SUPPORTING LOVED ONES WITH SUBSTANCE USE DISORDER: BALANCING EMPATHY AND BOUNDARIES

Morapedi Sibeko 

• Supporting a family member with Substance Use Disorder (SUD) requires balancing empathy with firm boundaries to encourage recovery without enabling harmful behaviours.
• By applying Family Systems Theory, social workers like Ms Zinhle Mqadi highlight how SUD affects the entire family, especially children, who often experience emotional distress and instability.
• Establishing compassionate but clear boundaries empowers the person with SUD to take responsibility for their actions, while also creating a support network for family members to address their own emotional needs, ultimately fostering a healthier, more resilient family environment.

Supporting a family member with Substance Use Disorder (SUD) is a delicate task requiring both empathy and firm boundaries. Family members instinctively want to protect loved ones from the negative impacts of SUD. However, a lack of boundaries can unintentionally lead to enabling behaviours that may hinder recovery instead of supporting it.

“Understanding family dynamics through Family Systems Theory helps highlight the ripple effects of a parent’s or family member’s SUD,” said Ms Zinhle Mqadi, a probation officer at the Vulindlela Service Office, during an ongoing training session in Boksburg from 11–15 November 2024. She referred to children as “innocent casualties” who are often overlooked yet suffer deeply from feelings of anger, despair, and abandonment due to the instability that SUD creates. This ongoing stress, brought on by a family member’s SUD, can lead to emotional impacts that may even manifest as physical health issues. Close family members may experience behavioural and mental health problems, compounding family dynamics and often creating a dysfunctional household structure.

Even when the person with SUD enters recovery, the effects of the disorder persist. Mqadi argues that long after treatment begins, the shame associated with addiction can continue to destabilise the family. “SUD fractures a household, and it can take time for this stigma to lift,” she said. Children may suddenly take on caregiving roles, reversing the family’s established structure and turning the home into a child-headed environment. Family healing is often a long and challenging process, demanding patience and support from all members; this role reversal, in particular, can be extremely taxing.

Support must be rooted in love, compassion, and encouragement. Genuine support acknowledges the person’s struggles while fostering positive change. Enabling, on the other hand, can make it difficult to distinguish support from inadvertently maintaining the cycle of addiction. For instance, providing financial support without accountability, covering up missed responsibilities, or excusing harmful behaviours can unintentionally perpetuate the cycle of addiction.

Setting boundaries encourages the person with SUD to take responsibility for their actions, while allowing family members to protect their own wellbeing. These boundaries might involve not providing money, placing limits on behaviour, or refusing to assume the person’s responsibilities. By establishing firm but compassionate boundaries, family members can show love without compromising their own mental and emotional health.

One of the challenging aspects of support is letting the person with SUD manage their own finances, face work-related consequences, or deal with missed responsibilities independently. These experiences can be powerful motivators, helping the individual recognise the need for change.

In addition to emphasising accountability, family members can provide emotional support by listening and offering encouragement. For instance, they might offer to accompany the person with SUD to therapy or a support group, but they should respect their independence by allowing them to make the final choice. This approach acknowledges that, while the recovery journey is difficult, it is ultimately the individual’s responsibility to navigate it.

Creating a secure and supportive network where children and other family members can openly discuss their experiences can also be beneficial. Those directly affected can confide in other trusted family members, teachers, or licensed counsellors, who can help them process feelings of loss, grief, and anger. In addition to supporting family members, counselling or outside help can alleviate the trauma and mental health challenges that may arise from living with someone who has SUD.