Understanding family systems

There’s the famous opening line of Leo Tolstoy’s 1877 novel, Anna Karenina: “All happy families are alike; each unhappy family is unhappy in its own way.” It means that happiness requires a specific, shared set of stable conditions, like trust, love, and safety, while misery can stem from a near-infinite, unique combination of dysfunctions.

Family systems is a wonderful theory and a lens that we can use to understand each family that has been affected by substance use disorders.

I’d love to start with interdependence. Interdependence is a unique way each family member influences one another, and when one member suffers from a substance use disorder, the whole family system is affected. Addiction professionals and clinicians who worked closely with families noticed that some family members might take on certain roles, such as the Identified Patient, a person who has the substance use disorder. Then we have a Caretaker, who does whatever possible to protect the identified patient from consequences and who also keeps it quiet, making sure that nobody knows what’s going on. The hero is the overachiever who compensates for the chaos, often by whatever means necessary. Then we have a lost or invisible child; they are often by themselves, withdrawn, don’t draw attention to themselves, and prefer it that way. Then we have a Scapegoat, whose role is to act out and draw negative attention away from addiction. They sort of try to beat chaos with chaos. And last but not least, we have a Mascot, the funny one, a person who uses jokes and humor to defuse the whole situation.

In my experience, from what I experienced personally and witnessed professionally, sometimes in some family systems one person can take multiple roles, especially if it’s a small family.

I was the hero, the scapegoat and the mascot

For example, from my personal experience, I was the hero, the scapegoat, and the mascot, depending on the situation. My family has been affected by alcohol use disorder. I had close family members who had severe alcohol use disorder, and I also have family members who would vary from mild to moderate. So, in middle school, I became a Baptist in Russian Orthodox Russia, right after the downfall of the Soviet Union and the renaissance of religion and Orthodox Christianity. That was a big slap in the face of family values, a betrayal of faith and communal values, and quite honestly, family values as well. It just happened at the beginning of the disaster phase, when my mom’s partner started binge drinking. Then I naturally evolved into the hero, became a sign language interpreter, and at the age of 23, I was a very well-known interpreter in the city of Moscow and in religious circles. I graduated with honors from my university and became one of the first family members with higher education, multilingual, who also rebuilt his life and career all over in the United States. It’s all while my mother had a very significant existential crisis and moderate alcohol use disorder combined with severe insomnia and depression. At least her son made it, right? And at the toughest and darkest times, I cracked hilarious and very dark jokes. I still have a very witty and dark sense of humor, and people love it. I was also the cruel one who made the last tough calls with family members who could not succeed with abstinence, and I was the one who cut cords and kicked those family members out because it was unsuitable for our family unit.

In my professional practice, I have seen similar dynamics playing out, especially with smaller families and families with a child with disabilities, which can complicate the family dynamic with substance use quite significantly.

One important component of the family system, and of any system in general, is homeostasis.

Homeostasis. Systems seek balance. Family members behave in ways that keep the family running as it always has, even when that balance is bad for individuals. A child who cleans up after an intoxicated parent keeps the peace and also keeps the drinking going.

Boundaries and communication patterns

Boundaries are essential for healthy family function. For families who have family members with substance use disorders, boundaries are often blurry or the opposite, quite disengaged.

Let’s look at the enmeshment. One example I’d love to illustrate here is an example of a parentified child. While in a healthy family, parents are the ones who shield their kids from the heavy load of parental responsibilities, in families with substance use disorders, a child might take another role of a caretaker or “parent,” especially if a parent is too involved with a family member who suffers from a substance use disorder or is not able to take care of children because of their own substance use.

The opposite of it is disengagement. It’s when a family member pushes other family members away to avoid communication. A family member might become distant, disengaged, or disinterested because of the heaviness of the situation and the behaviors that come with substance use disorders.

Communication patterns go hand in hand with boundaries, and there are a few patterns that I would love to emphasize for families with substance use disorders:

Secrecy. The substance use becomes the thing nobody names outside the house, and often inside it. The boundary around the family hardens to protect it. That bleeds into another pattern often upheld by families with substance use disorders:

Don’t ask, don’t tell. Very early, family members learn or establish the rule that there are certain topics we don’t talk about. The embarrassing behavior when a person with a substance use disorder exhibited it under the influence. The true feelings of disappointment, anger, grief, hopelessness are not discussed openly, because it’s not about them, it’s all about the person who has the substance use disorder. We don’t want to trigger them again, we don’t want them to use again, and we don’t want it to get worse.

Then come the off-limits topics. For example, a family may react strongly when someone brings up a contingency plan for what they’re going to do if one family member gets intoxicated on vacation. Or the times when a family member abused another family member while under the influence.

There are other communication patterns that could be visible in families.

Indirect communication. People talk around the person using rather than to them. When a third party gets pulled in to carry the message, that is triangulation.

Cover stories. Children are given explanations that do not match what they see. “Your dad is just sick, he needs his medicine.” The child learns to distrust their own perception.

Conflict avoidance. Direct requests and disagreements feel too costly, so needs get expressed sideways or not at all.

Chronic tension. Even in quiet stretches, the household stays braced. People scan mood, tone, and footsteps to predict what is coming, which is why children in these homes often become unusually good at reading adults.

Discord and blame cycles. When conflict does break out, it tends to escalate fast and resolve nothing, because the actual subject stays off the table.

Denial and minimizing. Language shrinks the problem. “He just had a few.” “It’s not that bad.”

Poor assertiveness. Parents with substance use disorders often struggle to state needs directly, and children model that.

Generational and systemic influences

Addiction does not happen in isolation. Often, factors such as multigenerational patterns, systemic inequalities, trauma, and substance use as a coping mechanism are passed down from generation to generation. In Internal Family Systems, we often call them generational burdens.

The tricky part of multigenerational patterns is that a person who is affected by a substance use disorder carries not just their own trauma, coping, and their own burden, but also the burden that passed through generations.

For example, I grew up in a mixed Russian family where drinking was a way to bond, solve conflicts, and create connection.

It became problematic when it was no longer a ritual but a disease.

What is also interesting, despite the popular correlation that children of parents or family members with substance use disorders will later develop addiction, often it’s quite the opposite. People who have been negatively affected by substance use in their childhood may choose the path where they don’t use substances or drink alcohol at all. We’re actually witnessing an interesting phenomenon that the new generation overall consumes less alcohol than previous generations.

Family dynamics and addiction

Family dynamics play a significant role in addiction, especially when it comes to stress and dysfunctional patterns.

Here’s an example: a hero is doing so well in life, gets promotions, runs businesses, on top of everything, and then later on discovers that they suffer from burnout or anxiety. They may not use the same substance as their family members did, but then they might discover a controlled substance for anxiety, or they find themselves on the wrong side of town, which is really out of character for them, and they start using as a way of self-medication.

Another example that I have noticed is when a partner starts using with their partner in hopes to control their use. They might think, well, if I stop, they will stop too. And often both partners get deeper into addiction, and the substance use disorder takes on the function of keeping the unit together.

A scapegoat child may start using themselves because it pulls the attention away from the main problem in their family, from their parent. Maybe it makes them rethink their use or even stop.

How these roles show up for gay and bisexual men in business and in love

I’d love to take this one step further, because I see these roles every week in the gay and bisexual men I work with, especially the ones who run businesses. The family might be thousands of miles away, and the roles still show up at work and at home.

The hero becomes the founder. The business is proof that we made it, that our family did not fail, and that being gay did not ruin anything. There’s even a name for it among gay men: the best little boy in the world. We learn early that achievement buys acceptance, so we keep achieving. And then one day the numbers are high, and we still can’t relax.

The caretaker becomes the boss who covers for everyone, and the partner who manages somebody else’s drinking or using. He keeps it quiet. He makes sure nobody knows what’s going on, at the office or at the party.

The lost child becomes the owner who stays invisible. He does great work and doesn’t talk about it. He doesn’t ask for the referral, he doesn’t raise his prices, and he doesn’t ask his partner for what he needs. Many of us practiced being invisible long before we knew why.

The scapegoat is often the one who came out. In some families, coming out made us the problem, and it moved the attention away from the drinking. In business, the scapegoat is the rebel who breaks the rules, sometimes brilliantly, and sometimes to beat chaos with chaos. In a relationship, he picks the fight, so nobody has to talk about the real thing.

The mascot is the funny one at the meeting and at the dinner party. Humor is a gift. It can also be the way we make sure nobody sees how heavy things are.

The communication patterns come with us too. For gay men, “don’t ask, don’t tell” was not only a family rule. Many of us grew up with it as a policy. Secrecy feels normal, because the closet was our first secret. And chronic tension becomes a professional skill. We read every client, every investor and every partner, scanning mood, tone and footsteps. It makes us very good at business, and it makes us exhausted.

In couples, I see homeostasis play out the same way it does in families. Sometimes the using keeps the relationship running as it always has. One partner uses with the other to keep it under control, and both get deeper into it. If you recognize your relationship here, you are looking at a system doing what systems do, and systems can change.

Family roles in treatment and recovery

Earlier, when I talked about interdependence, I introduced different family roles. Now, I’d love to provide a brief breakdown of how those roles can be beneficial and challenging in recovery.

It is worth mentioning that sometimes a person with an addiction may have a function for the family, or the substance itself played a functional role in the family system, and when it’s no longer at play and the family cannot find a healthier alternative, that can lead to a dissolution of the union.

Let’s look at how each role could benefit recovery and what unique challenges may arise with each role.

The Identified Patient. In early stages, they might be in denial, focused on themselves or their hopes and dreams, and not notice or be unaware of the dysfunctional dynamic in the family. In recovery, bringing awareness, acceptance, and connectedness with the family could be a beneficial shift. That shift changes unhealthy communication patterns, and other family members can play healthier roles and embrace their positive qualities.

The hero. The hero can bring a sense of relief to the family. Not only can the high achievement comfort a parent of a family member with a substance use disorder that they did not fail that person, but the hero has a unique talent to solve complex problems. With healthy boundaries and communication, the hero can be instrumental in recovery.

The caretaker can also be instrumental if they change their pattern of helping a person escape responsibility. In fact, a person in recovery needs a good support system. The caretaker is naturally good at that, and with healthier ways to provide care, their role could be instrumental.

The scapegoat. I believe a rebel or a troublemaker in the family could be such a useful player in recovery, especially when there is a need for quick and bold moves. They’re great at that. Maybe they can be a family bouncer if people from old circles with bad intentions are trying to intervene. They know how to act up, and when they do it right, that’s a nuclear weapon every family needs to have in case of an emergency. They are also very good at being a bad cop with insurance companies and when a system treats their family unfairly.

The lost child is a perfect child that takes care of themselves. In recovery, there is a healthier way to implement that. That child could be the one that helps with easing the burden of the family. It’s essential that the family still provides attention and care for them in a way that they don’t feel abandoned.

Which role did you play?

Tell me in the comments. And if you grew up in one of these families, or you are living with someone who is using right now, you don’t have to figure out your role alone. I work with gay and bisexual men on exactly these patterns. send an appointment request at goodhypnotherapy.org.

One thing I want to be clear about. I don’t treat addiction independently. If you’re in active addiction, you need a treatment provider, and I can work with you as part of your care team. If you’re the partner, or the ex, or the one holding it all together, I can work with you directly.

This first went out as a letter on my Substack on September 24, 2026. If you would rather get these by email, subscribe there.

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