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Chronic Sorrow

Older lady looking very sad and sorrowful, sitting next to doctor

Coping with the feelings

Is this grief?

When people talk about grief, they usually mean the loss they feel when someone dies. But other losses bring a type of grief with them too. Family/whānau and friends of people using alcohol and/or other drugs often comment that they wish things were different. Often very different. The feelings associated with this may be very strong.

Grief theorists call this grief Chronic Sorrow. This term resonates with many who watch as a loved member of their family/whānau or friendship group struggles with alcohol and/or other drugs. Though family members do not always feel sad or stressed or angry, the frequent reminders that their loved one is coping with the complications of alcohol and/or other drug use, brings with it an ongoing sorrow which often comes to the surface in daily life. The situation brings a sorrow that never goes away completely while there remains alcohol and/or other drug use by their loved one.

When I heard that phrase “Chronic Sorrow” I thought, “That’s it! That’s just what I feel.” I’m a pretty positive person, but the sadness about my son is always there, just under the surface. Whenever he slips a notch and there’s one less thing he can do – the sadness that it shouldn’t be this way hits me again. - Parent of a young man using methamphetamine.

“It’s always there. But it doesn’t mean you don’t laugh and have fun and good times.” - Mother of a daughter using alcohol.

“Chronic sorrow… I’ve got that.” - Sibling of a woman with poly drug use.

How is Chronic Sorrow Different from Grief?

Loss is part of life for everyone, and most people have found ways of dealing with loss as they grow up. Chronic sorrow, however, is different type of loss as it is a living loss. This type of loss can be a loss of some aspects of oneself, or the loss of some aspects of someone else, particularly someone who is loved and cared about.

The losses associated with having a family/whānau member or friend using alcohol and/or other drugs are just such a living loss. This loss, which we call chronic sorrow, is different from the ordinary losses such as a death or divorce or loss of a job. These losses have a finality about them. With chronic sorrow we have a continuing, ongoing loss.

The loss is ongoing

When someone has died, the loss is permanent and unchanging. Though it can take a long time, people usually find ways to come to terms with the new shape their life has without the person who has died. When a person is a user of alcohol and/or other drugs, there is a living loss.

As time passes, and even in the early years of a person moving past alcohol and other substance misuse, the difference between what might have been and the reality of what is, constantly changes.

Concerned significant others generally need to adapt to new challenges as the years pass. Financial, housing, relationship and other challenges need to be worked through. The repercussions of legal situations may impinge on work opportunities. Though family/whānau and friends will take pleasure in each new milestone achieved, there often continues to be feelings of chronic sorrow for lost opportunities and challenges to be faced, amongst the hope and possibilities of progress made.

The loss is unacknowledged

Many concerned family, whānau and friends say that the only people who understand how they feel are other people who have been through similar experiences. There are no rituals to help people acknowledge the loss felt, or to help family members to deal with this loss. Also, because people don’t usually acknowledge their ongoing loss openly, often due to the shame felt in sharing concerns, many people lack support during their ongoing struggle.

There are constant triggers

Family, whānau and friends often comment that they feel they are coping well, and then something “hits them out of the blue”. Important family occasions, work events and times when families share space may be hard. Occasions such as birthdays, anniversaries and times of death can also be hard.

Seeing and hearing of the progress being made by the family members of friends and relations is particularly challenging and painful when contrasted against the limitations that alcohol and/or other drug use places on one’s loved family members’ progress. Setbacks to the health and wellbeing in the person using alcohol and/or other drugs can also trigger feelings of sorrow. Planning for the future can be difficult and opportunities may seem to pass by.

The feelings of sorrow that come with having a family member or friend with challenges around alcohol and/or other drugs often seems to be “in your face”. At these times the gap between what the family/whānau member or friend using alcohol and/or other drugs is achieving, and how you and they wish things could be, is hard to deal with.

The loss is hard to “pin down”

When a member of a family/whānau or friendship group is using alcohol and/or other drugs, it is as if all that one has dreamed of for the person with challenges, and all that had been hoped for the person, needs to be put aside to some degree. Some people talk about feeling cheated. Their loved one’s life is not the healthy or normal life expected.

For most people, it’s not that they don’t love the person, but that they find it hard to accept that using alcohol and/or other drugs has robbed them of their fantasies of a family member or friend who will go on to live a full and happy life. Though this loss is “only” of a dream, rather than a reality, it is no less painful for many people.

"Chronic sorrow, a normal grief response, is not the same as grief at the finality of death, where the person who is loved will be forever absent. Chronic sorrow is not about endings; it is about living with unremovable loss and unmending wounds. It is about losses requiring – and demanding – energy and persistent courage to cope with crises and making the adaptations necessary in order to live a life of one’s own. It is about year upon year of dealing with the inevitability of a loss that continues and of finding a way to achieve some balance between reality and losing one’s grip entirely.”

Susan Roos (from the Foreword to “Chronic Sorrow”. See Further Reading for details)

What other factors affect family/whānau and friends as they cope with someone they care about who is using alcohol and/or other drugs?

Community attitudes play a big part in the way families/whānau and friends respond to having a person they care about who is using alcohol and/or other drugs. Chronic sorrow is a complex issue though, and there are many factors that affect the way people experience it. What may be a disaster to one person or family may seem less important to another. Some of the factors that may make a difference include:

How families see the alcohol and other drug misuse

Families may see any family situation as a threat to their family’s stability, a curse, or a burden. Some families see the situation as a time of challenge which can be met together.

How people see themselves

Similarly, family members may see themselves differently in response to the person using alcohol and/or other drugs. They may see themselves as being a passive victim of circumstances, or as someone who can’t cope with difficult things. Or they may see themselves as resilient and strong, courageous and assertive, loving and accepting. They may have a strong sense of themselves as a worthwhile person, or they may feel shaky about themselves. Seeking to build coping and resilience, however one sees oneself, is an important task.

How other people around them respond

People’s responses are also shaped by the way their family/whānau and friends respond to the person they care about who is using alcohol and/or other drugs, and by the amount of good support they get, to deal with him or her.

Family circumstances and background

The social and financial circumstances of the family can play a part in how they experience a person using alcohol and/or other drugs. A family which is already under strain financially, which has difficult living conditions, or existing problems such as alcohol and/or other drug use or abuse may find having another family/whānau member using alcohol and/or other drugs an extra burden. Families where there has already been loss, on top of existing grief from the past, may struggle to cope at times.

The nature of the drug used

The type of drug use can play a part in the level of intensity of chronic sorrow. The fact that alcohol and prescription drugs are legal drugs, whereas other substances are illegal drugs, can have an impact on family/whānau and friend’s ability to cope with chronic sorrow. If drug use results in sudden and unexpected crises, coping with feelings can be challenging.

The level of support from the community

There are some organisations in the community which work to provide help for families/whānau and friends who are supporting a person using alcohol and/or other drugs. Groups such as whānau organisations, church groups, and government or non-government organisations offer some support.

Support for concerned significant others, however, is not widespread. Having access to a small group of supporters outside the immediate family can provide a different perspective and allow family/ whanau and friends to see they are not alone as they cope with challenging situations.

How does chronic sorrow affect people?

In a word: differently. Everyone has their own response to loss. Chronic sorrow is like a fingerprint: everyone’s experience of it is unique.

Some of the more common feelings are:

Feeling guilty

Guilt can be a constant companion when there is a family/whānau member or friend using alcohol and/or other drugs. Concerned significant others may feel guilty about their feelings of resentment, or their constant longing that things should be different. They may find themselves thinking about how things might have been “if only…” and feel guilty about such thoughts.

Looking for something or someone to blame

In addition, many family members feel a sense of guilt that they caused the problem in some way. It’s very hard to live with the idea that very painful and difficult things can “just happen” out of the blue. They may try to regain some feeling of control. They may search for someone or something to blame in an attempt to make sense of what has happened. Where the reason isn’t obvious, people may blame themselves. There may be a rational reason for this guilt or it may be an irrational feeling. Parents can sometimes feel guilty that there is a genetic predisposition to usage of alcohol and/or other drugs.

Feeling anxious

Watching someone you care about is using alcohol and/or other drugs can cause anxiety at times, and sometimes it can seem as if anxiety is a constant companion all the time. Suddenly, family members and friends are dealing with difficult issues. They may not feel as if they have any control over their life and become anxious about what else might be in store for them.

For many people with family members using alcohol and/or other drugs, these kinds of anxieties and fears are part of the chronic sorrow they experience. Family members and friends talk about feeling constantly vigilant, of life feeling relentlessly stressful, and of never feeling they can truly relax and trust that their loved one is OK.

Life is unpredictable

The unpredictability of life with a family/whānau member or friend using alcohol and/or other drugs adds to the stresses felt. People who deal with stressful situations by planning carefully may find this especially hard. Planning ahead is so often disrupted by those whose behaviour is erratic.

For family/whānau members and friends who like to have a strong sense of being in control of their lives, this inability to manage their life can feel very stressful. Never knowing what’s around the corner, and how hard it might be to deal with, is unbearably stressful for many people who are trying to build coping and resilience in themselves and at the same time separate from a loved one’s behavior, while continuing to support them at the same time.

“I used to like to plan ahead for holidays and trips, but since our son became involved with drugs, the plans have been disrupted so many times that I don’t bother much anymore. I’ve learned to just take things as they come. I deal with one day at a time, and I don’t plan for the future too much.” - Parent of a son with poly drug use.

Time feels different

People often measure time in terms of expected milestones in their lives or the lives of their loved ones. When their child or partner doesn’t “fit the plan” they may start seeing milestones differently. Time may be measured instead by key events which are often bad experiences, such as “before she started using drugs” or “after her first encounter with the law, but before her second one.” Instead of a series of happy events to anticipate, life may feel like a story of things in the future to worry about.

Feeling numb

Some people deal with the feelings of chronic sorrow by shutting down emotionally. They function best by keeping a lid on strong feelings of sadness, anger or fear. Unfortunately, when they do so, they often say they find it hard to feel strongly positive feelings of happiness and joy as well. Life becomes all a bit grey and colourless.

Needing to find meaning

“Why us? Why our child? Why has this happened?” Making sense of what has happened is one of the hardest issues for family/whānau and friends of people using alcohol and/or other drugs to come to terms with. For some, having a family member using alcohol and/or other drugs feels like a punishment. For others, it feels more like a confirmation of their basic goodness, or of their ability to cope with hard things. However they see it, a life changing event like this is something that has to be fitted into their beliefs about themselves and their lives.

Feeling alone

Family/whānau members and friends sometimes feel like they are under siege, standing all alone with their back against a wall. Some people comment that they don’t feel comfortable discussing their fears and challenges about their loved one’s behaviour, with “normal” families, where their actions or their loved one’s behaviour might be misunderstood or judged. In a world designed for “normal” people, where their family life is very different, family members often feel very alone. Having family and friends who are unsupportive often adds to this aloneness.

“Everybody reacts differently. Some people need to talk about it, others go to ground and just hide or cry or whatever. And that can happen within the same household!” - Family member of a young man using methamphetamine.

Do men and women experience chronic sorrow in different ways?

People respond in very individual ways to having a family member or friend using alcohol and/or other drugs. Both men and women experience chronic sorrow, but they may show it differently. It’s hard to generalise, because for every generality there is an exception. It does seem, though, that the way men and women are brought up in our society often influences the way they respond to this situation. These differences can shape the way individuals experience, express, and deal with their losses.

How does chronic sorrow affect the rest of the family?

The wider family/whānau also generally experience chronic sorrow when faced with a family member using alcohol and/or other drugs. For grandparents this can be especially hard, as they grieve for both their grandchild and their own child. Their support can be crucial to the family, but often they find it hard to acknowledge the extent of the challenge faced by someone using alcohol and/or other drugs. Parents may find themselves needing to educate their own parents about the challenges involved, and then needing to do so again as the situation changes over time. In spite of these difficulties, families often provide strength as they work together to support one another.

Siblings also struggle with losses of their own when a brother or sister is using alcohol and/or other drugs. Some older siblings talk of a double loss: losing the brother or sister they expected to have a relationship with and also losing their parent or parents as they have known them. Suddenly their parents are often unavailable, distracted, sad or grumpy. Their attention has not only shifted but also changed. The normal issues of the sibling may seem trivial and inconsequential to his or her parents, who are confronted with much larger problems to focus on.

Like their parents, they struggle with the sense of life being unfair. They may feel angry about the family financial resources being spent on their sibling and about the times that plans have to be abandoned at the last moment. And like their parents, they feel guilty about these feelings. Parents are caught, trying to meet the needs of their family member using alcohol and/or other drugs and his or her siblings as well.

Things aren’t all negative. Families/whānau often find their other children become more tolerant of differences, more aware of the needs of others, and develop a greater sense of empathy and in some cases an increased appreciation of the importance of family support.

What helps for siblings?

  • Information makes a big difference.

  • Give brothers and sisters the chance to talk things over and express their feelings and opinions. This will help them to deal with worries and problems that inevitably come up from time to time, especially when things change.

  • Give siblings a say when plans are made that affect them. Even if things can’t go as they’d like them too, it helps with their sense of control if they know you are trying to take their wishes into account.

  • Provide siblings with the opportunity to meet other people who have challenges. Talking with other siblings, seeing how they handle things and what they feel makes it all more normal for them.

  • Set aside time with other children that is just for them. It only needs to be something small like having takeaways together, watching a movie, going for a walk or watching them play sport, but it sends them the message that they matter too, and you are there for them as well.

  • Encourage your other children to pursue their own dreams, so that they are aware that their involvement will be a choice rather than an obligation.

  • Help children to identify someone outside the immediate family that they can talk to in confidence if they want to.

  • Offer older children the opportunity to ask specialists any medical questions they have concerns about too. Often not knowing is far worse than knowing, even when the situation is serious.

How do families/whānau and friends cope over time with the chronic sorrow they experience?

When faced with the initial realisation that a family/whānau member or friend is using alcohol and/or other drugs, getting to the point where things seem manageable may seem a long way off. Building coping and resilience over time doesn’t mean life is not difficult at times; it means you find ways to separate from a loved ones behaviour, develop your own life and still support the loved family member or friend. The following are some ways that people managing the juggle have found useful.

Learning to “live life”

When loss of any kind occurs people hear a lot of advice from others about the need to “accept” what has happened. Though people might be able to find silver linings for this cloud sometimes, the fact remains that for many people it is a cloud, at least at first. Sometimes life doesn’t make sense and isn’t reasonable or fair. Developing coping and resilience skills around hobbies, time for self, work/life balance, enjoyable outings, friendships, etc is very important. Making time for these things often takes considerable effort.

Having a sense of humour

One of the things that often surprises newcomers to support groups, where they can meet with supportive others who understand what they are experiencing, is the laughter. Participants love to have a laugh about the sometimes appalling situations they find themselves in, with someone else who’s been there and understands. Family members often find that having a good laugh relieves tension and lifts their spirits like nothing else can.

Developing a positive and cooperative spirit in the family

A positive and cooperative spirit is one of the key factors that help families to cope with the stresses of having a person they care about using alcohol and/or other drugs. When families are faced with a lot of demands, it’s worth investing time and effort into building a positive kind of spirit when you can.

Prioritising enjoyable things that can be experienced and enjoyed as a family e.g., holidays, games, nice meals, video nights at home, family celebration, sports. Whatever is possible, is worthwhile. A cooperative spirit is also created when families talk through issues and make decisions together.

Using your strengths

Living with the chronic sorrow associated with having a family/whānau member using alcohol and/or other drugs can leave people feeling inadequate and helpless. It often helps to think about strengths, and how these might be used to cope with the situation.

If someone is a people person, for instance, it helps to get out with others, or join or start a support group. If someone is good with the mind, it is good to make plans and goals to work towards. If someone likes to write or is creative in other ways, keeping a journal or making or creating works that express feelings can give pleasure. If someone is practical and down to earth, working on a project may help ease stress. If the computer fascinates, the internet can be used to access information and support for oneself. And if one has good physical skills or wants to have better physical skills, sports or exercise are a way of working through feelings.

Don’t forget too, that there is usually someone else in the same boat that you can support.

Looking after yourself

Ask family/whānau members who are trying to support someone in the family using alcohol and/or other drugs where their own needs come, in relation to everyone else’s needs, and they’ll usually smile ruefully and admit that they put themselves at the bottom of the list.

Doing something for enjoyment, getting out and reminding oneself that there is life outside the immediate issues that often overwhelm one’s mind, really helps. Exercise is very important for many people. Making time for a run or a session at the gym can be hard but is worth the trouble. For others it’s cossetting things like a long bath, retail therapy, or going to the hairdresser. Many people enjoy distracting activities like losing themselves in a good book or a funny programme on TV.

"Getting out and being adult again sometimes makes the world of difference for me. I have to make myself do it, but I always feel much better for it." - Mother of a poly drug user

What are the positives?

Many people comment on qualities that they have developed; qualities they are proud of and that they feel have made them a better person. Often they say they have become stronger, or more patient, kind and caring. Some mention developing skills such as flexibility, advocating for themselves or their family member or friend, or developing empathy for other points of view.

Some people comment that dealing with health and law professionals has helped them become more assertive and stroppier, and they like that in themselves! And many people comment that this crisis in their lives has changed their perspectives about what really matters; that they don’t “sweat the small stuff” any more, and they have better skills for dealing with other problems that arise in their lives.

Meeting other families who are struggling with similar issues is one of the key positive outcomes for many people, although research suggests that seeking such help is very difficult for most people. To this end online support is generally found to be of real use and many people gain new knowledge and skills.

Spending time with other people who share newly developed perspectives on what is important in life, who understand that sometimes things change fast, and plans have to be flexible and who realise that nobody’s perfect, is an unexpected bonus.

Further Reading

Chronic Sorrow: A Living Loss by Susan Roos.

Published by Brunner-Routledge, 2002

ISBN10 1583913211

ISBN13 9781583913215

Susan Roos is a psychotherapist who has been in practice for over 36 years. Her daughter Karen died when she was 3 years old, and her daughter Val is severely retarded, autistic and has a seizure disorder. This is the key book to read if you would like to learn more about chronic sorrow. An updated version is now available. (See below)

Chronic Sorrow: A Living Loss by Susan Roos

Publication date: 2017

Edition statement 2nd New edition

ISBN10 1138230685

ISBN13 9781138230682

This 2nd Edition of Chronic Sorrow, published 15 years after the 1st edition above explores natural grief reactions to losses that are not final and continue to be present in the life of the griever. This second edition updates terminology, pertinent research, and the roles the concept of chronic sorrow has come to play in the nursing, medical, social work, pastoral, and community counselling professions, among others.

McLaughlin, Victoria Grace, “Chronic Sorrow In Family Members Of Addicts: An Investigation Of Partners Of Addicts And Divorcees To Explore Chronic Sorrow As A Theoretical Understanding Of The Experiences Of Family Members Of Addicts” (2016). Dissertations, Theses, and Masters Projects. Paper 1499449812.

Dr Pauline Stewart is an Educational and Counselling Psychologist in Private Practice in New Zealand. She is a member of the New Zealand Psychological Society and the New Zealand Association of Counsellors. She had many years of experience in teaching and management prior to becoming a psychologist. Pauline has a particular interest in the area of grief and loss in families and the challenges of alcohol and other drug use.


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