Heroin Addiction as a Family Phenomenon: A New Conceptual Model

Abstract

The chronic relapsing nature of heroin addiction can be explained from a family systems viewpoint. The addiction cycle is part of a family pattern involving a complex homeostatic system of interlocking feedback mechanisms. These serve to maintain the addiction and consequently the overall family stability. Drug-taking usually starts at adolescence. It is related to an intense fear of separation experienced by the family in response to the addict's attempts at individuation. The family becomes stuck at a particular developmental stage. Heroin provides a solution at several levels to the dilemma of whether or not to allow him independence. Paradoxically, it permits him to simultaneously be both close and distant, "in" and "out", competent and incompetent, relative to his family of origin. This is pseudoindividuation. An understanding of these concepts, and their integration into a homeostatic model, can provide the basis for effective treatment.

Expanding the family systems approach: Cultural, class, developmental and gender influences in drug abuse

“…Some studies have focused on adolescent drug abusers (Coleman, 1980;Egger et al, 1978;Kaufman & Kaufmann, 1979;Klagsbrun & Davis, 1977;Madanes et al, 1980;Schwartzman & Bokos, 1979), while others have used a retrospective approach with older addicts (Alexander & Dibb, 1975;Duncan, 1978;Graeven & Schaef, 1978;Stanton et al, 1978). Still other studies examine the re-creation of family-of-origin problems in the family-of-procreation (Harbin & Mazier, 1975;Seldin, 1972).…”

“…In this formulation, the father is typically described as an alcoholic, who is separated emotionally and physically from the family, and uses physical punishment and harsh discipline. The father is seen either as a straw man to the mother's covert controlling influence in the family, or as distant and clearly secondary to the mother in power (Schwartzman & Bokos, 1979;Stanton et al, 1978). In this model, as well, the mother is overinvolved with the abuser.…”

“…An early theoretical conception postulates a mother-son dyad in the beginnings and maintenance of drug abuse (Stanton et al, 1978). This prototypic pattern for male addicts includes a mother who is overinvolved with the child who is described by the mother as "good, and "the easiest to raise."…”

The rescuing therapist: A duplication of the pathogenic family system

“…In essence, this involves exploring the need for the client to be a family "rescuer" (Stanton, 1977). By bearing the symptom, the client draws massive negative attention and, as is often the case, provides a forum for theparents'marriage, thereby rescuing the parents from focusing on problems in their relationship (Stanton et al, 1978).…”

“…In essence, this involves exploring the need for the client to be a family "rescuer" (Stanton, 1977). By bearing the symptom, the client draws massive negative attention and, as is often the case, provides a forum for theparents'marriage, thereby rescuing the parents from focusing on problems in their relationship (Stanton et al, 1978). Real help involves staying with the family and moving toward the source of the real stress, the parents' marriage or separation/divorce, and the messages they have lived out from their own parents in their families of origin.…”