One of the frustrating things about working with substance abuse is a scenario that appears to repeat itself.  There might be different people filling the necessary roles, but certain themes present themselves over and over again. For example, there’s usually someone filling a “hero” role, someone filling a “good cop” role and, the one I see within substance abuse treatment, someone filling a “scapegoat” role.

Often, families come to need the substance abuser to continue using.  While it may sound strange, it’s a pattern that I do see and I think it’s rooted in the fact that, while the substance abuser is actively abusing substances, the individuals within the family can focus their attention on the substance abuser and not on themselves.  The substance abuser can become the scapegoat, of sorts, for those families whose relationships are toxic.  That is, the substance abuser is seen as the problem within the family and not anyone else.  Of course, no one cops to that feeling.  But it’s there, hidden from conscious thought.  To me, addiction and depression are similar in that they are both developmental and genetic.  Those families that need a substance abuser to remain a substance abuser need large mirrors such that they can see their own role within the substance abuse cycle.

For example, if a family demonstrates a history of Depression, then it can be clear that the family has a relationship with Depression.  That relationship will include ways of coping with the Depression.  It can become clear to see how a substance abuser emerges from the family with a history of Depression because there may be clues within that history that suggest that substance abuse, usually alcohol, is employed to cope with the Depression. That coping mechanism: Drinking alcohol is a symptom of a family system with a history of Depression.  Instead of being the scapegoat, perhaps the substance abuser is the necessary mirror.

No one lives in isolation.  For someone with an addiction, this is just as true.  Families and other social structures need to grow and change unhealthy behaviors and relationships such that someone who struggles with an addiction can also grow.  For any group of people to point their finger at a substance abuser and say, “he needs help” when that group is part of the addiction is little more that hypocrisy.  There’s no such thing as a person whose issues appeared out of the blue.  Family therapy is often a needed component of recovery.  It’s like this: An aspen’s leaves are green in the summer, gold in the fall, and non-existent in winter.  But throughout the seasons, the tree is simply responding to changes within its environment.  It remains the same, but the circumstances around the tree change.  If a person in recovery remains in the same circumstances, I can bet that, even if desire or readiness to change exists, he or she will continue to use.  It could be a simple matter of a family needing a scapegoat and ensuring, through persisting the role structure within the family, that the substance abuser can continue being the distraction the family needs.