Michele and I are sort of the go-to people in our family when it comes to addiction. Makes sense. In addition to both having had extended bouts with alcoholism and similar chemical complications to life in the Real World (well-known to the family at large, as our recovery has been), both of us have worked in the field of addiction treatment. Shel, in addition to her real world experience, is a Social Worker, Certified Addiction Professional, and Certified Mental Health Professional, presently a key person in a detox facility, and does private therapy. I’m no longer in the field, but still a very interested observer.

She’s the last of her line, in terms of the hereditary aspects of addictive disease, but there is enough on my side of the family to make up for it. The Celtic Virus is in our blood. Diabetes and addiction (which often go together) are the family diseases, and I can name half a dozen members of three generations (including spouses) who either admit to problems with alcohol or drugs, or who exhibit characteristics that make me suspect difficulties kept in check or under cover. From time to time, we get a phone call.

Given the conditions, you’d think it would be pretty easy: people you know, circumstances you’re at least somewhat familiar with, family ties, desire to help (if not be helped, in some cases), but you’d be wrong. If anything, it’s more complicated.

Let me hasten to point out that I’m speaking in a practical sense, not in the sense of willingness to help. First of all, codependency works both ways. When you have emotional ties to the people you’re trying to assist, the tough love that must be applied — not only to the “presenting member” but to the family as well — is considerably more difficult. On the other side of the fence, folks tend to expect more sympathy from a family member, and are sometimes jolted to discover that, in this context, a hard-nosed professional may lurk just beneath the surface of good ol’ easy-goin’ whomever. This is exacerbated by the facts of dealing with addiction, which often fly in the face of a great deal of learned behavior, habit, skewed relationships, guilt, wishful thinking, and are simply not intuitive for many family members.

The hands-off aspect of helping is especially hard. When decades have been devoted to caring for an individual, and perhaps even micro-managing their life, the approach of letting the loved one “stew in their own juice” is a really difficult pill to swallow — albeit an absolutely essential one. The first lesson that anyone in recovery must learn is that they are responsible for their own behavior and its results, and that can’t be learned when they have someone to help them avoid the fallout from their decisions.

As obvious as that may sound in the cold clear light of day, it’s different when the drunken son or daughter leaves treatment, gets high, and arrives at the door at 3:00 AM in the middle of a pouring rain. In that situation the only two acceptable courses are (a) driving them back to treatment immediately or (b) closing the door in their faces and, if necessary, calling the police to deal with the matter. When every ounce of your being wants to clutch them to your bosom — despite the smell — and simply Make Things OK, such measures come at great personal price. The less extreme examples of paying the rent, making sure there is food in the fridge, driving them places, making car payments and so forth all fall into the same category, yet aren’t they the things that a family is supposed to do when they are needed?

In a word, No.

People don’t change until they have an overpowering reason to change, and that never happens until they discover they’re no longer going to be taken care of. But it’s hard. It’s hard advice to take, and it’s hard advice to give to a loved one who is in pain about a beloved child, spouse or parent.

The nuts and bolts of helping a person into recovery are the easy part. Treatment is almost always available. Even indigent people, in most areas, have access to professional care. Perhaps they won’t be driven to Betty Ford in a limo, but help is there to be had. At the bare minimum, there are usually hospital emergency rooms and the rooms of the 12-step programs.

When it comes time to force the issue, however, there is always reluctance. Shame, the wish to do more, the neighbors, opinions of other family members, fear of alienating the loved one and many other pressures may come to the fore, and when the family find out that we strongly recommend a 12-step program in the community, well…. It rarely occurs to anyone that the community already knows about the problem — that their loved one hasn’t exactly been drinking, drugging and running amok in a vacuum. Family secrets run deeply, if seldom invisibly. Then the family discovers that we also recommend a 12-step program for them. “Hey, I’m OK! (S)he’s the sick one!”

Codependency. A killer disease, but an issue for another day.

So we do what we can. We recommend facilities, and put folks in touch with professionals. Ethically speaking, one does not treat family members, and it is seldom practical for other reasons as well. We provide what support we can, hope for the best, and hurt a bit along with our loved ones.

In the end, it’s family; and isn’t that what families do?