addiction is also a family disease. The attitudes and behaviors of family members toward the member with a substance problem affect the course of treatment, while the substance-abusing member's relationship with the substance also affects other family members. As a result of this mutual interaction, a system is formed within the family. The existence of this system constitutes a risk factor for the individual with an addiction problem. For the treatment of addiction, all family members must become aware of the attitudes and behaviors that trigger substance use and create a new system containing new attitudes and behaviors that facilitate the course of recovery. To achieve this, family members need to create a change in their communication with the individual who has an addiction problem. Instead of communication styles such as criticism, personalization, and "you" language, they need to adopt more constructive approaches such as "I" language and reflective listening. Instead of giving advice to the member experiencing a substance use problem, family members should listen to him carefully and without judgment. The family member should be given the opportunity to talk about the problems he experiences with the user. In addition, firm and clear new rules must be established. The user should not be the one holding the reins in the family. Family members need to start implementing a treatment-oriented program that will prevent substance use.
Seeing that the new system is reassuring and supportive for him, the individual with a substance use disorder will begin to see his family as a positive resource instead of substances to solve his emotional problems.
Family / Marital / Couple Therapies
Marital problems are among the most distressing problems in human life. Some problems are experienced in every marriage, but sometimes problems become unsolvable, causing couples to experience deep disappointment and making the continuation of the marriage difficult. However, it is possible to stop this negative trend. Although couples can sometimes achieve this through their own efforts by developing problem-solving skills, professional help is often required, and the need for marriage therapy arises. Family and couple therapy aims to identify problems, end conflicts by improving the interaction and communication patterns between couples, children, and other family members, and ensure peace within the marriage.
At what point is it necessary to consult family therapy?
Many couples may need help from time to time throughout their marriage. It is not strictly necessary to be in a troubled marriage to receive marriage therapy. Although not yet very common in our country, many couples with healthy marriages seek marriage counseling or participate in relationship enhancement programs to further improve their relationships or prevent potential problems.
Conflicted, troubled marriages present a different situation 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 occasionally felt emotion but is chronic, and individuals feel a deep dissatisfaction from their marriage or, for unmarried couples, their relationship. In such marriages and relationships, frequent and increasingly intense fights occur. Fights do not lead to solutions; they only create a sense of exhaustion. But the relationship in troubled marriages is not always argumentative. In some marriages, there are no fights, but the relationship lacks quality; spouses are completely disconnected from each other, completely cutting off communication and doing things for each other, in which case things begin to get worse in marital life.
Unresolved frequent arguments, loss of positive emotions, and a decrease in friendship, sex, and vitality are signs that a marriage is troubled. If neglect, withdrawal, violence, and complete disconnection are present, it can be said that the marriage is in deep trouble and the risk of divorce is high. Being officially married is not a prerequisite to speak of marital conflict. Marital/couple therapy may also be needed for such problems in long-term serious relationships.
What kind of problems requiring therapy occur in marriage?
In couples with communication problems, the relationship may go well for a while during the early romantic period of the relationship. However, if couples are not prepared for the long-term tasks of marriage, problems begin to occur after a while. Studies on couples show that marital incompatibility and the risk of separation are higher in the early stages of marriage. In addition, conflicts also increase after the couple has a child and after the children transition into adolescence or leave the home. Problems in marriage generally arise in areas such as communication issues, alcohol and substance use problems, individual psychiatric problems in couples, inadequacy of problem-solving skills, domestic violence, extramarital affairs, different perspectives of couples on child-rearing, cultural differences, and sexuality.
Sometimes marital problems are directly the result of individual psychiatric problems. Family balances can be disrupted due to certain problems such as alcohol-substance addiction, personality disorders, depression, anxiety disorders, schizophrenia, and mood disorders. In these cases, the treatment of the family member with psychiatric problems is the priority.
Marriage therapy is also required in the treatment of sexual problems because sexuality and other aspects of marriage are interrelated. Sometimes problems in marriage affect sex life, while sometimes sexual problems affect the marriage as a whole. Studies reveal that sexual dysfunctions and marital problems are seen together most of the time, if not always. Sexuality involves a relationship between two people, and in this relationship, unlike daily communication, emotions are expressed not only verbally but also with the body; therefore, a problem in this area cannot be thought of as being resolved without communication. Even if the spouses' sexual problem is an independent problem from other areas of marriage, harmony and cooperation must exist between them while solving the problem, and this communication is provided through marriage therapy.
It may also be necessary to benefit from marriage therapies in the treatment of children's problems. Restlessness and tension between spouses directly affect children. Therefore, in order to treat a psychological or psychiatric problem in a child, the problems in the parents' marriage must be eliminated. Studies show that children exposed to interparental conflict have more behavioral problems and emotional issues. Harmony and discord experienced in the family affect not only the inner lives of children but also their social relationships. Children model their parents in communication and problem-solving. Therefore, to make children healthy, the marriage must be healthy. Even if the child's problem develops independently of the parents' marital relationship, the parents must act together during the treatment process, which requires a good relationship and cooperation, and marriage therapy is beneficial at this point.
Consequences of a troubled marriage
A stressful marriage leaves very negative effects on the parties involved. It leads to problems such as pain, feelings of grief, anxiety, anger, tendencies toward violence, and depression. If it continues, research shows that it also has a negative impact on physical health. Children growing up in highly conflicted marriages have been observed to have more problems than other children.
What is marriage therapy?
There are effective treatments for marital problems. If couples decide to work on their relationship and make sufficient effort, they can make their marriage satisfying again.
Marriage requires certain skills such as understanding oneself, understanding one's spouse, knowing how to argue, solving problems, and accepting differences. Sometimes ineffective, negative behavioral patterns from the family we grew up in can be carried into the relationship, and sometimes the normal hardships of life can make maintaining a happy marriage difficult.
What is done in marriage therapy is, in a sense, enabling them to learn to communicate, go beyond blaming each other, discover their own roles in the problems experienced in the family, focus on problem-solving, develop positive behavioral patterns, understand the other's personality characteristics, reconcile reconcilable differences, and accept irreconcilable aspects.
Ongoing problem areas between spouses may be specific topics where arguments concentrate. The goal in marriage therapy is to enable spouses to talk about these issues and help them find solutions. The therapy process ensures that spouses stay on a trajectory of progress even while struggling with difficult problems and prevents the relationship from reaching a dead end.
Fine, but my spouse doesn't want to come to therapy!
Starting marriage therapy is not easy. Sharing the problems of a very private life like marriage with a stranger is difficult for most people, and the thought of discussing problems in front of a therapist may not be appealing. Since couples try to solve problems on their own and fail, and conversations mostly turn into arguments that bring no solution, there is a fear that this will also happen during the therapy process. They may think therapy cannot help resolve marital problems. The anxiety of what to expect can deter a person from coming to therapy.
Marriage therapy progresses more easily when it starts with the joint decision of the spouses in the form of "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 distress and have a desire to change. Being able to make a joint decision and arrive together shows that a certain level of communication has been established between the couple. Unfortunately, such a beginning is not always possible.
For some people, asking for help with their problems is difficult due to social conditioning or personality structures. Sometimes, as a result of conflict in the relationship, one of the spouses refuses to come to therapy. The mistake often made is bringing up the suggestion of counseling during a fight or at a moment when the problem is intensely experienced, before the negative emotions have subsided. A suggestion made at the wrong time delays or completely prevents starting therapy. When one of the spouses says "let's go to a therapist" during a fight, the other party usually perceives this as criticism or an accusation of being a "sick person" or "the problem is you," becomes defensive, and refuses the session.
If your spouse does not accept the suggestion to go to therapy, it is good to try to understand the reason and repeat this offer after some time has passed. Having the conversation in a more suitable environment while calm, being careful not to use accusatory and critical expressions, and speaking in a way that will reassure and draw the spouse into cooperation by explaining at the beginning of the conversation that we do not see the problem solely in the other person, that he also has a role in the conflict, and that we are ready to take our share of responsibility for change will increase participation in therapy.
If, despite all your efforts and encouragement, your spouse refuses to go to therapy, you can start doing things on your own. Of course, it is difficult to fix a troubled marriage alone, but at least by talking to a marriage or family therapist, you can see your own role in the problems experienced in the relationship, get informed about what you can do to resolve the conflict and improve the relationship, how to approach your spouse, and perhaps succeed in persuading him to therapy with the support and guidance of the therapist. Sometimes, when one of the spouses starts getting counseling and achieves an improvement in the relationship through the changes he makes in himself, his spouse can then see this improvement in their marriage, begin to trust the psychotherapy process, and subsequently agree to join the process.
How are family and couple therapies conducted at NPİSTANBUL Brain Hospital?
In the marital therapies applied in our clinics within the NP Group, regardless of the reasons why couples apply for therapy, their marriage is first evaluated in all aspects. During the evaluation process, joint and separate interviews are conducted with the spouses, and both parties are asked to define the problem and the history of the problem from their own perspective. Their suggestions and thoughts on a solution are gathered, and their expectations from therapy are determined. In this process, psychometric tests and certain scales used to determine the type and severity of problems in the marriage are administered to each of the couples in order to understand how the spouses' personality traits and any existing psychiatric disorders reflect on the marriage. In joint sessions, the spouses' communication style with each other and how they interact are observed.
There are many types of couple therapy. Therapies from cognitive behavioral, psychoanalytic, structural, experiential, pragmatic-experiential, existential, and other schools are applied according to the therapist's orientation.
During the therapy process, certain homework assignments to be applied between one session and the next may be given by the therapist to ensure change in the relationship. Implementing these assignments has several benefits. On the one hand, spouses get to see that the problems they experience can be controlled. Another benefit is important in terms of seeing that solutions and real permanent changes do not come from outside themselves, and that they will happen through changes they make in their own behavior rather than methods applied by the therapy/therapist, thereby increasing the sense of confidence in their lives.
The duration of therapy can vary depending on the type and intensity of the problem experienced and the pace of change of the individuals. The number of sessions is determined according to developments. Session intervals are arranged by considering that they should be long enough to allow the topics discussed in the sessions to be put into practice, but short enough not to allow old negative habits to persist. Starting generally as once a week at the beginning, as progress is achieved, the intervals are widened to ensure that the change continues with the individuals' own efforts, and therapy is concluded by spacing them out towards the end.
Family Information Meetings
Free family training sessions are held at our hospital one day a week.
Purpose of the Trainings
Addiction is a disease that affects not only the individual himself but the entire family. Therefore, getting to know the disease of addiction will enable you to support your loved ones with more accurate methods. In this program, where information on what you can do during your loved ones' recovery process is shared, solutions will be sought around common problems together with other families of addicts.
Content of the Training
- What is Addiction?
This is a session where topics such as “What is addiction? What kind of disease is it? How does recovery happen in addiction?” are discussed. - Substances and Their Effects
This is a session containing information about addictive substances and their effects. - Impact on the Family
This is a session where topics such as “How do families experience this disease? How does it affect families? What can be done?” are discussed. - Steps to Change
This is a session where topics such as “How should families behave in addiction treatment? What are the appropriate methods?” are discussed. - Communication
This is a session where topics such as “How can you establish healthy communication with your addicted loved ones? What are the appropriate communication methods?” are discussed. - Frequently Asked Questions
This is a session where appropriate methods regarding situations that challenge you during the recovery process are discussed.
Duration and Format of the Training:
The Family Training Program is aimed at spouses, parents, and adult children of alcohol or substance users.
Family Training is not a closed group study. The training program consists of a total of 6 sessions and continues uninterruptedly once a week. Families can enter from any session they wish and thus complete all sessions. The structure of the sessions is organized accordingly. However, since the last session is organized to reinforce the knowledge acquired in the previous two sessions, it is recommended that families regularly follow the last 3 sessions.
