Children of Alcoholics

 

The Disease Concept of Alcoholism
by Sheila Leskinen

 

Denial is the biggest symptom of this illness, and not just for the alcoholic.

Many years ago, I looked at alcoholism with a judgmental and moralistic eye, believing it only happened to "other" people. Then it hit close to home, with someone in my family. I will never forget the resources that helped me to understand this problem from a much different perspective. Eventually, I was able to view alcoholism with compassion and discernment.

In the '60s, '70s and '80s, alcoholism treatment was in its heyday. In 1956, the American Medical Association (AMA) stated alcoholism was a disease, as it met the five criteria needed in order to be considered a disease: pattern of symptoms, chronicity, progression, subject to relapse, and treatability. One could learn about the disease concept through community lectures, articles in the paper, alcoholism hotlines and, of course, Alcoholics Anonymous (AA) meetings.

I learned that alcoholism is an illness that crosses all social classes. Anyone could get it, regardless of age, sex, education, class, ethnicity or religion. Those with a family history of drinking are at a higher risk, even if they once swore they would never drink like their mother or father.

I also learned that alcoholism is a chronic, progressive disease that manifests itself with symptoms that affect one physically, mentally, emotionally, spiritually and socially. Denial is its number one symptom, and the alcoholic is usually the last one to believe he or she has it. Alcoholism has a ripple effect and affects at least four to five other people, including family, friends, co-workers, neighbors, etc.

There are four stages of alcoholism. Most people in the first or pre-alcoholic stage are usually amazed how much they can drink. In fact, many may joke about their "hollow leg" or being able to drink their friends "under the table." Other symptoms of this first phase include: drinking to provide relief from stress and mental fatigue, or to relax; seeking more opportunities when drinking will occur; and a gradual development of increase in tolerance (use of more and more alcohol to get the same desired effects).

In the second and early stage of the illness, the person may have alcohol-induced blackouts. These are amnesia-like periods that occur while drinking, when the person seems to be functioning normally but will later have no recall of some or all of what he or she said or did. The individual may not remember getting home or having said something hurtful or outlandish to another person. Other symptoms include: sneaking extra drinks before or during events; gulping the first drink or two; and feelings of guilt.

The third or middle stage of alcoholism is a crucial phase, for loss of control sets in. This is the inability to drink according to intention. Once the first drink is taken, the individual can no longer predict what will happen, even though the intention may have been to only have a few drinks. Other symptoms include: drinking bolstered with excuses; grandiose and aggressive behavior; persistent remorse; increase in amount and frequency of drinking; failure of repeated attempts to control drinking; failed promises and resolutions to self and others; loss of interests; avoidance of family and friends; trouble with money and work; unreasonable resentments; problems with the law; neglect of food and loss of willpower; tremors and early morning drinks; decrease in alcohol tolerance (needing less alcohol to feel the effect); and the beginning of physical deterioration.

The fourth, final and late state of alcoholism is chronic. Up until this point, the individual may have been successful in maintaining a job, but now drinking occurs earlier in the day and can go on all day. Symptoms in this stage include: onset of lengthy intoxications; moral deterioration; impaired thinking; indefinable fears; obsession with drinking; and vague spiritual desires. A person may not develop all of these symptoms or in this particular order, but there is a continual loss of control.

This disease is often described as cunning, baffling and powerful. The alcoholic is often just as puzzled as those around him or her, because no matter how he or she attempts to modify drinking, nothing seems to work. The individual just can't seem to get a "grip" on the problem. Denial is the biggest symptom of this illness, and not just for the alcoholic. Those around the alcoholic are also often in denial, believing the person just needs to stop drinking or cut down. It is only after treatment that this confusing problem begins to make sense. The alcoholic learns that he or she has a chemical reaction to alcohol and that it is the first drink that causes the trouble. That is, it's the first drink that sets the obsession to drink in motion.

Alcoholism does not have to continue through all four phases, but if help isn't sought, the fourth stage can end in death, insanity or incarceration. From recovery stories, we know that loving interventions planned by concerned others, with the aid of trained professionals, can help alcoholics avoid the pain and misery of all these stages.

Alcoholism is treatable, but successful recovery from alcoholism requires active participation of the individual. It is critical that the alcoholic accepts the illness and be willing to manage his or her recovery process, much like anyone with any other chronic illness has to do. Education is essential. Recovering alcoholics must be well informed about their illness and the need for good self-care. To avoid relapse, the individual needs to learn skills in treatment to maintain and enhance his or her ability to continue in recovery.

The recovering alcoholic needs emotional support from family, friends and the community to make the necessary changes to live within the limitations imposed by the illness. Family involvement and support are imperative for two reasons. Statistics show that if the family is involved in the alcoholic's treatment and their own recovery process, the rate of successful recovery is 70%. If the employer or employee assistance program is involved, success rates climb to 80%. Secondly, and most importantly, the family needs an opportunity to understand and talk about the impact this illness has had on them.

It is important to remember that alcoholism affects an individual five-fold: physically, mentally, emotionally, socially and spiritually. Recovery needs to take place in all these major life arenas as well. Finding new ways to handle life situations without the use of alcohol is the challenge and the blessing.

Sheila Leskinen, M.S., S.C.A.C., L.M.F.T., is a marriage and family therapist with a specialty in addictions. She has a private practice in Anchorage.

Alcoholism: A Family Illness
by Sheila Leskinen

 

Try as they might, families can't control the alcoholic's drinking. The only thing they can control is how it affects their own lives.

Alcoholism is cunning, baffling, and powerful. It is also insidious; most family members aren't aware they are being affected until they reach out for help. They can become angry, anxious, resentful, and sometimes even physically ill because of the stress of trying to cope with someone's drinking problem. The feelings, thoughts, and actions of everyone in the family are being controlled by the alcoholic's drinking.

Out of love, family members may try to fix the problem. Some family members enable and protect the alcoholic by making excuses for them, rescuing them, taking care of them, or by sharing the alcoholic's denial and buying into their delusions. They may walk on eggshells, avoid the situation by withdrawing or refusing to talk about it, or become frustrated or filled with anger. In trying to cope with the illness, families can become adept at rationalization and denial regarding their own attitudes, feelings and behavior. They can become so preoccupied with trying to control the alcoholic that they lose perspective on their own lives. This may lead to a self-perpetuating treadmill as continued behavior patterns become part of the problem instead of part of the solution.

There are certain human needs that are usually met in normal personal relationships: to love and be loved; to be needed and accepted; to have security and a sense of accomplishment; to feel worthwhile; and to have a purpose in life. When alcoholism develops in one member of the family, there is little chance of these needs being met. As the disease progresses, needs become more and more unfulfilled. Negative feelings develop and grow, and communication breaks down. Relationships may distort very slowly and imperceptibly until no one in the family has a healthy sense of themselves.

As alcoholism continues its course, the daily stresses and uncertainties experienced by family members (such as worry, dread, fear and anger) may so distort their reasoning powers that most reactions are emotional and often destructive. The pressure from constant emergency living is formidable, and a feeling of doom may hang over their heads. Generally, there is a good cause for anxiety, apprehension and anger over the continual crises. A period of calm, easy living, which might allow for even a little objectivity, is very rare. While the alcoholic is anesthetized from much of the pain of the daily problems, the family members are not. They usually experience the alcoholic's suffering as well as their own. They often resent this, but do not know how to avoid it.

Sometimes family members blame themselves for the drinking -- "If only I was a better person," or "If only I got better grades." They can become fearful of the unpredictable consequences of drinking -- the mood swings, anger, tension and sometimes even violence. They may fear the family will break up. There is disappointment, isolation, embarrassment, and a growing resentment as the disease places more and more unfair demands on the family. Thus, anger and resentment grows.

The family is often puzzled by the alcoholic blackouts, which are temporary losses of memory. The alcoholic will clearly be unable to recall some things he/she has said and done, and may strongly deny that they happened. The family members may argue about what really occurred, but they will also seriously question whether they themselves are in touch with reality. They may begin to develop an ominous fear about their own sanity.

Reaching out to extended family and friends often upsets and confuses family members even more because of society's misguided myths and prevailing attitudes about alcoholism. In fact, some will even blame the family for the drinking.

Try as they might, families can't control the alcoholic's drinking. The only thing they can control is how it affects their own lives. There are three things family members need to do in order to resolve this problem. First, they need to learn about alcoholism and develop a better understanding of how to deal with it more effectively. Second, they need to realize it is not their fault -- they can't cause, cure or control the drinking, but they can contribute to the problem if they continue the enabling, protective behavior. And three, family members need to get their own support and guidance from people who understand the problem. As family members begin to free themselves from the affects of the alcoholic's drinking, they can begin to make progress toward a normal existence for themselves.

Fortunately, there are excellent sources of help available to anyone touched by alcoholism. In addition to professional help, the self-help groups Al-Anon and Alateen bring hope to families and friends of alcoholics. Family members who become active in these groups find emotional and spiritual support as they learn about alcoholism. As family members effect change in themselves, things will get better for them, and the resulting atmosphere can be conducive to recovery for the alcoholic as well.

Sheila Leskinen, M.S., S.C.A.C., L.M.F.T., is a marriage and family therapist with a specialty in addictions. She has a private practice in Anchorage.

Children of Alcoholics
by Sheila Leskinen

 

These children need to know that alcoholism is a disease and their parent/parents are not able to stop drinking without help.

One of our major public health issues is the extraordinary number of children in this country who are exposed to alcohol abuse and dependence. The January 2000 issue of The American Journal of Public Health states that approximately one in four U.S. children under the age of 18 is exposed at some time to familial alcohol dependence (alcoholism), alcohol abuse, or both. Research has shown that families with an alcoholic member live in environments that are disorganized and unstable. According to the National Institute on Alcoholism and Alcohol Abuse, children of alcoholics (COAs) may be neglected or abused and frequently face economic hardship and social isolation. They are also at high risk for psychopathology and medical problems.

Reports have shown children from alcoholic families report higher levels of depression and anxiety and exhibit more symptoms of generalized stress. The COAs inpatient admission rate for mental disorders is almost double that of other children. They may show symptoms of depression and anxiety such as crying, bed wetting, not having friends, being afraid to go to school, or having nightmares. Adolescents may show depressive symptoms by being perfectionistic in their endeavors, hoarding, staying by themselves, and being excessively self-conscious.

In an alcoholic family, each family member adapts to the behavior of the chemically dependent person by developing behavior that causes the least amount of personal stress. They need to protect the painful accumulation of repressed feelings. The oldest child often takes on the role of the high achiever by excelling in school or sports (to bring a sense of esteem to the family) or they may take on the role of caretaking the younger children. The second oldest child may take on the role of the family scapegoat, acting out by drinking or drugging him/herself, or just being a problem kid. This behavior serves as a distraction to the family that diverts attention away from the problem drinker. The third child is called the lost child. This child tends to be quietly busy and spends much time alone. This role brings relief to the family. The youngest child frequently takes on the role of the family mascot or clown, providing fun and humor to the family. This child uses charm and humor to survive in the very painful family system. Although these roles sometimes evolve in healthy families, with an alcoholic family they tend to be more entrenched and get carried into adulthood.

Children of alcoholics grow up learning the family rule; "Don't talk, don't trust, don't feel." This makes it difficult for them to let someone know the pain the problem causes. These children need to know that alcoholism is a disease and their parent/parents are not able to stop drinking without help. They need to know they cannot control their parent's drinking. Most importantly, they need to be told, "It's not your fault. You did not cause the disease. You are not the reason your parent is drinking." These children need to realize that they are not alone, that there are many others in the same situation but, because of the "don't talk" rule, no one talks about it. Alcoholism has been compared to living with an elephant in the living room. People will walk round it, pick up after it, even feed it, but no one will talk about it. It is important for COAs to find a safe person to talk with -- a teacher, a friend's parent, an older sibling, an aunt or uncle, a neighbor, a coach or just someone who will listen to them.

Some COAs function well in spite of the parental alcoholism. Studies show these resilient children share several characteristics that contributed to their success, including the ability to obtain positive attention from other people, adequate communication skills, average intelligence, a caring attitude, a desire to achieve, and a belief in self-help.

A teacher can sometimes be helpful by having a discussion with a COA student. The teacher must be careful to limit talk to the student's feelings while bringing a supportive understanding of what alcoholism is and staying focused on school and social performance. It is helpful to explain to the child that the best way to aid their parent is to take good care of themselves.

The non-drinking parent can be helpful by educating him/herself about alcoholism and community resources. If the home situation is excessively disruptive or verbally abusive and your children go off to be alone, seek them out. Comfort them and assure them it's not their fault. Encourage and support your children to become involved in school and community activities. Everyone in the family needs to talk about the problem with someone that is knowledgeable and can help the family to explore options to function in healthy ways in spite of the problem.

A therapist can teach a child to survive with an alcoholic parent. This might include helping the COA to talk about their feelings, their situation and themselves. It also includes helping the child to have more rewarding and healthy relationships, and helping them develop a positive self-concept.

Anyone can help the COA understand three basic facts. First, the child is not alone; there are more than 11 million children of alcoholics under the age of 20 in the United States. Second, the child is not responsible for the problem and cannot control the parent's drinking behavior. Third, the child is a valuable worthwhile individual.

Here are seven "Cs" that may be helpful for any COA to remember:

	I didn't CAUSE it.
	I can't CURE it.
	I can't CONTROL it.
	I can take CARE of myself.
	I can COMMUNICATE my feelings.
	I can make healthy CHOICES.
	I can CELEBRATE being me.

Sheila Leskinen is a marriage and family therapist with a specialty in addictions. She has a private practice in Anchorage.