When people talk about grief, they usually mean the loss they feel when someone dies. But other losses bring a type of grief with them too. Family, whanau and friends of people with alcohol and other drug misuse often comment that they wish things were different, often very different. The feelings associated with this may be very strong.
Grief theorists call this grief Chronic Sorrow. This term resonates with many who watch as a loved member of their family/whanau member or friendship group, struggles with alcohol or other drug misuse. Though family members do not always feel sad or stressed or angry, the frequent reminders that their loved one is coping with the complications of alcohol and other drug misuse, brings with it an ongoing sorrow which often comes to the surface in daily life. The situation for their loved one brings a sorrow that never goes away completely while there is alcohol or other drug misuse.
Parent of a young man with methamphetamine misuse.
Mother of a daughter with alcohol misuse.
Sibling of a woman with poly drug misuse.
Loss is part of life for everyone, and most people have found ways of dealing with loss as they grow up. Chronic sorrow, however, is different type of loss as it is a living loss. This type of loss can be a loss of some aspects of oneself, or the loss of some aspects of someone else, particularly someone who is loved and cared about. The losses associated with having a family/whanau member or friend misusing alcohol or other drugs are just such a living loss. This loss, which we call chronic sorrow, is different from the ordinary losses such as a death or divorce or loss of a job. These losses have a finality about them. With chronic sorrow we have a continuing, ongoing loss.
When someone has died, the loss is permanent and unchanging. Though it can take a long time, people usually find ways to come to terms with the new shape their life has without the person who has died. When a person has alcohol or other drug misuse, there is a living loss. As time passes, and even in the early years of a person moving past alcohol and other substance misuse, the difference between what might have been and the reality of what is, constantly changes. Concerned significant others generally need to adapt to new challenges as the years pass. Financial, housing, relationship and other challenges need to be worked through. The repercussions of legal situations may impinge on work opportunities. Though family/whanau and friends will take pleasure in each new milestone achieved, there often continues to be feelings of chronic sorrow for lost opportunities and challenges to be faced, amongst the hope and possibilities of progress made.
Many concerned family/whanau members and friends say that the only people who understand how they feel are other people who have been through similar experiences. There are no rituals to help people acknowledge the loss felt, or to help family members to deal with this loss. Also, because people don’t usually acknowledge their ongoing loss openly, often due to the shame felt in sharing concerns, many people lack support during their ongoing struggle.
Family, whanau and friends often comment that they feel they are coping well, and then something “hits them out of the blue”. Important family occasions, work events and times when families share space maybe hard. Occasions such as birthdays, anniversaries and times of death can also be hard. Seeing and hearing of the progress being made by the family members of friends and relations is particularly challenging and painful when contrasted against the limitations that alcohol and other drug misuse places on one’s loved family members’ progress. Setbacks to health and wellbeing in the family member or friend misusing alcohol or other drugs can also trigger feelings of sorrow. Planning for the future can be difficult and opportunities may seem to pass by. The feelings of sorrow that come with having a family member or friend with challenges around alcohol and other drugs often seems to be “in your face”. At these times the gap between what the family/whanau member or friend with alcohol or other drug misuse is achieving and how you and they wish things could be, is hard to deal with.
When a member of a family/whanau group or friendship group has alcohol or other drug misuse, it is as if all that one has dreamed of for the person with challenges, and all that had been hoped for the person, needs to be put aside to some degree. Some people talk about feeling cheated. Their loved one’s life is not the healthy or normal life expected. For most people, it’s not that they don’t love the family/whanau member or friend they have, but that they find it hard to accept that alcohol and other drug misuse has robbed them of their fantasies of a family member or friend who will go on to live a full and happy life. Though this loss is “only” of a dream, rather than a reality, it is no less painful for many people.
“Chronic sorrow, a normal grief response, is not the same as grief at the finality of death, where the person who is loved will be forever absent. Chronic sorrow is not about endings; it is about living with unremovable loss and unmending wounds. It is about losses requiring – and demanding – energy and persistent courage to cope with crises and making the adaptations necessary in order to live a life of one’s own. It is about year upon year of dealing with the inevitability of a loss that continues and of finding a way to achieve some balance between reality and losing one’s grip entirely.”
Susan Roos (from the Foreword to “Chronic Sorrow”. See Further Reading for details)
Community attitudes play a big part in the way families/whanau and friends respond to having a person they care about who is experiencing alcohol and other drug misuse. Chronic sorrow is a complex issue though, and there are many factors that affect the way people experience it. What may be a disaster to one person or family may seem less important to another. Some of the factors that may make a difference include:
Families may see any family situation as a threat to their family’s stability, a curse, or a burden. Some families see the situation as a time of challenge which can be met together.
Similarly, family members may see themselves differently in response to the person with alcohol and other drug misuse. They may see themselves as being a passive victim of circumstances, or as someone who can’t cope with difficult things. Or they may see themselves as resilient and strong, courageous and assertive, loving and accepting. They may have a strong sense of themselves as a worthwhile person, or they may feel shaky about themselves. Seeking to build coping and resilience, however one sees oneself, is an important task.
People’s responses are also shaped by the way their family/whanau and friends respond to the person they care about who has alcohol and other drug misuse, and by the amount of good support they get, to deal with him or her.
The social and financial circumstances of the family can play a part in how they experience a person with an alcohol and other drug misuse challenge in the family. A family which is already under strain financially, which has difficult living conditions, or existing problems such as misuse or abuse may find having another family/whanau member with alcohol or other drug misuse an extra burden. Families where there has already been loss, on top of existing grief from the past, may struggle to cope at times.
The type drug misuse can play a part in the level of intensity of chronic sorrow. The fact that alcohol and prescription drugs are legal drugs, whereas other substances are illegal drugs, can have an impact on family/whanau and friend’s ability to cope with chronic sorrow. If drug misuse results in sudden and unexpected crises, coping with feelings can be challenging.
There are some organizations in the community which work to provide help for families/whanau and friends who are supporting a person with alcohol or other drug misuse. Groups such as whanau organisations, church groups, government or non-government organizations offer some support. Support for concerned significant others, however, is not widespread. Having access to a small group of supporters outside the immediate family can provide a different perspective and allow family/ whanau and friends to see they are not alone as they cope with challenging situations.
In a word: differently! Everyone has their own response to loss. Chronic sorrow is like a fingerprint: everyone’s experience of it is unique. Some of the more common feelings are:
Guilt can be a constant companion when there is a family/whanau member or friend experiencing alcohol or other drug misuse. Concerned significant others may feel guilty about their feelings of resentment, or their constant longing that things should be different. They may find themselves thinking about how things might have been “if only…” and feel guilty about such thoughts.
In addition, many family members feel a sense of guilt that they caused the drug misuse in some way. It’s very hard to live with the idea that very painful and difficult things can “just happen” out of the blue. They may try to regain some feeling of control. They may search for someone or something to blame in an attempt to make sense of what has happened. Where the reason isn’t obvious, people may blame themselves. There may be a rational reason for this guilt or it may be an irrational feeling. Parents can sometimes feel guilty that there is a genetic predisposition to alcohol or other drug misuse in the family.
Watching someone you care about experience alcohol or other drug misuse can cause anxiety at times, and sometimes it can seem as if anxiety is a constant companion all the time. Suddenly, family members and friends are dealing with difficult issues. They may not feel as if they have any control over their life and become anxious about what else might be in store for them.
For many people with family members experiencing alcohol and other drug misuse, these kinds of anxieties and fears are part of the chronic sorrow they experience. Family members and friends talk about feeling constantly vigilant, of life feeling relentlessly stressful, and of never feeling they can truly relax and trust that their loved one is OK.
The unpredictability of life with a family/whanau member or friend with alcohol or other drug misuse adds to the stresses felt. People who deal with stressful situations by planning carefully may find this especially hard. Planning ahead is so often disrupted by those whose behaviour is erratic. For family/whanau members and friends who like to have a strong sense of being in control of their lives, this inability to manage their life can feel very stressful. Never knowing what’s around the corner, and how hard it might be to deal with, is unbearably stressful for many people who are trying to build coping and resilience in themselves and at the same time separate from a loved one’s behavior, while continuing to support them at the same time.
Parent of a son with poly drug use.
People often measure time in terms of expected milestones in their lives or the lives of their loved ones. When their child or partner doesn’t “fit the plan” they may start seeing milestones differently. Time may be measured instead by key events which are often bad experiences, such as “before she started using drugs” or “after her first encounter with the law, but before her second one.” Instead of a series of happy events to anticipate, life may feel like a story of things in the future to worry about.
Some people deal with the feelings of chronic sorrow by shutting down emotionally. They function best by keeping a lid on strong feelings of sadness, anger or fear. Unfortunately, when they do so, they often say they find it hard to feel strongly positive feelings of happiness and joy as well. Life becomes all a bit grey and colourless.
“Why us? Why our child? Why has this happened?” Making sense of what has happened is one of the hardest issues for family/whanau and friends of alcohol and other drug misusers to come to terms with. For some, having a family member with alcohol or other drug misuse feels like a punishment. For others, it feels more like a confirmation of their basic goodness, or of their ability to cope with hard things. However they see it, a life changing event like this is something that has to be fitted into their beliefs about themselves and their lives.
Family/whanau members and friends sometimes feel like they are under siege, standing all alone with their back against a wall. Some people comment that they don’t feel comfortable discussing their fears and challenges about their loved one’s behaviour, with “normal” families, where their actions or their loved one’s behaviour might be misunderstood or judged. In a world designed for “normal” people, where their family life is very different, family members often feel very alone. Having family and friends who are unsupportive often adds to this aloneness.
Family member of a young man with methamphetamine misuse.
People respond in very individual ways to having a family member or friend with alcohol or other drug misuse. Both men and women experience chronic sorrow, but they may show it differently. It’s hard to generalise, because for every generality there is an exception. It does seem, though, that the way men and women are brought up in our society often influences the way they respond to this situation. These differences can shape the way individuals experience, express, and deal with their losses
The wider family/whanau also generally experience chronic sorrow when faced with the alcohol and other drug misuse of a family member. For grandparents this can be especially hard, as they grieve for both their grandchild and the pain being experienced by their own child. Their support can be crucial to the family, but often they find it hard to acknowledge the extent of the challenge faced by alcohol and other drug misuse. Parents may find themselves needing to educate their own parents about the challenges involved, and then needing to do so again as the situation changes over time. In spite of these difficulties, families often provide strength as they work together to support one another.
Siblings also struggle with losses of their own when a brother or sister is facing alcohol and other drug misuse. Some older siblings talk of a double loss: losing the brother or sister they expected to have a relationship with and also losing their parent or parents as they have known them. Suddenly their parents are often unavailable, distracted, sad or grumpy. Their attention has not only shifted but also changed. The normal issues of the sibling may seem trivial and inconsequential to his or her parents, who are confronted with much larger problems to focus on. Like their parents, they struggle with the sense of life being unfair. They may feel angry about the family financial resources being spent on their sibling and about the times that plans have to be abandoned at the last moment. And like their parents, they feel guilty about these feelings. Parents are caught, trying to meet the needs of their family member with alcohol or other drug misuse and his or her siblings as well.
Things aren’t all negative. Families/whanau often find their other children become more tolerant of differences, more aware of the needs of others, and develop a greater sense of empathy and in some cases an increased appreciation of the importance of family support.
When faced with the initial realisation that a family/whanau member or friend has alcohol or other drug misuse, getting to the point where things seem manageable may seem a long way off. Building coping and resilience over time doesn’t mean life is not difficult at times; it means you find ways to separate from a loved ones behaviour, develop your own life and still support the loved family member or friend. The following are some ways that people managing the juggle have found useful.
When loss of any kind occurs people hear a lot of advice from others about the need to “accept” what has happened. Though people might be able to find silver linings for this cloud sometimes, the fact remains that for many people it is a cloud, at least at first. Sometimes life doesn’t make sense and isn’t reasonable or fair. Developing coping and resilience skills around hobbies, time for self, work/life balance, enjoyable outings, friendships, etc is very important. Making time for these things often takes considerable effort.
One of the things that often surprises newcomers to support groups, where they can meet with supportive others who understand what they are experiencing, is the laughter. Participants love to have a laugh about the sometimes appalling situations they find themselves in, with someone else who’s been there and understands. Family members often find that having a good laugh relieves tension and lifts their spirits like nothing else can.
A positive and cooperative spirit is one of the key factors that help families to cope with the stresses of having a person they care about experiencing alcohol and other drug misuse. When families are faced with a lot of demands, it’s worth investing time and effort into building a positive kind of spirit when you can. Prioritising enjoyable things that can be experienced and enjoyed as a family e.g., holidays, games, nice meals, video nights at home, family celebration, sports. Whatever is possible, is worthwhile. A cooperative spirit is also created when families talk through issues and make decisions together.
Living with the chronic sorrow associated with having a family/whanau member with alcohol and other drug misuse can leave people feeling inadequate and helpless. It often helps to think about strengths, and how these might be used to cope with the situation. If someone is a people person, for instance, it helps to get out with others, or join or start a support group. If someone is good with the mind, it is good to make plans and goals to work towards. If someone likes to write or is creative in other ways, keeping a journal or making or creating works that express feelings can give pleasure. If someone is practical and down to earth, working on a project may help ease stress. If the computer fascinates, the internet can be used to access information and support for oneself. And if one has good physical skills or wants to have better physical skills, sports or exercise are a way of working through feelings. Don’t forget too, that there is usually someone else in the same boat that you can support.
Ask family/whanau members who are trying to support someone in the family who has alcohol and other drug misuse where their own needs come, in relation to everyone else’s needs, and they’ll usually smile ruefully and admit that they put themselves at the bottom of the list. Doing something for enjoyment, getting out and reminding oneself that there is life outside the immediate issues that often overwhelm one’s mind, really helps. Exercise is very important for many parents. Making time for a run or a session at the gym can be hard but is worth the trouble. For others it’s cossetting things like a long bath, retail therapy, or going to the hairdresser. Many parents enjoy distracting activities like losing themselves in a good book or a funny programme on TV.
Mother of a poly drug misuser
Many people comment on qualities that they have developed; qualities they are proud of and that they feel have made them a better person. Often they say they have become stronger, or more patient, kind and caring. Some mention developing skills such as flexibility, advocating for themselves or their family member or friend, or developing empathy for other points of view. Some people comment that dealing with health and law professionals has helped them become more assertive and stroppier, and they like that in themselves! And many people comment that this crisis in their lives has changed their perspectives about what really matters; that they don’t “sweat the small stuff” any more, and they have better skills for dealing with other problems that arise in their lives.
Meeting other families who are struggling with similar issues is one of the key positive outcomes for many people, although research suggests that seeking such help is very difficult for most people. To this end on-line support is generally found to be of real use and many people gain new knowledge and skills.
Spending time with other people who share newly developed perspectives on what is important in life, who understand that sometimes things change fast, and plans have to be flexible and who realise that nobody’s perfect, is an unexpected bonus.
Chronic Sorrow: A Living Loss by Susan Roos.
Published by Brunner-Routledge, 2002
Susan Roos is a psychotherapist who has been in practice for over 36 years. Her daughter Karen died when she was 3 years old, and her daughter Val is severely retarded, autistic and has a seizure disorder. This is the key book to read if you would like to learn more about chronic sorrow. An updated version is now available. (See below)
Chronic Sorrow: A Living Loss by Susan Roos
Publication date: 2017
Publisher Taylor & Francis Ltd
Edition statement 2nd New edition
This 2nd Edition of Chronic Sorrow, published 15 years after the 1st edition above explores natural grief reactions to losses that are not final and continue to be present in the life of the griever. This second edition updates terminology, pertinent research, and the roles the concept of chronic sorrow has come to play in the nursing, medical, social work, pastoral, and community counselling professions, among others.
McLaughlin, Victoria Grace, “Chronic Sorrow In Family Members Of Addicts: An Investigation Of Partners Of Addicts And Divorcees To Explore Chronic Sorrow As A Theoretical Understanding Of The Experiences Of Family Members Of Addicts” (2016). Dissertations, Theses, and Masters Projects. Paper 1499449812. http://doi.org/10.21220/W4R94S
Dr Pauline Stewart is an Educational and Counselling Psychologist in Private Practice in New Zealand. She is a member of the New Zealand Psychological Society and the New Zealand Association of Counsellors. She had many years of experience in teaching and management prior to becoming a psychologist. Pauline has a particular interest in the area of grief and loss in families and the challenges of alcohol and other drug misuse.