ABSTRACT
In addiction treatment, the “elephant in the living room” refers to a situation in which the addictive use of alcohol (or other drug) by a family member significantly impacts the remainder of the family, yet no one talks about it. The apparent blindness to the presence of a behavior that adversely affects the user and the family results from a variable combination of true unawareness by the spouse and/or children, along with some element of denial, disbelief, and/or covering up by the family. Effective family treatment of addictive disorders includes bringing to light the dysfunctional behaviors of both the addict and family members, addressing the associated shame, and developing strategies (a) for the addict to stop addictive use of the substance (alcohol, cocaine, etc.) or behavior (gambling, sex, risk-taking, etc.), and (b) for spouses or partners to focus on their own needs rather than on the addict's behavior and to become empowered to set boundaries for what is acceptable in the home and in the relationship.
