Families of Origin and Families of Choice

Like nongay clients, LGBT individuals seeking recovery are involved in multidimensional situations and come from diverse family backgrounds. Family, relationships, friends, social interactions, work issues, self-esteem, increased understanding of self-identity, and community support all are part of the focus of the treatment and recovery process. During the course of treatment, it is important to identify stressors that can trigger a return to substance abuse and addiction. LGBT individuals, in particular, need an intake assessment that is comprehensive, inclusive, and culturally sensitive.

Family of Origin

Family of origin refers to the birth or biological family or any family system instrumental or significant in a client’s early development. Taking a family history and reviewing the dynamics of the family of origin should be part of a thorough bio-psychosocial assessment. Counselors should exercise great care in asking sensitive questions, particularly about members of the family of origin. The client’s cultural norms will be particularly important during this questioning and should be respected for an assessment to be effective.

LGBT clients often will have unresolved issues about their family of origin, particularly regarding sexual orientation or gender identity. As they do with all clients, counselors need to review the client’s role in his or her family of origin, because unresolved issues with the family of origin can act as emotional triggers to a relapse.

The following questions can help the counselor gather relevant information and assess what unresolved issues might interfere with clients’ ability to maintain sobriety.

• What were the rules of the family system?

• Was there a history of physical, emotional, spiritual, or sexual trauma?

• Were all family members expected to behave or evolve in a certain way?

• What were the family’s expectations with regard to careers, relationships, appearance, status, or environment?

• In general, was sex ever discussed?

Concerning sexual orientation and gender issues, counselors can begin by reviewing with clients how differences were perceived in the family. The following questions would be appropriate to explore:

• Was anyone else in the family acknowledged to be or suspected of being a lesbian, gay, bisexual, or transgender individual?

• How did the family respond to other individuals coming out or being identified as LGBT individuals?

• Is the client out to his or her family?

• If the client is out, what type of response did he or she receive? The family of origin’s response to one’s disclosure of an LGBT identity can have a long-lasting and—if it is negative and unaccepting—often devastating effect on an individual. Responses can range from abusive, rejecting, or avoiding to tolerant, supportive, or inclusive. LGBT individuals need to process these messages, roles, rules, images, and stereotypes about sexuality in addition to the messages they receive from society in general.

What makes the LGBT experience different from the experience of other cultural minorities is that LGBT individuals experience prejudice and, most frequently, a disconnection from other members of their minority group. Even in a multicultural family, an adolescent is able to look beyond his or her immediate family to the cultural community and find someone to identify with. This typically is not true for LGBT individuals. who usually grow up without information on or contact with other LGBT individuals.

In his book, Healing the Shame That Binds You, John Bradshaw, Ph.D. (1988), refers to the “toxic shame” that is created in childhood and stays until the individual learns to purge it. Similar processes have been explored by authors who write about recovery and families, for example, Janet Woititz, Adult Children of Alcoholics (1990); Earnie Larsen, Stage II Recovery (1991); Ann Wilson Schaef, When Society Becomes an Addict (1988); and Michael Picucci, The Journey Toward Complete Recovery (1998), as well as numerous others who acknowledge the importance of resolving these conflicts from our childhood and our family of origin.