Breaking the Intergenerational Cycle of Substance Abuse

Children raised in a household with one or more parents struggling with a substance use disorder often use compliance as a coping mechanism—a skill that often no longer serves them well in adulthood, according to an expert who spoke recently at the National Council Mental Health and Addictions Conference.

Teaching new skills to substitute for learned patterns can help break the intergenerational cycle of substance abuse, says Robert Neri, MA, LMHC, CAP, Senior Vice President/Chief Clinical Officer of the WestCare Foundation in St. Petersburg, Florida.

“We see a number of clients who have learned to be compliant because of how unpredictable the adults were in their life—they realized the best strategy was to blend into the woodwork, and not to make waves or test anyone,” he says. “Most kids test the adults around them, to stretch and make their world bigger, but in children living in families with substance abuse, compliance is a survival tool.”

Neri teaches his counseling staff that if a client does everything in treatment correctly, that can be a sign they are not internalizing, but rather simply adapting. “We see that with people who have been in treatment settings a lot—they learn not to make mistakes. But as the saying goes, ‘If you make an A in treatment, you make an F in recovery.’ We have to realize that mistakes are a wonderful opportunity to learn.” He encourages his staff to tell clients that making mistakes allows them to learn how to tolerate frustration.

Compliance is one key reason so many people with substance use disorders do well while in the criminal justice system, but relapse, often only days after they are released. “They do well in a structured environment, but when that structure goes away, the person hasn’t built any internal structure to rely on.”

Learning how to play is another coping skill Neri teaches clients. “Children who grow up in a family with substance abuse become pseudo-adults, learning how to take care of their parents,” Neri says. “They’ve missed their childhood. When we get them into treatment, they often avoid leisure-time activities. They are uncomfortable with these activities, because they never experienced them as children,” Neri observes.

Knowing who to trust is also a vital coping skill, according to Neri. “First, we have to acknowledge that not trusting people has, in many cases, probably kept them alive, but now they need to expand their interpersonal tools to learn how to trust,” he says. Clients learn how to evaluate who is trustworthy through exercises such as making a list of qualities they would want in a potential business partner, and interviewing members of their treatment group to see who matches the qualifications.

Clients who have spent years viewing themselves as victims can break the cycle of substance abuse by learning they are free to make choices, Neri states. “This gives them a model of empowerment, so they can take control and change the script.”

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    Gerald kozlowski

    August 22, 2014 at 12:41 PM

    As a former resident under Mr. Neri I would have to agree with this article, I for on did walk the walk of expectation so as not to make mistakes. But after almost 2 years when I did “Fall” ( it wasn’t to drugs or alcohol) he asked me to leave. From that point on I have lived my life with most of the lessons I learned from him. After 30years clean and sober and still made some mistakes I am eternally gratefull to him
    Gerald Kozlowski

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    Patti Herndon

    May 16, 2012 at 1:22 AM

    Thanks so much for this article. Great information!

    We know that there are biological, psychological and sociological factors that contribute to the development of maladaptive coping with alcohol/drugs. In addition, we understand that there are those individuals who develop addiction(s)(substance use disorder)even though ‘neither’ parent uses or abuses substances.
    This article speaks to something so very important. Typically, we do not encounter education/discussion of it outside of a university classroom or context of the field of Behavioral Science Professions…That being, ‘Family Systems/Family Roles Theory’.

    We all have so much to benefit from in our personal lives by doing our own learning about family systems, and the roles assigned to us in our childhood/family-of-origin (the family we grew up in).

    What we all have to gain in this kind of learning -and the applying of that learning to our lives/our relationships- will foster acceptance and peace regarding our past, as well as provide us with insights, hope and increasingly healthy perspectives toward our present and our future. i.e. the stuff that self efficacy, joy, purpose…quality of life… is built on.

    Encouraging us all to ‘get our google on’ regarding family systems and family roles theory :0)

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    Mary H

    May 15, 2012 at 5:14 PM

    What Mr. Neri states is very true however, most non addicted family members also engage in this behavior. Blending in the woodwork, rescuing, compliance, the survival tools go on and on for family members. What’s worse, they will be labeled that dirty word, enabler, when their misguided efforts for trying to help, just hinder. Where did the family members learn the misguided behavior and coping strategies, from the family of course. The cycle just keeps repeating unless everyone involved in addiction, including family members are treated.

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    kathryn page

    May 15, 2012 at 12:34 PM

    I love the point Neri makes. Also want to jump on the intergenerational topic with something that so often gets left out–how prenatal alcohol exposure predisposes us to addiction (along with the practices that lead to the next generation of scrambled-brain, addiction-prone people). It also makes effective treatment much more complicated.

    thanks for letting this somewhat sideways comment through!

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