DEALING WITH PARENTAL ISSUES
Although most of these families come to treatment
because of their drug-abusing member,
it is not uncommon for parental problems to eventually emerge in therapy. Two common ones, a parental mar-riage
problem and heavy drinking by a parent, are discussed here.
The Parents' Marriage
As
mentioned earlier, when positive change starts to occur in the IP's use of drugs, or he stops drug taking altogether,
problems in the parents' marriage are apt to
come to the fore. /t is crucial at this time for the
therapist to keep the parents working together and not to separate, at least until the crisis is over. If the therapist
puts stress on the
marriage by addressing it directly, he increases the likelihood of their separating. Thus he should defer dealing with such marital problems—glossing over them if need be—while
emphasizing team-work and the
family's working together toward a positive outcome The main idea is to continue
engaging these people in their roles as parents, not as spouses.
The inexperienced therapist is most likely to be
enticed into (prematurely) leaping to
the -hot" marital issue. He tends to think, -Now we're going where the problem really lies." He plunges in and is then surprised when the parents or family stop
coming to therapy. He fails to
recognize that what motivated these parents to
engage in therapy was the problem in their son
or daughter, not their own marital problem. If they had wanted to deal
with their marriage, they would have gone to
a marriage counselor, but they did not do this.* Usually one or both of them is tentative or denies the marital problem; for example, in the case described in
Chapter 7, the father notes a marital problem and the mother sidesteps
it, at least initially. Consequently, all the therapist has to go on at this
point—his primary source of leverage—is the
problem of the IP. It is for this problem, and perhaps no other, that the parents will convene. Conversely, dealing too soon with their marriage usually leads to an
aborted therapy—either one or both of
them will terminate prematurely—and the entire treatment effort will rapidly deteriorate.
On the other
hand, once the IP is stabilized and has been free of drugs for a time, it may
be possible to deal with problems within the parents'
marriage. Again, this applies only after there has been symptomatic improvement. At such a point, several things have to have
happened to make a difference: (1) from a theoretical standpoint, the system
must have changed in some way; (2) the parents may now possess a sense of accomplishment or even pride in having made progress; (3) they probably feel stronger in
general, and perhaps more hopeful or
willing to tackle their difficult marital issues; (4) usually they have a sense of being joined with the
therapist and are more trusting of
him, both because of the way he has supported them and because he has helped
them to succeed. This last factor is critical, for, as Haley66 notes, it is necessary for the parents to be able to lean
on the therapist, rather than the IP,
as they undergo the stress of dealing
with their marriage.
When the focus of therapy shifts to the parental
relationship, it is crucial to keep
the abuser and other family members from getting involved in the parents' problems. Often the IP will attempt to reenter their relationship after he has been clean
for a while, and the
Parental Drinking
As noted earlier, in the majority of families treated within the AFP, at least one parent had a drinking problem. In such a situation, many therapists are inclined to try to deal with this problem first, or at the same time that they deal with the IP's drug abuse, under the assump tion that therapeutic progress is otherwise not possible. However, it is our experience that this assumption is wrong, for several reasons.
First, it must be reiterated that the parents did not come to therapy for a drinking problem in one (or both) of them; they came to help their son or daughter. To ignore this notion is to misjudge their motives and trade a clear source of therapeutic leverage for one that probably does not exist. The second reason to initially avoid focusing on parental drinking is a structural one. The therapist wants to strengthen the parents as a subsystem and to weaken intergenera-tional coalitions. If he starts by confronting a parent about his drinking problem, he puts that parent in a one-down and weakened position, relative both to the other parent and to the children. Often the whole family will join the therapist in this attack and the entire enterprise will develop into a kicking game against the drinker. The drinking parent is then likely to become furious, withdraw from treatment, and be henceforth unavailable. He probably thinks to himself, -I went to the session to help my son and all I get is a bunch of crap from my spouse, kids, and that therapist. Who needs itr By allowing this to happen, the therapist has thus succeeded in turning the therapy
exactly counter to its goals.
In contrast, we recommend that the therapist devote considerable effort to joining the drinking parent—treating him with respect, noting his positive accomplishments, acknowledging his concern for the IP, soliciting his opinion, and even challenging him when he says
his opinion has little value—perhaps kidding him
with little remarks such as, -Don't give me that. You've
been working for 27 years. You know what goes on in the outside world a lot
more than anyone else in the family. I want to hear what you think
about this matter.- By building the drinker up to a
level of parity with his spouse, and above that of his children, the therapist
sets the stage for the two parents to work together and negotiate
a plan for the IP. Again, he works with them in their roles as parents. Of
course, he is also indirectly working on their relationship as
spouses within the total system, but this is
not his expressed goal.
Even when the drinking problem seems unavoidable,
such as when it interferes directly in the family's plan for the IP, the
therapist can deal with it in such a way that the drinker is not disparaged. For example, if a task is established for the
drinker and the IP to spend an hour or so
during the week engaged together in a particular activity, it may be possible to negotiate a contract with the
parent to postpone his drinking for a
brief period before, and also during, the activity, with the agreement that he resume drinking
afterward if he feels the necessity.
Or, as in Chapter 12, a contract can be drawn up in which the drinker agrees to take no alcohol during the
weekend when the son undergoes home
detoxification, or at least to abstain both several hours before and during his time on watch duty.
Despite the prevalence of drinking problems
among parents in the AFP population, we rarely dealt with them directly,
especially in the early and middle phases of therapy. The outcome data
presented in Chapter 17 indicate that there may have been some merit to our
position.
