Ambivalence Is Normal — Approaching Substance Use from the Sibling Perspective with Meg and Stephen

Watching a loved one struggle with substances is always confusing and painful, but from the perspective of a sibling, it can be particularly hard to understand. Even though siblings often notice the substance use before the rest of the family, as peers, they lack the tools and perspective to fully recognize what's happening, and including parents can feel like a betrayal. On this episode of "Rethinking Rock Bottom", hosts Dr. Carrie Wilkens and Reverend Jan M. Brown welcome Meg and Stephen, siblings who were very close and then grew apart as substance use played an increasingly complicated role in their relationship. Together they highlight the struggles of Stephen's substance misuse, the secrets and burdens that Meg felt that she had to carry alone, and why she, as a sibling, did not fully understand or appreciate her role in Stephen's healing journey. Sibling dynamics are complicated, to begin with, and substance use disorder tends to amplify underlying tensions. The damage can take years to repair, long after the substances are gone, but together Stephen and Meg share the hope they have found in their relationship as they have each healed.  "Sibling relationships are so important within a family, especially during a crisis. Together we heal."    [:30] Siblings Stephen and Meg were constants in each other's childhood despite multiple international moves and the introduction of substance use.  [4:29] A picture-perfect childhood coupled with bouts of anxiety and depression were complicated by early access to alcohol. [7:44] Substance misuse warning signs in adolescence can be hard to spot amidst normal teenage experimentation, but Stephen recognized his own problems early on.  [9:00] The college party scene led Stephen to drink and experiment with hallucinogens until a tragedy turned his substance use into self-medication.  [12:59] Despite a precarious balancing act of substance use, Stephen's professional life wasn't slowing down at all.  [14:20] The point when Meg realized that Stephen was using heavily and had grown more paranoid as a result.  [15:42] In the Invitation to Change approach, ambivalence is normal and can come in many forms depending on the family context.  [16:40] Stephen's graduation experience was a turning point in the family's awareness of his drug use.  [21:06] Meg reflects on the state of Stephen's apartment and how she felt once she started sharing her feelings with their mom.  [23:04] In rehab, some elements of the healing process caused more harm than good for the entire family.  [26:12] When Meg finally needed Stephen's support, he wasn't there for her because he was too deep in post-acute withdrawal.  [30:00] Rebuilding a broken sibling relationship started when Stephen realized that his using and healing affected more than just him.  [33:39] Being "done with it" is a completely normal part of the sibling experience of substance use disorder.  [35:16] Stephen's hope for the siblings who are facing the same challenges as he put Meg through, and her hope for siblings who are ready to repair broken relationships.    Additional Resources: CMC: Foundation For Change Beyond Addiction Workbook: https://beyondaddictionworkbook.com/ Beyond Addiction: How Science and Kindness Help People Change Massachusetts Overdose Prevention Helpline   Tweetables: "I think the closer you are, the more complicated relationships can get." — Meg "We have quite a bit of alcohol use in our family so I recognized early warning signs that I needed to slow down." — Stephen  "I tried to stay strong for people, instead of actually experiencing the grief myself, and processing it, and crying. Instead, I just repressed it with more drinking and just trying to avoid dealing with the problem." — Stephen  "There's plenty of ways you can explain away behavior, and I was a pro at explaining away behavior." — Stephen  "At that point, there were no more secrets. I felt much worse when I was keeping secrets." — Meg "I felt like I was not forgotten. I was feeling consistent and helpful and like I'm showing up to rehab and then I was given this label and then as things unfolded after that that was what was in my head." — Meg "I didn't realize Megan was mad at me for the three years that she was mad at me. Because I was so not self-aware and so self-absorbed." — Stephen  "I would like parents to know that the sibling is going through something as difficult, if not worse, and just as difficult as the parents are going through and they're going through it in a very different time in their lives, in a time of growth and a time when they're meant to be still focused on themselves." — Meg "A sibling is in a unique position to be able to offer that viewpoint without criticizing somebody's use directly." — Stephen