Jane McGregor, Ph.D. MPH. PGCHE and Tim McGregor, RN, PG Dip.

communicating concern about addiction

Are you worried about a family member with an addiction problem? In this article we focus on the small changes that you can make to better communicate your concerns.

Sometimes the person with the addiction problem doesn’t seem to care about themselves or anyone else. They may struggle even to identify their own feelings, let alone the feelings of other people. The inability to identify and describe one’s own feelings occurs quite commonly in people who chronically use mood-altering substances (it is also recognized as a psychological syndrome called alexithymia).

Another reason people with addiction problems lack apparent empathy can be underlying mental health problems. Conditions like bipolar disorder or depression may cause the individual to block out the outside world and the people in it. The individual may feel emotionally empty and consider that others’ lives are far happier than their own, or they may become highly dependent and look to others as caretakers to rescue them.

So does addiction or lack of empathy come first? Research rather confusingly points in both directions. Evidence from studies of children who later developed chronic addiction problems suggests that loss of empathy often precedes drug use. There’s also evidence that this loss of empathy is made worse by becoming heavily reliant upon alcohol and other drugs.

Managing relations more effectively
Here are five ways to managing relations with the person you’re concerned about:

  1. Step back before you respond – your natural response to a person lacking concern like this may be a critical riposte. Trust that the other person does not mean to be difficult. Take time to think of your response, instead of reacting immediately. The more you can separate the behaviour from the person, the less likely is it that you’ll view their words or actions as a personal attack.
  2. Stop wishing they were different –the individual is not irritating on purpose. The best way to see a change in them is to change your own thinking and behaviour about them.
  3. Approach each interaction with an open mind – really listen to what the individual has to say and remain open to their viewpoint. When people feel your support they will be more willing to engage with you.
  4. Acknowledge differences in your points of view but don’t argue –an effective approach is to acknowledge their viewpoint and suggest that there may be more than one way to deal with the issue in question. This approach positions you as equal partners.
  5. Don’t be a difficult person yourself! – It is easy to identify someone else being difficult, but how often do you acknowledge that you can be difficult as well, especially when you feel stressed or tired? Recognize what triggers your own responses. Take responsibility for your actions and view yourself from the other person’s perspective so that you don’t become the person that others avoid.

Tips on better communication

Addiction is an entrenched behaviour that differs in severity. If you notice the warning signs of any of these behaviours in a friend or family member, you may be hesitant to say anything for fear of being mistaken or saying the wrong thing and alienating the person. Although it’s undeniably difficult to bring up such a sensitive issue, don’t let these worries keep you from voicing reasonable concerns.

Sometime people are afraid to ask for help. Sometimes they are struggling just as much as you are to find a way to start a conversation about their problem. Others have such low self-esteem they simply don’t feel they deserve any help. But the problem will only get worse if it goes unacknowledged, and the emotional and other damage can be severe. The sooner you start to help your partner, daughter or son, the better their chances of recovery. When you communicate your concerns, try to:

• Focus on feelings and relationships. Share your memories of specific times when you felt concerned about the person’s behaviour. Explain that you think these things may indicate that there could be a problem.
• Express concern about behaviour but do respect privacy. Your partner or child may well appreciate knowing that you are concerned and ask for help.
• Avoid power struggles over behaviour. Don’t demand change; avoid scare tactics, angry outbursts and put-downs. Trying to force someone to change behaviour when that person is not ready can make things worse.
• Do whatever you can to promote self-confidence and the belief that pulling off enduring change is indeed possible.
• Avoid prescribing both the speed of change and the solution. The pace of change and the solution must be determined by the individual.
• Don’t become so preoccupied with the other person’s problems that you neglect your own needs. Make sure you have your own support so that you can provide it in turn.
• Recovering from any entrenched behaviour problem takes time. There are no quick solutions or miracle cures so it’s important to have patience and compassion.

Listening and observational skills are two of the most important aspects of effective communication. Successful listening means understanding not just the words being communicated, but also how speakers feel about what they’re communicating. Good communication sometimes entails looking for humour in the situation. Humour can be a great way to relieve stress when communicating. And be willing to compromise – sometimes, if you can both bend a little, you’ll be able to find a happy middle ground. If you realize that the other person cares much more about something than you do, compromise may be easier for you. Finally, sometimes it is necessary to agree to disagree – take a quick break and move away from the situation.

The table below outlines the different stances people commonly adopt, and is adapted from one of the bestselling self-help books ever published, Thomas A. Harris’s ‘I’m OK – You’re OK’. The position in the middle (shaded area) – the ‘I’m OK, you’re OK status – is your best bet and the place to aim for.

So, don’t hold back and hide your concerns, or let resentments build. Your efforts in initiating new ways of communicating may make all the difference to the person concerned, and prompt them to get further help for their addiction problem. Your attempts to show concern may encourage them to consider other help options such as seeking support from a mutual aid organization, or finding out more information about options of treatment and recovery. And what’s more, and just as importantly, your efforts may go some way to improving relations and family dynamics!

Note: This article is based on ideas expressed in our newest book
‘Coping with Difficult Families’, published February 2014 by leading UK health and self-help publisher Sheldon Press.

Dr. Jane McGregor is a freelance writer and part-time lecturer in addiction at the University of Nottingham, England, UK.

Tim McGregor is a health and social care commissioning advisor, freelance trainer, and writer on health matters.

Jane and Tim are joint authors of The Empathy Trap: Understanding Antisocial Personalities (Sheldon Press, 2013) and Coping with Difficult Families also by Sheldon Press, and published February 2014.