Background: Research has shown that a family member's problematic substance use has significant deleterious mental and physical health impacts on other members of the family. Women are more often affected than men. These negative health effects persist as the person with problematic substance use ages, and they vary according to the relationship status. Aim: The aim of this study was to gain a deeper understanding of how women experience and are affected by their family member's substance use problems. Method: A metaphorical analysis of narrative interviews with 11 daughters and five wives of older adults (>65 years) with problematic substance use. Results: We identified four areas of signification in which metaphors were employed: (1) experiences (chaos and crash and walking on eggshells); (2) strategies (complicity and silencing); (3) dilemmas (deceit or a disease and open or closed dilemmas); and (4) consequences (obtaining or retaining an identity, health and different types of help). Conclusion: Family life with a parent or spouse with a substance use problem was described as chaotic, unsafe, uncertain and with no prospects of change. The study illustrates how metaphors are used to mediate experiences and worldviews pertaining to existential matters founded in deep negative emotions, deceit, shame and stigma. Metaphors make up a crucial material for communicating emotions and themes that are difficult to convey due to shame and stigma.

中文翻译：

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房间里的大象：女性描述与吸毒问题家庭成员生活的隐喻

背景：研究表明，家庭成员有问题的药物使用会对家庭其他成员的精神和身体健康产生严重的有害影响。女性比男性更容易受到影响。随着物质使用问题的人年龄的增长，这些负面的健康影响持续存在，并且根据关系状况而变化。目的：本研究的目的是更深入地了解女性如何经历家庭成员的药物使用问题以及如何受到其影响。方法：对 11 名女儿和 5 名有药物滥用问题的老年人（> 65 岁）的妻子进行的叙述性访谈进行隐喻分析。结果：我们确定了使用隐喻的四个意义领域：（1）经验（混乱、崩溃和如履薄冰）；(2) 策略（共谋和沉默）；(3) 困境（欺骗或疾病以及开放或封闭的困境）；(4) 后果（获得或保留身份、健康和不同类型的帮助）。结论：父母或配偶有药物滥用问题的家庭生活被描述为混乱、不安全、不确定且没有改变的前景。这项研究说明了如何使用隐喻来调解与存在主义事物相关的经验和世界观，这些存在主义事物建立在深刻的负面情绪、欺骗、羞耻和耻辱的基础上。隐喻是传达由于羞耻和耻辱而难以传达的情感和主题的重要材料。