When Children Mistakenly Become Caregivers

When Children Mistakenly Become CaregiversFrequently, children are thrust into the premature role of caregiver. They become “parentified” children, or “young carers,” taking on responsibilities inappropriate to their age and developmental level. They may be put in charge of younger siblings, tasked with preparing meals and cleaning house, and left to be the provider, rather than the beneficiary of a structured household.

This further isolates children from peers and school, and cuts off the child’s access to developmentally appropriate play. It can distort relationships with younger siblings who may resent the “young carer” for appearing to usurp the parental role. In some cases, parentification can extend to providing emotional support to the addicted parent or to other adults desperately trying to cope.

“Parentified children often feel the pressure to be perfect, so that they are the solution, not an added concern.”

While being thrust into a “young carer” role is fundamentally at odds with optimal development, there may be short term positive outcomes. Some children who take on parenting functions prematurely report feelings of greater competence, satisfaction at being needed and enhanced understanding of the needs of others.

Not all children react to parental addiction by becoming “young carers.” Others may assume the “mascot” role, distracting and diverting the family with antics. Others become “scapegoats,” by acting out aggressively, running away, or getting into trouble at school, thus unconsciously focusing family attention on the “problem child” and away from the addicted parent. Finally, the “placater” role has been identified; these children come to tolerate inappropriate and even threatening parental behavior and lose their ability to protect themselves.

When parents are in treatment, a new set of stressors may emerge. Since most residential programs do not accommodate children, they may endure long periods of separation, with no assurance of when the parent might be well enough to rejoin the family. These separations can easily feel like abandonment, disrupting secure attachment bonds. When the parent does return, the hope of a “cure” may be illusory, with further relapses felt to be broken promises. In this way, from the child’s perspective, the parent betrays the child once again.

It is unfortunate that treatment often entails parental separation from the family. In an assessment of mothers and fathers in treatment for alcohol addiction, greater parental involvement was associated with less severity of addiction and higher parenting skills and self-esteem, especially for fathers. Of course, parents with less severe addictions and more skills may have the psychological resources to involve themselves more fully with their children. Still, the study’s authors urge treatment programs to build in more parental involvement, in the hopes that some causal mechanism—from parental involvement to better recovery—may lurk underneath these correlations.

The opioid crisis commands the headlines. We are learning about the causes and triggers of addiction, from the easy oversubscribing of prescription opioids to the hopelessness in rural areas with high unemployment and poor prospects. Less attention has been given, however, to the devastation that drug and alcohol addiction wreaks on families as a whole. Children are especially vulnerable. Behind the statistics, a few qualitative studies are painting a picture of children whiplashed by multiple stressors: emotional and verbal abuse, disparaging remarks, withholding of love and affection, threats and real abandonment. A parent who is alternately attentive and loving, then moody and withdrawn, then irritable and violent instills in the child feelings of being unsafe. Hyper-vigilance and other symptoms of PTSD may ensue. As one study put it: “the brain becomes proficient at potential pain detection.” Often families are trying to hide the addiction, isolating the family and burdening the child with secrets.

We need to be hearing children’s voices. While the empirical research on how parental addiction affects children is sparse, an even greater gap stems from the lack of children’s voices. We need to hear the felt experience of children who are bravely trying to navigate through a family riven by addiction.

Tags: pubic health, public safety, addicted parents

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