The Dangers Of Launching While Intoxicated- LWI And Arrested Development

By Ronald B Cohen,MD

Launching LWI

The stresses of helping to guide and facilitate our adolescent and young adult children’s journey to economic and emotional self-sufficiency are greatly compounded by misuse of both legal and illegal “mind altering substances”, as well as misappropriation of prescription medications. Alcoholism, substance abuse, and chemical dependence can be devastating to the individual and the family. Alcoholism is a systemic process that requires a systemic solution.

Alcoholism and chemical addictions affect the psychology of entire families. While waiting for sobriety many families fall apart. Family therapy helps initiate change even when the alcoholic denies the problem and is unwilling to seek help. Engaging the entire family has multiple benefits in multiple domains including treatment outcomes, patient recovery, family recovery, long-term maintenance of sobriety and prevention of alcoholism in other family members.

The relational traumas of chemical dependence include:

• A chaotic, unpredictable, and often unsafe home environment
• Marital discord, infidelity, separation and divorce
• Child, parental, and spousal abuse and/or neglect
• Inappropriate hypersexuality and incest
• Cutoffs and estrangement
• Disruption of family life cycle stages

Bowen Family Systems Therapy treats the individual with a chemical dependence as part of a family unit that has a multigenerational history that led to addictive behavior. Intergenerational patterns of power, loss and control (“overfunctioning” or “overresponsibility”), transmit poisonous attitudes from parent to child. If left unresolved, these problems often remain, even after sustained sobriety. Recovery from alcoholism and substance abuse involves healing the emotional relationships of all members of the family.

One of the paramount concerns for sober family members is being recognized as individuals in need of assistance. Family members must first learn to cope with their own problems before any beneficial effects can reach the individual with chemical dependence. Reducing the negative impact of chemical dependence is protective of future generations.

The advantages of family involvement include:

• Providing Cohesiveness and Support
• Undermining Denial
• Addressing cognitive distortions
• Promoting abstinence and adherence to the treatment plan
• Relapse Prevention

Twelve step programs (AA, Al-Anon & Ala-Teen) are critically important parts of treatment for individuals with chemical dependence and their families. During the crucial first year of sobriety, the family’s tasks include learning new behavioral skills for coping with stress and conflict in order to adjust to a change in lifestyle that supports both abstinence and a stable family system, thereby developing healthy interdependence and family reorganization.

In their landmark book, The Responsibility Trap: A Blueprint for Treating the Alcoholic Family, Claudia Bepko and Jo Ann Krestan introduced three key constructs central to the understanding and treatment of addiction in family systems: (1) over- and under responsibility; (2) pride, shame, and power; and (3) the role of alcohol as a mediator of gender role construction. They also define the “co-alcoholic” as the overresponsible and overfunctioning non-drinking family member, be it parent, child or spouse, who is as nonresponsible as the underesponsible alcoholic. Both the non-drinking person and the one drinking alcoholically share a complementary process of abdicating responsibility for self.

Bepko and Krestan further delineate three stages in the family recovery process:

(1) attainment of sobriety,
(2) adjustment to sobriety
(3) long-term maintenance of sobriety.

It is vital to prepare the family for the “crises of sobriety” which engenders bitterness, resentment, fear, rage and a sense of “unjust demotion” in the coalcoholic. This necessitates a re-organization of the family in order to establish healthy relationships, address other family issues, and help achieve desired level of intimacy. The adjustment to a more functional lifestyle that supports both abstinence and a stable family system requires family members to break out of the responsibility trap and adapt to new roles.

Children are molded by the alcoholic family to be over-responsible (calm, efficient but lonely and filled with self doubt) or under-responsible (filled with rage, demanding constant care and praise, but filled with violent resentment towards anyone that helps them). Conversely over- and under-functioning in families and relationships provides a welcome mat into people’s homes for alcohol and addictive chemicals. Therapeutic interventions are aimed at modifying ineffective and inefficient family patterns in which symptomatic behavior is embedded. The goal is to solve problems in current relationships so as not to leave a damaging legacy for the next generation.

In their delineation of the six stages of the family life cycle, Betty Carter and Monica McGoldrick begin with a focus on the individual young adult. This Family Life Cycle transition, Becoming an Adult: Leaving Home and Staying Connected, begins with the adolescent’s struggle for identity and independence, and continues with the development of autonomy, healthy emotional interdependence, and self-differentiation during young adulthood. Developmental tasks include differentiation of self in relationship to the family one grew up in, development of intimate peer relationships, and establishment of financial responsibility and independence. Ideally one can stay meaningfully connected to significant others yet remain autonomous in one’s own emotional functioning.

Seen from the larger systemic family perspective of parenting adolescents and launching young adult children, key developmental changes in family structure, process and function include increased flexibility of family boundaries, expansion of the empathic envelope, and shifts of relationships from parent-child to co-equal adults. Taken together, the sum total is that “Launching” is a relational task, children have to launch and parents have to launch them.

A young adult’s tasks in this launching phase transition are primarily focused on the development of autonomy and healthy emotional interdependence. The parents’ tasks begin with facilitating the transition from the parent-child relationship to a more co-equal adult-to-adult relationship. In addition, parents must attend to other midlife developmental tasks including becoming a couple again and resolving issues with their parents, caring giving and adapting to their death.

Family members often fail one another in important and painful ways during this life cycle stage, yet they remain family forever and must find their way forward together. Failure to launch results in both fusion and enmeshment, wherein the young adult does not “leave home”, or distance, cut offs and estrangement, where contact is kept to a minimum or not at all. Either way the members of the family remain highly reactive to each other, tied up in not being free to develop and grow.

Substance abuse and chemical dependence can have a devastating effect on the individual and the family during these life-cycle transitions. Family therapy can help families become aware of their own needs and aid in the goal of keeping substance abuse from moving from one generation to another. Family conflicts, low family support, drug use among other family members and parenting stress have all been shown to contribute to relapse.

The goals of Family Therapy in the treatment of Chemical Dependence include:
(1) “Utilize the support and leverage of the family to reduce the individual’s drug use and implement other important lifestyle changes”
(2) “Alter problematic aspects of the family environment to maintain positive changes in the individual and other family members and promote long-term recovery”.

Ultimately we are all responsible for our own emotional well-being. In the alcoholic family, as in all families, one is powerless over anyone else. Coercion, blaming and distancing are rarely productive. Rather work to promote a consideration of reasons for change, increase awareness of discrepancies and negative consequences of not changing behavior, and increase sense of self-efficacy.

While the alcoholic is solely responsible for his/her sobriety, family behaviors can maintain an environment in which the task is much harder to achieve. However, change yourself and you change the relationship. Change the relationship and you give others in the system the best opportunity to do their own self-differentiation work.

Family Systems Coaching or “family therapy with one person” focuses on understanding the rules and roles of one’s family of origin and developing the freedom to make one’s own decisions. The goal is self-differentiation, the process of changing one’s part in old, repetitive, dysfunctional emotional patterns so that one is able to speak one’s personal views calmly and non reactively regardless of who is for or against them. What distinguishes Bowen Family Systems Coaching for Individuals is “Working with individuals to solve their problems with their families”

The goal of Family Systems Coaching is to help individuals proactively define themselves in relationship to others in their families without emotionally cutting off or giving in. The process of change is built upon ownership of one’s emotional reactions to old triggers and interactions. Family Systems Coaching offers individuals a process for making change in their relationships even without the participation of other family members. It is family therapy from the individual’s point of view.

modifying ineffective and inefficient family patterns in which symptomatic behavior is embedded. The goal is to solve problems in current relationships so as not to leave a damaging legacy for the next generation.

In their delineation of the six stages of the family life cycle, Betty Carter and Monica McGoldrick begin with a focus on the individual young adult. This Family Life Cycle transition, Becoming an Adult: Leaving Home and Staying Connected, begins with the adolescent’s struggle for identity and independence, and continues with the development of autonomy, healthy emotional interdependence, and self-differentiation during young adulthood. Developmental tasks include differentiation of self in relationship to the family one grew up in, development of intimate peer relationships, and establishment of financial
responsibility and independence. Ideally one can stay meaningfully connected to significant others yet remain autonomous in one’s own emotional functioning.

Seen from the larger systemic family perspective of parenting adolescents and launching young adult children, key developmental changes in family structure, process and function include increased flexibility of family boundaries, expansion of the empathic envelope, and shifts of relationships from parent-child to co-equal adults. Taken together, the sum total is that “Launching” is a relational task, children have to launch and parents have to launch them.

A young adult’s tasks in this launching phase transition are primarily focused on the development of autonomy and healthy emotional interdependence. The parents’ tasks begin with facilitating the transition from the parent-child relationship to a more co-equal adult-to-adult relationship. In addition, parents must attend to other midlife developmental tasks including becoming a couple again and resolving issues with their parents, caring giving and adapting to their death.

Family members often fail one another in important and painful ways during this life cycle stage, yet they remain family forever and must find their way forward together. Failure to launch results in both fusion and enmeshment, wherein the young adult does not “leave home”, or distance, cut offs and estrangement, where contact is kept to a minimum or not at all. Either way the members of the family remain highly reactive to each other, tied up in not being free to develop and grow.

Substance abuse and chemical dependence can have a devastating effect on the individual and the family during these life-cycle transitions. Family therapy can help families become aware of their own needs and aid in the goal of keeping substance abuse from moving from one generation to another. Family conflicts, low family support, drug use among other family members and parenting stress have all been shown to contribute to relapse.

The goals of Family Therapy in the treatment of Chemical Dependence include:
(1) “Utilize the support and leverage of the family to reduce the individual’s drug use and implement other important lifestyle changes”
(2) “Alter problematic aspects of the family environment to maintain positive changes in the individual and other family members and promote long-term recovery”.

Ultimately we are all responsible for our own emotional well-being. In the alcoholic family, as in all families, one is powerless over anyone else. Coercion, blaming and distancing are rarely productive. Rather work to promote a consideration of reasons for change, increase awareness of discrepancies and negative consequences of not changing behavior, and increase sense of self-efficacy.

While the alcoholic is solely responsible for his/her sobriety, family behaviors can maintain an environment in which the task is much harder to achieve. However, change yourself and you change the relationship. Change the relationship and you give others in the system the best opportunity to do their own self-differentiation work.

Family Systems Coaching or “family therapy with one person” focuses on understanding the rules and roles of one’s family of origin and developing the freedom to make one’s own decisions. The goal is self-differentiation, the process of changing one’s part in old, repetitive, dysfunctional emotional patterns so that one is able to speak one’s personal views calmly and non reactively regardless of who is for or against them. What distinguishes Bowen Family Systems Coaching for Individuals is “Working with individuals to solve their problems with their families”

The goal of Family Systems Coaching is to help individuals proactively define themselves in relationship to others in their families without emotionally cutting off or giving in. The process of change is built upon ownership of one’s emotional reactions to old triggers and interactions. Family Systems Coaching offers individuals a process for making change in their relationships even without the participation of other family members. It is family therapy from the individual’s point of view.

Family Systems Coaching teaches the possibility of dealing with differences without losing connection, which is one of the primary developmental tasks for a young adult. If you are tied up with all of the stuff and rules and roles of your family of origin, it is really hard to figure out whom you are and what you want to do with your life.

Family Systems Coaching promotes “differentiation in action,” guiding people through a process of changing their own participation in unsatisfying family relationship patterns. It is a conscientiously thought through approach to establishing a unique one-to-one relationship with every individual in the family system.

“All families can benefit from relational therapy. The good news is if one motivated family member changes in the context of relationship dynamics, the entire family’s functioning improves. The goal is to change your relationships with other members of your family of origin to improve your life and your family’s life regardless of what anybody else does. Taking responsibility for what you can take responsibility for and attending to your needs in the context of intimate relationships, opens the door to facilitating healing of the entire family.”

Working on self-differentiation in one’s family of origin is always available, is uniquely efficient and effective regardless of the situation, and cannot be sabotaged by anyone else. Family Systems Coaching helps parents and children become more self-directed, self-supporting and better able to make choices to change based on one’s internal beliefs, rather than slavishly conforming to or reflexively dismissing out of hand, the rules, roles, relationship requirements and rituals of one’s family of origin.

The good news is most families have successfully accomplished and completed this life cycle transition, thereby being well prepared for inevitable stressors of subsequent life cycle stages. For those stuck in pre-launch relationship patterns, consultation with a well trained Family Systems Coach can assist the family to expand its knowledge base and skill set, and help the entire family move forward in a positive direction.

Ronald B Cohen, MD is an Experienced Systemic Family Therapist and Board Certified Psychiatrist who specializes in Bowen Family Systems Coaching to help individuals, couples and families develop healthier, more satisfying relationships. The more responsible you can be to your own values and beliefs, the greater the likelihood of strong, resilient friendships and secure intimate partner relationships. Dr. Cohen trained in Bowen Family Systems Theory and Therapy at The Family Institute of Westchester, where he actively and planfully
experienced the anxiety and avoidance, the emotional impasses and seemingly immovable triangles, and the negative reactivity and pushback of working on self-differentiation in the family he grew up in.