On Substances and Shadows
A question I keep turning over: why is this so hard?
Not hard in the sense of "why can't people just stop," which is the wrong question entirely. Hard in the sense of why substance use grips people so completely. Why recovery can feel like deep-sea diving with limited oxygen in the tank. Why people who genuinely want to change find themselves back at the beginning, again and again.
I've sat with this question for years, in my own life and in the clinical work. The work is not tidy. Relapse happens. Relationships fragment. The self gets shattered and rebuilt and shattered and rebuilt. There's grief in this work. Sadness, frustration, helplessness- a kind of defeat that can settle into the body. It is not an easy road for anyone involved, including the clinician.
Yet the people I work with who struggle with substances are some of the people I find most moving to sit with. I don't say that lightly. There's something about this population: they are often deeply sensitive, attuned to feeling in ways that became unbearable. Not to mention they are often viciously humorous. They've been carrying something heavy for a long time, usually without knowing what it is or where it came from. Part of the work is figuring out what they inherited, what was placed on them, and what they might, finally, be allowed to set down.
Inheritance
Addiction runs in families. This is both obvious and insufficiently understood.
The genetic component is real. Research suggests that somewhere between 40 and 60 percent of the vulnerability to addiction is heritable. This doesn't mean addiction is destiny, but it means some people are born with a nervous system more susceptible to the grip of substances, a brain that responds differently to alcohol or opioids or stimulants, a baseline that's harder to regulate without external help. This was passed down before you took your first breath, written into your body by ancestors you may never have known. Fun!
Then there's the relational inheritance. Children learn to regulate their emotions through their caregivers. When that attunement is consistent enough, the child develops the capacity to soothe themselves, to tolerate distress, to trust that difficult feelings will pass. When attunement is inconsistent, absent, or disrupted by the caregiver's own addiction or mental illness, that capacity doesn't fully develop. The child is left with a nervous system that dysregulates easily and few internal resources to bring it back online.
So a person might inherit both the biological vulnerability and the relational context that activates it. The predisposition and the pain. The match and the kindling.
This is not about blame. As I say all of the time, many of our parents were doing the best they could with their own inherited limitations, their own un-metabolized grief, their own nervous systems shaped by what came before them. The point isn't to assign fault. The point is to understand what you're carrying and where it came from, because that understanding changes everything about how you approach recovery.
The Scapegoat
Here's another frame I return to often: the scapegoat.
In family systems theory, the scapegoat is the one who carries the unprocessed pain of the whole group. They hold the shadow—the parts the family doesn’t look at, can't integrate, won't acknowledge. The anger no one expressed, the grief no one processed, the secrets everyone pretended weren't there, the addiction that skipped a generation but left its mark anyway.
The scapegoat acts out. They become the "problem." In doing so, they serve a function: they give the family somewhere to put its discomfort. As long as one person is the mess, everyone else gets to feel comparatively okay.
Substance use fits this role perfectly. It's visible and it gives people something to point at. That's the problem. That's what's wrong with this family. It draws focus away from the underlying fractures—the emotional neglect, the unspoken trauma, the secrets, the ways the system was failing long before the substance entered the picture.
When I sit with someone who has difficulty not using, I'm often listening for the shadow material. What feelings were never allowed in your family? What roles did you get assigned? What have you been holding that was never yours to hold? What does this substance help you avoid, or regulate, or express? Sometimes the substance is the only honest thing in the whole system—the one place where the pain becomes visible.
Why It Grips
Substances work. That's the thing no one wants to say plainly, but it's true. They regulate the nervous system. They soften unbearable feelings. They create a sense of relief, connection, or control in a body that learned early on that those things weren't reliably available from other people.
For someone who grew up without consistent attunement, without a safe place to bring their emotional experience, substances offer something the relational world never did: reliability. The drink doesn't leave. The high doesn't disappoint. The relief comes when you call for it, which is more than many people in active addiction can say about any relationship they've known.
This is not a moral failure. This is an adaptation—a brilliant, costly, ultimately unsustainable adaptation to a world that didn't meet your needs quite enough, using a nervous system that may have been primed for exactly this vulnerability.
The grip is so strong because the need underneath is so real. We're not just treating a behavior. We're treating a grief. We're treating decades of inheritance, biological and relational, that converged in this one person's body and found its expression here.
The Ugly Truth
This work can be brutal.
Relapse doesn't feel like a "learning opportunity" when you're in the middle of it. It feels like failure, like evidence that you're broken, that you'll never get it right, that everyone who gave up on you was justified. The shame feels enormous. The self-criticism is relentless.
Relationships get damaged. Trust erodes. People who love you get exhausted, and sometimes they leave. The person in recovery is left holding the wreckage, wondering if it's even worth trying again. I have sat with people in that moment, when they're not sure the answer is yes.
I don't say this to discourage anyone. I say it because pretending recovery is a linear path of growth and insight does a disservice to the people actually living it. The road is hard. The setbacks are real. Acknowledging that isn't pessimism. It's respect for what this actually costs.
A Relational Approach
Harm reduction, in my practice, isn't about lowering expectations. It's about meeting people in the truth of where they are.
That means not insisting on immediate abstinence as the only marker of success, though I fully support abstinence when it's accessible and desired. It means prioritizing safety, autonomy, respect, and honesty. It means working with someone through relapse rather than treating relapse as the end of the therapeutic relationship.
Most importantly, it means getting curious about the function of the substance. What is it doing for you? What need is it meeting? What would you have to feel if you couldn't use? What role did you inherit in your family, and how does the substance help you play it or escape it?
From a psychoanalytic lens, we're not just managing a behavior. We're exploring a story that started maybe even before you were born. We're looking at what got passed down—the genes, the patterns, the roles, the unspoken grief—and asking what it would mean to live differently with this inheritance. Not to pretend it doesn't exist, but to have more choice about what you do with it. We're asking what it would mean to let relationships do some of the work that substances have been doing, and why relationships haven't been safe enough to do that work until now.
This isn't about willpower. It's about understanding. It happens slowly, in the context of a relationship that can hold the mess without flinching. And it is OK if you are not that person.
What You Can Set Down
If you've struggled with substances, you've probably internalized a lot of shame. You've been the "problem" for so long that it's hard to imagine yourself any other way.
Here's what I want you to consider: you may have been carrying something that was never yours alone. The vulnerability in your nervous system was inherited. The pain you've been numbing might have roots that extend back generations. The role you were assigned in your family, the feelings you absorbed, the dysfunction you acted out—these were systemic, not just personal. You were the place where everything converged.
None of that is fair. It's also not the whole story. Whatever you inherited, the work of recovery is yours to do. No one else can do it for you. Understanding where your patterns come from doesn't exempt you from taking responsibility for them now—for the harm caused, the relationships damaged, the ways you've hurt yourself and others. The inheritance explains. It doesn't excuse. At some point, you have to decide whether you're going to keep being shaped by what was handed to you or whether you're going to do the hard, unglamorous work of living differently. That choice, at least, is yours.
You adapted to an impossible situation with the tools you had, including the tools your biology made especially effective. That adaptation kept you alive. It also cost you more than anyone should have to pay.
Some of what you inherited, you'll carry forever. The genetic vulnerability doesn't disappear. But the relational patterns, the shame, the role of family scapegoat- those can shift. You can learn what's yours and what was never yours. You can put down what you didn't choose to pick up. You can stop being the container for other people’s shadow.
That's not a cure. It's not a tidy ending. But it's a different way to live with what got passed down.
If This Resonates
I work with adults who want to understand their substance use in the context of their history—biological, relational, systemic. This work is hard, but it doesn't have to happen in isolation.
