ADDICTION AND THE
FAMILY CYCLE
We are proposing that drug addiction can be
thought of as part of a cyclical process involving
three or more individuals, commonly the addict and his two parents or parent surrogates. These people form an intimate, interdependent, interpersonal system.
At times the equi-librium of this
interpersonal system is threatened, such as when discord between the parents is amplified to the point of impending separation. When this happens the addict becomes
activated, his behavior changes, and
he creates a situation
that dramatically focuses attention upon himself This
behavior can take a number of forms. For
example, he may lose his temper, come home high, commit a serious crime,
or overdose on drugs. Whatever its form, however, this action allows the parents to shift focus from their marital conflict to
a parental overinvolvement with him.
In effect, the movement is from an unstable dyadic interaction (e.g., parents
alone) to a more stable triadic
interaction (parents and addict). By focusing on the problems of the addict, no matter how severe or
life-threatening, the parents choose
a course that is apparently safer than dealing with long‑standing marital conflicts. Consequently—after the
marital crisis has been successfully
avoided—the addict shifts to a less provocative stance and begins to behave more competently. This is a new step in the
sequence. As the addict demonstrates increased competence, indi-cating that he can function independently of the
family—for example, by getting a job,
getting married, enrolling in a methadone program, or detoxifying—the parents are left to deal with
their previously unresolved conflicts.
At this point in the cycle marital tensions increase and the threat of separation arises. The addict then behaves in an attention-getting or self-destructive way,
and the dysfunctional triadic cycle continues.
This cycle can vary in its intensity. It may occur
in subdued form in treatment sessions
or during day-to-day interactions and conver-sations around the home. For example, a parent hinting at vacation-ing without the spouse may trigger a spurt of loud
talking by the addict. If the stakes
are increased, the cycle becomes more explosive and the actions of all participants grow more serious and more dramatic; for example, the parents threatening
divorce might well be followed by the
addict's overdosing. Whatever the intensity level, however, we have observed such patterns so often
that we have almost come to take them
for granted. Viewed from this perspective, the behavior of the addict serves an important protective function and
helps to maintain the homeostatic balance of the family system.
The onset of
the addictive cycle appears in many cases to occur at the time of adolescence and is intensified as issues of the addict's
leaving home come to the fore. This developmental stage heralds difficult times for most families and requires
that the parents renego-tiate their
relationship—a relationship that will not include this child. However, since the parents of the addict
are unable to relate to each other
satisfactorily, the family reacts with panic when the integrity of the triadic relationship is
threatened. Thus we find that most
addicts' families become stabilized or stuck at this develop-mental stage in such a way that the addict remains
intimately in-volved with them on a
chronic basis. In addition to staying closely tied to the home, his failure to separate and become
autonomous may take several other
forms: (1) he may fail to develop stable, intimate (particularly heterosexual) relationships outside
the family; (2) he may fail to become
involved in a stable job, in school, or in another age-appropriate activity; (3) he may obtain work
that is well below his capabilities;
(4) he may become an addict.
The drug addict is locked in a dilemma. On the one
hand he is under great pressure to
remain intensely involved in the family (it may fall apart without him), while on the other,
sociocultural and psycho-biological
forces dictate that he establish intimate outside relation-ships. Addiction is
the unique paradoxical solution to the addict and his family's dilemma of
maintaining or dissolving the triadic inter-action. On the systems level, the addiction cycle serves to give the appearance of dramatic movement within the family
as the triad is dissolved, reestablished, dissolved, and reestablished again.
In addi-tion, the addict becomes involved in a homeostatic pattern of
shuttling back and forth between his peers
and his home. An interpersonal analysis
of the system reveals, however, that the addict forms rela-tionships with the drug culture that in effect reinf orce his
dependence on the family. Again, the
outside relationships can be considered as the arena for pseudoindependent and pseudocompetent behavior by the
addict while, paradoxically, the greater his involvement with the peer group, the more he becomes helpless, that is,
addicted. This helplessness is
redefined in a dependency-engendering way by the family, that is, as -sickness,- and is therefore acceptable.
SEPARATION' AND DEATH
The fear that these families show of the addict's
departure or de-velopment of outside relationships, that is, their fear of
separation, has another paradoxical
quality. At the same time that he is held back from attachments to others he is engaged in activity that can poten-tially end his life—for example, through drug
overdose. Yet this ultimate separation—death—is not viewed with the same terror
as are other types of separation. The
family seems to feel that his demise
will somehow preserve the family system or pattern. In the short run this may be so. Upon the addict's death,
the triadic inter-action is ostensibly
dissolved, but in fact the parents are united in grief and, once again,
can focus their attention on their child. Unlike addiction, however, this solution is only temporary. We have ob-served
that the parents eventually find that marital conflicts once again lead to either (1) the formation of a new
triad (e.g., another
