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Substance Use Blog Series: Communication with Loved ones Experiencing Substance Use Challenges

Today’s Substance Use Blog post is about communicating with loved ones who are struggling with their substance use. So many factors can come into play when communicating with a loved one about this, such as their point of recovery, your existing relationship, and both of your communication styles and temperaments, to name a few.

Depending on which stage of change your loved one is in regarding their substance use recovery, it can be difficult to express your concern in ways that meet them where they are at and that do not feel threatening. It may seem like conversations around this topic escalate quickly and in ways that are seemingly out of your control. Like we said, so many factors can contribute to why this happens and we cannot address all of them in this post, but we will offer some techniques and things to keep in mind while communicating, in hopes of being proactive and preventative.

Safety

Of course in any interaction involving substances, safety is the primary concern. If your loved one is incredibly intoxicated to the point of near-unconsciousness, calling 9-11 to keep them safe is top priority.

The suggestions offered in this post are meant to be used when your loved one is not under the influence. Otherwise, they will not be processing the information and cues to their fullest capacity and communication will not be as effective.

Calm demeanor

Remaining calm while communicating with a loved one is the first thing to keep in mind. This post provided some family resources and includes videos that demonstrate maintaining this sense of calm. If somebody is struggling with substances but is not actively at the point of wanting to change, they may feel easily threatened if you express your concerns too firmly, so calmness is important. 

Part of expressing calmness is being self-regulated and grounded yourself. If you are activated and in a state of high stress, chances are that will be clear to your loved one and your stress may play off each other. Taking a few moments before the conversation to ground yourself by taking deep breaths, orienting to your surroundings, and really attuning to the present moment will help the conversation stay manageable, and your worry will be less likely to take over.

Working on your communication approach can make a huge difference in setting the tone for whether your loved one will share their struggles and process with you or not. A tone of acceptance and openness is the goal here. One study looked specifically at the interactions between caregivers and youth who used substances, and found that youths were more likely to report communication difficulties with their families as a main struggle, while parents were more likely to report ‘problems’ in the child’s attitudes and external influences that affected their behaviour [1]. 

When it comes down to it, interactions within the home are the scope you have the most direct control over, and honing communication skills have shown to make a huge difference both in de-escalation and preventative measures.

Validation

Validation is typically the first step to de-escalating an interaction that is losing its ground, or ideally preventing an escalation in the first place. When noticing signs of discomfort or unease in your loved one, validating their emotions will help them feel seen and understood. You can do this if they are having a struggle or dilemma at home, or if they start to express discomfort during a conversation (ie. through defensiveness, avoidance, isolating, anger, etc.)

Emotion focused family therapy breaks this process down into steps and I summarize them briefly here:

1. Attend to the emotion – Be aware of what feeling your loved one is expressing. It can be difficult when coming up against something like substance use which inevitably involves worry on your part, but really focusing on what your loved one is feeling in the moment rather than the behaviour you want to change is the core focus here.

Eg. If your loved one is hiding substances and becomes snappy and/or avoidant when you notice, resist the urge to demand honesty or let your frustration take over. It’s hard and takes practice, but is worth it. Instead, notice the emotion they might be feeling that is leading them to respond through avoidance and/or defensiveness.

2. Name the emotion – Determine what word most accurately describes your loved one’s feeling.

It is important to keep in mind that what someone expresses and what they’re feeling might not be the same thing.

If staying with the previous example for instance, your loved one may express themselves through snapping at you, but “snappy” is not the emotion they are feeling. Rather, they may be feeling threatened, angry, or imposed on. If they responded through avoidance, they may be feeling embarrassed. This is where your expertise comes into play, since you know your loved one the best and likely have more insight into reading them. 

It is okay to get it wrong. Naming an emotion incorrectly is absolutely fine, because attempting to tune into your loved one’s emotions still communicates that you are trying to connect. If you’re wrong, work with their correction, thank them for sharing it with you, and move on.

Dan Siegel briefly speaks to the calming effect that having emotions named can have on the brain and the nervous system. This speaks to the power of validation:

3. Validate the Emotion – Once you have a name for the emotion, validate your loved one’s experience of it to communicate that you get why it is there. There is always a reason for an emotion to be there. Oftentimes interactions escalate because somebody feels misunderstood. Communicating to your loved one that you are trying to understand is much less likely to result in an escalation.

Validation sentences usually look something like this:

It makes sense that you might feel _________, because ___________, and because __________, and because ___________.

In our previous example, it might look something like this:

It makes sense that you might feel angry because you’ve been dealing with so much lately, and because I’ve been asking you about it so often, and because you’ve finally met a group of friends you want to spend time with.

4. Meet the Emotional Need – Once the feeling or feelings have been validated, then you can meet the emotional need. It is important to focus on the emotional need before practical needs, because it tends to the why that is driving the emotion you just validated. This makes your loved feel further understood and allows their emotions to process in a healthy way.

Some common emotional needs include:
• Sadness: soothing, giving a hug
• Anger: Helping to set and defend boundaries
• Fear: Protecting from danger
• Anxiety: Helping to confront the anxiety-provoking situation with love and support (Emotion focused family therapy).

5. Meet practical needs – After your loved one has been validated and their emotional need has been met, then you can approach the practical needs. These may involve giving them space, setting a limit or boundary on behaviour, or making a proactive suggestion on how to tackle a situation together. Meeting their resistance in these cases with further validation is also important to keep in mind. 

It can be tempting to jump immediately to practical needs in difficult situations, but as long as your loved one is safe in their immediate setting, going through the previous steps first will have more long-lasting effects. It will help them process their own emotions, and foster a relationship between the two of you, even while navigating turbulent conditions.

If you would like to learn more about these skills, Mental Health Foundations has an excellent 4-part video series that goes into them in more depth.

‘I’ statements

When you’re feeling deep concern for someone close to you, communicating your own worries also has a place. Before describing your own concerns, we encourage you to go through the previous steps of validation to ensure you’re bringing them into a space that feels regulated and calm.

Once in this space, you can voice your own emotions and concerns. Especially if you have a close relationship, doing so can help your loved one shift their perspective to the bigger picture versus what is simply occurring within them internally, but it is vital that you do not express your emotions from a place of blame.

Of course having emotional reactions when somebody you love is struggling with substance use is absolutely normal and valid, but accepting responsibility for your own emotions is also crucial. If you are having trouble coming to terms with your own emotions, using the previous validation steps on yourself can help foster self-compassion. This post lists substance use resources in Delta that offer support to caregivers and loved ones, and last week we explored self-care for loved ones. 

Feeling uncomfortable and at times overwhelming emotions in response to your loved one’s struggles with substance use is normal and can be communicated, but the distinction between blame and honest expression lies in the fact that your loved one is not making you feel a certain way. Using “’I’ statements” expresses this distinction.

If we stick with the previous scenario, an example of communication that expresses an emotion but does not take responsibility for it is:

“You can’t keep coming home so late and lying. You don’t even care how scary it is for me or how this affects anyone else.”

The feeling of fear was voiced here, and that feeling is understandable, but it was framed through blame and assumes intention that may not be there. Expressing the same emotion through an ‘I’ statement instead may look like:

“I feel afraid when you come home late and I don’t know where you are, and when we’re not talking about it I feel lonely and worried.”

Similar to what we were saying before, this kind of language is far less likely to lead to misunderstandings that escalate the situation. This is because you’re not assuming and telling the other person what they’re thinking, you’re only voicing your own feelings. As stated in the Validation section above, there is always a reason for the presence of emotions that can be addressed respectfully. Expressing your own emotions in this way may also serve as a model for your loved one, making them more likely to express themselves in a similar respectful and validating way.

It may feel strange to switch to this kind of language at first, but with some practice you may be surprised how quickly it becomes natural. You can download a worksheet that uses this language here.

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[1] Forsbrey, A. D., Frabutt, J. M., & Smith, H. L. (2005). Social isolation among caregivers of court-involved youths: A qualitative investigation. Journal of Addictions & Offender Counseling, 25, 97-113.

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