alcoholism within a multigenerational traumagenic family framework
DESCRIPTION
This is a presentation that presents the nature of traumagenic family dynamics and how those dynamics support the inter-generational transmission of trauma and addictionsTRANSCRIPT
Alcoholism within a Multigenerational Traumagenic Family Framework
P. Robert Rhoton PsyD
www.Azturamatherapy.com
Psychological Health and Wellness
Today’s objectivesToday’s objectives
•Family Patterns Related to multi-general Alcoholism
•Traumagenic family patterns
•Addiction cycle
•Summary and Questions
What are Addictions?
Habitual patterns of intentional, appetitive behaviors
Become excessive and produce serious consequences
Stability of these problematic behavior patterns over time
Interrelated physiological and psychological components
Addicted individuals have difficulty modifying and stopping them
Traditional Models for Understanding Addictions Social/Environmental Models Genetic/Physiological Models Personality/Intra-psychic Models Coping/Social Learning Models Conditioning/Reinforcement Models Compulsive/Excessive Behavior Models Integrative Bio-Psycho-Social Models
A basic truth No single developmental model or
singular historical path can explain acquisition of and recovery from addictions
A focus on the process of development and maintenance of interacting systems can be useful to comprehending Alcohol use and family dynamics
BECOMING ADDICTED Happens over a Period of Time Has a Variable Course Involves a Variety of
Influencers/Predictors that can be both Risk and Protective Factors
Involves a Process of Change
Defining the Traumagenic Family
When patterned and habituated family behavior and interactions interrupt or interfere with the normal developmental (emotional, psychological, and social) processes --- this can be designated a traumagenic family structure.
Families with multigenerational Alcoholism meet the criteria of being traumagenic
WHAT DO WE KNOW ABOUT TRAUMAGENIC/ALCOHOLIC FAMILIES They are often socially isolated, and have little
emotional and financial support. Depression is a common factor in the neglect of
children. They are prone to use the same abusive techniques
with their own children, that they hated as children.
WHAT DO WE KNOW ABOUT TRAUMAGENIC/ALCOHOLIC FAMILIES They often show limited insight into the
complexity of the child's emotional and psychological needs and development
Such parents are at high risk to become overwhelmed and frustrated, and engage in hostile discipline and parenting as well as increased substance use.
Parents who do not understand these issues often attribute their child's misbehavior to willfulness on the child's part, a conscious intention to cause the parent aggravation and frustration.
WHAT DO WE KNOW ABOUT TRAUMAGENIC/ALCOHOLIC FAMILIES They often experience high levels of stress and
discord in their lives, often as a result of the chaotic and unhealthy environments in which they live.
The parents who have substance abuse problems show higher levels of marital discord and violence.
Substance abuse generally exacerbates stress, and stress is more likely to occur after a partner has been using substances. As a result, the children experience high levels of anxiety and become "emotionally overloaded."
WHAT DO WE KNOW ABOUT TRAUMAGENIC/ALCOHOLIC FAMILIES The children often feel responsible for the
stress, and experience intense feelings of helplessness and powerlessness related to dealing with the dynamics created by parents that use.
children receive inconsistent structure, support, and affection for extended and unpredictable periods of time. "Interrupted parenting" or a "wavering commitment" to parenting is most harmful.
WHAT DO WE KNOW ABOUT TRAUMAGENIC/ALCOHOLIC FAMILIES Sometimes children show extreme difficulty
bonding with the parent and feeling safe with them
Parents use power control strategies (e.g., threats, demands, disapproval), and fail to respond positively to the child's good behavior.
Parents respond to the child's increasing disobedience with more negative, controlling, and punitive behaviors, and the child's behavior becomes worse.
WHAT DO WE KNOW ABOUT TRAUMAGENIC/ALCOHOLIC FAMILIES The parent is likely to show hostility, be demanding
and rigid, and respond critically to the child. Family shows poor conflict resolution skills The children are likely to withdraw from the parent,
show more aggressive behavior and disobedience, and initiate poor quality positive peer and child-adult contact.
Children more likely to adopt and use family interactional style and abuse substances to cope with family dynamic
Five Traumagenic Family Themes DISCONNECTION & REJECTION
IMPAIRED AUTONOMY & PERFORMANCE
IMPAIRED LIMITS
OTHER-DIRECTEDNESS
OVERVIGILANCE & INHIBITION
Theme #1: DISCONNECTION & REJECTION A family Pattern where a child’s expectation
that their needs will not be met in a predictable manner. Especially those needs for:
1. Security and safety
2. Stability, nurturance, and empathy.
3. Sharing of feelings, acceptance, and respect.
Theme #1: DISCONNECTION & REJECTION The perceived instability or unreliability of those
available for support and connection. Involves the sense that significant others will not provide emotional support, connection, strength, or practical protection
Family members are emotionally unstable and unpredictable (e.g., angry outbursts), unreliable, or erratically present, frequently related to substance use.
Theme #1: DISCONNECTION & REJECTION The three major forms of deprivation are: Deprivation of Nurturance: Absence of attention,
affection, warmth, or companionship. Deprivation of Empathy: Absence of
understanding, listening, self-disclosure, or mutual sharing of feelings from others.
Deprivation of Protection: Absence of strength, direction, or guidance from others.
All forms of deprivation are increased with high levels of substance abuse in the family
Theme #1: DISCONNECTION & REJECTION Family members including children frequently have
the feeling that they are defective, bad, unwanted, inferior, or invalid in important respects; or unlovable.
May involve hypersensitivity to criticism, rejection, and blame; self-consciousness, comparisons, and insecurity around others; or a sense of shame regarding one's perceived flaws.
Theme #2 DEPENDENCE / INCOMPETENCE Belief that one is unable to handle one's
everyday responsibilities in a competent manner
Belief that without considerable help from others (e.g., take care of oneself, solve daily problems, exercise good judgment, tackle new tasks, make good decisions) one will fail
Belief that substance use will improve overall performance and ability.
Often appears as helplessness to others
Theme #2 DEPENDENCE / INCOMPETENCE Excessive emotional involvement and
closeness with one or more significant others (often parents), at the expense of full individuation or normal social development.
Often involves the belief that one cannot survive or be happy without the constant support of another or a substance.
Theme #3: IMPAIRED LIMITS Deficiency in internal limits, responsibility to others,
or long-term goal-orientation. Leads to difficulty respecting the rights of others,
cooperating with others, making commitments, or setting and meeting realistic personal goals.
Family pattern characterized by substantial substance abuse, permissiveness, overindulgence, lack of direction, or structure.
Poorly established limits in relation to taking responsibility, cooperating in a reciprocal manner, and setting goals.
Theme #4: OTHER-DIRECTEDNESS An excessive focus on the desires, feelings,
and responses of others, at the expense of one's own needs.
Behaviors to gain love and approval, or avoid retaliation.
Family patterns of conditional acceptance where family members must suppress aspects of themselves in order to gain love, attention, and approval.
Parental emotional needs and desires are valued more than the unique needs and feelings of each child.
Theme #5: OVERVIGILANCE & INHIBITION Excessive emphasis on suppressing one's
spontaneous feelings, impulses, and choices OR on meeting rigid, internalized rules and expectations about performance and ethical behavior often at the expense of happiness, self-expression, relaxation, close relationships, or health.
A family pattern that is demanding, punitive and focused on performance, duty, perfectionism.
A family pattern of hiding emotions, and avoiding mistakes dominate over pleasure, joy and relaxation.
Traumagenic Families Experience Agitation and irritability Sadness, grief, depression Feeling hopeless (nothing they do will make
things better) Feeling numb (poor or little recognition of
emotions) Suspicious/untrusting (constant testing of
every relationship)
Characteristics of children and adults
Victim Stance1. Blame others for not meeting responsibilities
2. Blames others for their inappropriate behavior
3. Always have a ready excuse
4. Fight for the right to be a victim
5. Resist efforts to appropriately solve problems that are causing them distress
6. Focus away from assuming responsibility
Characteristics of children and adults
Sense of Injustice1. View normal expectations as unfair
2. Refuses to follow “unfair” directions
3. Refuse to meet “unfair” expectations
4. Complain that the consequences for any of their actions that bring negative feed back or correction is unfair
Characteristics of children and adults
Uniqueness (Grandiosity)1. Claim that they are different or unique and
should have a different set of rules and expectations
2. Demand others understand them
3. Accuse others of not understanding them or making adequate efforts to understand them
4. Focus on how they are not understood rather than resolving problems or conflicts
Characteristics of children and adults
One way boundaries1. Demands respect and privacy in inappropriate
ways
2. Violates others privacy
3. No reciprocity in respecting the rights of person or property
4. Behaves suspiciously and then becomes enraged when those behaviors are questioned
Characteristics of children and adults
Concrete transactions1. Sees rules, guidelines, and restrictions as
obstacles that must be overcome
2. Manipulate others by being charming or compliant in order to avoid being held accountable to the rules
3. Focus on one-way rights (seeing their own rights and not the rights of others)
Characteristics of children and adults
Pride in Negativity1. Enjoy showing off their knowledge of negative
or inappropriate things
2. Gets power from negative behavior or ideas
3. Places high value on learning and knowing things that are hurtful, hateful, evil or demeaning to others
Characteristics of children and adults
Anger that is instrumental1. Loses control to get their own way
2. Trains others to avoid them when angry or else
3. Claim that they “lost control” after and aggresssive, destructive or abusive incident
4. Uses anger to have power in a situation
5. Others become timid and “walk on eggshells” when they have to discuss problems or responsibilities
Characteristics of children and adults
One way training1. Uses inappropriate behavior to train others to
give in to them
2. Uses inappropriate behavior when their wishes are opposed or resisted
3. Resists attempts to problem-solve and be re-directed
Characteristics of children and adults
One Way Role Models1. Models self after negative peers, neighbors,
the famous “bad” people
2. Adopts behaviors of negative role models
3. Act non-responsively to or directly reject positive role models
Characteristics of children and adults
Wishing1. Has unrealistically high opinion of their own skills and
abilities
2. Talks about how things will be but avoids goal setting or commitments designed to achieve goals
3. Acts as if talking about it is the same as doing it
4. Constantly put off activities or tasks which are perceived as “responsibilities”
5. Respond with anger when pressed to perform in a timely manner
Characteristics of children and adults
Casing (or) Sizing Up1. Size people up for how much power they have
and respond differently based on their view of that power
2. Reacts negatively to or dominates those that appear to have less power
3. Act charming toward those with more power4. Resist developing relationships with those that
might be more powerful than they or threaten their power
Characteristics of children and adults
Dishonesty and misinformation1. Use omission and vagueness to confuse or avoid
2. Pretend to have misunderstood
3. Keep secrets for no apparent reason
4. Tell others what they think the other wants to hear
5. Say yes and agree to avoid further feedback
6. Act confused when challenged on an inappropriate comment or behavior
Traumagenic Families Experience Emotional outbursts (screaming, yelling,
crying, etc) Self-soothing or distracting behaviors
including early on-set of substance use Poor communications (not effective and
responding to feedback well, or making behavioral changes based on feedback)
Social withdrawal
Traumagenic Families Experience Social isolative behaviors (doing things to
create distance) Poor Attachment (repeated failures to
effectively engage in a relationship, or maintain relationships)
Pre-occupation with stressors
Traumagenic Families Experience Difficulty concentrating, focusing or attending Appears inattentive or distracted Difficulty making effective decisions Difficulty following through on decisions to
accomplish goals Engages in pointless lies, deceptions or
partial truths to avoid
Highlights of the behaviors common for children raised in Traumagenic familiesImpaired executive functions:
Inhibiting Shifting Planning Organizing self-monitoring emotional control working memory
Stage I: Introductory Phase
Hangover/Feeling IllMay Be ExpensiveMay Be IllegalMay Miss Work
EnergyThinking AbilitySexual/Social ConfidenceEuphoriaWork OutputIncreased Status Relief from: Loneliness Insomnia Depression Anxiety
Parties
Special Occasions
Triggers
Responses
Infrequent Use
No Physiological Response
Pleasant thoughts about AOD
Stage I: Introductory Phase
Stage I: Introductory Phase
Confidence Boost
Sexual Enhancement
Social Lubricant
Boredom Relief
Depression Relief
Beginnings of Physiological DependenceFinancial ProblemsVocational DisruptionRelationship Concerns
Stage II: Maintenance Phase
Stage II: Maintenance Phase
Triggers
Responses
PartiesFriday NightsFriendsConcertsAlcohol“Good Times”Sexual Situations
Thoughts of AODCravings Occur as Use
ApproachesMild Physiological
ArousalEager Anticipation of
AOD UseOccasional Use
Stage II: Maintenance Phase
Social CurrencyOccasional EuphoriaRelief from LethargyRelief from Stress
Nose BleedsInfectionsRelationship DisruptionFamily DistressImpending Job Loss
Stage III: Disenchantment Phase
Stage III: Disenchantment Phase
Triggers
Responses
WeekendsAll FriendsStressBoredomAnxietyAfter WorkLoneliness
Continual Thoughts of AOD
Strong Physiological Arousal
Psychological Dependency
Strong CravingsFrequent Use
Stage III: Disenchantment Phase
Relief from FatigueRelief from StressRelief from Depression
Weight LossParanoiaLoss of FamilySeizuresSevere DepressionUnemploymentBankruptcy
Stage IV: Disaster Phase
Stage IV: Disaster Phase
Triggers
Responses
Any EmotionDayNightWorkNon-Work
Obsessive Thoughts about AOD
Powerful Automatic Response
Powerful Physiological Dependency
Automatic Use
Stage IV: Disaster Phase
No Simple Answer
What can we do to address the multigenerational nature of Alcoholism?
Family-focused Intervention & Prevention
Positive outcomes from rigorous studies
Increase Caregiver-child bondingIncrease effective Child managementIncrease Social, emotional and cognitive
competencies (e.g., problem solving, goal setting)Reduce substance use community wideIncrease effective mental health treatment
Objectives
─ Enhance family protective factors (e.g., caregiver-child bonding)
─ Reduce family-based risk factors for child problem behaviors
─ Reduce family-based risk factors for adult and caregiver problem behaviors
Family-focused Intervention & Prevention
Family-focused Intervention & Prevention
Improved parenting skills Improved youth skills (e.g., peer resistance, social
competencies) Improved school engagement and grades Decreased aggressive/destructive behaviors,
conduct problems Decreased mental health problems (e.g.,
depression)