[Two Pronged] My friend needs help with addiction, but her family dynamic might be the problem

Rappler’s People section runs an advice column by couple Jeremy Baer and clinical psychologist Dr. Margarita Holmes.

Jeremy has a master’s degree in law from Oxford University. A banker of 37 years who worked in three continents, he has been training with Dr. Holmes for the last 10 years as co-lecturer and, occasionally, as co-therapist, especially with clients whose financial concerns intrude into their daily lives.

Together, they have written two books: Love Triangles: Understanding the Macho-Mistress Mentality and Imported Love: Filipino-Foreign Liaisons.

Dear Dr Holmes and Mr. Baer,

I am a second year undergraduate of BS Psychology from UP. I have a best friend, “Gemma.” She is a fellow major in Psychology who got into drugs last year.

I know the reason for her addiction, but I do not know if I should tell her parents. They really want to help her as much as they can, but they cannot really, because they are the cause of her addiction. I know because that is what she told me.

She told me her mother never stops complaining about her father or her in-laws. Once, she had asked her mother to stop. To stop bad-mouthing her father and her in-laws because it overwhelmed her.

Her mother got angry with her. This is what she told Gemma and I am just quoting her: “If you are so overwhelmed just hearing about this, how do you think I felt actually experiencing all this?!!? Don’t be so selfish. You don’t know how lucky you are!”

I sensed a change in her after this. She has now gone to three psychiatrists. They have all given her pills to take, but none have helped her or lessened her addiction.

I feel her relationship with her mother has much to do with her addiction, but I don’t know how to relay this information.

Please tell me what I should do,
Mitos

Dear Mitos,

As Alexander Pope wrote in his An Essay on Criticism (1711), “A little learning is a dangerous thing”.

You are a Psychology undergraduate, not a certified psychologist, and it would be wise to remember how much knowledge you still have to acquire before you are ready and able to analyze others professionally.

However, your desire to help Gemma is admirable and just needs direction.

Your understanding of Gemma’s situation however seems based solely on her account. Her parents’ version might of course put matters in an entirely different light. You recognize that telling her parents how you see things is probably not the best strategy, particularly if they are in fact part of the problem, so perhaps you should concentrate your efforts to assist by giving Gemma as much support as you can and pressing her, and by extension her parents, to seek family therapy.

It seems clear after all that medication alone will not resolve Gemma’s addiction, especially if her troubled relationship with her parents remains unresolved, so a psychiatrist who merely prescribes drugs is no solution.

Talking therapy is the next option, if feasible involving Gemma’s parents as well as Gemma herself. This may be easier to suggest than to achieve, but it is the most direct way to unveiling and addressing the problems between them.

As a non-family member your contribution may not carry much weight but your support for Gemma at this juncture will be invaluable.

Best of luck,
JAF Baer

Dear Mitos,

Thank you very much for your letter. In my opinion, Mr Baer had addressed all your concerns about addiction in his answer.

Thus, I hope you will understand if I discuss family therapy which, I hope, will help you and our readers realize how often individual therapy is not enough. Family therapy and indeed, radical therapy are sometimes what is necessary before our lives can get better.

By this, I mean real family therapy — this was started by Dr. Murray Bowen in the early late 40’s/early 50’s, though he did not officially publish his research that confirmed the success of family therapy until 1966.

Let me give you a different example so our other readers can, perhaps, relate to it more: I had a 20-year old friend — let’s call her Myra — who was seeing a psychiatrist for clinical depression.

The psychiatrist gave her antidepressants; and after two months, suggested he see her parents. Myra was ecstatic because at last she hoped that, under the relatively safer space having a therapist present could bring, she could now share how she truly felt and, perhaps get some (real) feedback about why the parents behaved the way they did. She also hoped that if they all met, they could find some common ground.

However, what the psychiatrist did was talk to her for 30 minutes, then ask her to leave the room then talked to her parents while she was waiting outside.

This is definitely NOT the Family Systems Therapy that Dr. Bowen developed. Bowen’s Family Systems Therapy is a therapeutic approach that treats the family as an interconnected emotional unit rather than focusing on individuals. There is no such thing as an identified patient (IP) which Myra would be if traditional therapies were involved.

In Family System Therapy, the entire family is the patient, because there is usually something wrong in the family dynamics that is causing, or exacerbating, Myra’s clinical depression.

In Family Systems Therapy, what happens to one happens to all. A system is a unit that wants to maintain homeostasis at all cost. Thus, if even 1 element of the system changes (say, Myra’s way of responding) then the entire system will change so homeostasis is achieved once again.

All Myra’s psychiatrist did was confirm that Myra was the problem and that the only reason the psychiatrist talked to her parents was to help them help Myra. Help Myra because Myra was the only one, supposedly, who was suffering from clinical depression.

I say supposedly because often depression can be ‘disguised” as anger or apathy.

Like Gemma, Myra was strongly affected with how her parents behaved. Like Gemma, Myra was still dependent on her parents and thus could not escape their toxic behavior even if she wanted to do so,

However, unlike Gemma, Myra thought she knew that her family was the cause of her deep depression. That is why she was so disappointed in the way the psychiatrist’s session with her family went. 

What could have been the start of effective therapy turned out to be just “the same old, same old”  of traditional therapy.

Sometimes, however, families are incapable of changing, Mitos. In that case, perhaps the best thing you can do is remind Gemma that “Friends like you are God’s way of apologizing for families some people are saddled with.”

All the best,
MG Holmes

– Rappler.com