By Dr. K.J. Foster, LMHC, CAP

mother and daughter touching hands outside

“The entire family is in recovery. Every person in this room is in recovery. The sooner you accept this truth and begin to focus on your own growth and recovery process, your own personal change, the better chance your loved one will have for a successful recovery. This is the best way for you to support your loved one in their own recovery success. Focus on you and your own change, your own recovery.” Recovery is a family affair!

As the family program director at a nationally known treatment facility, this is what I tell every family member and friend who comes to visit a loved one who is in treatment for a substance use disorder. I do so, every single visit, twice a week, week after week. It’s my mantra “the entire family is in recovery.”  It’s my mantra, because it’s the truth!  Recovery is a family affair. And it’s often a hard truth for family members to hear, understand and accept.  None-the-less, it’s a fact. 

As a counselor working in the field of substance use disorder treatment for over 10 years, I have found, over and over again, that we can arm an individual in treatment with all the knowledge, skills and tools they need for a successful recovery, and that same person can have all the willingness and desire for recovery that’s possible. Yet, if that person returns into a family environment and a family system that hasn’t changed, with individuals who haven’t changed, and who have no understanding of recovery and the impact of their own behavior, then that person, the person we have spent 28 days or even a year preparing for a successful recovery, will be at a much greater risk for relapse. Generally, because the family dynamic (dysfunction) is such that it’s often much stronger than any change or desire for recovery that’s occurred within that individual.

This is usually when at least one family member will protest, “Wait a minute here, KJ. This is not my problem. It’s theirs. I shouldn’t have to do anything. They’re the problem, not me!” And this is my opening, my opportunity to help families to understand the impact the illness has had on the family. Not the impact of the individual, the impact of the individual who has an illness. A mental illness that has made the entire family sick.

Family members generally don’t see their loved one’s issue as a mental illness or if they do see their loved one as mentally ill, they don’t understand their own role or the role of the family in that mental illness. This is where helping family members understand the impact of issues like codependency and shame can make the difference between relapse and recovery.

Codependency can be defined as being obsessed with or addicted to controlling someone else’s behavior, although it manifests with an array of characteristics that make it much more complex than any single definition can fully capture. When it comes to codependency, it can be so insidious and so ingrained in some family systems that it’s often like trying to determine which came first, the chicken or the egg. Codependency, gone untreated, will contribute to relapse. Recovery is a family affair.

Shame is another issue that contributes to relapse and is not something that’s just experienced by the individual with the substance use disorder. It’s experienced by family members too. This shame, the family member’s shame, is often then imposed upon the individual with the substance use disorder, piling more shame upon their existing shame, and making it that much worse. This can often occur unwittingly by family members, although many times it occurs overtly, due to anger and frustration over their loved ones’ behavior while actively addicted. Either way, it’s extremely damaging to the recovery process.

The way in which I see shame manifest in family dynamics most often, is when a family member talks to or otherwise treats their loved one as if they are the illness and not someone with an illness. This is a subtlety that, in and of itself, can make it much more difficult for individuals to recover. Addiction is an illness. It’s not who someone is as a person. Never-the-less, for some, it can become an identity, an identity that is all they’ve ever known, making it even harder to break free and get well. Family members can add to that difficulty by continuing to treat their loved one as if they are their addiction.

The words guilt and shame are often used interchangeably. However, they’re not at all the same. Guilt is external and can be thought of as healthy. Guilt often leads to seeking treatment. Whereas shame, on the other hand, is internal and unhealthy. I like to use the analogy of good cholesterol versus bad cholesterol. Guilt is good for us, shame is not. Guilt is “I feel bad about something I’ve done” and shame is “I feel bad about who I am.”

Because shame is internal, we often can’t see shame. In fact, shame is something that many people go to great lengths to protect or keep locked down and out of sight. Which means, that it can sometimes present as arrogance and entitlement and would seemingly appear to be the opposite of shame but is really a mask for internalized shame.

However it manifests, whether you can identify it or not, one thing is absolutely certain, if you have a substance use disorder, you’re generally experiencing a certain degree of shame, some more than others. Just as family members of those experiencing a substance use disorder will also experience their own degree of shame. The key, as the family member, is to understand the role and impact of shame, and be careful not to inflict more shame upon shame. Because if you do, you’re only making your loved one’s illness worse and more powerful.

Is it true that as a family member you didn’t cause it, you can’t control it and you can’t cure it?  Absolutely! But one thing is also true. You can contribute to the illness and make it harder for your loved one to recover. By focusing on your own change and growth, you can begin to identify those behaviors that may be contributing to your loved ones’ illness. After all, we don’t know what we don’t know, until we know it. Through your own awareness and change process, you will be doing the one thing that will contribute the most to your loved ones’ success – your own recovery. Recovery is a family affair.

Dr. K.J. Foster is Founder of Fostering Resilience, LLC, Co-Founder of the Center for Sobriety, Spirituality & Healing and Family Program Director at the Beachcomber Family Center for Addiction Recovery. She is a Resilience Expert, Educator, Entrepreneur, Public Speaker, YouTube Creator, and Author of The Warrior’s Guide to Successful Sobriety, available at