Today on the show, we're going to talk about a difficult subject.
How to talk to our kids about substance use disorders.
And I know some of you might be thinking, no one in my life has a substance use disorder.
I'm not sure if this episode is for me.
I totally get that.
And at the same time, I think this episode is really about how to talk to your kids in a
way that's honest when you're discussing difficult topics.
You know, I've received a lot of requests to talk about this.
So many of you have written in saying, my partner has a major alcohol use problem.
Or a family member just went to rehab.
They usually come over every week.
What do I tell my kid?
And I think I was hesitant for a little bit about getting into this.
But I thought about it.
And I came back to a guideline that really drives me.
And the work I do here, the things I talk about with you, and the way I discuss things
with my own kids.
And that's truth over comfort.
There are things that are uncomfortable to discuss.
But that mantra, truth over comfort, helps me make decisions that are in line with my
values.
In this episode, I'm joined by Dr. Nicole Kassanki, as I really felt I needed an expert
to help tackle this important discussion.
Nicole is a clinical psychologist and the director of family services at the Center for Motivation
and Change.
She works with a lot of people who have substance use disorders and helps family members and
friends know what to do when someone they care about is struggling.
In this episode, you'll learn more about what kind of language to use, how to follow your
child's lead and answering the questions they might have, and so much more.
I'm Dr. Becky, and this is Good Inside.
We'll be back right after this.
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So we're going to be answering some questions that came in directly from listeners about
addiction, about how to explain addiction to kids, about how to deal with addiction within
a family when there are young kids around.
Before we go into those questions, can you give us a definition of addiction?
How do you think about that word?
To be honest, I don't really use that word very much.
I use the diagnosis, which is a substance use disorder.
The reason why is because a lot of people have a lot of different feelings about the word
addiction, and it's sort of a catch all.
It can be, I'm addicted to coffee, I'm addicted to this Netflix series.
That kind of minimizes the intensity of a real diagnosis and the impact that it can have
on a family.
So I really talk about it in terms of that.
In terms of the impact on people's lives, is it causing consequences?
Is there any diagnosis is going to include using something or doing something despite
the consequences?
That's kind of the formal definition.
But many people think about it differently.
It's really important to sort of drill down into how is it impacting people's lives.
What does it feel like?
What's happening?
Not get too bogged down by the labels because that can just be messy and make people, well,
people have big feelings about different labels and that can get in the way of actual communication.
I love that.
Before we address the specific questions we're going to hear from parents, are there any
general guidelines you think about how to address this topic, this topic of substance use
disorders with families or with kids?
Sure.
So, I mean, it's a big question because just talking about substances with other adults
is challenging.
Right?
Like what we think as a culture about substances right now is in huge slucks, right?
Some things are being legalized.
This is a changing landscape.
So we have that backdrop.
And we also have a lot of, well, an absence of research really about treatments and is
it a moral problem, a characterological problem, is it a scientific or disease problem?
Like there are a lot of big questions that lead us to this moment in our history of psychology.
So when I talk with families about substances, I'm talking about the impact on them specifically.
And again, trying to get away from labels, but speaking more to the validity of people's
experience.
So, for a child, there's even bigger questions, right?
There's bigger questions of trying to protect children, speaking to them in a language they
can understand, developmentally appropriate ways.
You know, kids tend to see the world from the self-centered perspective, because that's
how their brain works and they will take responsibility for things that aren't their fault.
So that is a big issue that I talked to families about is trying to really open up dialogue
with kids around what their perceptions are and be curious and empathic and try and understand
what it is that they're seeing and what they're making of it.
It may not at all be obvious to the adults around them what they're making of what they're
seeing.
I love that point.
I think that's so important.
Okay.
Before we jump into some of these recordings and hear these specific questions, anything
you want listeners to keep in mind as, you know, as we talk through these?
I mean, there's a lot of judgment and shame inducing thoughts and feelings that people
have about substance use.
And I think that that can get interwoven with these questions of how do we respond to
kids who are asking good questions about what's going on with dad or mom or the neighbor
or that person we passed when we walked to the subway or there's a lot of big valid questions
and our own feelings of judgment or sort of punishing thoughts or questions or, you know,
those can really get in the way of being able to have an honest and clear, curious conversation
with our kids.
So I think that is the backdrop that we're coming to this conversation with that is kind
of tricky because adults themselves are going to have a hard time talking about this.
Yeah.
I think that's a really helpful note, like all of us notice our judgment and listen with
the same curiosity that we really do often listen to anyone else's struggles.
So on that note, let's listen to a question from a listener.
We'll listen together and then we'll talk about what's going on.
Here we go.
Hi, Dr. Becky.
My name's Ashley and I was calling to get your help with a family situation with my daughter
and my mom.
So my mom is an active alcoholic, as best I can tell.
And we still have a guarded relationship with a lot of boundaries and done a lot of therapy,
but you know, still want her to be an active part of my life and my kids' life.
So we've continued to have very structured and kind of walled interactions rather than
shutting the door to those relationships completely, which I've done in the past.
But my question is, my daughter who is in kindergarten and is so smart and observant,
more than I could possibly give her credit for, is starting to notice things like the fact
that we have my in-laws over more often or that they'll go to my in-laws to babysit
and my parents are much closer but we never have them for those kinds of things.
And I just want to try and figure out an age-appropriate way to explain to my daughter
that relationships are complicated and that we love Nana very much, but we also need
to be careful around her and also keep it where she's comfortable coming to me and telling
me anything that she saw around my mom that might make her uncomfortable.
So yeah, that's my question.
If you have any insight or guidance, I'm here for it because me word vomiting 37 years
of childhood feelings about alcoholism, I don't think it's the way I want to go.
I want to like point in beautiful way to lay out this question.
So Nicole, let you go first. What comes to mind for Ashley here?
Well, first of all, I mean, I'm really appreciating how thoughtful she is and how much time and
consideration, careful consideration she's put into this question.
She's trying to maintain a relationship for the sake of her kid and maybe herself, but
there are these ways that she has worked really hard to put up boundaries that feel safe
and that's really smart and great for her and for her kid.
And now she's noticing that her kid is pretty observant and is noticing things.
And that's a great observation because it allows her to have a dialogue and allows her
to really ask what it is that her kid is seeing.
I mean, this is the thing that we talk about in parenting all the time, right?
Is like, what is the biggest thing that you want to focus on is keeping the dialogue
going, continuing to be a person that your kid is willing and able to come to when they
have difficulty, et cetera.
Yes.
And, you know, I want to also say for all the listeners, right?
Our kids do notice things, right?
And I think there's some belief out there, like, oh, she's in kindergarten.
Like, what does she need to know about alcohol, about substance use, about conflictual family
relationships?
I think that's a narrative that's, I don't know, been passed down to us or somewhere in
the ether that we've picked up.
But Nicole, I think you and I are saying the same thing where kids are insanely good observers
of the world.
They really are.
It actually what scares me is the way that we almost teach kids to stop observing the world
because when they're young, so often they hear you're wrong or you're too young for
this.
And then we wonder why years later, you know, things happen where we say to them, like,
didn't you notice or why didn't you say something?
You know, and sometimes I feel like kids are like, well, you've told me for the first
10 years of my life that I wasn't supposed to notice things that are kind of tricky around
me.
So I kind of just did us told, right?
So the fact that a kindergarten or notice is, hey, some grandparents come around more
than others.
And it even really makes sense because one of my grandparents lives closer than the other.
So I can put two and two together, but it's not adding up.
A kid is actually doing exactly what we want them to do.
That's amazing.
And I think this mom really recognizes that.
And then I think the next step is something that can feel really uncomfortable.
Or it's like, oh, am I going to enter into this conversation?
It's messy and it feels awkward.
And I think we'll always have that thing in the back of our head.
Like, are they too young for this?
But I think a different way of seeing it is like they already notice the pieces.
So they're clearly not too young to notice the pieces.
So either I'm going to leave them to write the story to connect the pieces on their own,
which I know is not going to be good or accurate, or I can kind of help them do that.
And so let's just push it Nicole.
Let's say this mom's daughter is like, why don't we see grandma more often?
Why don't you have grandma come over and then you go to sleep with her with me and you
guys could go out the way that you do with my other grandparents.
Like, because kids ask it so on the nose sometimes.
Right.
Right.
Totally.
And I think the first thing is to just validate the perception.
Right.
So that you're not, as you were saying, like, I think that we do it to serve us to kids
by sort of shutting them down because we're uncomfortable or we don't think they're ready
for it or it's inappropriate or whatever the reasons are.
And the whether you're going to have a conversation about the 27 year history of your relationship
with your mother or not with your kindergarten or I think we all know that's not going to
happen.
But the fear that that's what you need to do if you're going to open the can of worms at
all is what keeps you from having any kind of conversation.
So I think the notice that to notice that you have some obstacles around having a
big conversation and notice that your kid has some good observations that are worth
validating.
You're right.
We don't we do really different things with our with your grandparents.
Don't we?
That's a good observation.
Like I'm really liking how you you notice the world around you.
Like what else do you notice about the relationships?
Like they're really different people.
Those four individuals that you have in your life.
Like what else do you notice?
Like broad net to what her perceptions are and ground yourself in those to be responding
to rather than start with your huge story and narrative and throw it on top of the kids
head.
Get can feel unwieldy to both of you.
But start with what they're seeing and what do they notice saying and go from there.
Okay.
So let's let's go from there.
And I think sometimes the parent you kind of know your kids asking a question.
They're kind of like, but maybe they do.
There's like, but why?
Like, so why don't you leave me with grandma?
Grant, you were talking about going on a work trip.
Grandma could stay with me.
Right.
Let's say, right?
And I do think parents are eager for like what are the words?
Like how do you describe alcohol, substance use, disorder to a kindergarten?
Like if that is really the reason why that grandma doesn't stay alone.
How do you enter into that?
I'm happy to hear from you.
If you want, I'm happy to like give it a go Nicole and take your edits because as an expert
in the field, I'm sure you'll be like, Becky, don't say that or no, I would shift that.
So I'm happy to put a version out there if we want to play the game that way.
Whatever.
I mean, that's fine.
But the I think the big pieces that I would say about having a conversation is to follow
the lead of the child.
So if the child notices something, attend to that.
And it's much more organic to the child's brain and to your relationship if you can go
from what their perceptions are.
So in other words, if this child has seen the grandmother, at loopy or fall down the
stairs or knows about her being in the hospital or knows that she goes to therapy every day or
she goes to meetings, whatever the child knows is where I would start with.
So if the child says, hey, you know, she lives closer than my other grandma.
Like, how come we never see her?
Is it because she has, you know, she has to go to the doctor or, you know, is it because
she fell or is it because she's always drinking?
I mean, kids might go straight for it, right?
They might know exactly what's going on and you're trying to beat around the bush, but
they've seen things and they know, you know, what's happening.
She seems like a really different person when we see her at night, like that.
She made me uncomfortable that one time that she came over.
She was so loud and you seem to get rid of her really fast.
Like, that is that why she doesn't come over is because her voice is too loud.
Like there may be some very specific thing that the child is actually asking about.
Like loud voices are things that upset mommy or, you know, if you have medical problems,
you shouldn't be around kids.
Like it could be very like magical thinking or, or it could be very specific.
Like, she makes me uncomfortable.
She hugs me too tightly when we see her at night or when we see her, whatever it is.
And those very specific things, I think you can speak to.
So if she says like, is it because this is good that you can say, actually it is because
of that because there are ways that she can behave at night that I think do have to do
with her, her emotions and her medical state.
And if the kid asks a lot more questions than they're ready to hear the answers, you know,
but I'd like to sort of go hand in hand with kids to not get ahead of them too much.
And so I just want to kind of summarize or maybe mirror what you're saying and you're telling
if I got it right.
So you're saying really follow the lead of your kid.
We have a whole story from our history.
We have so many feelings.
We have so many worries about telling them or how to get it right.
And one of the things you can do is say, okay, let me actually just zone in on what my
kid is saying and exactly where they are, not as a way of avoiding the conversation, but
actually getting closer to the thing that's actually on their mind and what they actually
either want to say or ask.
And so then every conversation is going to look a little different because if you say
to a kid, well, what did you notice?
You know, or why does that grandma not come around us often?
I don't know.
Why don't you notice about like, why do you think?
Right?
That makes sense.
What about when a kid, because I think this happens a lot too, they're like, I don't
know.
I'm asking you like why, why don't you lead me alone with grandma?
So I, again, I'm not trying to dodge the question because I really love that you're
as specific as you are.
I think people really need words to use, but it really is so specific to the situation.
Like if, if the child knows that there is a particular thing going on, they know details
about it, then you can work with those.
And that makes the story much more organic to the child and allows you to sort of stay
in the lane of what they're ready for.
So if it's about leaving, it probably isn't about leaving the child alone because that's
not how a kid would think, right?
They would think more like, how come I can't ever go to grandma's house?
Or she's like two minutes away.
Maybe I could ride my bike there or, you know, it would be something more specific about
doing a thing, right?
So if that were the question like, how come I can't do that?
Well, I think you can do that someday, but not yet because, you know, there are lots of
things at grandma's house that are just don't feel safe.
Like remember that time when we came over and it seemed like the stove had been on for
too long and there was smoke in the kitchen like, that makes me too nervous and I, it's
my job to keep you safe.
So there are some stuff in that house that just make me a little nervous, but that's
okay.
We can have them over on the weekends and you know how we went to this place or that place
and, you know, but it might feel a little disappointing to you.
Are you feeling disappointed about that or?
And what you're doing here, Nicole, that I think is so helpful for parents as they hear
you model it is in our mind, our parents substance use disorder is centered.
And that makes sense.
Like I hear it from this parent like she's been through a lot of pain around it.
She's very focused on it.
For a kid, their own emotions are probably what we need to center.
Like yeah, they might be like, that's a bummer.
I want to see both of our grandma's house and like we think, okay, I'm going to tell them
about the alcohol and I'm going to tell them about this thing that happened and it really
might not be what's on their mind.
Their experience might be very similar to the other day when you told them they couldn't
see a certain movie because they weren't old enough and, you know, and so asking some
questions is really a way of making sure we're like centering on our kids' experience.
And I love that you're making that so clear.
And I think that also gives parents a lot of permission to not have some perfect words
to say I'm going to this conversation.
I'm going to say this thing because first of all, it might not be what your kid needs.
Second of all, I get a lot of comfort with my own kids.
I'm like, there's no one conversation about anything.
Like there's no the talk.
There's no one talk about sex.
There's no one talk about the grandma's alcohol struggles, right?
And so like if I ease in and I learn more and I later say, you know what, I kind of feel
like I wish I said more.
I feel like my daughter was asking, guess what?
Amazing.
You can go into her room be like, Hey, did that leave you having more questions?
You could always do it, right?
And there's not one moment that you're going to like get this right.
And so I just want all the listeners to know to have a little faith in yourself, right?
That over a number of conversations, a number of years, right?
It's going to end up feeling more complete to you with your child, even if it doesn't
in that one moment.
Absolutely.
Absolutely.
I love that you're pointing that out because I encounter that a lot too that people put
a lot of pressure on one conversation.
They're going to ask me someday, they're going to ask me, and what am I going to say?
You know, that is a totally understandable and valid fear.
You're putting a lot of pressure on yourself to have that one conversation answer all the
questions they might have.
Kids don't have a long attention.
Like, they're not in it for a long conversation about anything.
So having the confidence and faith that you're going to be able to have many conversations
with them, you're going to be able to make mistakes.
You're going to say addict or something and then regret that and that feels judgmental.
So you're going to go back to them the next day or the next week or the next month and
say, you know, when we're talking about grandma, I use that word.
It doesn't, I didn't feel good about that because that does, it feels like that's all
she is.
Which isn't true, right?
She has long hair.
She's a little short.
She has a red nose and she drinks too much and that's part of who she is.
And we can talk more about that anytime you have questions.
The one thing I want to add that I know we talked about earlier is how often kids need
to hear things like, and it's not your fault, you can't see back grandma's house.
And sometimes it seems like a non-sequator where like they didn't ask if it was their
fault.
But when kids feel disappointed and upset, it is just so quick to get to oh, and I must
have done something that caused this.
And part of that is for a kid is like, well, if I caused it, I can maybe fix it.
But we don't want kids to kind of wire fault and blame.
And so I think that's always helpful just for parents to like have that line in the back
of your head.
And like trust yourself, you're going to know when to sprinkle it in and you don't have
to do it every conversation, right?
But I think just knowing that sometimes kids do use that idea to kind of again connect
the tots.
There's been so many moments with my own kids with things where I watch myself say,
I don't know, this babysitter can't come anymore that they love.
And I'm like, and you didn't do anything to cause that.
And I kind of see that somewhere deep in them, they like needed to hear that.
Even though they didn't explicitly ask.
Yes, because that, especially with issues like that where there's separation of relationship
and like what we're talking about with the caller, right?
There's curiosity and concern about the separation.
Why is this different than that?
Why don't I get to see this person more than that person?
Like this is a, this is an especially sensitive area, I think, where kids are likely to fill
in the gaps of like, what did I do?
What could I do differently?
And they're not even necessarily conscious of it, but you can tell by their follow-up questions
that that's where their brain is going.
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Why?
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They're the ones who will trip and fall and then blame you even though you were not
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These kids are misunderstood because they're seen for their difficult behaviors.
Instead of for their underlying core struggles.
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And approach that parents tell me leads to the first time they've ever understood their
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Okay, I want to hear from our next parent.
So let's listen together.
We've got a tricky situation going on at home.
My nine year old son's favorite person is his dad who he hasn't seen for two months
because his dad's been using drugs and then away at treatment.
And unfortunately, this is not the first time this has happened.
My son is both the most injured party and the most innocent party.
And it is heartbreaking to watch him suffering through the consequences of his dad's addiction.
It seems to him like his dad's choosing drugs over him and doesn't love him, which I know
as an adult is not the truth about how addiction works, but my son doesn't understand that.
He feels lonely because he can't talk to his friends about this huge struggle and stressor.
His trust has been violated so much at this point that he barely has any hope.
He's actually depressed to the point of talking about not wanting to be alive.
He's afraid of what happens if dad gets out of treatment and relapses again because his
dad will lose his job.
We lose our house and we have to move out of state.
So the fear is totally legitimate.
I don't know how best to help him.
And it's even more difficult because I'm dealing with a lot of the same feelings as he
is.
Lack of trust, lack of hope, feeling abandoned and betrayed, not wanting my life, being
terrified because my whole future depends on an addict's single relapse.
And I'm angry to help my son.
I keep the conversation open.
I give him information to help with his anxiety.
I tell him I'm glad he's talking to me about his feelings.
I try to validate so he doesn't feel alone in it.
Without giving him the impression that I'm feeling out of control too, it's just such
a tricky situation and I wish I knew what else would most help him.
So we're here from this parent who's partner is obviously struggling with a very serious
substance use disorder.
So much of their life feels like it's literally hanging by a thread and is related to his
functioning.
They have this nine year old son and so many things struck me, but hearing the way the
nine year old internalizes, my dad is choosing drugs over me.
Right.
Right.
I mean, that's heartbreaking and so in line with what we were talking about before of
how the kid is blaming themselves.
Right.
Like, there's something that is more important to my dad than me.
And maybe if I did something different or, you know, there's an internalizing of that
experience that as adults, we know it doesn't work like that and it's so much more complicated,
but totally valid for that kid to feel that way.
And, and, you know, she's also mentioning some really scary things like maybe suicidality,
you know, maybe homelessness as a result of him not being able to keep a job.
I mean, those are really real valid concerns.
So I mean, that is the first place to really start, I think, is to be giving this child
a lot of validation for feeling the way he does, you know, totally understandable, really
valid concerns that she shares to.
I feel angry in her too.
Sometimes when there is substance use in the family, you can start to feel like you need
to balance out the other person like he feels angry.
So she might feel like, well, I have to remind him that he's also a good person or I have
to, you know, balance out the perception, but it really is more important sometimes to
join with the child.
So I really hear how angry you are.
That makes a lot of sense.
I feel angry sometimes too.
And hear what the next thing is, you know, allow it to evolve.
I want to stay on that because when I hear this mom say, my son, you know, basically
says, my dad's choosing drugs over me, right?
And then I hear her say, like, I know that's not, you know, exactly what's happening.
I think this is one of the hardest things in parenting.
I really do, it's like this dance.
It's like, okay, in my head, I know the way my kid is thinking about this, both isn't true
and isn't kind of helpful.
And they are thinking about it this way currently and they have really big feelings that are
very real as a result.
And I think the inclination often is even in a very loving way to try to convince your
kid out of that thought.
And we'll say, like, I know, but look, let me explain substance use disorders to you.
And your dad is a good person having a very hard time and he loves you.
And it's not a choice.
And it's kind of, you know, like this.
And there might be a time, I'm sure, for like a metaphor or something like that.
But other times, I think as a parent, you have to kind of hold in your head.
Like I know that's kind of not true.
But I can't lead with that.
And instead, what I lead with my kid is like, that is the most painful thought.
Like, like, just, you're not quote, validating that their thought is true.
You're actually just validating that they actually are thinking about it this way.
And they actually are having feelings about it that are real.
And I think that's really important.
And I find myself fighting myself in those moments with my kids because I'm like, oh,
if I see the pathway where I can help you.
But I think for this kid, I don't know, I think probably for all of us, the hardest thing
is to feel alone, right?
I often say like, we can't change the hard.
We can change the alone.
And right here, one of the hardest things for this kid, right?
It's all the things that's pom-late out.
But I'm sure what makes all of it harder is potentially feeling like I don't even have
anyone else in my life who really believes me or understands that I feel this way.
And I think just knowing when you sit with your kid and you say things like, that is such
a painful thought.
Sweetie, look, I might see it differently, but I know you don't.
And I know that is the biggest pain, right?
As big as this house or whatever.
How have you want to describe it?
You are doing your kids such a service.
And I think you're really showing support.
And kind of like we were saying Nicole before, like you have so many conversations we're
going to have with our kids about hard topics.
Over time, that thought that my dad is choosing drugs over me.
Like I think we can have faith that that thought will, I don't know, will loosen or that
thought will shift over time, but probably not in like one specific conversation or moment
with you as the parent.
Yeah.
And just to be like really concrete about it, like I think that a parent in that moment
of starting a conversation or responding to a statement like, my dad is choosing drugs
over me.
You have like a lizard brain impulse to protect this child, right?
Like you want dad's really to make that feeling go away to make it go away.
And what I think can be a really helpful strategy is to notice and be aware, but also compassionate
with yourself that it makes sense that you want this feeling to go away.
And that makes you a good parent.
And there's nothing wrong with that impulse.
But if you can respond to that impulse in yourself by doing something like affectionate,
like touching your child or letting them sit in your lap or like come here, honey, like
let's talk, have them sit with you, hold their hand, put your arm around them.
That is the connection.
That is the way that you are helping their feelings be swashed, be comforted.
And then the words that you use can be, oh, that's horrible that you would feel that way.
I would feel awful if I felt that way.
Let's talk about this and really allow the child to open up around what it is that their
mind is doing with this stuff.
So then you can attend to what it is that their brain is doing, how they're feeling.
And usually in that moment, it's kind of fall apart.
They feel seen and heard and they let it out.
They let it out and what a gift to give your child is to let those feelings out, to understand
those feelings a little bit better.
And that is helping the feelings be comforted.
It's not the words, it's not correcting their view of addiction and what it's supposed
to be called and all the nuances is not doing any of that.
And maybe over time, all of those conversations happen.
But in that moment, helping the child feel like their feelings are valid and worthy of
attention and connection.
Yes.
Nicole, there's so many other things that I know that are left undone.
Then it kind of makes me think about actually what we're talking about with parents, right?
All these conversations with our kids, we'll kind of mirror that.
I'm sure.
Anything else that you feel like needs to get into this conversation that you want to leave
listeners with.
I think that a lot of the ways that our culture and general thinks about substance use disorder
is the backdrop of this conversation, right?
That there is a lot less compassion that we have for ourselves in loving someone who
has a problem.
And for the person themselves, then certainly any other medical problem, right?
Person has cancer, they broke their leg.
You know, we have a whole lot more compassion for those kinds of situations than we do for
substance use disorders.
And that being the case brings in a lot of layers and the judgment we were talking about
before.
So for me, the vocabulary around it, the awareness building, having more of an understanding of
why it makes sense, it may not make sense from the outside, but from the inside, there's
something that makes sense there that can help build compassion.
And the more compassion we have, the more ability to have like meaningful conversations
and connection.
And I feel like there's a lot of value that friends and family can bring to these conversations
when they start from that place of compassion.
Well, ending on compassion is never a bad place to end.
So thank you, Nicole.
Thank you so much for being here.
Thank you.
For more information about the Center for Motivation and Changes Nonprofit Foundation
for Change, please visit cmcfc.org.
They offer resources like workbooks, groups, and trainings all at low or sliding scale to
help reach as many people as possible.
The link is also in today's show notes.
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