Adapting to and Addressing Addiction Issues in a Family System

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While all families have varied strengths and difficulties, addiction and other chronic behavioral health issues present significant risks to family well-being and wealth preservation. When those issues surface, advisors may need to adapt their skill sets to manage the impaired beneficiary and encourage the family to seek professional help.

Common misconceptions hold that wealth is a buffer from addiction and mental health issues, but recent research suggests a higher incidence of these issues within affluent communities. The reasons for this are varied, but in wealthy families where an individual lacks a daily accountability structure (e.g., a job, school), substance abuse and depression can become more acute. Similarly, the ability to evade the consequences of addiction may reduce the impetus to seek treatment and address the need for change.

The following case is illustrative:

Eliza was born into a family of generational wealth in an affluent area in New England. Always bright, rebellious and charming, Eliza skated through boarding school with little effort. Boredom and the endless search for novel fun accompanied her. She knew that she had not earned all of her gifts; they were hers at birth. She also had a genetic predisposition for addiction. By high school, Eliza was snorting heroin and cocaine. Drugs quieted her searching mind and provided the diversion from a life already made dull by the lack of struggle. Given Eliza’s unlimited resources she was a “functional” addict and was able to navigate school and maintain a reasonable grade point average.

Eliza’s sister, Anne, saw things differently. She noticed her sister’s changed physical appearance, her rapid speech patterns and erratic behavior. Anne saw a sister who used to be social with friends starting to isolate and avoid family events. Anne relayed her concerns to her parents but they dismissed her claims noting that Eliza was doing well enough in college. Extremely distraught with worry, Anne then sought the assistance of the advisor. This advisor was savvy about addiction and the impact on the family system and was able to be a voice of reason for the family and help coordinate professional help.

Fortunately the advisor in this situation took Anne seriously and noticed the signs and symptoms of addiction, such as changes in behavior and appearance. The “truth tellers” in an addicted family often behave in ways that make it is easy to discount their reports. They may seem like they are over-reacting or overly controlling, particularly if other members of the family discount their concerns or there hasn’t been a ‘crisis.” At times, those family members might appear sicker than the addicted and often struggle with stress-related emotional and physical problems from living or loving someone with an addictive disorder.

There may also be those in the family who are determined to protect the addicted loved one from any consequences of addiction, not out of mal-intent but out of a concern for preserving their loved one’s reputation and future. In Eliza’s case, her parents may have believed something to be slightly “off,” but wanted her to complete college. When consequences are shielded, the odds of a successful treatment are greatly reduced. Born of fear, protecting behavior, also known in the industry as “enabling,” shields the addicted loved one from potentially enlightening pain. This behavior can take the form of:

  • Remaining silent in the face of obvious drug and alcohol use even after addiction is acknowledged
  • Bailing out the addicted loved one from legal consequences time and time again
  • Keeping addiction secret from those who will most likely help
  • Allowing minor children to remain in unsafe living situations
  • Using drugs and alcohol with addicted loved ones

If the entire family is silent about its concern or it looks like they are all covering for their addicted loved one, there are still options for the advisor. First, gather factual information such as:

  • Absence from or disruptive presence at social gatherings, business meetings, philanthropic discussions, and other family events
  • Isolation and disconnection from siblings and parents; lack of a social network
  • Overspending
  • Inability to commit to completing any activity – school, work, philanthropic, and recreational endeavors
  • Legal issues
  • Medical problems that are commonly the result of addiction such as pancreatitis or liver ailments
  • Job or school suspensions
  • Overreaction to challenges; lack of coping skills

Next, we suggest that the advisor have a professional waiting in the wings with whom the family can consult. Specialists in behavioral health issues will aid the family in developing a plan of action. Their services range from educational resources, interventions, treatment center recommendations and long-term coaching, case management and planning

Once information is gathered, determine who in the family system would be most receptive to a conversation. In this case, Anne came forward, which made it easier to intervene. In cases where a family member does not clearly articulate concerns or hints around them, an advisor may use some of the language below to start the conversation:

  • Ask for permission
    • “May I raise a sensitive subject?”
  • Speak in the first person about the specifics observed
    • “I have observed that you or a loved one is struggling…”
    • “I am concerned about spending….”
  • Verbalize compassion
    • “I am concerned about your level of stress”
  • Normalize problems
    • “Every family has issues…”
  • Offer help
    • “How can I help you with this?”

While these language suggestions can help align an advisor with a family member and avoid any hint of judgment about the situation, there are still some risks involved with addressing the issue with the family. Family members may feel that you, as the advisor, are overstepping the bounds of your relationship. They may transfer their anger from a loved one’s behavior to you, and identify you as the problem. Other family members may just dismiss your concerns. The best tactic to avoid these dynamics is to raise the conversation gently, particularly with a family member who seems open to it and to encourage the engagement of a professional. Advisors can also independently consult with a professional to strategize the best approach in a particular situation.

The risks of jeopardizing a relationship with a client increase as an advisor provides uneducated advice about how to “solve” a problem (e.g., “cut him off”); if the advisor’s advice fails, the client may decide to leave the firm. Finally, while medical problems (e.g., hospitalization), school suspensions, and legal troubles due to addiction raise the level of stress in a family system, they also provide an opportunity for an advisor to introduce the use of professional resources.

Although raising a conversation has some risks, there are also risks in staying quiet. Advisors may appear to be ill-equipped to address important challenges for the family. Unaddressed addictions often lead to the following:

  • Mental health, addiction or other illness progress
  • Patterns of family dysfunction become entrenched
  • Resentment builds among family members
  • Family memories are tarnished or non-existent
  • Inheritance or resources diminish

Many advisors report that when there is “an elephant in the room,” like substance abuse, it is difficult for them to engage in work in other areas, such as governance or succession planning in a family business.

Addiction and other behavioral health disorders challenge a functioning family system as well as those of its team of professionals. If advisors want to help families preserve their resources, they may have to guide families towards professional support when an issue arises, even when families appear resistant or in denial. Advisors can also play a crucial role with families by encouraging them to be patient and supportive of a loved one’s involvement with a treatment professional. Addiction is a chronic disorder that needs long-term planning and care. The best outcomes in the addiction field are from those who have support and accountability services for a minimum of two years. Eliza benefited from her family member, advisor and a professional collaboratively working towards a goal of getting her the help she needed.

About the contributor

Arden O’Connor is the founder of the O’Connor Professional Group, a firm that addresses the needs of families and individuals struggling with an array of behavioral health issues. She can be reached at [email protected] . Arden will be presenting at the FFI global conference in Miami in October.