Walking the Tightrope: Communicative Tensions in Disenfranchised Grief Among Families Managing Substance Use Disorder

This study investigates the communicative tensions inherent to the experience of disenfranchised grief among family members of individuals with substance use disorder (SUD). In the context of a family member with SUD, 98 adult-affected family members (AFMs) described their struggles with disenfranchised grief, a form of grief characterized by deprivation of support or recognition from others. The results of a deductive, qualitative analysis guided by relational dialectics theory (RDT; Baxter & Montgomery, 1996) indicated that AFMs traverse the dialectical poles of integration-separation, stability-change, and expression-non-expression both within the relationship (internally) and with those "on the outside" (externally). Additionally, AFMs grappled with a tension cited in previous work examining contradictions among spouses managing adult dementia: presence-absence (Baxter etal., 2002). The findings (a) illuminate the disenfranchised grief experienced by AFMs, (b) unpack the interactional implications of this unique form of suffering by situating disenfranchised grief as a communicative phenomenon, and (c) call for increased social and clinical support for AFMs experiencing disenfranchised grief.