“What lies behind us and what lies before us are tiny matters compared to what lies within us.” —Ralph Waldo Emerson
What lies within us are all the experiences, interactions, emotional styles, physicality, nervous system responses, generational memories, styles of behavior, values and beliefs of our primary caregivers – our families.
As more and more studies come forth indicating that addictive disease is a brain disease, that the chemistry of the person with the primary disease is not “normal” and often may have been abnormal even before the drug or alcohol use, one can begin to ask the question, “What’s going on?” What about the genetics? Is the fact that addiction occurring in multi-generational families is totally related to genes that are not functioning properly? If so, how does this start? Who is “patient zero”?
Let us begin to ask some new questions. What, for example, is the impact of trauma in a family on the genetic makeup of its members? Can it change in one or two generations? What is the impact on the central nervous system, the chemistry? Can it be possible that addiction in a family member can have a traumatic impact on other members of the family – the spouse, the parents and the children?
So here, I believe, is the main question. There are some of the most talented people one can imagine — intelligent, caring, compassionate — treating those afflicted with the primary disease of addiction. However, in not making treatment and therapy easily available to those people with the secondary impact of addiction, are we almost guaranteeing that this affliction will go on to the next generation?
Most practitioners who work with treatment and recovery have experienced the simple fact that the alcoholic/addict is much easier to convince to attend 12-step, self-help meetings — often daily — than to convince family members to attend 12-step, self-help meetings related to co-dependency, once a week.
This is the fiction that we live with: “I’m not the person with the problem. If he/she gets better, I’ll be fine. The problem with me is you.” Perhaps the biggest fiction is, “The children are not affected; they are fine, and there is no need to talk to them. We’ll tell them that daddy/mommy is away working or visiting”. Children always know what is happening in a family; what they are often unable to do is articulate their knowing. However, they know and they also know that it must be bad because no one is talking about it to them; no one is helping them to understand and find language to talk and be comforted. So they learn to comfort themselves, they learn to be afraid of things not spoken; they learn to become hyper-vigilant, super-quiet or super-good. They know. Emotionally, they know. Physiologically, they know. The next question is in what way this might affect not only their adult lives, but also the lives of their children.
Psychological stress (trauma) is a type of damage to the psyche that occurs as a result of a traumatic event or series of events. The heightened arousal of a child’s primary caregiver signals danger to the child. Without knowing what is wrong, they nevertheless begin to physiologically imitate the nervous system responses of their parents.
With increasing levels of stress (or trauma) we begin to see some signs of insecure attachment. Secure attachment is a form of affect regulation. Damage may involve physical changes inside the brain and to brain chemistry, which damage the person’s ability to adequately cope with stress.
With exposure to trauma as a child, a person may re-experience the trauma and try to avoid trauma reminders. Often, the person is completely unaware of what is happening and begins to engage in disruptive or self-destructive coping mechanisms.
The brain uses epinephrine to execute autonomic and neuroendocrine responses, serving as a global alarm system. The autonomic nervous system provides the rapid response to stress known as the fight-or-flight response. The interactions between the mental state, nervous and immune systems can impair developmental growth in children, which later alters their perceptions of, and reactions to, stress.
The trauma associated with addiction in a family is similar to a bomb
going off in a room. Everyone is hit, but the family identifies only
one member as the problem. Whether that one person recovers or does not
recover, the family still has the autonomic trauma responses.
Since the other co-dependent family members believe the only problem is the identified “problem one”, no one seeks help. Each member in the family goes on to create their own families based on unhealed trauma.
“Childhood adversity, stemming from abuse, parental loss, witnessing of domestic violence or household dysfunction is a major cause of poor mental and physical health. One major consequence of early adversity is a markedly increased risk for substance use, abuse, and dependence“ (Chapman, ET. Al. 2004, Dube et al, 2003; Felitti, 2002).
From a Harvard Medical School study, we now have new information about stress on children.
“Under non-addictive states, the nucleus acumbens receives input from a number of brain regions, including the hippocampus and the prefrontal cortex. These inputs serve to modulate the response of the nucleus accumbens in a manner that is controlled, flexible, and contextually relevant. Following stress exposure, this system is less well modulated. Hippocampal gating of cortical inputs is reduced. Moreover, the prefrontal cortex inputs respond more selectively to drug-conditioned cues which is a vital critical factor leading to relapse.” 1
This study goes on to explain that with this loss of flexibility, the ability to experience stress relief easily, access pleasure and the simple joy of the world around us is significantly reduced… until a person with this brain state encounters a drug, such as alcohol, or other drugs (including some medication). At this point, the individual experiences relief, euphoria and relaxation, never before realized. This becomes the euphoric recall that presents itself in times of real or imagined stress. The negative consequences after the drug use are not stored in the same manner.
When we look at family members who have not developed the primary addiction, we frequently see patterns of behavior intended to soothe, relax and give pleasure. These behaviors have a similar impact as drugs to the addict. They work for a short while then need to be repeated….over and over and over. These behaviors include: shopping beyond one’s means daily or several times a week; Internet addiction; gambling; sexual compulsion; control issues; work that excludes balance; serial monogamy – always needing new relationships and the chemistry that goes with them; and food addiction of all kinds, such as compulsive overeating to starving oneself to binging and purging.
A study unrelated to addiction but of major importance was first introduced by Dr. Lars Olov Bygren, a preventive-health specialist who is now at the prestigious Karolinska Institute in Stockholm. He is a pioneer in the study of epigenetics, which is looking at how one’s environment and choices can influence your genetic code and that of your children – not over several generations, but immediately. We have always believed that the choices and circumstances of our lives might negatively impact our brains or bodies, but wouldn’t change our genes, our DNA . Now it appears that “stressors can activate epigenetic marks, modifying histones or adding methyl groups to DNA strands. These changes can turn genes on or off and may affect what gets passed down to your offspring. If you overstimulate genes for, say, obesity or a shortened life span, your kids can inherit these overactivated sequences. That could mean a lifetime of battling unfavorable gene expression”. 2
What can we do to begin to affect a change and not simply treat symptoms? Families need help as intensively as does the family member with the primary disease. Children need to be involved. Children are always involved in the problem; we need to involve them in the solutions.
Open up conversations appropriate to their age level and begin to teach them ways to become healthy, relieve stress, talk about whatever is bothering them, listen to what they are saying carefully and respond. The Betty Ford Center in California has a program, at an extremely reasonable rate, for children and a stand-alone program for co-dependents. Neither of these programs requires that one have a family member in treatment. There may be other similar programs around the country as well.
We need to focus and develop mechanisms to help families over a period of time – not just a week or weekend, but extended therapeutic intervention and training. If more interventionists included intensive family work – education; skills training; directing to treatment when possible; Al-anon and Alateen, over a period of months, we might begin to make some changes to this multi-generational affliction. Some have started doing this work – more is necessary.
1 From Neuroscience and Biobehavioral Reviews, a review of “Desperately driven and no brakes: Developmental stress exposure and subsequent risk for substance abuse”. By Susan L. Andersen and Martin H. Teicher, from a study of Developmental Biopsychiatry Research Program, McLean Hospital/Harvard Medical School, Belmont, MA
2 From “Why Your DNA Isn’t Your Destiny”, Time magazine, January 2010, by John Cloud, Vol. 175, No. 2