In working with drug and alcohol addiction one not uncommonly hears the person report that they were the black sheep in the family. They were the problem child in the family and other siblings were the ‘good’ child(ren) and often they can be quite successful in their lives at least at a practical level like in their eduction or careers. In family therapy this problem child is referred to as the ‘identified patient’. The family structure is designed such that it needs one member to be a problem which they all discuss, worry about, be critical of, compare to the good children and so forth.
This can be seen as a variant of an epi script. The other family members need the child to be self destructive but not necessarily for them to avoid their own self destructiveness.
This is not really a drug addiction in that the drug user does not become so psychologically dependent on the drug as a true drug addict would. The family system drug addict will use the drug in an addictive fashion because that is what they have to do to fulfil their role in that family. Of course all of this is not in conscious awareness of the family members.
Every one of us do this, we all have an unstated (usually) psychological role in our family. Most often it does not involve being self destructive so it is never noticed as such a thing. All families have the funny one, the caring one, the smart one, the musical one, the pretty one, the social one, the sporty one, the nerdy one and so on.
For a family system drug user it is actually a good thing, as it is easier for the person to eventually stop using the drug. The true drug addict when they stop using find it very hard not to re use and they will talk about ‘hanging out’ for the drug. The drive for them to re use is very strong and persistent and most often they do. The family system drug addict when they stop using will not report the same ‘hanging out’ feeling and report that there are significant periods when they don’t even think about the drug and feeling high. The true drug addict will think often and long about the drug and using. It is much harder for them not to have it in their mind.
If the family system drug user eventually moves away from their family and has little contact the need to keep using the drug subsides and often they will stop using for significant periods of time. It is easier for them to stop than the true drug addict.
I came across an interesting variant of this family system drug addict the other day.
A man reported that his father many times spoke about his (the son’s) drug problem in front of him to other family members. He reported that his father did this so as to elicit sympathy and support from other family members. Again we can see how family dynamics played a role in his addiction.
One however in this instance could diagnose the father with Munchausen syndrome by proxy. The father encourages the unhealthy behaviour (habitual drug use) in the son so that the father can get the attention usually given to a ‘patient’ or a harmed person.
This throws interesting insight onto the concept of the co dependent or the enabler as they are called. The long suffering and complaining wife about her husband who drinks alcohol to excess may at times be displaying Munchausen syndrome by proxy herself.