With decades of experience as a social worker and family therapist, Antonia Maria has published “Families Addicted ,” a work that proposes a systemic approach to understanding and treating addiction. Through case studies, theoretical foundations, and field research in Brazil and Canada, the book encourages us to shift the focus from the individual to reflect on the role of the family and social context in addressing chemical dependency.
You worked for many years as a social worker and family therapist, working directly with vulnerable people. How did this experience influence the way you structured the book “Addicted Families”?
This question is quite complex, as it involves two different but complementary perspectives: one from the perspective of a social worker and the other from the perspective of a family therapist.
As I mention in the author’s note, I intertwine the past with the present, envisioning the future when I refer to the ever-changing wheel of life. In other words, even though the family is one of the main targets of social work intervention, in my early days working with addicts, I was still trapped in the conventional model that the addict was solely responsible for their illness and the family was the victim. However, over time, I realized that this didn’t add up. That’s when I realized I wanted to deepen my knowledge, and I took a specialization course in family therapy, where I began to develop a new, circular worldview. In it, it’s not just the substance abuser who is considered ill and responsible for their illness, but the family system as a whole. From this principle, I began to share my concerns with the public.
The book aims to shift the individual’s perspective to the family and social system in which they are inserted. What do you believe changes in an addict’s recovery when the family is also treated as part of the process?
Throughout our lives, we have been conditioned to see the world in a linear way, always blaming others for our pain and suffering, without involving ourselves in these problems. The systemic view deconstructs this thinking pattern, showing a circular path and urging individuals to become involved in everything that happens in their lives, whether in good (pleasant) times or bad (unpleasant) times. Family relationships are no different, because when addiction arises in the family system, its members often organize themselves in such a way that they place the addict solely responsible for the entire family’s suffering. This is where the role of the systemic family therapist comes in, to demystify this thinking, helping the family understand that substance addiction is a disease, and like any other disease, the addict needs to be welcomed and cared for by their family. Likewise, this family also needs to be cared for, so that they can find more assertive measures to deal with this illness that initially seemed to be solely the addict’s, but which later became the illness of the entire family system. With this mindset, the addict can reframe their relationship with the substance and, consequently, reclaim their role within this system in a healthier way. And, who knows, replace the psychoactive substance with other, healthier sources to fill their existential voids.
You delve into systemic theories, but also share real clinical cases in the book. What was the process of choosing and retelling these stories ethically, without losing their transformative power?
This was perhaps the most difficult part, as these are stories of people who confided their personalities to me. Therefore, it was my ethical duty to preserve their anonymity, as well as the names of institutions and locations. On the other hand, I also had to find alternatives that could contextualize the reader without losing the chronological storyline and without exposing the protagonists of these stories. Therefore, I chose to use fictitious names for the patients and their families. In the case of the institutions, I preferred to simply indicate the category to which they belong.
In the third part of the book, you examine the dynamics of addiction among homeless people and compare Brazil and Canada. What surprised you most about this comparison, and what do you think Brazil could learn from Vancouver’s policies?
What surprised me most was discovering that, even in developed countries, such extreme social inequalities existed. In addition, there was a very high proportion of homeless people, a mix of substance abusers and people with mental disorders, certainly resulting from substance abuse. Following Canada’s example, Brazil could offer more specialized psychosocial support to families of addicts, helping them learn to better cope with the situation and adopt more assertive measures in caring for their loved one. This way, they would begin to embrace the addict, even if they are unable to stop using psychoactive substances, as tolerance increases when continued use is accompanied by support such as family therapy, support groups, and harm reduction strategies.
The topic of addiction is often surrounded by taboos, prejudices, and moral judgments. How do you address these stigmas in your work, and how does the book seek to break down these barriers?
One of the immediate measures I took was to replace pejorative terms (alcoholic, drunkard, drunkard, drug addict, etc.), commonly used by both family and society) with terms that soften the burden and guilt the addict carries, redirecting them to the position of someone who needs help. When we change these terms, we inevitably change the way we view addicts and, consequently, the way we treat them. Thus, we encourage families and society to reevaluate their behavior and change segregating and exclusionary patterns of behavior.
Families living with addiction often oscillate between love and exhaustion. What kind of support do you believe these families need most—and often don’t receive?
THE The first step would be to listen to the family’s complaints without judgment, which often involve a significant amount of suffering. Even when there is love, it is very common for them to report inappropriate behaviors and attitudes in dealing with such problems. Therefore, it is important to create public policies to support these families, providing more assertive and specific guidance on how to deal with these addicts at home. This approach can prevent the addict from worsening the situation, making family life unsustainable, to the point of leaving the family system, either independently or through exclusion. In some cases, this departure can lead to homelessness.
You bring an approach that combines integrative practices, active listening, and science. What was it like building a narrative that embraces spirituality and emotional care, but without neglecting technical rigor?
This is a minefield, as we are a country with many diversities in this area of spirituality, which requires therapists to manage the boundaries between technical knowledge and individual beliefs. Because of this, I chose not to address this issue in the book itself. However, when the topic is brought up by the family during the therapeutic process, we use it as an ally in the development of that process.
Ultimately, your book proposes navigating the “turbulent waters of addiction” toward calm. What message would you like each reader to take away upon closing the final page of this work?
To answer this last question, I’ll quote an excerpt from the blurb of my book: “The good news is that all is not lost. Systemic therapy can act as a compass, guiding adrift vessels so they can safely and serenely find their way back to familiar dry land.”
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