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Here at LITT, we often refer to this place we parents find ourselves in as a journey. It is helpful to break down the journey into stages to remind ourselves that there is movement and forward propulsion in this illness.
By the time most families come to us, they have moved through the early stages of this illness and are smack in the middle of the worst of it. Their child is often in what I refer to as Stage Three or possibly Stage Four. In identifying the stages, we can start to see the signs that indicate an upcoming shift and prepare to work with or support our child in the best possible way. To follow is a very general breakdown of the stages as I see them.
Stage #1 - Vulnerability
Our child is vulnerable to this disease. That is NOT to say we are responsible for what may ensue. But it is to say that our child may be predisposed either by genetics, trauma or because they suffer from anxiety and have a difficult time regulating mood or emotion. Research is revealing more every day about what makes some individuals vulnerable to this illness and we often discuss this in our meetings, but the bottom line is that we do not cause our child’s illness. It is possible that there may be ways we can identify this vulnerability and work with our child to head off the onset of addiction, but while research is—thankfully—ongoing, there is no formula for preventing the onset of illness.
Stage #2 - Dependence
This happens when our child, often as a teenager, begins to dabble in substances but is able to control their usage so that it doesn’t generally disrupt their life. They often work, go to school, play sports, raise their children, but there is periodic drug or alcohol binging and perhaps grades drop, work is missed, responsibilities are ignored. There are spaces between usage and perhaps some discomfort on their part, but their body is not so physically addicted that they need substances in order to avoid severe withdrawal and illness, though there might be withdrawal symptoms immediately following a binge or extended high similar to mild flu symptoms or exhaustion. They typically do not acknowledge in any way that they might have “a problem” and believe their usage is purely recreational.
"The ways in which we interact with our child during the course of their illness combined with our own selfcare and an enhanced understanding of what we are up against can go a long way in supporting best possible outcomes."
Stage #3 - Addiction Madness
At this point the addiction is physical and the brain is beginning to rewire itself. Daily effort goes into securing substances and there is a physical and painful reaction to being separated from drugs or alcohol. The ability to make good decisions is impaired and impulse control is severely compromised. In the beginning of this stage most individuals with a substance use disorder fail to acknowledge the illness and try to convince themselves that they are still in control of their usage even though it is wreaking havoc in their life. On the latter end of this stage there may be some acknowledgment that an illness exists, but they are not ready to seek help. This particular stage is the one in which many parents will find themselves shocked by the things their children say and do, the choices they appear to be making, the chaos they have brought into their lives. In a nutshell, we don’t recognize our child and it is a struggle to remember the child who lies within, buried under their illness.
Stage #4 - Recovery Dance
At some point, most addicted individuals will begin to realize the toll addiction has taken on their life and will make attempts to end the cycle. Some will start this process by trying—and usually failing—to detox themselves. Others will check into a recovery facility. Some go willingly and some are coerced. This is a first step and failure is likely. The first inpatient stay is usually an introduction to recovery with few choosing or able to stay in this zone for sustained periods of time. However, the person will be provided tools for their recovery and get some education as to what they are experiencing and what steps will need to be taken to move into full recovery. The cycle of recovery/relapse can go on for many months, even years, with the individual wobbling and waffling in and out of recovery. This is perhaps the most difficult stage for addicted individuals in that they struggle with the shame of their past, the shame of failure to stay in recovery, the intense anger and frustration of friends and family and the slow (two steps forward—one step back) healing of their damaged brain and low mood which is working to defeat them. Some days they are positive and upbeat about their future, determined to refrain from using and other days they are defeated, desperate, and certain that recovery is not in their future.
Stage #5 - Long-Term Recovery
Moving into stage five and taking the steps necessary to heal and abstain from drug use for the long-term is sometimes likened to a switch being thrown. It is often precipitated by an incident such as the loss of a friend, an overdose, or a personal revelation of some sort. Those who make this move into long-term recovery are usually supported by a sober community and a 12-step program. The choice to move into long-term recovery is less a choice about not using substances and more a series of daily choices to focus on selfcare, seek support, and recognize signs that precipitate relapse. The most common denominators amongst those in long-term recovery are acceptance of the illness, learning to take responsibility for the illness, letting go of blame and anger for their illness, self-forgiveness, and—above all—recognizing that the disease controls them and they do not control the disease.
I think it is important to recognize these broadly defined stages in assessing our child’s current disease state juxtaposed against the place in which we as loving parents find ourselves. In seeing this illness more broadly and as a journey that we are moving through with our child, we can be better prepared to support recovery and refrain from enabling. The ways in which we interact with our child during the course of their illness combined with our own selfcare and an enhanced understanding of what we are up against can go a long way in supporting best possible outcomes. This disease is a journey. The situation as it stands with our child today will surely shift and change moving forward. No matter where you and your child are in this journey, we can all work together to share our experience and help one another move forward.