At the Hazelden Betty Ford Foundation, we cherish the connection between our patients and their support network, and we know that one way to foster that connection is through understanding each other’s perspectives. However, sometimes patients struggle to communicate their perspective, especially while in treatment. This could be for various reasons: Some patients worry that they won’t be able to adequately articulate their thoughts about being in treatment or fear that their words will come across the wrong way. Others are concerned about hurting their loved ones’ feelings or don’t know exactly how to express what they’re going through. This is completely normal. Entering treatment is overwhelming for patients and families alike, and identifying related emotions can be difficult. Oftentimes patients have spent a long time trying to ignore their emotions or cover them up with drugs or alcohol, which makes recognizing certain feelings even more difficult. This, combined with the physical pain and discomfort that comes with withdrawal from substances, can create a barrier that prevents communication.
Using the insights and words of patients in our Plymouth facility, we have created this document to help you understand how your loved one might be feeling. To gather information for this article, we interviewed patients from all three units with a wide range of ages. While every patient is unique in their experience and feelings, we noticed many patients shared similar sentiments, which are compiled below. We hope that this document will help explain what your loved one may be feeling while in treatment.
The main thing that patients want their caregivers to know is that addiction is not a choice. Many of the patients interviewed said they worry that their caregivers might blame them for their substance use disorder. These patients said they sometimes feel as if the people in their life believe that they are “choosing” addiction or that they could just stop if they wanted. As one patient pointed out, active addiction is painful and draining, and it’s hard to imagine anyone would choose to suffer through that. It is important to know that addiction is a disease, meaning it is not a choice, and it cannot be controlled with willpower alone. Once addiction gets ahold of a person, it’s extremely hard to escape its grasp. One patient noted that, at a certain point, using their drug of choice became “just like breathing.” Another patient explained that their addiction is not logical, and it’s difficult for a person to fathom it without going through it themselves. Even then, substance use disorder is a baffling disease, and people with the disorder themselves struggle to fully understand it.
Another often-mentioned topic is a patient’s journey to treatment. While support from family is invaluable, and your prompting may have been a contributing factor to your loved one entering treatment, the recovery process is something they alone must be responsible for. Getting sober “for” a family member, guardian, friend, significant other, or other important figure rarely leads to sustainable recovery and is usually a recipe for disappointment and resentment for both parties. Patients explained that while they are extremely grateful to have support, treatment is something they have to do on their own, for themselves. Patients also said that their families sometimes try too hard to protect them from anything that may trigger substance use. While this stems from a caring and generous place, it does not always result in the intended outcome. One patient said that they want to be “held accountable, not babied.” They mentioned that their family and friends would try to prevent them from any exposure to alcohol, whether at a party or in a commercial on TV. This made them feel like their substance use had become all that their loved ones saw—they didn’t see them; they saw a weak person who needed constant protection. Instead, they wanted to be understood as a whole person: someone with value, someone with likes and dislikes, with morals, with flaws, with skills and talent—someone with personhood. In addition to that, no matter how hard we try to protect our loved one, they will eventually encounter drugs and/or alcohol in their day-to-day life. When that happens, it’s best for them to be equipped with skills to deal with the situation. If we constantly guard our loved one, they might not get much practice using those skills.
On a similar note, many patients want to express the shame they feel about their substance use disorder and past behaviors. While addiction is nothing to be ashamed of, it can be humiliating and embarrassing, and patients want their caregivers to understand that. Shame is an emotion well known to people with substance use disorder, and oftentimes it’s self-directed. Shame is harmful in many ways: it can destroy confidence, diminish self-respect, lead to isolation, and drive people back toward substances. Patients also mentioned that shame does not make them want to get help; it does just the opposite. One patient explained that the more shame they felt, the more they wanted to use. They said that they were “using drugs to fill the hole [they’d] dug [themself] into.” It’s likely your loved one is feeling shameful also, whether that shame seems to come from family, friends, coworkers, peers at school, or even themselves. Patients would like their caregivers to recognize that shame and try to avoid furthering it. Patients were adamant that dismantling shame bolsters their recovery, self-respect, and dignity, allowing them to focus on getting better.
It’s also important to patients that their conversations with their caregivers revolve around something other than their substance use disorder. Patients have expressed that when the people around them focus on their addiction, all of their thoughts are then directed there as well. When your loved one is in inpatient treatment, most of their day is centered on recovery, and speaking with their support network can provide a welcome break from that intense focus. Patients mentioned that they appreciate talking about “normal things” with their caregivers, meaning topics other than their substance use disorder, recovery, and time in treatment. This also relates back to patients’ desire to be treated as a “whole person.” Talking with your loved one about things other than addiction and recovery can help them see themselves as more than their substance use disorder.
Finally, many patients expressed a fear that their family might give up on them. Getting sober can be scary, and it’s common for patients to feel unworthy of support or like a burden to their loved ones. Oftentimes, all it takes to calm these nerves is a bit of reassurance that they won’t be alone and that you aren’t going to give up on them. Right now, your loved one is facing a lot of hard work. Once they know they have your unconditional support, treatment may begin to feel more surmountable.
While we can’t know exactly what your loved one is feeling, it’s likely they may be experiencing some mix of the emotions mentioned in this article. This can be a complicated and confusing time for both patients and their caregivers. The Hazelden Betty Ford Foundation believes communication is key to success, and as long as you and your loved one have agreed to an open release of information, you can expect a check-in phone call once a week during your loved one’s time with us. This phone call is a time for you to share your feedback and ask your loved one’s counselor any questions. In addition to that, your loved one has phone access from 4 p.m. to 10 p.m. Monday through Friday and from 2:30 p.m. to 10 p.m. on Saturday and Sunday. At any time, you can call and leave a message for your loved one at (763) 509-3858. Your message will be hand-delivered on a small note. Communication is an important part of recovery, and we strive to encourage connection between you and your loved one. We wish to thank all patients who contributed their thoughts to this article. Your feedback is invaluable, and we appreciate you taking the time to share your experience with us.
