Up Close With Dr. E

When treatment works


Children do not choose their families, they are just born into them. The chance that a child will end up in a healthy family — kind, loving, stable — is the same as buying a lucky lotto ticket: A game of chance. Unfortunately, for children born into troubled families, life is not a game. No, for them, living in a family shattered by alcoholism, drug addiction, infidelity, and earthquake-like instability, is a constant nightmare of survival. Children born into deeply troubled families live with forces felt but not seen. Like an invisible monster, unhealthy family forces tear, rip and dismember the emotional hearts of their children. These children have one hope — someone with great power will save them, rescue them and fix all the wrongs done to them. Too young to know the word, they yearn for justice.

But what if these troubled families cannot fix themselves? What if no one in their family has the power to repair the damage? This is the story of one such family.

From birth to 6, Alicia’s life was stable. Her mother was a stay-at-home mom, and her father, a medic/EMT, worked three days on and four days off. At age 7, Alicia’s life was derailed: Her mom lost her second child at two months of age to Sudden Infant Death Syndrome and, unable to recover from the loss, she began drinking alcohol and taking pain medication, at the same time. Alicia took the role of “mommy’s helper” and began to do housework, dishes and laundry. As her mother’s depression and addiction worsened, Alicia’s support and loyalty to her grew (she believed she could fix her mother). Her father, a man who avoided all conflicts and hated arguments, stayed passive and quiet until he learned that his wife was having affairs. He told her she had one choice: “Get treatment for your depression and addiction, stop your affairs, or get out.” So, Alicia’s mother moved two hours away to live with her sister, and her father filed for divorce. Her father received custody of Alicia, with her mother having visitation.

When Alicia was 9, her father re-married. Problems erupted when Alicia turned 10. Each time she returned from visits with her mother, Alicia was hostile, mean and defiant to her step-mother. It would take two to three days, after returning from her mother’s house, for Alicia to settle back into her normal routine. When Alicia reached 13, problems worsened: Her grades dropped to D’s, she developed a pattern of lying, began to hang around with kids who used drugs and her anger toward her step-mother was out of control. I became involved with Alicia when her step-mother brought her in for treatment. The event which forced her into treatment was when her step-mother found her diary, which covered topics such as having unprotected sex and smoking pot. Another problem became clear: Alicia had achieved great power over her father, with threats of “going to live with mom.” Dad wilted under this threat. Basically, Alicia had blackmailed her father.

Alicia’s family is a perfect example of the need for family counseling. Some of the goals for the family would be:

1.) Dad needs to overcome his fear that Alicia would leave him and go live with mom and apply parental power with clear rules and consequences for his daughter. He also needs to back up Alicia’s step-mom, so she can begin effective parenting of Alicia.

2.) Alicia must learn that her mother’s depression and addiction were not her fault, and that she had not failed to cure or heal her mother.

3.) Once Alicia’s mother receives the proper care for her depression and addiction, she will be able to rebuild her relationship with Alicia.

4.) Alicia’s father should become more involved in Alicia’s life by spending much more time, one-on-one, with her.

5.) Alicia’s stepmother needs to build a deeper relationship with her, one that will teach Alicia that being close to her stepmom is not a betrayal of her loyalty to her mother.

6.) Both Alicia’s mother, father and Alicia have work to do on their grief over the loss of their child and brother, that died at two months of age.

Family counseling is an opportunity to rebuild damaged relationships and restore healthy family functioning. It takes great courage and commitment by parents to tell your children: “Our family needs professional help”. Children learn from the actions of their parents. When they see their father, mother, or stepparent really trying to fix family problems, they learn a life lesson — My parents love and care for me, and I am their priority.

The content of this article is for educational purposes only and should not be used as a substitute for treatment by a professional. The characters in this story are not real. Names and details have been changed to protect confidentiality.


Dr. Richard Elghammer contributes his column each week to the Journal Review.


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