Parenting in Recovery: Accentuate the Positive

0:00:14 William Moyers
Hello! And welcome to another interview in our Let's Talk podcasts. From substance use prevention to quality research, treatment of addiction and recovery from it. These award-winning podcasts focus on the issues of importance to Hazelden Betty Ford. Issues that we know matter to you, too. I'm your host, William C. Moyers, and yes if you're a regular to these podcasts you'll note that it looks a little different around here today. As we all know a lot has changed in the world since our last round of podcast interviews back in the winter of 2020. Hazelden Betty Ford takes seriously the need to do everything possible to prevent the spread of coronavirus among our patients and our employees. Even here in the studio we are following public health guidelines. As a result, I can take off my mask for this interview because the production crew, the Executive Producer, and yes, even my guest, are elsewhere. Dr. Kate Gliske is a research scientist with the Hazelden Betty Ford Butler Center for Research. But for this interview, we are tapping into her expertise as a scientist with a doctorate in family science. She's joining us today to talk about the parent/child interactions and the stress that parents feel during recovery from an addiction. Dr. Gliske, thanks for joining us today.

0:01:28 Dr. Kate Gliske
Thanks for having me, William.

0:01:29 William Moyers
What is it about early recovery that impacts parenting so much?

0:01:33 Dr. Kate Gliske
Well, because we know that a major trigger for cravings occurs when people encounter stressful situations, any ongoing source of stress is in turn a risk for relapse. So, William, you have children, correct?

0:01:44 William Moyers
Yes. Yes.

0:01:44 Dr. Kate Gliske
Yep. And no matter what age children are, there are joys and difficulties. And, you know for me, I have two great kids. They're 2 and 5 years old. But on a fairly regular basis, they stress me out. [Moyers chuckles] Sometimes it's bigger things like when I'm worried that one is falling behind developmentally. But most of the time, it's smaller things like when they bicker with each other incessantly or cry for days on end. Or whine. And these little things tend to build up until I either deal with them internally, when I'm at my best, or when I blow up, when I'm at my worst. Parenting involves navigating a multitude of ongoing stressors even when everything is going fairly smoothly in a family system. Stressors that are exacerbated when a major stressor like addiction has entered into the picture.

0:02:32 William Moyers
And another major stressor could be like a virus—

0:02:34 Dr. Kate Gliske
Absolutely. Yep and then they all build up one on top of the other, leading to a really big stressful situation.

0:02:40 William Moyers
Yes. And so, tell us more about this family system.

0:02:45 Dr. Kate Gliske
Yep. So, I think one of the easiest ways to think about this is think about a baby's mobile that hangs above their crib—

0:02:49 William Moyers
Right. [gestures with hands] Going around.

0:02:51 Dr. Kate Gliske
Yep. And how all of the extensions balance each other out, they come to rest, and this is a really good example of a healthy family system. So, imagine then that you put a weight on one of the extensions. And what happens to the rest of the mobile? It's all out of whack. Yep. Everyone moves around and so, in a family system, anything that affects one person substantially, like an addiction, necessarily impacts all other aspects of the family system.

0:03:17 William Moyers
Hmm.

0:03:18 Dr. Kate Gliske
So, think about what would happen if you cut off one of the extensions. It would again—all, everything would rebalance, but eventually it would come to some semblance of normalcy.

0:03:27 William Moyers
Mmm-hmm. Mmm-hmm.

0:03:29 Dr. Kate Gliske
That's akin to a family of one of the parents leaving the family system to go to residential treatment. And or, even having to take a lot of time to devote to recovery activities. It's going to impact everyone. So, what happens when that parent returns to the family system? So, think about gluing or taping them back onto the main branch.

0:03:48 William Moyers
Right.

0:03:49 Dr. Kate Gliske
It's gonna disrupt everything once again. Even if it's positive change. It's still disruptive to the whole family. Every time a family system changes, the kids are thrown out of whack in this. And that can trigger a lot of negative emotions and behaviors. So, unlike adults, kids are not great at articulating how they feel. So, a five-year-old, it would be great if they could say 'Mom, when you left I was really sad and it hurt a lot and when you came back, I was so happy to see you but also still really mad at you that you left me in the first place.' [shakes head] No, that same child is going to hit the neighbor kids or cry all the time or act out in some way because kids show how they're feeling through their behaviors. There are a lot of risky components that collide here at this point in time. You have parents that are already stressed out because of the major ongoing stressor of dealing with their, or their spouse's, recovery from an addiction.

0:04:37 William Moyers
Mmm. Mmm-hmm. [nods]

0:04:40 Dr. Kate Gliske
You have kids that are suddenly acting out at the very time when you'd expect them to be acting their best. And that very behavior can be a powerful trigger for cravings and can lead to a cycle of negative interactions between parents and their children.

0:04:51 William Moyers
And those interactions, talk more about that.

0:04:54 Dr. Kate Gliske
We know that when parents are dealing with a major ongoing stressor like financial problems, military deployment, or in our case an addiction, that they themselves are stressed out and that that impacts their parenting skills. So, when I'm having a hard day at work, I am infinitely more likely to snap at my kids than days when I'm not dealing with stress otherwise. My tolerance is just lower. Research tells us that one of the main pathways linking family stressors to internalizing problems like depression, anxiety, and externalizing problems like acting out and lying in children is through that stressor's impact on parents' parenting skills. So, when parents are stressed out, they're more likely to initiate conflict with their children and to follow through with inconsistent discipline. Imagine a parent walks into a living room to find that their kids have torn it apart, moved all the furniture, after they spent copious amounts of time that morning cleaning up. [Moyers chuckles, nods] If the parent is having a hard day already, they're going to snap. They're gonna start yelling. 'How could you do this to me?! I spent so much time cleaning up!' And their reaction in turn—the kids—are they're gonna cry or they're gonna start angrily yelling back, and it's gonna escalate. They're going to feed off of each other. Until either the parent storms out because they're so upset or 'til the kids just through their tears do what the parent asks. But either way, it's—it doesn't end with a good outcome. It's not a positive impact on the relationship. And this is what is called a coercive interaction.

0:06:17 William Moyers
So, that doesn't sound like a good thing, this thing called coercive interaction. [grins]

0:06:22 Dr. Kate Gliske
No. No. Coercive interactions are not. And they are when one person uses aversive events or techniques to control the behavior of another person. So, think temper tantrums in a two-year-old. Or a parent screaming at their child to get them to do something. Both are experienced by the other person as highly negative and upsetting. So to escape the yelling, the parent or child will often comply. But it's at some cost to the relationship. This is where the concept of a family system is so important. Because this kind of aversive behavior, if it's not responded to by the other person in kind, will fizzle out on its own. So, if—one-to-three-year-olds, that's the peak of coercive behavior in children, and if every time a toddler melts down their parents respond with firm boundaries, not giving in, and in turn also are highlighting and reinforcing all the positive things that child is doing, then eventually by the time that three-year-old is a four or five-year-old, their pro-social behaviors are going to outweigh their anti-social behaviors.

0:07:22 Dr. Kate Gliske
[continued]
The problem with coercive interactions is that like anything else, they are learned. And they become automatic in a family system. And so, it's much harder to unlearn these processes when they've been embedded over a series of years. We know that one of the main trajectories that links substance use in adolescence, delinquency, arrests, poor academic outcomes later on starts in early childhood with kids seemingly acting out in pretty benign ways. But the problem is over time, that acting out, if it grows in kids, it can lead to pro-social peers rejecting them in school. So the kids have to go to the anti-social peer groups and those are the peer groups where these kind of behaviors tend to grow out of. The good news is that we also know that one of the best ways to disrupt this pattern is to teach parents skills. Like teaching through encouragement. How to set effective boundaries. How to monitor their kids. And if we do this, it helps them to feel like a more effective parent. And it turns out that like most things in life, when we are confident that we know what we're doing at something, we do a much better job at it. And that is true about parenting.

0:08:28 William Moyers
So you're talking about parenting—and we all know the dynamics of parenting and the challenges and the good opportunities with it—but then, of course, for the Let's Talk podcasts, we've gotta bring back in that dynamic of early recovery. What do families—what can they do?

0:08:45 Dr. Kate Gliske
So, parenting I always say is one of those things that is—it's one of the most challenging and important jobs that any of us are going to do in our lifetime—

0:08:52 William Moyers
Mmm. [nods]

0:08:53 Dr. Kate Gliske
And it's also the job that comes with no formal training. So, all of us are doing the best we can to figure out how we can do our best based on what we experienced ourselves or what we saw in others. It's normal that there are times when you're stumped. Fortunately, there have been several successful interventions developed for parents over the years to teach these kind of skill-based tools to add to our kind of proverbial parenting "toolbox." [uses air quotes]

0:09:18 William Moyers
Mmm-hmm.

0:09:18 Dr. Kate Gliske
That can really help particularly when families are under stress. So, we've learned a couple of things that I'm gonna just pull out, you know, for families that are in early recovery. The first is to focus on quality interactions with your kids. So, as I've talked about previously, early recovery is a time when parents need to stay engaged and connected to resources that support their ongoing sobriety. So they don't—you don't tend to have a lot of time left over. So if you don't have a lot of time, then you have to focus on quality time with your kids. And that's—even if it's fifteen minutes a day—intentionally prioritizing moments of positive connection with your kids is important. It's getting down on the floor and playing with them if they're little. Or playing a video game with them if they're older. Whatever it is, the more that we can give kids opportunities to have positive interactions with us, the less they're going to need to seek that behavior through negative acts on their part.

0:10:13 Dr. Kate Gliske
[continued]
The other really big thing that families can do is to prioritize activities that help them—you, as a parent—to better regulate your own emotions. Everyone knows that when you fly, part of the pre-flight instructions are that if the cabin depressurizes and masks fall, you put it on yourself first—

0:10:30 William Moyers
Right. Right. [grins]

0:10:30 Dr. Kate Gliske
—And then on your kids. Because you're no use to anyone if you pass out. The same is true in parenting. You have to take care of your own emotional needs so that you aren't at your worst and lashing out at your kids all the time. And luckily there's a lot of different resources out there from, you know, deep breathing techniques to mindfulness exercises, to yoga, whatever—you name it. So, think about that parent that walked into the room and found it torn apart by their kids. If that parent felt in themselves that their anger was rising, and instead of yelling at their kids right away, stepped out of the room and took some deep breaths, thought for maybe ten minutes 'til they cooled down again about what they could do differently, and then reentered the room, they're gonna address the situation much differently. They might calmly talk to the kids about how they're gonna clean up when they're done or better yet, they might join in and become another pirate on their kids' pirate ship.

0:11:19 William Moyers
Mmm-hmm. [nods, smiles]

0:11:21 Dr. Kate Gliske
Either way, it's a much more impactful and positive way leading to a much more positive outcome for not only parents but for the entire family.

0:11:29 William Moyers
We only have about two minutes left—let me just ask you this question. So what about, you know, bringing your children, age-appropriate, to you know your recovery meeting if you're a mom or a dad in early recovery? Is that—is that something that you would think would be a good idea?

0:11:45 Dr. Kate Gliske
I think anything that parents think that even making the offer to their children to see if they're interested in it—

0:11:50 William Moyers
Yes. [nods]

0:11:51 Dr. Kate Gliske
—I think the more quality time spent with your kids the better. I wouldn't necessarily take them to multiple hour-long meetings [Moyers nods]. If they're little, and expect them to be able to sit through it. You have to meet them where they are developmentally. But I—I think that there are a lot of ways that kids can be really integrated into the recovery process that parents just kind of assume they either don't want or don't need. And it's always better to just talk to them and come up with a solution that works for the whole family.

0:12:19 William Moyers
You know it's really interesting your knowledge is extraordinary and some of the suggestions that you've had it makes me think about when I was finally getting into early recovery in the early nineties and my children were six months old and twenty months old. My two boys. My daughter wasn't even born. And nobody in treatment was telling me how I should be a parent when I got outta there and I'm kinda wondering maybe that's something that should be incorporated into the treatment regimen. [chuckles]

0:12:43 Dr. Kate Gliske
Absolutely. I think that every person can benefit from parenting skills that are just overlooked as being something that we should know. And I think particularly families that have dealt with addiction and that are in early recovery could benefit from this more than almost anyone else.

0:12:58 William Moyers
Well we certainly benefitted from your insights today. Thank you, Dr. Gliske, for bringing those to us today. [turns to camera] And thanks to all of you for joining us. Be sure to tune in again for another edition of our regular podcasts, Let's Talk.