Why Does My Therapist Ask me About My Family?

Why Does My Therapist Ask me About My Family?

When in the beginning stages of rehab treatment, talking about your personal life may feel uncomfortable. But your therapist must find out as much as she can about you and your unique situation if treatment is to be successful. Dr. Dennis O’Grady, PsyD for PsychCentral, describes therapy as the fine art of asking directive questions.[i] The questions therapists use help them to determine the right treatment plan for you. Because your family is such an integral part of your life, your therapist must learn as much about your family dynamic as possible. Knowing what kinds of questions she may ask ahead of time can make the process easier. The most important thing to remember is that your therapist is there to help you begin your new life free from the control of a substance.

Psychotherapy Basics

The Mayo Clinic describes psychotherapy as a general term used for the treatment of mental health problems through talking to a psychologist, psychiatrist or other mental healthcare provider.[ii] Psychotherapy sessions are designed to help you learn about your conditions and the moods, emotions and general state-of-mind associated with that condition. Psychotherapy sessions help you create a plan to better control your life by controlling your feelings, emotions and responses to stress and other negative stimuli.

During rehab, you will participate in both individual and group therapy sessions. Individual sessions help you learn the coping skills necessary to deal with triggers that might lead to relapse. Group therapy sessions help you learn to communicate about your addiction in healthy ways and draw strength from others who are struggling with similar issues. Family therapy sessions help you learn to recognize negative communication and behavior patterns within your family and work to change them. Each therapy scenario helps you look at your addiction from different points of view.

The Family and Addiction

Each person plays a role in his or her family. Typical family roles often depend on birth order, personalities and other factors. But for the family who has been touched by addiction, family roles can be reversed or confused. Licensed Marriage and Family Therapist and Certified Alcohol and Substance Abuse Counselor, Marni Low in her article, “Substance Abuse and the Impact on the Family System,” for Pro Talk Rehab Community, suggests that family members affected by addiction can be placed into one of five distinct roles.[iii] These are:

  • The Enabler – Often the non-abusing parent or the oldest child in a single-parent household, the enabler stands in the gap for the addict by doing everything the addict cannot or does not do. This includes packing lunches, paying bills, getting the kids to school and making excuses for the addict at family and social functions. The enabler is often in denial about the severity of the problem because he or she is working so hard to keep it covered up.
  • The Hero – The family’s hero is an overachiever. He or she seems confident and able to take on any situation with grace and strength. Often the oldest child, the hero becomes the parent, providing emotional support to younger siblings as well as the addict. The hero performs tasks and takes on responsibilities well beyond his or her developmental age.
  • The Scapegoat – Constantly acting out to deflect the negative family environment, the scapegoat is often in trouble at school, at home or even with the law. This connects the child with authority figures outside the home where the chaos is occurring. The scapegoat often experiences anger and resentment of the problems the addiction is causing.
  • The Mascot – The Mascot is the family clown who tries hard to bring laughter and levity into her difficult home life, even at the expense of her own feelings and emotional needs.
  • The Lost Child – This child withdraws from other family members and is unable to connect with parents, siblings, extended family members or others outside the home. The lost child has difficulty developing social skills and resorts to fantasy play as a way of escape.
  • The Addict – The addict stays somewhere between guilt and remorse for using, and anger and resentment for being asked to stop using. The addict is the center of the home difficulties, and all the other players in the family revolve around how the addict is doing at any given moment.

During treatment, your therapist will help you or your loved one understand how your addiction has impacted your family and what role you play in helping to bring healing to those who have been hurt by your substance abuse. The only way for the therapist to understand your family dynamic is to ask questions. In this way, the therapist helps both you and your family heal from the negative effects of drug or alcohol addiction.

Finding Help for Addiction

If you or you loved one struggles with substance abuse, we are here for you. Call our toll-free helpline, available 24 hours a day, to speak to an admission coordinator about available treatment options.


[i] O’Grady, Dennis, PsyD. “10 Introductory Questions Therapists Commonly Ask.” PsychCentral, accessed February 25, 2016. http://psychcentral.com/blog/archives/2014/10/24/10-introductory-questions-therapists-commonly-ask/

[ii] The Mayo Clinic. “Psychotherapy.” Accessed February 25, 2016. http://www.mayoclinic.org/tests-procedures/psychotherapy/basics/definition/prc-20013335

[iii] Low, Marni, LMFT, CASAC. “Substance Abuse and the Impact on the Family System.” Pro Talk, accessed February 25, 2016. http://www.rehabs.com/pro-talk-articles/substance-abuse-and-the-impact-on-the-family-system/