Beautiful Boy Reaction: Family, Addiction, and Recovery

Treatment Barriers and Family Impact

Part III of David Sheff's memoir Beautiful Boy addresses the author's attempt to get his son, Nic, into a treatment program. Nic's hostility toward his father is palpable, as is David's helplessness in the situation. Nic, though a boy by many societal standards, is legally an adult, and David's power to compel him into treatment is limited. Furthermore, Nic's medical condition — as assessed by the addiction rehabilitation counselor at Oakland Rehab — is severe. Not only is he using a greater quantity of drugs than many abusers much older than he is, but he is also engaging in the dangerous practice of combining substances. The counselor explains that the program is not right for Nic because he is proud of his "hardcore" status, resistant to treatment, and in denial about the severity of his problem. She offers David other resources but does not believe Nic will succeed in rehabilitation (Sheff, 2008, p. 127). This element of the book powerfully addresses the hopelessness families face when battling a loved one's drug addiction. Even the best help-seeking efforts often fail to yield results, which can cause a downward spiral in family morale, exacerbating tension and potentially influencing continued drug use by the addict.

Sheff also has young children at the time Nic is struggling with addiction. In this section, he addresses how he and his wife approach their younger children, Daisy and Jasper, about Nic's addiction. They encourage their children to seek help from people at school, though they are not good about following their own advice for self-care. Their response to a counselor's suggestion that they go on a date — that they are, in fact, on a date by attending counseling — indicates just how profoundly the family dynamic has been altered by Nic's addiction (Sheff, 2008, p. 132). Both of these passages underscore that addiction is a systemic problem, impacting the entire family rather than the addict alone.

Al-Anon, Accountability, and the Disease Model

Part IV of Beautiful Boy, titled "If Only," opens with David and Karen heading to an Al-Anon meeting — their version of a date while navigating Nic's addiction. David discusses his initial reluctance to talk about Nic's addiction with anyone. Notably, he says this reluctance was not born of shame for himself, but rather of a desire to protect Nic from having others change their opinion of him. The fact that David was aware of how people's perceptions would shift, and that he initially looked down upon other family members at Al-Anon meetings, speaks to a common stigma surrounding addiction. He ultimately finds solace, comfort, and strength in those meetings, and they give him the courage to stop hiding his son's illness.

David also begins to understand the distinction between his son and the disease. He acknowledges that it is Nic's addiction that drives so many of his negative behaviors, and he reminds himself that Nic's recidivism is part of the disease — though he wonders whether relapse reflects a "moral failing or character flaw" (Sheff, 2008, p. 179). Sheff arrives at a conclusion that is important for all those dealing with addiction: "It is not Nic's fault that he has a disease, but it is his fault that he relapses, since he is the only one who can do the work necessary to prevent relapse. Whether or not it's his fault, he must be held accountable" (Sheff, 2008, p. 179).

The concept of accountability is critical in addiction recovery because addicts frequently seek to avoid responsibility for their condition. For example, Nic revealed to David that he wished he had any other disease, because people would not blame him for it. The reality, however, is that people would expect him to seek treatment for any other disease and would hold him accountable for failing to do so. At some point, the failure to seek treatment for any serious illness becomes less an act of self-neglect and more an overt harm to those who love the person. This tension between compassion and accountability is central to the disease model of addiction.

References

Sheff, D. (2008). Beautiful boy: A father's journey through his son's addiction. New York: Houghton Mifflin Company.