Ask an Expert: My Family is Hostile to our Addict Cousin

By Doreen Maller 02/19/15
Today's question is on what to do if your family can't get past the stigma of addiction and really help a loved one with their problem.

We are a Persian family in this country for 20 years.  I came here when I was 11 and  so mostly grew up with an American sensibility and have studied some psychology, though that is not my profession (I am a sales person).  Most of the immigrant Persian families I know are very tightly knit and keep this going partially by being very judgmental, blaming and emotionally controlling of each other. They all the speak the “you should” language. This is not unique by any means to Persians, and I recognize it was a survival system in the old country. The issue now is that the full weight of this way of relating is being slammed at my cousin, who we recently learned is addicted to methamphetamines. I don’t know how to get through to most of the family that he needs our support and not blame and condemnation, with almost everyone in the extended family defending themselves that they did nothing to create the situation for him.  I am pretty lost about what to do here to turn this around and asking for any guidance you can give. – Adar


Doreen Maller: Thank you so much for this question, I think issues of blame, shame and stigma arise in many families regardless of cultural background as you mentioned, and are very typical responses that tend to bubble up in families during times of crisis.  I appreciate your concern for your cousin and your desire to connect with your family to move beyond their initial response of blame and defense toward a more generative response of support and education.

Methamphetamine has its own culture.  Its use, abuse and addiction can be devastating to individuals and families and its culture of use can distance family members through concern, fear and secrecy.  Recovery from a meth addiction takes time and care; your cousin has a journey ahead, which will include physical and emotional recoveries.  As noted in your question, there are aspects of recovery that impact the family as well.   Here is a link to some information about methamphetamine.

Family therapy which can be a component of many recovery models provides support for the family toward education regarding drug use, abuse and addiction in general and for this substance in particular and also can provide support as the family comes to terms with their own healing.  Compassion for each other and an understanding of recovery as a process can be helpful.

One of the tools that I have found particularly useful is the Prochaska & Diclemente Model of Change.  This model illustrates the nuanced stages a person passes through as they incorporate change into their lives.  From a family systems point of view, all family members are in need of aspects of recovery.  This model breaks down that journey into the following steps:

Pre-contemplation:  The individual is not even contemplating changing behaviors and has no plan

Contemplation: The individual is considering making changes in their lives

Preparation:  The individual is pulling together the team, tools or considerations necessary for change to occur

Action:  The individual is actively working on change and incorporating elements of change in their lives

Maintenance:  Change has been incorporated into a person’s life and while support might still be necessary, a new way of being is somewhat dependable.

There is a caveat to this model that notes that relapse is possible at every step.

As a family therapist I use this model in numerous ways, not the least of which is to remind myself that change takes time, has many elements and that there are quite a few steps necessary before “Action,” also, that relapse may be part of the process and should be considered as possible rather than a surprise if it occurs. The goal at each stage (including relapse) is to remember that this is a generative model that moves forward with possibilities of hope and sustainable change.

From a family-systems perspective, when one member enters recovery it is important to remember that everyone in the family is in a cycle of change.  From that point of view, I find it helpful to introduce the “Wheel of Change” and take an inventory on where each family member may be on his or her own change process.  Often family members will find themselves to be in very different places; one may be assuming “Action” while another may still be in “Contemplation.”  Understanding that we all are paced differently and that we have individual journeys as well as collective journeys can yield ripe conversation and deepen a family’s understanding of themselves as individuals and their collective relationships.  Therapists believe that this kind of insight can deepen family trust, support and relationships and that accepting differences can lead toward realistic support and healing through the recovery process.

You can find an in depth free power-point of this model here.

I hope your cousin finds a program that works for them and that your family finds the support it needs at this time.  A quick Google search can yield results in many communities for Family and Individual support for families in recovery.



Doreen Maller, MFT, PhD, began her practice in community mental health with a specialty in high-risk children and their families, including numerous families coping with addiction issues. Dr. Maller is the series editor of the three-volume Praeger Handbook of Community Mental Health Practice. See   Full Bio.

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