"Dad's an addict." "Mom's going to rehab." These are not easy conversations to have with a child, even one that has long been aware that there's a problem.
More than 28 million Americans are children of alcoholics, yet addiction isn't being talked about in most homes. Instead, children grow up facing a lifetime of issues other kids don't have to manage. They tend to have more emotional, behavioral and academic problems than other kids, and are four times more likely to become addicts themselves. They are also at greater risk of abuse and neglect, witnessing domestic violence, and marrying an addict later in life.
As children learn to fend for themselves to survive, unpredictability and chaos become the norm in addicted homes. Lack of consistent discipline can produce deficits in self-control and personal responsibility, or conversely, over-control or hyper-vigilance. Children may even feel that their parent's drug problem -- and the subsequent breakup of the family or removal of the child from the home that sometimes ensues -- is their fault.
Their emotions run a confusing gamut. At once resentful of and loyal to their addicted parent, children are reluctant to open up and share long-held family secrets, even if they desperately want the support. They may have a strong self-preservation instinct, but at the same time, they're not sure if they deserve to take care of their own needs when their parent is spiraling out of control. The conflicting feelings continue as children get a glimmer of hope when their parent promises to quit even though they've been disappointed repeatedly.
In this impossible situation, what can parents, caretakers or other adults say to their children? How do they explain the wreckage of addiction to someone who, at a young age, has already been overexposed to some of the darkest potentialities of life?
Time the Conversation. A conversation about a parent's addiction is best had when there are no distractions and the situation is relatively calm. If possible, bring it up when there is a plan in place to get help for the addicted parent. Explain that there's a problem and you're taking steps to improve the situation. Talk about what will change (e.g., Mom or Dad will go to rehab, or one parent may move out if separating or divorcing). Repeat the conversation as often as needed so that the child feels comfortable having an ongoing dialogue.
Keep It Age-Appropriate. The language you use and the level of detail you provide depend on the age and maturity of the child. Break the issues down as simply and directly as possible, and finish with a message of hope.
Tell the Truth. Although you'll need to use different terms depending on the age of the child, you should always be honest about the problem. Children have an innate ability to read when adults are lying. Explain that addiction is a disease caused by a number of factors, including genetics, environment and past trauma. Similar to people with diabetes and heart disease, their parent is sick and needs treatment to feel better.
Get Educated. Educate yourself about the disease of addiction so you are in a position to answer any questions the child may have. If you don't know the answer, work on finding one together.
Acknowledge the Impact. Rather than skirt around the impact a parent's addiction has had, validate the child's experience. Apologize for the pain inflicted on the child and ask open-ended questions about how they've been feeling.
Release the Shame. One of the most important things for children to understand is that addiction is not their fault. They didn't cause their parent to abuse drugs or alcohol and they cannot cure or control it. This can be hard for children to understand, especially if the addicted parent blamed their drug abuse on a child's behavior (e.g., "I wouldn't need to drink if you'd do your chores."). Children need help to understand that what the addict says and does under the influence isn't really who they are or how they feel. Addiction hijacks the brain and just as the child is powerless to stop it, the parent is out of control as well.
Put Things Into Perspective. Children from addicted homes tend to idealize other families without realizing they have struggles of their own. Help them understand that they are not alone; in fact, millions of children are in the same situation. They are normal kids thrust into an unhealthy home environment who are doing their best to cope with an extremely stressful situation.
Invite Dialogue. After being disconnected from themselves and others, it may take practice for the child of an addict to be able to identify and process their emotions. To combat the secretiveness, fear and loneliness addiction brings, encourage them to talk about their feelings without criticism or judgment.
Teach the Seven Cs. According to the National Association for Children of Alcoholics, children need to know the "Seven Cs of Addiction":
Find Additional Sources of Support. Just as the addicted parent needs treatment and support to get well, children need to know there are resources available to help them process their emotions. If they don't feel comfortable talking with a parent or relative, they can reach out to a teacher, counselor, child or family therapist, religious leader or support group such as Alateen.
The toughest topics are often the most important to broach with children. For each day that a child lives with an addict, damage is being done. And while not every child will fall prey to addiction or other emotional or behavioral disorders, they need honest discussion and support in order to beat the odds.
David Sack, M.D., is board certified in psychiatry, addiction psychiatry and addiction medicine. He is CEO of Elements Behavioral Health, a network of mental health and addiction treatment centers that includes the Promises Malibu rehab centers, The Ranch, Right Step, and Spirit Lodge.
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