Parenting factors placing children at risk for substance abuse

Although other factors are likely also at play, the seven most influential parenting factors that place children at risk for substance abuse problems are discussed here.

1. Temperament of the child

Because the temperament of the child is present at birth, I chose this as number one, particularly when associated with the children of alcoholics. This is a behavioral characteristic that exists in the first few months of life. Temperament is genetically determined, and it effects social ability.

Early prevention is crucial in these children. Temperament can predict behavioral problems and substance abuse. In the 1977 Mass and Tremblay study, boys, who were 6 years old at the time, were predicted to misuse substances before the age of 14. These 6-year-old boys also exhibited disruptive behaviors, oppositional behavior, and hyperactivity. In their adolescent years, they used tobacco, alcohol, and drugs.

Parents of such children have several obstacles to overcome, as temperament does predict low harm avoidance and high novelty seeking behaviors. In other words, they might be considered thrill seekers.

Johnny was a 10-year-old boy who could not sit still in class, and was easily distracted. He was frequently hurt during recess, and had to see the nurse daily. He was described as a daredevil, and would do things such as jumping off of the swings or running on asphalt. He was also known to push other kids around, and was also involved in fights. On two occasions, he was caught smoking. It was thought that he may be a thrill seeker, and he was suspected of having Attention Deficit Disorder. His teacher spoke to the school counselor so that he could be scheduled for testing.

2. Attachment disorders

Attachment disorders are caused by inadequate nurturing. I listed this one second because attachment disorders occur at an early age.

Attachment disorders are caused by a lack of bonding with the parent. Females with attachment disorders are prone to Borderline Personality Disorder, while attachment-disordered boys tend to exhibit Antisocial Personality Disorder. Children with adverse childhood experiences may use alcohol or other substances in order to self-medicate at an early age. Difficulties with emotional regulation are common in children with attachment disorders.

The lack of early bonding with a parent can effect the relationships these children have with other people, as well. These children have a hard time forming intimate relationships, and are likely to suffer from poor self-concept on an ongoing basis throughout their lives. They may also suffer from depression.

Alcohol and drugs can cause the addicted parent to be unavailable to their children, and the children of fathers with substance abuse issues are found to have higher levels of insecure-avoidant style of attachment.

Karen is an adult who recently came into a recovery program. While at a meeting, she hears a woman speaking who has been in long-term recovery. She identifies with the woman when she hears her speak of her fourth marriage ending. Karen listens intently as the woman talks about her childhood, with parents who were both alcoholics. The woman recalls having to take care of her sister when she was seven. She hated her father and avoided him as much as possible, and. her mother was never around.

Her grandmother, who passed away several years ago, took care of her, but her grandmother was also an alcoholic. The woman speaks of being left alone, even at a young age, and being kept in her playpen. At a very young age, she learned that her mother was in a state hospital due to alcoholism and mental health issues.

The woman also speaks of her feeling that she was never truly loved. She also speak of her fear of conflict, and that she would avoid her last husband at all costs. Karen is overwhelmed by the story. It seemed as if it were her own story.

The woman then says that she was recently diagnosed with attachment disorder. She says that she can't believe the progress she is now making in recovery. She only wishes she will have a true, intimate, ongoing relationship in her recovery. She never felt connected in her past relationships, and something always happened to cause them to end badly. She was never intimately close to any of the men she was married to. However, she thanks God that she doesn't drink anymore. Maybe now, she will have half a chance.

3. Parental imbalance and substance abuse

I chose this as the third factor because it is responsible for a large number of adverse childhood experiences. Twenty-eight million Americans have at least one parent with substance abuse disorder.

Substance misuse can cause an imbalance in the family system, which can have a negative impact on the children. Parents who misuse alcohol or drugs often model negative behaviors to the child, such as anger, criticism, and critical blame. This can lead to feeling of isolation and being alone, with subsequent negative consequences to the child. Additionally, the lack of supervision and emotional availability can place children at risk for substance abuse. The words and actions of an imbalanced parent can severely impact the child.

Karen always felt like she was wal
king on egg shells when it came to her parents, as they were always drinking and arguing with one another. Whenever she entered the room, her parents would be critical of her weight and appearance.

Her mother would tell her that she had her father's genes, and she was going to be fat her whole life like her father's sister. Karen's mother was beautiful and slim, and Karen never felt as if she measured up.

Her parents told her that she was lazy, and spent too much timme lying around in her room. Her father said she dressed like a boy, and that she was the boy they never had. Other than this, her parents never had much to say to her, as they drank and argued with one another. They only interacted with Karen on a negative basis.

Karen's parents modeled this behavior since she was a baby, and Karen believed what they said, internalizing what her parents thought of her. When she was old enough, Karen got out. It couldn't be quick enough. She left it all behind.

Karen met a man twice her age, married him, and had a child. Because Karen had never had healthy role models for herself, she was emotionally unavailable to her son. Because of her own limited emotions, she didn't express emotion with her son. The only connections Karen had ever had were negative.

From the time that her son was born, he was chunky. Once he was old enough to understand, she began to ridicule her son at the dinner table, speaking to him in the same manner that her parents had spoken to her. Like her parents, Karen had also grown up to be a drinker, and she would quarrel with her husband all the time. In response, her son would only come out of his room when he had to. When he did, he knew to expect constant anger, criticism, and condemnation.

In recovery, and through counseling, Karen came to realize that she had learned these behaviors, and to appreciate that she was doing the same thing to her son that her parents had done to her. She was modeling the same behavior that her parents had modeled to her.

4. Shame and imbalanced parenting

I chose the fourth factor because shame can be at the core of a person's being.

The parents are active substance abusers. The father has sexually abused his son, Johnny, and the mother protects the father because she feels guilty. She drinks so much that she passes out at night. The son is damaged, depressed, and suicidal, living with invasive boundaries and no discernable rules of interaction.

Depressed, Johnny slips into feeling unlovable, and feels tremendous shame about what has been happening. He has no one he can confide in, he doesn't feel worthy of being loved, and he doesn't feel safe. Confused over the sexual abuse, he feels partly responsible for what has happened, and is experiencing terrible guilt. The mother feels shame and guilt over not having helped her son, while the son feels shame and guilt over something he had no control over, the violation to his core.

Johnny attempts suicide and ends up in the hospital. As a result, his mother and father both feel a great deal of shame around their behavior, the father for having sexually abused him, and the mother for having failed to protect him from her husband.

Nevertheless, when the doctor recommends counseling for their son, the boy's parents are resistent because they are afraid that their secrets will get out. They just want him to get over it. The boy doesn't know how to communicate with his parents, nor they with him. This is a shame-based family.

Untreated, Johnny grows up and meets a girl, and they move in together. It isn't long before Johnny gets frustrated with her because she doesn't come home on time. This makes him feel that he is unimportant to her, and that he doesn't matter. His parents never let him feel as if he was important to them. As he watches the clock, his frustration grows. Her lateness is viewed as a lack of respect for him, and his anger grows.

The moment she comes in the door, he accuses her of cheating on him, saying that she clearly doesn't love him enough to respect his time. Anger turns to rage, and he starts pushing and hitting her. Of course, his behavior pushes her further away from him.

This sequence of behavior replays over and over again. His girlfriend is stuck in this cycle of domestic violence and feels violated yet, due to Johnny's adverse childhood experiences, trauma, and guilt, the relationship continues this way, stuck in a cycle of abuse. Johnny always feel ashamed afterward and vows not to let it happen again, but it does. His behavior perpetuates the shame, and he feels that he is damaged forever.

5. Boundary problems (triangulation)

I chose this as the fifth factor because it, too, can cause imbalance in the family system. For some reason, I think this might be one of the softer family system setups, although it does interfere with connections, so it is a potential problem. Triangulation caused by rigid boundaries can have a negative impact on a child, and the family system becomes unbalanced. With rigid boundaries, there is a preset code, rules are to be adhered to strictly, and the preset code is the priority. There is no room for adaptability or responsiveness to situational change.

A healthy boundary is one that sets respectful negotiation and connection with the children. Parents who neglect boundaries set their children up for poor developmental skills. Healthy boundaries set up as a way of interaction and function.

Substance abuse in the family causes imbalance and confusion, as the substance-use family revolves around the alcholic who is unbalanced, and trying to keep the alcoholic in the family system. This is in stage one, characterized by early denial and clustering. In stage two, anger replaces denial. In stage three, individual boundaries become clearer, while stage four includes action to resolve the problems brought about by alcoholism. When successful, family members can begin to connect, set up. healthy boundaries, and develop relationships in stage five.

However, when the parent or parents who are addicated to alcohol or other substances fail to go through the stages of recovery, the outcome is likely to be unhealthy. Often seen, is that one parent will try to win the child over, creating triangulation and imbalance within the family. Children may also be expected to take unhealthy advantage of this imbalance, furthering the imbalance caused by triangulation. One parent, usually the mother, will be become overinvolved, mking excuses for the child, overlooking or making excuses for violations of curfews or other boundaries that may have been set up. On the other end of the triangle, the father will insist that the child adhere to the curfew, and do so very rigidly. The boundary enforcer becomes the bad guy, while the mother becomes favored, furthering imbalance in the family system.

6. Parent criticism, anger, and blaming the child

This, too, can erect barriers for the child that may not be overcome without good counseling. The lack of emotional and physical availability can place the child at risk of substance abuse, and being the target of undeserved blame can isolate the child from other family members. Criticism results in defensiveness on the part of the child, who will not want to communicate with the criticizing parent, and is likely to develop problems in other relationships. Frequent criticism, anger, and blaming will cause emotional distancing.

For instance, Johnny may have low self-esteem due to the lack of availability of a stable parent, and the presence of what feels like unwarranted criticism, blaming, and anger. It seems that Johnny can't do anything right. Even when he completes all of his chores, is father angrily points out flaws that he finds in what Johnny has done. Criticism turns to anger and shouting. In anger, the father tells Johnny that he is useless, and that his two-year-old sister could do a better job.

As the rage amps up, Johnny backs away from his father, while his father keeps edging closer and, by now, he is screaming at his son. "You are such a stupid boy! You will never amount to anything! When your mother gets home, I am going to tell her how stupid you are. You are worthless!"

Johnny runs from the room, and isolates. This occurs on a daily basis. As Johnny is in his formative years, he internalizes all of this, resulting in a negative sense of self. Johnny believes that he is all of those things that his father called him. Not only does this add to the unbalance in the family system, but it creates fear-based barriers for Johnny, particularly in the areas of trust and connection. Johnny is at risk of substance abuse because he may drink or use in order to numb the negative feelings and emotions.

7. Parenting style

I chose this as the seventh factor because negative parenting can created a variety of survival coping mechanism, including fight, flight, or freeze. The child is unable to grow in healthy, balanced relationships, and this can cause trauma.

If Johnny and his family do not seek help, Johnny's unhealthy coping mechanisms will play out over the course of his life, and these will likely include substance abuse.

In adulthood, Johnny may keep re-traumatizing himself in unhealthy relationships. In recovery, this can be a second bottom. In fact, Johnny chooses these unhealthy relationships, albeit not on a conscious level. This type of relationship has become so ingrained in Johnny that he keeps playing it out. On a deep, subconscious level, Johnny doesn't feel like he is worthy of anything better. Instead, he seeks the familiar, and cannot connect on any other level. When one relationship after another fails, this adds to the guilt and shame.

Early intervention might have resulted in a different outcome.

-- Suzanne Correiro