“What lies behind us and what lies before us are tiny matters compared to what lies within us.” —Ralph Waldo Emerson
What lies within us are all the experiences, interactions, emotional
styles, physicality, nervous system responses, generational memories,
styles of behavior, values and beliefs of our primary caregivers – our
As more and more studies come forth indicating that addictive disease
is a brain disease, that the chemistry of the person with the primary
disease is not “normal” and often may have been abnormal even before the
drug or alcohol use, one can begin to ask the question, “What’s going
on?” What about the genetics? Is the fact that addiction occurring in
multi-generational families is totally related to genes that are not
functioning properly? If so, how does this start? Who is “patient zero”?
Let us begin to ask some new questions. What, for example, is the
impact of trauma in a family on the genetic makeup of its members? Can
it change in one or two generations? What is the impact on the central
nervous system, the chemistry? Can it be possible that addiction in a
family member can have a traumatic impact on other members of the family
– the spouse, the parents and the children?
So here, I believe, is the main question. There are some of the most
talented people one can imagine — intelligent, caring, compassionate —
treating those afflicted with the primary disease of addiction. However,
in not making treatment and therapy easily available to those people
with the secondary impact of addiction, are we almost guaranteeing that
this affliction will go on to the next generation?
Most practitioners who work with treatment and recovery have
experienced the simple fact that the alcoholic/addict is much easier to
convince to attend 12-step, self-help meetings — often daily — than to
convince family members to attend 12-step, self-help meetings related to
co-dependency, once a week.
This is the fiction that we live with: “I’m not the person with the
problem. If he/she gets better, I’ll be fine. The problem with me is
you.” Perhaps the biggest fiction is, “The children are not affected;
they are fine, and there is no need to talk to them. We’ll tell them
that daddy/mommy is away working or visiting”. Children always know what
is happening in a family; what they are often unable to do is
articulate their knowing. However, they know and they also know that it
must be bad because no one is talking about it to them; no one is
helping them to understand and find language to talk and be comforted.
So they learn to comfort themselves, they learn to be afraid of things
not spoken; they learn to become hyper-vigilant, super-quiet or
super-good. They know. Emotionally, they know. Physiologically, they
know. The next question is in what way this might affect not only their
adult lives, but also the lives of their children.
Psychological stress (trauma) is a type of damage to the psyche that
occurs as a result of a traumatic event or series of events. The
heightened arousal of a child’s primary caregiver signals danger to the
child. Without knowing what is wrong, they nevertheless begin to
physiologically imitate the nervous system responses of their parents.
With increasing levels of stress (or trauma) we begin to see some
signs of insecure attachment. Secure attachment is a form of affect
regulation. Damage may involve physical changes inside the brain and to
brain chemistry, which damage the person’s ability to adequately cope
With exposure to trauma as a child, a person may re-experience the
trauma and try to avoid trauma reminders. Often, the person is
completely unaware of what is happening and begins to engage in
disruptive or self-destructive coping mechanisms.
The brain uses epinephrine to execute autonomic and neuroendocrine
responses, serving as a global alarm system. The autonomic nervous
system provides the rapid response to stress known as the
fight-or-flight response. The interactions between the mental state,
nervous and immune systems can impair developmental growth in children,
which later alters their perceptions of, and reactions to, stress.
The trauma associated with addiction in a family is similar to a bomb
going off in a room. Everyone is hit, but the family identifies only
one member as the problem. Whether that one person recovers or does not
recover, the family still has the autonomic trauma responses.
Since the other co-dependent family members believe the only problem is
the identified “problem one”, no one seeks help. Each member in the
family goes on to create their own families based on unhealed trauma.
“Childhood adversity, stemming from abuse, parental loss, witnessing
of domestic violence or household dysfunction is a major cause of poor
mental and physical health. One major consequence of early adversity is a
markedly increased risk for substance use, abuse, and dependence“
(Chapman, ET. Al. 2004, Dube et al, 2003; Felitti, 2002).
From a Harvard Medical School study, we now have new information about stress on children.
“Under non-addictive states, the nucleus acumbens receives input from a
number of brain regions, including the hippocampus and the prefrontal
cortex. These inputs serve to modulate the response of the nucleus
accumbens in a manner that is controlled, flexible, and contextually
relevant. Following stress exposure, this system is less well modulated.
Hippocampal gating of cortical inputs is reduced. Moreover, the
prefrontal cortex inputs respond more selectively to drug-conditioned
cues which is a vital critical factor leading to relapse.” 1
This study goes on to explain that with this loss of flexibility, the
ability to experience stress relief easily, access pleasure and the
simple joy of the world around us is significantly reduced… until a
person with this brain state encounters a drug, such as alcohol, or
other drugs (including some medication). At this point, the individual
experiences relief, euphoria and relaxation, never before realized. This
becomes the euphoric recall that presents itself in times of real or
imagined stress. The negative consequences after the drug use are not
stored in the same manner.
When we look at family members who have not developed the primary
addiction, we frequently see patterns of behavior intended to soothe,
relax and give pleasure. These behaviors have a similar impact as drugs
to the addict. They work for a short while then need to be
repeated….over and over and over. These behaviors include: shopping
beyond one’s means daily or several times a week; Internet addiction;
gambling; sexual compulsion; control issues; work that excludes balance;
serial monogamy – always needing new relationships and the chemistry
that goes with them; and food addiction of all kinds, such as compulsive
overeating to starving oneself to binging and purging.
A study unrelated to addiction but of major importance was first
introduced by Dr. Lars Olov Bygren, a preventive-health specialist who
is now at the prestigious Karolinska Institute in Stockholm. He is a
pioneer in the study of epigenetics, which is looking at how one’s
environment and choices can influence your genetic code and that of your
children – not over several generations, but immediately. We have
always believed that the choices and circumstances of our lives might
negatively impact our brains or bodies, but wouldn’t change our genes,
our DNA . Now it appears that “stressors can activate epigenetic marks,
modifying histones or adding methyl groups to DNA strands. These changes
can turn genes on or off and may affect what gets passed down to your
offspring. If you overstimulate genes for, say, obesity or a shortened
life span, your kids can inherit these overactivated sequences. That
could mean a lifetime of battling unfavorable gene expression”. 2
What can we do to begin to affect a change and not simply treat
symptoms? Families need help as intensively as does the family member
with the primary disease. Children need to be involved. Children are
always involved in the problem; we need to involve them in the
Open up conversations appropriate to their age level and begin to
teach them ways to become healthy, relieve stress, talk about whatever
is bothering them, listen to what they are saying carefully and respond.
The Betty Ford Center in California has a program, at an extremely
reasonable rate, for children and a stand-alone program for
co-dependents. Neither of these programs requires that one have a family
member in treatment. There may be other similar programs around the
country as well.
We need to focus and develop mechanisms to help families over a
period of time – not just a week or weekend, but extended therapeutic
intervention and training. If more interventionists included intensive
family work – education; skills training; directing to treatment when
possible; Al-anon and Alateen, over a period of months, we might begin
to make some changes to this multi-generational affliction. Some have
started doing this work – more is necessary.
1 From Neuroscience and Biobehavioral Reviews, a review of
“Desperately driven and no brakes: Developmental stress exposure and
subsequent risk for substance abuse”. By Susan L. Andersen and Martin H.
Teicher, from a study of Developmental Biopsychiatry Research Program,
McLean Hospital/Harvard Medical School, Belmont, MA
2 From “Why Your DNA Isn’t Your Destiny”, Time magazine, January 2010, by John Cloud, Vol. 175, No. 2