Addiction Recovery and Support for Families

0:00:14 William Moyers
Hello and welcome to Let's Talk, a series of Podcasts produced by the Hazelden Betty Ford Foundation on substance use issues. Issues that matter to us as an organization and issues we know that matter to you too. Issues related to prevention, research, addiction, treatment and recovery from a substance use disorder. I'm your host William Moyers and today our topic is addiction recovery and support for families. I can't think of two better colleagues who are experts when it comes to addiction recovery in the family than my two who are joining me today, Sarah Schwalbach and Julia Edelman welcome to both of you.

0:00:53 Sarah and Julia
Thank you!

0:00:54 William Moyers
You are both therapists. Is that the right way to describe it, at the Hazelden Betty Ford Foundation Center for Youth in suburban Minneapolis in Plymouth, Minnesota?

0:01:02 Sarah Schwalbach 
You got it.

0:01:03 Julia Edelman
And we both work in the Family Program in particular.

0:01:06 Sarah Schwalbach
Yeah.

0:01:07 William Moyers
Okay and tell us just a little bit about the Family Program. The Family Program is for family members, why family members?

0:01:12 Sarah Schwalbach
'Cause there's a family recovery process. So it's a three and half day program that we offer to the family members of our clients who come through residential addiction treatment programs with us. It's also open to the public too. And we do a lot of education, we do a lot of processing, we help families navigate this journey.

0:01:35 William Moyers
So it's addiction that brings people to the facility but your goal is to help them begin their own recovery process?

0:01:41 Julia Edelman
Yes. Each and every person.

0:01:44 William Moyers
Why is that important? Recovery in the family. Whether or not the addict in the family recovers, the family must recover, right?

0:01:51 Julia Edelman
We don't know if the addicted individual is going to recover. Hopefully they will, right? But regardless, each person in the family needs to reclaim their own life. And they need to not go down with the ship if the ship is going to go down. And so, a lot of our work is around helping families redefine what their family is, who they are, who they wanna be, what's been lost, and how they can move forward.

0:02:18 William Moyers
So let's focus on a couple of things as it relates to that. One of them being trust. Another one being boundaries. Relapse. And then we're going to end up talking about resources that are available for family members. Sarah, talk to us about the toll that addiction takes on trust and how that trust is rebuilt.

0:02:35 Sarah Schwalbach
Yeah. There's a big toll that's taken on trust in families and in family relationships when addiction enters the picture. That trust is broken in a variety of ways.

0:02:48 William Moyers
Sure.

0:02:49 Sarah Schwalbach
And so it needs to be rebuilt in a number of ways.

0:02:53 William Moyers
How do you do it?

0:02:53 Sarah Schwalbach
Yeah. Through a few different ways come to mind. Boundaries, having clear, healthy, effective boundaries in place and following through with those boundaries with a loved one. You know we talk a lot about actions aligning with words. And when somebody's actions are aligning with their words, that's how trust is rebuilt, right? So we don't want to just give trust back unearned. It's something that needs to be rebuilt. Something too that I talk with families about quite a bit is thinking it's really easy for families to say we have to have these boundaries in place because we don't trust you. Trying to reframe that to, I want to build back trust with you, this is how we're going to do it, these are the boundaries that are in place, these are what the expectations are, and this is how we're going to be able to rebuild some trust.

0:03:51 William Moyers
I like that.

0:03:53 Julia Edelman
Sometimes I ask families to look at this as though you're looking at a computer screen. And if your computer screen looks anything like mine, it's filled with a bunch of icons, right? We're going to wipe all those icons off of the computer screen, we're going to start fresh.

0:04:09 Sarah Schwalbach
Mmm-hmm.

0:04:10 Julia Edelman
And we're just gonna put on the icons that matter the most to our family. So honesty, maybe family fun time, right? So we're just going to put on a few icons. We're going to start small so we have better chances for success, right? And then we can build from there.

0:04:32 Sarah Schwalbach
Mmm-hmm.

0:04:33 William Moyers
Parents are used to being parents right, when we're parents, we tend to be in our child's business for all the right reasons. But when you talk about boundaries, how do you set a boundary if you're a parent and still be the parent you want to be?

0:04:52 Julia Edelman
So, there's this phrase detaching with love that we often use.

0:04:56 William Moyers
Yes. Yes.

0:04:58 Julia Edelman
Right? And what does that mean is always the big question we get. So we're always parents. We'll be parents when we're 80 years old, 90 years old, right? How we parent is different and how we parent someone in active addiction is different than how we parent someone in early recovery is different from how we parent our kids when they have kids. So, it's very situational. A lot of our work is situational. We try to look at each family and help guide each family along. It's going to be different in each case.

0:05:33 Sarah Schwalbach
With parents too, we often talk about how they're powerless over the addiction. Right? Now even though you're powerless over the addiction, that doesn't mean that you're without influence. And so how do you leverage that influence to have the outcome that you're hoping for?

0:05:52 William Moyers
And talk about recovery in the family when the addict or the alcoholic in the family is not necessarily recovering? That's important right? Moms and Dads and siblings, we haven't talked about siblings, but Moms and Dads and sisters and brothers they need to take care of themselves no matter what, right?

0:06:09 Julia Edelman
Right. Absolutely.

0:06:11 Sarah Schwalbach
Yep.

0:06:12 Julia Edelman
Absolutely. So, understanding sometimes siblings get lost in helping to cover up their brother's or sister's addiction, right? So when they come to the Family Program, we give them a forum, a safe place, to talk about that. And they can ask themselves is this helping me, is this hurting me, usually it's hurting, right? So we give them an opportunity to talk about that.

0:06:38 Sarah Schwalbach
It comes back to boundaries too, or maybe plays into the boundaries topic. Family members having healthy boundaries for themselves. Modeling that behavior for their loved one is actually what's going to be most helpful.

0:06:51 William Moyers
And nobody masters this overnight or even in the four or five days that they're in the family and parent and sibling program, right?

0:06:59 Sarah Schwalbach
No.

0:06:59 Julia Edelman
Right. Recovery from addiction is a lifelong process.

0:07:01 William Moyers
Right.

0:07:01 Julia Edelman
As we often say, each day at a time. In early recovery it's each hour at a time. Same holds true for family members. And family members, as an addict might get triggered by driving by a liquor store one day, a parent may be triggered by their son or daughter not being home at curfew.

0:07:22 William Moyers
Mmm-hmm.

0:07:23 Julia Edelman
Right? So, they have choices. They can get in their car and they can start doing maybe their old behavior or driving around to all the friends' houses or the various venues to see if their son or daughter is there. Or they could call a sponsor from Al-Anon for example.

0:07:39 Sarah Schwalbach
Mmm-hmm.

0:07:39 Julia Edelman
Talk to their spouse or a good friend. Then, take the opportunity to talk to their son or their daughter the next day.

0:07:47 William Moyers
Mmm-hmm.

0:07:47 Julia Edelman 
We have to do things differently.

0:07:50 Sarah Schwalbach
Mmm-hmm.

0:07:51 William Moyers
Of course we do know that with the chronic illness of substance use disorder, chronic means it can come back and there are lots of experiences of relapse, or as we like to say, a recurrence of use. How does the recurrence of use, the relapse, factor into the boundaries that a parent might have? Does that mean that the parent just turns away and says whoop, you're on your own, good luck and don't come home or whatever? How does the family deal with that?

0:08:21 Sarah Schwalbach
It's going to vary from family to family. Each family has had a different journey, a different path to get them to the point that they're at now.

0:08:32 William Moyers
Mmm-hmm.

0:08:33 Sarah Schwalbach
So the family has to do what they're comfortable with. All is not lost if a relapse were to happen or recurrence were to happen. Families can often come out the other side much stronger than they were before. And the same for the addict/alcoholic, it can be a really big learning experience. Yeah.

0:08:54 Julia Edelman
And as we talk about a prevention plan for families. There's always a prevention plan for the clients and for the patients before they leave Hazelden Betty Ford. We also give the families an opportunity to have a prevention plan. And they talk about it with their loved one that's in addiction treatment. They talk as spouses or partners with one another about what that prevention plan is going to be. And it does go back once again to looking at values, setting boundaries, following through. But we really talk about if you're having these feelings come up, if you're finding yourself with an urge to drive around the town at 2:00 in the morning looking for your son or daughter, what do you do? Right?

0:09:40 William Moyers
I wanna talk about resources and support groups in just a moment but I want to end on a positive note there. And before we get there, I want to talk just a little bit about a reality that we have just become more keenly aware of in the opioid epidemic which is that sadly, when there's a recurrence of use, or when people relapse, often times that can lead to overdose and that can lead to death. It happens. And it's a reality of the illness. But that doesn't mean that the family can't recover, right?

0:10:10 Sarah Schwalbach
Mmm-hmm.

0:10:10 Julia Edelman
Right. Absolutely.

0:10:11 William Moyers
So what's your message to those families who might be tuning in today who've lost their son or their daughter or their sister or brother, or their grandchild, to this illness as it relates to their own recovery, what's the message?

0:10:25 Sarah Schwalbach
That there's hope. And that they can still choose recovery for themselves. Yeah.

0:10:32 Julia Edelman
We do talk about the process of grief regardless if there's been a loss in the family, we really look at a grieving process that we all go through. Elisabeth Kubler-Ross's stages of grief, we use that model because we have denial and we have bargaining and we have depression and hopefully we come through these stages of grief and we come into a place of acceptance. And I have seen even families that have lost a loved one to this insidious disease come to that place of acceptance and still hope.

0:11:08 Sarah Schwalbach
Right. And that acceptance doesn't mean that you ever forget or aren't impacted by the loss of a loved one. You come to a different place with it though. You're able to live.

0:11:24 William Moyers
Able to live.

0:11:23 Julia Edelman
That's yeah, and somehow oddly stronger families. And then we practice Step Twelve helping other people.

0:11:31 William Moyers
Yes.

0:11:31 Julia Edelman
Helping other families. Helping other people that are still suffering.

0:11:35 William Moyers
Let's talk about the resources and support groups that are available to families who may have a loved one in active addiction, or families who are, as the focus today is, on recovery. What are those resources that are available to them? We've talked a little bit about Al-Anon. Families Anonymous. What else?

0:11:52 Sarah Schwalbach
Whatever the family needs to do so that they can be taken care of themselves. Maybe that looks like individual therapy, maybe it looks like marriage/couple/family therapy, maybe it means getting connected with an Alcoholics Anonymous group for themselves. Getting reconnected with an AA group. Maybe it means getting connected with an Al-Anon group, or getting reconnected with an Al-Anon group.

0:12:14 Julia Edelman
Yeah.

0:12:15 Sarah Schwalbach
If they're local, there are lots of resources here in the Twin Cities.

0:12:20 Julia Edelman
I had the most beautiful experience a few months ago. There was a teenager who was recognizing a lack of resources for herself. So she started an Al-ATeen meeting in the neighborhood. I just thought wow, that takes a lot of chutzpah!

0:12:33 William Moyers
Hmm.

0:12:38 Sarah Schwalbach
Courage. Yeah, yeah, yeah.

0:12:40 Julia Edelman
It was really, really cool. So, there's also a lot of online resources. Personally, I'm a big believer and this was my path. I'm a big believer in walking into a meeting and being able to sit down and look at someone in the eye and say I need help, or I'm struggling. And so I really believe in the face-to-face and building a real, live community. But a lot of people do benefit from online communities. We all also know, I'll say, that there's a lot of isolation that happens with this disease, right?

0:13:14 William Moyers
Yes.

0:13:16 Julia Edelman
So, again, I'm making a case for just doing it in real-time and getting to a meeting whether it is, you know, for the parents or for the addict. But getting to a meeting and as a fallback, there is online community.

0:13:32 Sarah Schwalbach
Right. I agree with Julia that in person is probably what we would recommend, in person Al-Anon meetings. Those sorts of things. However, there is a time and a place and a space to augment with some online support. Including the Daily Pledge, that's a really good one that we have at Hazelden Betty Ford. There are online Al-Anon meetings, AA meetings, there's a caring families group online every Tuesday evening. So getting involved with some of those resources. Knowing that you're not alone.

0:14:06 William Moyers
Right.

0:14:07 Sarah Schwalbach
Yeah.

0:14:09 Julia Edelman
And then, of course there's personal resources. So, gosh I used to do yoga three times a week. I haven't done a sun salutation in a year! So, getting back to some of the things that really gave us some joy and health. Yep.

0:14:24 Sarah Schwalbach
Journaling. Gratitude.

0:14:25 Julia Edelman
Yes.

0:14:26 Sarah Schwalbach
Mindful—a mindfulness practice.

0:14:28 Julia Edelman
Absolutely.

0:14:29 William Moyers
And what about, just before we close 'cause we're almost out of time, what about parents who go to their son's or daughter's recovery meeting or sons and daughters that go to their parent's recovery meeting, is that okay, right? Or not?

0:14:43 Julia Edelman
It is. I believe that it is absolutely okay, but talk first. Check it out first. We had a young man who was in treatment for heroin and a Dad came through the Family Program a number of years ago. He also was in recovery from heroin. I thought it was the most beautiful thing. Dad said, 'Hey, would I be stamping on your toes if I went to a meeting with you? What do you think about that?' So they talked about it, they had some solidarity, they did go to a meeting together. But check it out first.

0:15:16 William Moyers
Mmm-hmm.

0:15:16 Julia Edelman
Same thing about sponsorship.

0:15:20 Sarah Schwalbach
Yeah.

0:15:20 Julia Edelman
Sometimes it's like oh yeah, Uncle Bob, he's been in recovery for 20 years, he'd be a great sponsor for you! Mmm, maybe not. Proceed with caution.
[They all grin and chuckle]

0:15:28 Sarah Schwalbach
Because that's Johnny's recovery process. That's part of his process to find his sponsor.

0:15:31 Julia Edelman
Yes. Yes.

0:15:35 Sarah Schwalbach
And so we don't wanna take that opportunity away from him.

0:15:39 Julia Edelman
Right. Right. And this is a program of attraction, right? So let Johnny find somebody who he really connects with.

0:15:44 Sarah Schwalbach
Right.

0:15:45 Julia Edelman
Maybe it's not Uncle Bob. Maybe it is! But eh.

0:15:49 William Moyers
Well, Julia Edelman and Sarah Schwalbach thank you very much for bringing your experience, strength, and hope, your professional expertise and that personal passion I can tell both of you have to our topic for today, addiction recovery and support for families. Thank you for all you're doing to help people to recover.

0:16:05 Julia Edelman
Thanks for having us.

0:16:06 Sarah Schwalbach
Thank you, William.

0:16:06 William Moyers
You're welcome. On behalf of all my colleagues at the Hazelden Betty Ford Foundation, I'm your host William Moyers and we thank you for another edition of Let's Talk, a series of Podcasts on the issues that really speak to the essence of recovery from a substance use disorder. I think the key message from all of these Podcasts is that there is hope. And we hope that you will hold onto that hope. At least until our next Podcast. So please join us again for Let's Talk. Thank you.