The document discusses breaking the intergenerational cycle of substance abuse. It summarizes that unhealthy family patterns can be passed down through generations due to a lack of attachment between parents and children. This causes children to lack trust, have low self-esteem, and continue the cycle by selecting partners who also struggle with substance abuse issues. The document proposes interventions like building healthy relationships, teaching social and parenting skills, and establishing social support networks to help individuals break this cycle.

1. Breaking the Intergenerational
Cycle of Substance Abuse
National Rx Drug Abuse Summit,Atlanta,GA,April 6th
2015
Robert L.Neri,LMHC,CAP - SeniorVice President,Chief Program / Service
Officer
WestCare Foundation,Inc.

2. A Historical PerspectiveA Historical Perspective
of the Problemof the Problem

3. The Study of “Epigenetics”The Study of “Epigenetics”
How the environment actually
turns certain genes…
On or Off

4. Healthy Family ExpansionHealthy Family Expansion

CommunicationCommunication

RolesRoles

Emotional InvolvementEmotional Involvement

Behavior ManagementBehavior Management

5. World of Abnormal RearingWorld of Abnormal Rearing

DeprivationDeprivation

SurvivalSurvival

Dependency NeedsDependency Needs

6. ““De·pend·ent”De·pend·ent”
Dependent (adj):Dependent (adj): relying on someone orrelying on someone or
something else for aid, support, etc.something else for aid, support, etc.
Dependent (n):Dependent (n): a person who depends on ora person who depends on or
needs someone or something for aid,needs someone or something for aid,
support, favor, etc.support, favor, etc.
Controlled by a variableControlled by a variable
Based on the Random House Unabridged Dictionary, © Random House, Inc. 2006.

7. Causes of DependencyCauses of Dependency
An inability to fulfillAn inability to fulfill
one’s needs independentlyone’s needs independently

8. CoreCore Healthy FamilyHealthy Family ThemesThemes
Nurturance & Trust

9. CoreCore Healthy FamilyHealthy Family ThemesThemes
Nurturance & Trust
Expectations
& Control

10. CoreCore Healthy FamilyHealthy Family ThemesThemes
Nurturance & Trust
Expectations
& Control
Relationships &
Self
Esteem

11. CoreCore Healthy FamilyHealthy Family ThemesThemes
Nurturance & Trust Support
Expectations
& Control
Relationships &
Self Esteem

12. UnderstandingUnderstanding
The W.A.R. CycleThe W.A.R. Cycle
““World of Abnormal Rearing”World of Abnormal Rearing”

13. Reasons for Having ChildrenReasons for Having Children
Planned/UnplannedPlanned/Unplanned

14. Stages of the WAR CycleStages of the WAR Cycle
ConceptionConception

15. Stages of the WAR CycleStages of the WAR Cycle
ConceptionConception
Wanted/Wanted/
UnwantedUnwanted
PregnancyPregnancy

16. Stages of the WAR CycleStages of the WAR Cycle
ConceptionConception
Wanted/Wanted/
UnwantedUnwanted
PregnancyPregnancy
UnrealisticUnrealistic
ExpectationsExpectations

17. Parental AttachmentParental Attachment
and Attunementand Attunement

18. ATTACHMENTATTACHMENT
is the driveis the drive
to be Closeto be Close
andand
Cared AboutCared About

19. Attachment RelationshipsAttachment Relationships
give us our concept of the world:give us our concept of the world:
HostileHostile
FriendlyFriendly
NurturingNurturing

20. ATTUNEMENTATTUNEMENT
is about being in tune emotionallyis about being in tune emotionally
with the childwith the child

21. PARENTINGPARENTING
is more about theis more about the
RelationshipRelationship thanthan TechniquesTechniques

22. SAFETYSAFETY
is a learned behavioris a learned behavior

23. Stages of the WAR CycleStages of the WAR Cycle
ConceptionConception
Wanted/Wanted/
UnwantedUnwanted
PregnancyPregnancy
UnrealisticUnrealistic
ExpectationsExpectations
Role ReversalRole Reversal

24. CChildren learn to behildren learn to be
stress absorbers –stress absorbers –
““Soaking up the worriesSoaking up the worries
of their parentsof their parents.”.”

25. Living in a constantLiving in a constant
environment of stressenvironment of stress
means thatmeans that
high-stress becomeshigh-stress becomes
my “Baseline”my “Baseline”

26. II will seek outwill seek out
Stress and CrisisStress and Crisis
as my “Comfort Zone”as my “Comfort Zone”

27. Stages of the WAR CycleStages of the WAR Cycle
ConceptionConception
Wanted/Wanted/
UnwantedUnwanted
PregnancyPregnancy
UnrealisticUnrealistic
ExpectationsExpectations
Role ReversalRole Reversal
ComplianceCompliance

28. Must be taughtMust be taught
Healthy Survival SkillsHealthy Survival Skills

29. COMPETENCY BASEDCOMPETENCY BASED
APPROACH TO LEARNINGAPPROACH TO LEARNING
Competency Mastery Requires:Competency Mastery Requires:
o Information knowledgeInformation knowledge
o Implementation knowledgeImplementation knowledge

30. Both areBoth are Internalization ProcessesInternalization Processes
needed to achieve Recoveryneeded to achieve Recovery
 Internalization is checking forInternalization is checking for
UnderstandingUnderstanding
 Taking ownership of newTaking ownership of new
KnowledgeKnowledge

31. InternalizationInternalization is about makingis about making
learning Relevantlearning Relevant
Making associations betweenMaking associations between
characters and situations thatcharacters and situations that
can shape their decisionscan shape their decisions

32. Stages of the WAR CycleStages of the WAR Cycle
ConceptionConception
Wanted/Wanted/
UnwantedUnwanted
PregnancyPregnancy
UnrealisticUnrealistic
ExpectationsExpectations
Role ReversalRole Reversal
ComplianceCompliance
IsolationIsolation

33. Adults who hadAdults who had predictable,predictable,
nurturingnurturing parents are comfortableparents are comfortable::
o Being close and aloneBeing close and alone
o Have a secure attachment styleHave a secure attachment style

34. Adults who hadAdults who had inconsistentinconsistent,,
emotionally unavailableemotionally unavailable parents:parents:
o Often have an anxious attachment style
o Crave closeness and fear abandonment
o Want and need less space and are
more smothering

35. Adults who had parents who wereAdults who had parents who were
rejectingrejecting often have an:often have an:
o Avoidance attachment style
o Resisting closeness
o Seeking space
o Fear of being hurt

36. ““Adults areAdults are unpredictableunpredictable People”People”
““ People turn on you ”People turn on you ”
““ Trust only myself ”Trust only myself ”

37. Stages of the WAR CycleStages of the WAR Cycle
ConceptionConception
Wanted/Wanted/
UnwantedUnwanted
PregnancyPregnancy
UnrealisticUnrealistic
ExpectationsExpectations
Role ReversalRole Reversal
ComplianceCompliance
IsolationIsolation
Trust NotTrust Not
LearnedLearned

38. Stages of the WAR CycleStages of the WAR Cycle
ConceptionConception
Wanted/Wanted/
UnwantedUnwanted
PregnancyPregnancy
UnrealisticUnrealistic
ExpectationsExpectations
Role Reversal
ComplianceCompliance
IsolationIsolation
Trust NotTrust Not
LearnedLearned
I’m No GoodI’m No Good

39. Stages of the WAR CycleStages of the WAR Cycle
ConceptionConception
Wanted/Wanted/
UnwantedUnwanted
PregnancyPregnancy
UnrealisticUnrealistic
ExpectationsExpectations
Role ReversalRole Reversal
ComplianceCompliance
IsolationIsolation
Trust NotTrust Not
LearnedLearned
I’m No GoodI’m No Good
Selection ofSelection of
FriendsFriends

40. Social Support DeficitSocial Support Deficit
Choosing relationships with people who have “like”Choosing relationships with people who have “like”
problemsproblems

41. Stages of the WAR CycleStages of the WAR Cycle
ConceptionConception
Wanted/Wanted/
UnwantedUnwanted
PregnancyPregnancy
UnrealisticUnrealistic
ExpectationsExpectations
Role ReversalRole Reversal
ComplianceCompliance
IsolationIsolation
Trust NotTrust Not
LearnedLearned
I’m No GoodI’m No Good
Selection ofSelection of
FriendsFriends
Select PartnerSelect Partner

42. Relationships DamagedRelationships Damaged
Relationships are aboutRelationships are about
Dependency &Dependency &
using each otherusing each other

43. Stages of the WAR CycleStages of the WAR Cycle
ConceptionConception
Wanted/Wanted/
UnwantedUnwanted
PregnancyPregnancy
UnrealisticUnrealistic
ExpectationsExpectations
Role ReversalRole Reversal
ComplianceCompliance
IsolationIsolation
Trust NotTrust Not
LearnedLearned
I’m No GoodI’m No Good
Selection ofSelection of
FriendsFriends
Select PartnerSelect Partner
RelationshipRelationship
FailsFails

44. Themes & Stages of the WAR CycleThemes & Stages of the WAR Cycle
ConceptionConception
PregnancyPregnancy
UnrealisticUnrealistic
ExpectationsExpectations
Role ReversalRole Reversal
ComplianceCompliance
IsolationIsolation
Trust NotTrust Not
LearnedLearned
I’m No GoodI’m No Good
Selection ofSelection of
FriendsFriends
Select PartnerSelect Partner
Relationship
Fails
Nurturance & Trust Support
Expectations &
Control
Relationships &
Self Esteem

45. IInterventionsnterventions
toto
BBreak thereak the CCycleycle

46. WAR Cycle – Adults look backWAR Cycle – Adults look back
at what helped them:at what helped them:
o One-on-one time with a loving adultOne-on-one time with a loving adult
o Informal support from a neighbor,Informal support from a neighbor,
teacher, coach, ministerteacher, coach, minister
o Early insight – “It’s not about me” –Early insight – “It’s not about me” –
“These people are sad and angry.”“These people are sad and angry.”

47.  A passion for reading, musicA passion for reading, music
 A sense of humorA sense of humor
 Love for the ArtsLove for the Arts
 Physical activity – release from painPhysical activity – release from pain

48. Assess/Deprivation NeedsAssess/Deprivation Needs

Abuse HistoryAbuse History

Resiliency FactorsResiliency Factors

49. High Pain
Low Pain Low Hope
High Hope

50. Understand Role ReversalUnderstand Role Reversal

Facilitate PredictabilityFacilitate Predictability

Address childhood playAddress childhood play
through safe, socialthrough safe, social
activitiesactivities

51. Facilitate movement fromFacilitate movement from
compliance to internalizationcompliance to internalization
through gradual reduction ofthrough gradual reduction of
structure and insight workstructure and insight work

52. Create a treatment cultureCreate a treatment culture
that promotesthat promotes
“Mistakes are wonderful“Mistakes are wonderful
opportunities to learn.”opportunities to learn.”

53. Establish a therapeutic allianceEstablish a therapeutic alliance
and facilitateand facilitate
transfer of trusttransfer of trust

54. Victims of Emotional Manipulation
Disclose “way too fast”
No small talk which is “testing talk”
Each conversation goes a little deeper
(gradual)

55. Clients Are SkillfulClients Are Skillful
atat
ADAPTINGADAPTING
o Face Readers
o Can be Manipulative

56. WWe teach them bye teach them by
observing us beingobserving us being genuinegenuine
&& authenticauthentic
= Role Modeling= Role Modeling

57. Relational FrictionRelational Friction –– Beats them upBeats them up
Relational Work in TherapyRelational Work in Therapy ––
Restores themRestores them

58. Hearing their narrative (story) asHearing their narrative (story) as
a survivor –a survivor –
““Empowerment is Therapeutic”Empowerment is Therapeutic”

59. Teach social network mappingTeach social network mapping
and assist clients with buildingand assist clients with building
a social support networka social support network

60. Teach everything you can aboutTeach everything you can about
relationships including patterns,relationships including patterns,
boundaries, roles, etc.boundaries, roles, etc.

61. Establish ConversationsEstablish Conversations

ParentingParenting

Contact ComfortContact Comfort

Family ExpansionFamily Expansion

62. Competency Based ContinuumCompetency Based Continuum
Numbness ApathyNumbness Apathy Self HelpSelf Help
Learned HelplessnessLearned Helplessness Mutual HelpMutual Help
IndifferenceIndifference IndustriousIndustrious
Arrested DevelopmentArrested Development Social LearningSocial Learning
““No Learning” Learning fromNo Learning” Learning from
ExperienceExperience

63. Unpredictable AdultsUnpredictable Adults Role ModelsRole Models
IsolationIsolation Connected to Self/Connected to Self/
Higher Power/Higher Power/
OthersOthers
Emotional DeprivationEmotional Deprivation Contact ComfortContact Comfort
Emotional LiteracyEmotional Literacy
Self SootheSelf Soothe
DisplacementDisplacement BelongingBelonging

64. Thank YouThank You
for Your Time andfor Your Time and
Attention!Attention!
Robert L. Neri, LMHC, CAPRobert L. Neri, LMHC, CAP
Senior Vice President,Senior Vice President,
Chief Program / Service OfficerChief Program / Service Officer
WestCare Foundation, Inc.WestCare Foundation, Inc.