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Substance Use Blog Series: Self-Care for Loved Ones

Today’s post is about self-care for loved ones of individuals who struggle with substance use challenges. This can refer to caregivers, partners, family members, or anybody who is close to the person struggling. There’s a lot of information available about self-care and it is an important topic for everybody, but the topic warrants unique consideration for loved ones of those with substance use challenges.

When someone we care about is struggling, the emotional toll can be devastating. It may feel counter-intuitive to engage in self-care at all because of how all-encompassing the worry for your loved one may be, but taking a step back to care for yourself is incredibly important for the wellbeing of everybody in the family, including the loved one who is struggling.

Common struggles for loved ones

While every individual, dynamic, and family is different, various studies have found common factors among loved ones of those with substance use challenges, some of which include isolation and depressive signs [1].

Isolation

Isolation is one of the most common and detrimental of these factors. There are many reasons loved ones may feel driven to isolate. Stigma is defined by the Canadian government as “negative attitudes and beliefs about a group of people due to their circumstances in life.” Several blog posts have already approached the topic of stigma, the first of which can be found here. Substance users face a great deal of stigma from various angles, but caregivers experience stigma aswell, which is referred to as secondary stigma:

“the experience of stigma by family or friends of members of stigmatized groups.”

Loved ones may feel judged by those around them, and/or may experience self-blame for their loved one’s struggles. If as a loved one, you feel judged by your community, isolating is a natural reaction. The wounds of feeling excluded and unsupported while going through such a vulnerable time run deep, and it may feel like isolating is a protection from them. While isolating may feel like a protection against the direct threats of being judged, it may also result in caregivers feeling like they need to deal with their personal pain while bearing the pain of their loved one all on their own [2].

Resources

While isolation can be one of the hardest things caregivers and loved ones go through, connection can be one of the most healing. It may feel like there are no places to turn to experience connection and validation for the pain you’re going through, but there are resources and they have been shown to help. Some of the most effective connections for caregivers are individual therapy, psychoeducation groups, and support groups [3]. This post provides a list of resources for caregivers in Delta, and our individual counselling services also offer caregiver support.

Various Recoveries

Recovery is usually referred to as a personal process for the person experiencing substance use challenges. This is the primary focus of course and is deeply personal for the person struggling, but the family also goes through a simultaneous recovery, as does each individual in the family. A previous blog post went through the Stages of Change, which is a framework describing where someone is at in terms of readiness and desire to change, starting with precontemplation and ending with maintenance after a change has been implemented.

Family members can go through the same stages as substance users in terms of accepting the reality of the situation. Just like recovery is a personal for the person struggling with substances, it is personal for loved ones as well.

The processes of these multiple recoveries may not always line up, and family members may find themselves at conflicting stages at different times [4]. Experiencing your own grief and/or isolation on top of worry for your loved one can be absolutely draining and feel like a loss of hope. This is why self-care is so important.

Hope

In a study that looked at what factors are associated with family recovery, hope, coping skills, and reclamation of choice were among the strongest. Sterling Shumway and Thomas Kimball defined hope as “a reawakening after despair” and “the ability to expect with greater confidence.”

As it turns out, as a loved one, it is just as important to nurture hope for yourself as it is to hope for improvement in the life of your loved one [4].

This is easier said than done to be sure. It can be incredibly difficult to grasp hope while navigating a loved one’s substance use challenges as well as your own worry, but it is vitally important to hold on to it when and where you can find it.

The first step to finding your own hope is to acknowledge the emotions you’re experiencing and allow them to be there honestly. Letting go of control can begin to release these emotions, and expressing compassion towards them is so important. Of course everybody will engage in their own process, as there is no one-size-fits-all way to approach this. American Addiction Centers suggest some self-led exercises, one of which is to write a letter to yourself from the perspective of a loving, kind, and compassionate friend. When in the throes of overwhelming emotions it can be hard to untangle self-criticism enough to access self-compassion, but oftentimes speaking to yourself as you would to a close friend can help to bridge that gap.

Coping skills

Hope helps to build healthy coping skills.

Coping skills are defined as “the development of effective skills to manage the stress of life,” and are strongest when flexible and adaptive to changes [4].

If it feels like your coping skills are unmanageable during early recovery, or at any point in recovery, that is absolutely normal. Effectively managing stress is hard enough in the best of times, but when someone you love and care about is struggling, it becomes so much harder.

When we’re overwhelmed, our fight-or-flight response that reacts to threats in our environment is activated, and our rational brain essentially shuts down. This makes it harder to see gray areas, be adaptive, and be in tune with the world as it changes around us (Gottman Institute). This stops us from being able to practice coping skills rationally, especially in a flexible way. We step out of fight-or-flight mode by slowing down and regulating our nervous system. Once we’ve done this and our emotions are able to process through our body, then our rational brain is more accessible and we are able to cope more effectively. This is another reason why stepping back, validating your emotions, and nurturing your own sense of hope is so important. The last factor we’ll discuss is reclamation of choice.

Choice

We discussed the importance of reclaiming stories for those who struggle with substance use last week. Reclamation is so important because those experiencing substance use challenges often feel a lack of control in their lives due to the strenuous recovery process that includes so many struggles they did not choose.

Finding ways to regain a sense of choice in areas that are accessible to them can be very healing and can help them foster their own sense of hope.

This becomes difficult to accomplish if they feel all of their choices are being made for them or they are coming up against processes that are out-of-sync with their own, even if it comes from a place of worry that is rooted in love.

It may feel wrong to focus on taking care of yourself while your loved one is struggling, or like a kind of abandonment even if momentary. Oftentimes, loved ones feel that worrying makes them diligent, and that if they disengage from it even for a few moments, they will miss something crucial. If you relate to this feeling, just know that such anxiety shows how much you love and want the best for your loved one and is totally understandable, but support cannot be offered in its full capacity if you’re running on empty.

Modelling can also play a huge role when close to someone struggling with substance use. This means that if you are taking care of yourself while in contact with your loved one, they will observe that behaviour and be more likely to treat themselves in a similar way. The book Beyond Addiction: How Science and Kindness Help People Change sums up self-care for loved ones:

“When you take care of yourself, you build strength to both tolerate what you can’t change and change what you can. At the same time, as a calmer, happier person, you will be contributing to an atmosphere that is conducive to change you hope to see in your loved one, and you will be modeling healthy behaviours you wish for in your loved one.”

Today’s post was mainly about the importance of practicing self-care as a loved one of someone experiencing substance use challenges, because we know it can be difficult to approach. One of our previous posts provides suggestions and methods for self-care. Since it can be common for loved ones to be so focused on the individual who is struggling, you may feel somewhat out of touch with your own self-care needs. We have provided a self-care assessment that you can fill out that encourages you to reflect on your own wellbeing and notice which areas may need extra attention. It can be downloaded here.

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[1] Settley, C. (2020). The physical and psychological wellbeing of caregivers of individuals suffering from substance addiction. Archives of Psychiatric Nursing, 34, 107-109.

[2] Soares, A., Ferreira, G., & Pereira, G. (2016). Depression, distress, burden and social support in caregivers of active versus abstinent addicts. Addiction Research & Theory, 1-7.

[3] Coulombe, S., Krzesni, D. A., Jones, S., & Boyd, M. H. (2018). Supporting family caregivers of people living with mental health, addiction, and other issues: Narrative review of Canadian and international intervention studies. J. Psychosoc. Rehabil. Ment. Health, 5, 183-197.

[4] Bradshaw, S., Shumway, S. T., Wang, E. W., Harris, K. S., Smith, D. B., & Ustin-Robillard, H. (2015). Hope, readiness, and coping in family recovery from addiction. Journal of Groups in Addiction & Recovery, 10(4), 313-336.

 

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