One in four American kids grow up in a household where substance abuse takes place, forcing them to grow up too early, endure emotional or physical trauma, and take on the role of caregiver much too young. For spouses or domestic partners, addiction causes a tremendous amount of conflict, financial and legal difficulties, and contributes to domestic abuse.

Despite these widespread impacts, most families still focus on the addictive behavior itself, insisting that the person with the substance use disorder is the only one who needs help. After all, they’re the one with the problem, right? But addiction doesn’t live in a bubble, and in fact, some family members may even be complicit in or partially responsible for the addictive behavior, perhaps without even realizing it. Unfortunately, that can be a tough pill to swallow, especially for parents, who often insist they did everything right and just want someone to “fix” their child.

1. The Cumulative Effect of “Little T” Traumas

Not only do I see this every day with my patients, but I also lived it. You see, I was the drug addict in my family. I started using drugs when I was about 15 years old, and by the time I was 18, I’d already attempted suicide twice.

Having suffered most of my life with mental health issues, I’d been in therapy from a young age, trying to cope with the trauma of my childhood. While neither of my parents had a substance problem, and I was not a product of abuse per se, I was still subjected to smaller, chronic, systemic trauma as a child. These “little T” traumas can take many forms — failure to teach children self-reliance or to nurture their self-worth, dismissing their thoughts, feelings or opinions, or making them feel inadequate, incapable or unworthy.

For me, it was living with the constant feeling of inadequacy and being an outsider. Growing up in West Texas, my brother and I were some of the only Black children in our community. There was no one around who looked or talked like me, and I felt isolated and unworthy. My mother had been a beauty queen in our native Jamaica and for many years she served as the director of the Ms. Lubbock USA beauty pageant. My grandmother had been a prominent fashion designer in Jamaica, so I grew up surrounded by beautiful women, none of whom looked like me.

I lived with a relentless pressure to look a certain way, to have a tiny waist, straight hair and to always look “put together,” no matter what the cost. My role models — my mother and grandmother — placed an extremely high value on appearance, and my natural hair and athletic build did not fit the bill. I felt inferior and less than.

In my home, like in so many others, these transgressions were unintentional — it was just part of the family dynamic. My mother was completely unaware of the damage these “little T” traumas were causing. My internal dialogue was completely dominated by my mother’s expectations and I couldn’t discern her voice from my own. I believed that if I could just change the way I looked that things would be so much better — I wanted so badly to disassociate from my vessel.

I eventually resorted to self-harm and substance use to cope with my pain. It wasn’t until after my third suicide attempt at age 20, when I finally entered a rehab program, that I began to discover how to love myself again for more than my appearance.

2. Addiction is More Than Just Substance Use

What many families — including mine — fail to realize is that addiction isn’t just a drug or alcohol problem. It’s a maladaptive emotional reaction —  the inability to cope reasonably or responsibly with emotions. These maladaptive reactions can take different forms — it could be drug or alcohol addiction, but also anger issues, compulsive gambling or shopping, or even being a workaholic.

Regardless of how it manifests, at their root these behaviors stem from the family culture. It’s learned behavior that, when you don’t feel loved, acknowledged or valued, and you’re unable to cope with those feelings, you turn to something outside yourself to fill the void.

I see this lived trauma at play every day in my work, fueled by a variety of inherent family beliefs: strict religious convictions that create paranoia, a purity culture and the feeling of being damaged goods if women don’t “save” themselves for marriage; gender-based expectations that force men to hide their feelings or encourage women to use their bodies as currency; women who grew up with mothers obsessed about their weight or appearance who inadvertently taught their daughters to feel inferior.

And it can manifest in unexpected ways. I once had a client with whom I identified deeply. She was a tall white woman with red hair — a look I would have killed for as a child. But she had been raised in a Philipino community and felt completely out of place. She was the outlier, and although we looked very different, we were cut from the same cloth.

3. A Family Disease Requires Family Treatment

These chronic “little T” traumas are why it’s essential that mental health and addiction treatment must be a family affair — the entire family must learn to stop the maladaptive cycle. Not only must we help children unwind the complicated relationships and feelings that shaped their experience, but also work with their parents to help them understand the family dynamics that may have led to the addictive behavior and how to stop perpetuating the cycle of maladaptive behavior.

Addiction doesn’t live in a bubble, and neither does recovery. It takes a community of support to begin and to sustain healing. If someone you love is in treatment, don’t let pride get in your way — get help for yourself, too. There’s no better gift to give your family than the peace that comes from putting dysfunction behind you on the path to creating a better future for the next generation.

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Jahmela Headley is a Licensed Therapist at Recovery First Treatment Center, an American Addiction Centers facility.

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