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Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
Dr. Schwartz's Weblog

Intervention, ADHD, Addiction and Enabling and the Family Crucible

Allan Schwartz, LCSW, Ph.D. Updated: Jan 20th 2010

crack pipeOne of the best reality television shows is A+E's Intervention. Last night, Monday, January 18, 2009 and 10 PM Eastern Standard Time, the show focused on the tragic struggle of a family and its oldest son's addiction to crack cocaine. This particular show was notable for the way it accurately depicted several comorbid mental health problems. The title of the show is "Vinnie," the drug disordered son.

The case of Vinnie:

The family consisted of the oldest son, Vinnie, twenty eight years old, an older sister and a younger brother. The parents were divorced when Vinnie was 14 years old. Unable to handle Vinnie without beating him, the father gave up on Vinnie and sent him to live with his mother and sister.

Vinnie's father was totally unable to understand his son and his ADHD. He used physical punishment and verbal insults in an attempt to control Vinnie. Yet, Vinnie, who came to hate his father, was desperate for his father's approval. 

Vinnie was diagnosed with ADHD when he was eight years old. He was uncontrollable at school, always acting as the class clown. Despite the fact that he was prescribed Ritalin, he would cheek and spit out the pill each time it was given him because it made him feel too calm.

Extremely impulsive due to his ADHD, Vinnie excelled at risky sports and at building cars. At age 13, he became a champion dirt bike racer for his age group. As a result, he was placed in an older group but defeated his older rivals there. Impressed with Vinnie's racing abilities, the league wanted to send him to Florida to engage in training for serious dirt bike racing. However, when Vinnie tried to discuss this with his father, whom he thought would be proud of him, he was told it was a "stupid idea and that the is a moron." Defeated, Vinnie gave up on bike racing.

After his parents divorced, Vinnie dropped out of High School land started to experiment with drugs, especially marijuana which he found to be very calming. He then advanced to crack cocaine and became quickly addicted. His addiction increased to a level where he was smoking 7 times each day and spending over $1000 per week.

Talented with automobiles, just like his father, Vinnie funded his drug abuse by stealing either cars or parts of cars. Because of his skills, he could defeat any type of car alarm and steal without ever being caught by the police.

Ultimately, there was an intervention that the father did not attend. Vinnie agreed to attend a drug rehab. program in California but left after 90 days. In fact, his mother flew him home first class. He returned to her house and relapsed.

Discussion:

In my view, what is particularly valuable about this series of programs is that it demonstrates the importance of the family as a dynamic group or system that deeply impacts the behavior of each member right into and including adulthood. What this really means is that any type of psychiatric disorder is not the fault of any one person. Rather, families are held together by long established patterns of behavior that, when threatened, harden until every member falls back into compliance with those patterns. This happens even when the behaviors are maladaptive or disordered.

In the case of Vinnie, he was assigned or was born into the role of "patient or problem child." Without realizing it, the entire family conspired to keep him in the role of the "sick one." In is not an exaggeration to say that family members praised their father while devaluing Vinnie.

The Interventionist pointed out that Vinnie going into drug rehab was not enough to ensure his future health. She especially appealed to the mother who, she said, needed to change or Vinnie would relapse once home. Despite being offered a free scholarship to the Bette Ford clinic where she would learn about how to really help her son, she refused and cancelled the appointment after flying him home from California.

Caution:

It is important to state that the problem is not the mother but the family system. As with all human systems, everyone works to maintain the status quo. Any threat to that balance is eliminated. Sadly, the interventionist was viewed as a threat and not a friend.

First, the father refused to be part of the program, the younger brother was never able to alter his opinion of Vinnie nor of his father and the sister seems to have had no real voice. The mother looked for and found thousands of reasons to give Vinnie money and a place to live while refusing to attend the program at Bette Ford.

Too often ADHD and addictions go together. This case is a good example of what is happening in thousands of homes across the nation. Vinnie and his family are not bad or "evil people." I am including his father in this. Rather, they are just frail human beings who are threatened by change even when the change could be for the better.

One of the things that needed to change for this family is its understanding of ADHD. ADHD has nothing to do with intelligence, skill or being "good or bad." In fact, Vinnie is clearly talented in his ability to build cars and race motor bikes. However, the title, "loser," that his brother constantly applies to him remains pinned to his chest as does his father's label, "moron."

Vinnie needed to complete his rehab and to then be treated for his ADHD while the entire family and not only the mother, needed to learn more about both addictions and ADHD.

People live together in families and groups for nurturance, security and love. While these are necessary and even vital things, they can also serve to undermine our own best interests.

If you have someone in your family who is struggling with addiction, please remember that it is not only the individual who must change but all of you who form part of the family system.

If you have a child with ADHD or whom you suspect might have ADHD, have an evaluaton done and start treatment, whether that treatment includes medication and therapy or therapy alone.

Your comments and questions are stronly encouraged

 

 

Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at dransphd@aol.com for details.

Reader Comments
Discuss this issue below or in our forums.

Family dynamics - Symora - Jan 23rd 2010

It was so interesting reading our article.  I actually lived a relevant situation just tonight.  I went ot my sister,s birthday dinner at a restaurant, and we were my Mum, my aunts, my niece, my sister and her husband.  So lots of family dynamics going on :-)  And we started talking how I was so wild when I was young.  If fact I was not so wild, I just did things before I should have because I had a good adult job at the age of 16 because I finished High School so young.  And I was a 'hippie'.  Not a real one in my eyes, but I did walk around barefoot, listened to the Beatles and was an independent thinker.  What I was mostly is the person that was trying to say 'Please stop beating me, I can't take it anymore', but that was never heard...

Anyway there were always these family dynamic where I was the huge rebel, the hard child, my sister (this birthday sister) and my dad made me into the family scapegoat way back when and for some reason it got perpetuated for 40 years... no matter was I did, I was always the screw up.  Irony is I wasn't.  I've always held a good job, I raised two great girls alone, bought my own house, went to school, managed cooperatives.  I never understood why I could not change the family dynamic. 

But then 2 years ago my Dad died, and now things are changing.  My sister laughed hysterically tonight when I said I was not such a bad teenager, I simply was doing things too early because I entered the workforce too early.  She just looked at me and I think it was the first time she questionned what the reality really was.  Maybe everyone had always been protecting my Dad by putting all the focus on me...

All of that to say that I agree with you.  You can change, or try to change (for me the issue is lifelong depression), but when negative family patterns become entrenched it's not easy to pull yourself out of self-abasing behaviour when the ones around you don't want anything to change....

I haven't seen the shows but I'll start looking for them.

Salut

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