From: GETTING YOUR CHILDREN SOBER
Copyright by Toby Rice Drews

PART ONE: Finding the Right Kind of Help

Chapter 2: Is It "Just a Phase"?

Most parents of teenagers today are in their late thirties and forties. Back in the 1960s, marijuana and psychedelics were just making their way on to college cam­puses and avant garde high schools, espe­cially on the East and West Coasts. But who knew much about cocaine or valium? Who had ever heard of teen alco­hol­ism and cross-addiction? And who could imag­ine ten-, eleven-, or twelve-year-olds ex­peri­­menting with PCP and other "de­signer" drugs?

What are you hearing today from educators? From the media? For the most part you are hearing very confusing, fright­­ening, and alarmist general­ities and pro­nouncements. But what is really impor­tant is sorting out the right information - and the correct information - and knowing what it means in terms of your child.

Can "responsible" kids become alcoholics?

The major educational focus today is on alcohol and drugs as an issue of moral integrity, a matter of "being responsible."

What is dangerous about that per­spec­tive is that kids can reach age twenty-one, can legally drink alcohol, can do so in a "responsible" manner - and can still be­come alcoholics.

This strength of character approach does not at all consider that we are talking about a disease. When children who come from the sixty percent of American house­holds which have a family history of alco­hol­ism use addictive drugs at all (and that in­cludes alcohol, which is a drug), they are at a very high risk of developing an addic­tion.

A further danger of this strength of char­acter approach is one I have not heard spoken about at all: If we continue to view teen addiction as merely a usage problem and if we see the solution only lying in kids' abstinence, we are not facing the untreated family prob­­lems that are a direct result of family mem­bers' lives revolving for years around a chem­­­ically-addicted person. Once a kid has stopped his or her usage, we want to believe that "the problem is over."

Even many parents who are members of community-advocacy groups work­­ing to stop drug problems balk at going to Al-Anon! A majority of these parents have addicted children or are themselves adult children of alcoholics. Yet they often do not view alco­holism as a disease, but rather as an issue of will-power or moral choice. Hence they see no need to go to Al-Anon.

We must stop seeing ourselves and our children as either strong survivors who can say no, or weak people who got hooked. Otherwise, not only will we not get over the effects of this family disease, but we will be reinforcing the centuries-old mis­taken attitude towards alcoholism: that it is solely a matter of strength of character, or moral integrity, of right and wrong.

I know too many ministers, priests, rabbis, nuns, and other very good people who drank with very "responsible" atti­tudes, and still became addicted. For that is the nature of the disease (as we'll see in Chapter 3, dealing with the genetic facts about alcoholism). Your body can either metabolize alcohol, or it can't. If it can't, and if you drink any alco­hol, the addiction process will set in - regardless of whether or not you drink responsibly. The more we perpetuate the idea that alco­holism is a question of moral integrity, the more alco­holic adults and children and their families will be reluctant to go to treat­ment. Who wants to appear weak? Who can bear the social stigma?

Facts on teen addiction

No matter what other drugs a kid may try, if he or she tries any, alcohol is very probably going to be one of them.

When there is a history of alcoholism in your family, even if your child "just tries" alcohol (or any other addictive drug), there is a very high chance of the addiction process being started. Your child can "just drink on weekends at parties" and the physical addiction can begin.

Once that addiction process begins, cross-addiction is a complicating, danger­ous element that needs to be considered. Cross-addiction means that once the addic­tive process starts, no matter what addic­tive drug your child ingests (and that includes "just beer" or "just one joint"), the addiction is kept active, and pro­gresses.

Now, we come to the "synergistic" fac­tor. If more than one addictive sub­stance is ingested, a multiplier effect takes place. In practical terms, this means that if an adult takes one valium and has one beer, the ­effect is equal to drinking about ten beers. But we are not talking about the addiction going on in adult bodies - but in chil­dren whose livers aren't yet fully developed.

There's a 5-to-15 rule commonly used among teen-addiction specialists: On the average, it takes 5 to 15 years for an adult male who drinks, but who does not take other drugs as well, to develop a chemical addiction. (A combination of alcohol and other drugs speeds up this process tre­men­­dous­ly.) On the average, it takes 5 to 15 months for an adolescent, and 5 to 15 weeks for a pre-adolescent.

So, when I'm asked, "How can he be an alcoholic - he's so young?", the answer is horribly simple to explain.

The four most significant causes of death in 16- to 24-year-olds are all directly alcohol or drug-related: auto accidents, suicide, homicide, and drug overdose.

Sixty-five percent of the children of alco­holics become alcoholics or marry alcoholics.

Ninety percent of teenage alcoholics go on, often after an apparent lull in drinking, to become adult alcoholics unless they get help from alcoholism treatment centers.

The progression of the illness of addic­tion, whether alcohol or other-drug re­lated, is never a straight line. You should anticipate periods where there is more usage, followed by less usage. This is the period that fools most parents. They be­lieve the "less usage" of beer, or wine, or pot, or whatever, means the child has the addiction under control.

Facing the addiction is less painful than denying it

Parents I talk with almost invariably express the understandable hope that their children are "just going through a phase"; that is, drinking as a result of going through a "teenage psychosis," rather than seeing the craziness as a result of alcohol or drug abuse. They hope it is "just a phase" because they want to believe that if they ­ignore it, eventually it will pass.

When parents tell me that their chil­dren are calming down a bit and seem to be getting their lives in order, I hesitate before I plunge in and remind them that 90 percent of the time, we're dealing with a disease that will not "just go away."

I hesitate because I know what the reac­tion will be. There will be a con­fu­sion in the face, a clouding in the eye. Typi­cally a mother will look away from me in a second or two of terrible panic, before brushing her hands in front of her face as if brushing away the idea. Then she will change the subject.

As a counselor, I know that I must remind parents of reality. But I feel their pain. "It was almost unbearable!" they are saying. "Why bring it up again?"

Yet if I don't, I'm lying. I would be help­ing parents pretend that if the drink­­­­ing isn't going on now, it won't go on again later. But it often will. If I pretend it won't - and help perpetuate the idea that it won't - then, when the alcoholism raises its ugly head again, the parents will spend more time denying what's happening because of me, and will spend more time in pain.

Why does denial equal pain?

I absolutely believe that once parents have spent some time in Al-Anon or addic­­tions counseling, and some healing has taken place, then it is easier to go through the acute pain of facing the alcoholism than the chronic, horrible pain of not fac­ing reality and exper­iencing the relentless guilt, confusion, bewilderment, and aug­mented pain that we all feel when we do nothing.

Why do I say that the acute pain of facing the alcoholism will be over with quicker if we face it, than if we deny it?

Because, after counseling thousands of members of alcoholic families, I have found that after the first step in confront­ing the disease is taken the other steps are easier - much easier. It always looks harder before you do it! Plus, the self-­respect parents feel when they finally do some­thing that they know is good for their child is enormously comforting.

What if your child seems to be doing better?

If your child is not showing symptoms for a while (that is, he or she is not drinking, or is "controlling" the drinking), why not believe that it might be "just a phase" and not alcoholism?

Well, it is possible that your child is get­ting smarter at hiding it, so you are find­ing out less about what's really going on. It may be that you are understandably ex­hausted and want to find out less. And it may be that although your child is "getting it together" (meaning, for exam­ple, getting good enough grades in high school so he or she will be supported financially while in col­lege), he or she might just be "biding time" until the proverbial escape away from home and parental control where cir­cum­stances allow your child to do what he or she wants to do, including a lot of "partying."

It may be that the disease is in one of its "remission" stages, and you can breathe easier, but it's not usually a good idea to think it's all over.

Parents, learn to be gentle with yourselves

Oh, the ways parents beat themselves. They want to know what is going on and they feel they have a right to know. But even when parents recognize that alco­holism is a disease, still they partly believe the lie that they are "butting in" - and partly they are afraid to find out the truth.

If you are like most parents, you are so scared you feel immobilized. You've prob­ably read the "tough" articles that tell parents what they are supposed to do, no matter what they feel, "because it is the job of parents." No one, it seems, is talk­ing about your concerns, except in a dis­missive way: "Sure you feel terrified, but that's part of being a parent. So, pull up your socks, and do what's right for your kid. Otherwise, what kind of parent are you, anyway?"

Remember how scared you were as a new parent? Remember how you bought Dr. Spock and other child­care books? Remember how you read everything you could find in order to figure out what that cough meant, what that rash meant? Please try to read the list of symptoms that follows in the same way. These symptoms only indicate the begin­ning of a disease that is so arrestable, so treatable, that the only shame is to ignore the symptoms.

A little pain and a little panic to get a child to treat­ment is nothing com­pared to the joy of recovery. And your child will be grateful to you when he or she is truly sober. I know you can't believe that now! It's the cun­ning­ness of the disease that makes every­one in a family believe the disease when it bullies parents and tells them they'd better "butt out!" The disease is trying to scare you into thinking you'll lose your child if you just dare to look at it and see the symptoms your child might have.

Now, if you can, read the list of symp­toms that follows. Stop when you want to. Come back to it when you want. There is to be no shame on your part, about being afraid. All of us have these fears. That's part of the nature of the family affliction aspect of the disease. Only fam­­ily treat­ment, in Al-Anon or another parent self-help or pro­fessional group, works for most people in finally getting rid of these dis­ease fears.

If the list that follows is too scary for you to consider, just allow yourself to put it on the shelf, so to speak, to perhaps think about later. This is very important - no one has the right to push you into think­ing or doing what you are not ready for. Later, when you've attended Al-Anon or a parent group for a time, and feel sup­ported enough, calm enough (no one is calm around this stuff; I never feel that one has to be calm in order to make a decision, nor do I feel that one gets rid of all doubts before taking action), then re-read this section in order to be able to determine the actuality of the situation.

Thirty symptoms of teenage addiction*

1) Has your child stayed out all night, without your permission? (Before you say, "All kids do that," they don't all do that.)

2) Have you come across inappropriate things in his or her bedroom?

3) When your child comes home, do his or her eyes look bad?

4) Does your child come home seeming "spaced out"?

5) Does this child physically hurt younger brothers and sisters?

6) Does your child act up at public gatherings where a certain decorum is expected, and where other kids are behaving properly?

7) Has a teacher or principal called you about your son or daughter?

8) Has he or she been suspended from school?

9) Are this child's school grades worse than they were last year?

10) Is he or she truant?

11) Has your child dropped out of sports or other school activities? Does he not want to lift weights when he used to? Did she used to like tennis, and now makes excuses not to play?

12) Has there been a change in your child's dress, even within the implied dress code of his or her peers?

13) Does your child no longer do chores willingly, if he or she used to? Are you given as an excuse, "I have to go out"?

14) Does your child tell you, often, that he or she "has to meet friends on the play­ground"? Often, in elementary or junior high school, after hours, the school grounds are filled with alcohol and other drugs. Parents tell them­selves, "I'm glad my kid is straight­en­ing out and going along with school friends to play." (After all, when we were kids, there weren't drugs on the play­ground.) And you, of course, want to believe your children. We think it's a moral issue; we forget it's a disease.

15) Does your child refer to "pleasur­able" drinking that is months or years in the future? ("I can't wait to go to college so I can drink and party there!") Or, if you're talking about another person who stopped drinking, does your child exclaim, "But, what about beer and crabs next July?" (when it's now December).

16) Has your child ever come in after a good time and commented that he or she drank everyone under the table?

17) Does your child use the word "party" as a verb, rather than as the noun that it is? (i.e., If your daughter is going to an upcoming party, does she talk about "partying" in general, or is she talking about the people who might be there?)

18) Does your child want to spend the night at a friend's house often? Does Susie's mother maybe not mind if they drink "just beer"? Does your child tell you that Susie's mother will be there, and she's not? Check on the facts.

19) Are you finding empty liquor or beer bottles under your child's bed?

20) Is your child hanging out at a shop­ping center? Is there a liquor store there? Are the kids buying booze there, or getting an adult to buy it for them?

21) Has your child's circle of friends changed in a way that is noticeable?

22) Are drugs in the medicine cabinet slowly disappearing? Kids often get their initial supply of drugs there.

23) If you keep alcohol in the house, does it seem diluted? If you've had a party, have people claimed that it seems weaker than usual?

24) When you ask your child questions, does he or she seem to "skate"; mean­ing, not being direct with answers, but kind of going all around the point, being vague?

25) Is money missing from your pocket­book? From piggy banks in the home?

26) Is your child getting an allowance and lunch money, and still coming back and saying he or she needs more?

27) Are your possessions disappearing?

28) Has your child been stopped or arrest­ed by the police for drinking while driving?

29) Have you ever considered seeing a professional about your child's behavior?

30) Has your child ever spoken about, or attempted, suicide?

If your child has two or three or more of these symptoms, they often form a pattern of probable addiction. Children manifest these symptoms differently, at different times. As discussed earlier, at times they may appear to stop altogether. That is the disease's de­cep­tion which makes parents think that their child's problem is gone, that it has cleared up.

AA says that alcoholism is cunning, baffling, and powerful. So how can you know - when the symptoms disappear for a while - if the problem might really be gone? Well, unfortunately, the statistics are not on your child's side. The disease may lie dormant, by the seeming "control­ling" of it, and your child may appear to "do well" again at school and in general be­hav­ior. But, if that child holds on to his or her "right" to drink socially, that is often a symp­tom of a continuing prob­lem with alcohol.

Suppose you had always enjoyed straw­­berries and had no problem eating them. And then one day you ate some and got violently ill. If the doctor said you'd prob­ably have the same reaction sometime again if you continued to eat them, you would gladly pass them up in the future. You wouldn't have a problem letting go of straw­berries, except occa­sionally, when they might look especially good. However, just remembering your illness would make you shudder and say no thanks.

Only an alcoholic will fight for his "right" to drink and argue that it's no prob­lem when it is. Why is it so important to fight for this right? Your child doesn't know it, but it is his or her biochemical crav­­ing that's doing it. The disease is tell­ing your child's brain to argue you under the table, to humiliate you, to be­wilder you when you try to help so that the alcoholic can continue to drink.

But alcoholism is not an indictment of your parent­ing skills. A child who drinks does not tell you to "butt out" because you're a bad parent, but because the alco­holism is talking.

Reflection/Action Guide

Write On:

1) What do you tell yourself when you begin to see a possible pattern of addic­tion in your child?

2) What are the "reasons" you give for your child's addiction patterns, other than the fact that they are symptoms of addiction?

3) Write out the ways you have been taught to not "see" the addiction when it is there.

Suggested Activities:

1) When you begin to fear reality, pamper yourself immediately.

2) Remind yourself that we family mem­bers make molehills out of mountains.

3) Allow yourself to re-read this chapter when your child's alcoholism acts up again.

Chapter 3: Parents Are Not Guilty: The ­Genetic Facts About Alcoholism

Nothing is more immobilizing or more terrorizing to parents than the guilt they exper­ience because they feel that they somehow caused the alco­hol affliction in their children. Mothers tell themselves, "I should have left her father," or "I should have stayed with them." Fathers say, "I should have paid more attention," or "Maybe I was too hard on them."

Even parents who have been in spe­cial­ized family alcoholism treat­ment programs experience this guilt. They may say it's a disease without believing that deep down.

Parents who have been to Al-Anon, sometimes for years, often believe that the term "family disease" refers to the family rather than the disease. They believe that if their children get alcoholism too, it is because of the example set by the drinking behavior of family members rather than the result of an inherited physical ten­dency.

If your guilt is based on a belief that this disease is caused merely by bad parenting, it will be greatly diminished when you understand and accept the true physi­cal nature of alcoholism.

Dr. James Milam is the author of ­Under the Influence and co-founder of the Milam Recovery Centers in Bothell, Wash­ing­ton. He has been a pioneer in the United States in educating mental health pro­fessionals about alcoholism as a pri­mary dis­ease. I asked Dr. Milam how parents can deter­mine if alcoholism is in their family.

He immediately stated that psycho­logical and social problems do not cause or even con­tribute to being an alcoholic. Then he went on to explain that we've got genet­ic material from two parents, four grand­parents, eight great grandparents, and so on. All that genetic material com­bines in a lot of different ways. In ­genet­ics, it's always a matter of proba­bil­ities. Rates of alcoholism in different families range from near zero up to near 100 percent.

I asked, "So people who say that it is not in the family are not looking very far back, when they're talking family history?"

He said, "Right, and there are several reasons why, if they do look back, alco­­holics are missed in the family tally. Until very recently, alcoholism was almost never diag­nosed as alcoholism. Because of the shame and stigma, par­ents almost never told their children that a grandparent or a great grand­parent, or anyone else in the family, was a drunk. Denial has a long history.

"Then, too, in counting alcoholics in the family, it's important not to over­look the total abstainers. The reason people abstain is nearly always be­cause of their own alcoholism or their reaction to their parents' alcoholism."

I thought about this. In most families, no one would ever admit that a grand­mother could have been an alcoholic. But a good way to determine if this were so is to find out if her adult children were teetotalers. As Dr. Milam said, almost all total abstainers do so as a revulsion reac­tion to parental alcoholism.

And there often are many other hidden women alcoholics in family histories as well as uncounted early-stage alcoholics, who even today are rarely recognized. Most people can only see the disease when it is very obvious, when the person is in late-stage daily maintenance drinking.

I have heard countless parents tell ­stories of "Uncle John" or "Cousin Smith" who died in an accident - "and, yes, he drank a lot, but no one thought he was an al­coholic!" - only to discover months later, when they had finally tracked down the fam­ily rumors, that the uncle or cousin had been thrown out of the house years earlier until the drinking was finally brought ­under con­trol and the family went back to living as usual.

Suppose you want to see if alcoholism is in your family. "Statis­tically," Dr. Milam explained, "if you want to see how heavy the pre­disposition might be in your children, you have to see how many people out of a hundred, on both sides, have alco­hol­ism in your family. That means, in ­order to get a large enough sample, you've got to look a lot further back than grand­parents! Most people, when saying that they don't have a family history of alco­holism, don't realize that they have to look back about six or more generations to see if the pre­dis­position is ten percent, or twenty per­cent, or more, in their par­ticular family history."

A number of scientific studies have explored this hereditary phenomenon, Dr. Milam explained, and have proven that alcoholism is genetic. First he talked about the well-known "foster-home study." Sci­en­tists studied adults who had been sep­a­rated from their biological parents at birth and raised in foster homes. These adult chil­dren had no contact with or knowl­edge of their birth parents. The study of par­tici­pants were divided into two groups, and their alcoholism rates com­pared. One group had biological parents who were known to be alcoholic; the other (the con­trol group) were from biological par­ents known not to be alcoholic. Twenty-five to thirty percent of the adult children of the alcoholic parents were found to be alco­holic; in contrast, the alcoholism rate of the control group was only about five percent!

Dr. Milam told me of an opposite kind of study which confirms the finding that heredity, not environ­ment, is the prime cause of alcoholism. The children of non-alcoholic bio­logical parents who were raised by drinking alcoholic foster parents were no more likely to be alcoholic them­selves than if they had been raised by non-alcoholic foster parents!

This research doesn't deny or mini­mize the psycho­logical trauma and devas­ta­tion of being raised by drink­ing alco­holic par­ents; it just says that the environ­ment isn't what caused their children to grow up to be alcoholic.

Thousands of research studies over many years have tried to link up early psy­cho­logical problems with later alco­holism. All have failed to find any such connection.

Another remarkable and very well-known study was conducted by Dr. George Vailliant of Harvard Uni­ver­sity over a forty-year period in the Boston area. In 1940, some 600 young men, half from college and half from town, were studied for per­son­ality, character, family history, school records, com­mun­ity rela­tions, and other factors. For the next forty years, the study par­tici­pants were re­evaluated every five years to see how earlier experiences affected their lives. During the course of the study, the alco­holics were identified.

In 1980, all the data was correlated. The researchers looked for early-life ex­per­iences that would explain why some of the men became alcoholics and why ­others did not. To their surprise, the researchers found that except for heredity, nothing else correlated!

This result meant that in Dr. Milam's words, "All of our favorite reasons for de­vel­op­­ing alcoholism went out the win­dow: poverty, serious family prob­lems, delin­quency, poor self-image, anti­social per­son­ality, de­pression, mental illness, stress on the job or at home, the lack of financial success. None of these had anything to do with who was alcoholic!"

But what is it that gets inherited? What is it that makes this dis­ease "genetic"?

"We already know many things that are different about alcoholics, before they even start drinking," states Dr. Milam. These are differ­ences in brain wave pat­terns, in how they metabolize alcohol, in nerve transmitters, in blood sugar man­age­ment, and other differences in how the liver and brain process and react to alco­hol. And recent reports indicate that re­searchers have identified the alcoholic chromosome and are working to identify its specific genetic components."

It's not over and done with

Parents know their kids are crazy while they're on booze and drugs. But once they're sober and clean and have been through treatment, parents often ask, "Why do they still need to go to all those AA meetings afterwards?" These parents may have let go of (at least some of) their guilt about having caused their children's alco­holism. But they may have replaced it with the idea that "genetic" means that alco­holism is just a physical disease and stops just as soon as the actual drinking and drugging stops.

But alcoholics, including children-alcoholics, cannot be cured. Alcoholism is a disease that can only be arrested, one day at a time. The triggering mechanisms are always there and can be set off with a drink or other addictive drug, even after fifteen years of absti­nence. Alcoholics need AA to remind them that they are alcoholics and cannot drink, because the disease is patient and will wait until a person's guard is let down and there is no mental defense against the first drink.

Newly-sober alcoholics, of any age, go through what is called the "protracted with­drawal syndrome," which can mean up to thirty-six months of withdrawal symptoms, including anxiety, mood swings, depres­sion, and unknown fears. The amount and intensity of these symptoms will vary with the person and with the amount of alcohol or drugs that are stored in the system. Some drugs take more time to leave the body, because they are not water-soluble and are stored in the fatty tissues.

When alcoholics are going through this withdrawal of chemicals from the body and brain - experiencing the fears, terror, and de­pression - very often, only the re­assur­ance from other recovering adults and teen­agers who have gotten through this period can convince your child that these symp­toms will truly pass; that he or she need not fear the symptoms; that one can get through it without drinking or using other drugs. Remember, your child has a long-time habit to unlearn: the habit of getting imme­diate gratification for emo­tional pain, of not waiting for it to pass, or believing that it ever will pass. You might be think­ing, "Oh, my child only drank for eighteen months before we got him into treatment." That may be so, but eighteen months is a big chunk out of a young person's life. The learning process has definitely set in, and must be unlearned.

So you see, even though this disease is physically caused, the mental and spiritual effects of its onslaught are enor­mous. Stoppages, breakages, "short cir­cuiting" in the central nervous system and brain ­affect vital areas, including those that make or distort decisions about basic life values, and whether or how to attain them. In a child, this is particularly pre­carious, since his or her value system hasn't even gotten a chance to fully develop.

For alcoholics, once usage has stopped and the chemicals have been withdrawn, much reparation to the body and brain must be made. Dysfunctional patterns must be un­­learned. I believe that AA's Twelve Step program is the best reparations system going.

In the same sense, after the usage has been stopped, parents, too, need repara­tions done to them. Kids need to make amends to their families as AA says, to help restore family balance. This does not mean that kids are guilty. They've been sick, not bad.

Here's an analogy: Suppose I had un­diagnosed (and therefore uncontrolled) epilepsy and, in seizure, I fell and broke a neighbor's lamp. No, I am not guilty, but the lamp is still broken. In all good con­science, with­out beating on myself that I was bad, I still need to replace the lamp. For my own peace of mind, I can­not ­ignore the unconscious guilt I would be inviting on myself if I knew that damage was done (even though by accident) but I didn't care enough about my neighbor's feelings to help right the issue. With this per­spec­tive, I would need to make amends. So too, I need to right wronged relation­ships while maintaining my dignity.

After the usage has been stopped, parents need to make amends to them­selves, too. They need to seek help in Al-Anon or a family recovery group to help them to re­cover from the terrible guilt, rage, worry, and resentment that has been perpetrated on them by this disease. These symptoms ­(especially the resent­ment) do not just go away overnight.

Going to a family recovery group that specializes in parents whose children are actively addicted or recovering addicts does not mean that it is the parents' fault or prob­lem. It means that the parents have intelli­gently chosen an effective way to more quickly get past their symptoms of the disease. To go it alone can prolong the recovery for years.

Reflection/Action Guide

Write On:

1) Write out a future day's scenario where you see yourself rational and guilt-free about your child's illness.

2) Start writing a family-alcoholism tree, an investigative project to free yourself from the family-disease symptom of irrational guilt.

3) Write a list of phrases you've told your­self that make you feel as if you contributed to your child's addiction.

4) Now, write the factual answers to that list.

Suggested Activities:

1) Every time you're about to chastise yourself for "having done" or "not having done" something that "might have set the scene" for your child's addiction, re-read this chapter.

2) The very next time you feel guilty, tell yourself to stop, and say, "That guilt is my disease talking!"

Chapter 4: Why Most Therapies Haven't Been Able to Help

Since many parents have gone to clergy, counselors, and general mental-health practitioners, and have become even more confused and despairing after doing so, this chapter is meant to clarify why the sessions may have been ineffective and why your kids' problems often got worse rather than better during the course of the therapy.

This chapter will be a beginning in helping you to make better choices about choosing counselors for your children, your spouses, and yourselves.

This chapter also will be helpful to the ever-growing number of thera­pists who are rec­og­nizing how pervasive all forms of alcoholism are in their caseloads, and are looking for addiction education and understanding to add to their expertise and enhance their effectiveness.

What are the basic myths all of us have been taught about therapy - myths that pre­vent the healing of alcoholic families, myths that do not take into account the disease concept of alcoholism and all that it implies?

Myth #1: Patients always tell therapists the truth about their drinking.

I have spoken with thousands of parents who took their children to see a therapist in an effort to bring some sanity back into their house­holds. After the thera­pist posed a question or two to the child about his or her drinking, the matter was often dropped. Why? Let's look at a typical encounter:

Therapist: Do you drink?

Child: Yeah, some.

Therapist: How much?

Child: A couple of beers, at parties, with other kids. That's all. All the kids do it. My mother's paranoid.

Therapist: Why do you say that?

Child: I don't know. Ever since we moved, after my father got trans­ferred on his job, my mom is really unhappy. She takes it out on all of us. My dad's always telling her she nags.

Therapist: Does she?

Child: Yeah! Ask my sister if you don't be­­lieve me. She's going to leave home as soon as she's eighteen next year. She told me she can't stand it there any more.

Therapist: Do you feel the same way?

Child: Yeah.

Therapist: Let's talk about that, next session. Maybe we can find some ways for you to talk more directly to your mother about how you feel about the way she treats you.

This therapist has made her first mis­take by believ­ing the alcoholic's mini­miz­­­­ing of the drinking problem. The child's dis­ease helped him divert the ­issue com­pletely.

Alcoholics - even child alcoholics - will lie to pro­tect their drinking. In coun­seling, I've never had an alcoholic patient tell me that he or she drinks more than "a couple." Alcoholics are incapable of telling the truth due to a disease process that is extremely cunning in its efforts to protect its supply of alcohol. This is not a moral judgment. It is merely a fact of the disease. (See the list of questions at the end of this chapter to ask yourselves in order to crack through much of the child's denial and get at the truth. If you find a family history of alcoholism and if your child seems to have a problem, too, chances are your child does have a problem.)

If your child's therapy sessions pro­ceed from the first myth - that your child told the truth about his drinking - then the next logical con­clu­sion in this erroneous thought process is to think that, instead of addic­tion being the problem, "underlying ­mental-health issues" must be to blame.

Myth #2: These "underlying mental-health issues" can be re­solved by teach­ing "good communications skills" to members of that alcoholic family.

This is impossible. Your alcoholic child can be very sincere and really want to co­operate by trying to communicate better. But even after a terrific family therapy session, all his insight can go flying out the window with the next intake of alcohol. Furthermore, every day your child con­tinues to drink, the disease is progressing. That means that in addition to ex­periencing secondary physical problems, his or her ability to cope with life at all is pro­gressively diminished.

If your child is going through with­drawal, the severe agitation will be ­causing anger, anxiety, and overall, an in­ability to have any "good communications."

Myth #3: Alcoholism is a result of un­resolved conflicts, anxieties, and undealt-with anger. As soon as your child's ­ther­a­pist can "get at the root of the prob­lem," the need to drink will wither away by itself.

I have personally seen terrible results from belief in this myth: Early deaths of children that could have been prevented; much confusion and despair for families; and the waste of lots of time and money in ineffective treatment sessions.

Putting it simply, problems do not cause alcoholism. Almost all of the time, after alcoholics stop drinking and attend AA regularly, their serious emotional problems disappear or at least diminish greatly with help. On the other hand, it is impossible for the still-drinking alcoholic to get well emotionally.

Myth #4: Even if the alcoholism is not dealt with as the primary issue, good therapy is being practiced if families are straight about feelings.

Even during therapy sessions where the alcoholic is acknowledged to be an alcoholic, many therapists have been trained to focus on asking parents how they feel about all this. On the surface, this may seem sensitive and caring. Unfortunately, such an approach often leads to fifteen, thirty, or even fifty sessions on how each family member "feels about" everybody else, and not much else is accomplished.

In this erroneous process, the next step for the therapist is to help everybody to improve their communications skills about how they feel! By that time, the drinking is no longer brought up on any regular basis. The drinking is merely discussed in terms of how everyone else feels about it.

When feelings - rather than drinking or drugging - are in the spotlight, then the onus is on parents to justify their over-reactive feelings (say, when their child may stop drinking for two or three weeks) and does not take into account the dynamic of the child's addiction and the constant tensions and crises it perpetuates on you.

More damaging, perhaps, is the prob­ability that your therapist can get sucked into believing the charming ­facade that even an alcoholic child is ­capable of pro­ducing, thereby invalidating the credibility of your statements (that it is crazy, ­living in that household). The therapist thinks the alcoholism may be being exaggerated.

Myth #5: The alcoholic does not know how the family feels.

I'm also skeptical of counseling ­methods that assume your child does not know how you feel! It does not take three months of therapy sessions with Susie (who's con­stantly truant from school) to let her know that her father and mother are angry!

Counselors wish that if parents stated their feelings and needs in a straight­for­ward manner (that is, learned "good com­muni­cations skills" in order to "ex­press feel­­ings appro­priately"), then the child would be given the incentive needed to want to stop the drinking or drugging. Not only is this magical thinking, resulting from lack of knowledge about the dynamics of the disease process of alco­holism, but it again subtly places the responsibility for the cause of the drinking on the parents, instead of on the alco­holism. (Parents often quit the counseling at this point, feeling even more depressed and despairing than when they entered counseling.)

I believe there is at least a partial ­ex­plana­tion for this lack of under­standing and knowledge about the disease concept of alco­holism. We all once believed alco­holism's lie that "the alcoholic wouldn't drink if all was right with his or her world." Unfortunately, no one's world can be just right.

Another partial explanation for this professional lack of knowledge about the disease concept of alcoholism is more hidden: many helping professionals are them­selves adult children of alcoholics, spouses or former spouses of alcoholics, and parents of addicts. Since denial is the main symptom of alcoholism and addic­tion - and since professionals are no more immune to the symptom than anyone else - when coun­selors are themselves un­treated for their family disease symptoms, they bring this denial symptom to their work. Thus, we have a client whose main problem is a disease that may remain un­diagnosed be­cause the therapist's own ­family disease ­remains undiagnosed, be­cause the ther­apist's main symptom, too, is denial around even seeing the disease!

Myth #6: When parents are told they are "enablers," it leads them to stop the enabling.

"Enabling" is meant to describe the res­cue opera­tions that the spouse or parent of an alcoholic carries out, when he can't stand watching the alcoholic suffer the con­se­quences of the disease. When that hap­pens, he "cleans up" the alcoholic's messes (lies to the school that his son has the flu when the child was actually picked up for drunk driving). That way, the alco­holic doesn't suffer the real conse­quences of his behavior.

A parent must learn, eventually, to get some detach­ment on watching these crises happen in order to stop cleaning up after the child. The idea is to allow the disease to hurt the child so much that he or she wants to get sober. Of course, it takes a parent a lot of time in a healing group such as Al-Anon in order to be able to do this. And this detach­ment can't be forced or rushed by counselors. It is a slow process, and very frightening.

When a mother rescues her alcoholic child and I label her an enabler, she ob­viously is still doing the rescuing behav­iors and is not yet unafraid enough to give them up. She knows I am being judg­mental when I use this term. Even when I say it lovingly, I seem to be admonishing her to go faster than she is capable of doing at that time. And she feels des­pairing, because she is doing her best. She may get so discouraged and frustrated and overwhelmed that she stops treatment.

More specifically, the term enabler implies that while the parents did not cause the drinking, their rescue operations con­tributed to the perpetuation of the drinking. Such thinking is dangerous; it leads alco­holics, who are already looking for a way to blame others for the drinking, into again placing responsibility for the drink­ing on the family.

Alcoholics do not need any encourage­ment to blame others! Alcoholism coun­selors spend most of their time trying to crack through the blame-systems of alco­holics. It is considered to be a major break­through in the wellness process of alcoholics when they begin to acknowl­edge that nothing "got them drunk." In contrast, alcoholics who have had relapses and are re-entering treatment are now often heard saying, "I wouldn't have gone out that time if I hadn't been enabled!"

The alternative to being labeled enablers is to teach you to end the rescue operations through the simple but effec­tive process of detach­ment. For, de­tach­ment will help end your fears - and it is your fears that origi­nally caused you to rescue. And even though, in this book, we are pri­mar­ily talking about par­ents and kids, the detachment process is espe­cially important if you also are married to an alcoholic. It is important for you to lose your fears of that adult alcoholic so you can get on with your life and become more able to deal with your children-alcoholics.

How does detachment work? How does it help you to lose your fears of your alcoholic child or spouse? The general process goes something like this:

1) When you begin to learn ways to stop watching the alcoholic in order to begin the healing process of seeing to your own needs, the alcoholic has ­radar and senses this switch in focus.

2) Much of the "games" stop then, be­cause the alcoholic child knows that less attention will be paid to him or her.

3) By continuing to focus on yourself in­stead of the alcoholic, you get an even greater distance (detach­ment) from the threats, and begin to lose your fears of them. You begin to see how you gave the alco­holic so much of his or her power. You can take it back!

4) Again, the alcoholic senses this. He or she begins to threaten even less.

5) You see that detachment works! You gain more confidence. Many of the illusions in your household are begin­ning to end.

6) You lose much of your preoccupation with the alcoholic. Your pre­occu­pa­tion was based on your needing to stop him or her from hurting you. You now see they are much less capable of hurting you than you thought. They've already done most of the damage they can do. But the game has been to keep up more of the same junk, to keep up the illusion that the alcoholic is powerful. This no longer works. You have learned not to look at him or her; to walk out of the room; out of the house - to not beg.

7) The alcoholic now stands alone with his or her disease. They've lost their audience, and therefore drop much of the bullying. You are not watching it.

8) The alcoholic can no longer get you to believe you are responsible for his or her drinking and for the craziness in that house.

9) The alcoholic has a chance to grow up and make a decision to get help.

10) You are free.

When I teach parents the dynamic of what I have just described, they begin to naturally let go of the disease - to detach, and therefore stop enabling - ­because they are losing their fears of the alcoholics. All of us stop manipu­lating and controlling people when we lose our fears of them.

*  *  *

As a therapist, I try to let parents know that I will gently help them along the not-straight road toward freedom from their fears. I let them know that they do not have to meet a timetable. In fact, I let them know that I am aware that I do not walk in their shoes, that they must be comfortable to make even a small step; that what I will do is love and accept them, even when they vacillate in their ability to detach from the disease.

I let the parents know that I know they will be ready some day. I try to give them the same hope that Al-Anon holds out - that my acceptance of them will be part of the healing and will help move them along toward health and the choices that they now can only dream of.

And then, gently, naturally, inter­ven­tions do happen, because with one hand I provide the healing embrace and com­fort of total acceptance and without pressure; while with the other hand, I hold up the mirror of reality and nudge them along ever so gently toward reality.

Is There A Family History of ­Addiction or Alcoholism?

Twenty questions for family members. Answering yes to any two of these often indicates alcoholism. Ask these questions about yourself, your spouse, parent, grand­­parent, uncle, aunt, sibling, cousin, and any other family member.

Have/do you or the other relative ...

1) Ever talked about switching from ­liquor to wine or beer?

2) Have idiopathic epilepsy?

3) Have adult onset diabetes?

4) Have essential hypertension?

5) Ever complain or "nag" about a rela­tive's drinking?

6) Have adult children who are tee­totalers?

7) Did anyone ever talk about a rela­tive's drinking?

Did that relative ...

8) Seem to drink a bit too much?

9) Fall a lot?

10) Fall asleep on the sofa a lot?

11) Have a lot of arguments?

12) Seem to be able to drink more than most people and not feel it?

13) Have any liver problems?

14) Go from job to job?

15) Have credit problems?

16) Ever get stopped for drunk or reckless driving? Or ever have a single-vehicle accident on a weekend night?

17) Frequently have a red nose? Red eyes?

18) Have a beer breath?

19) Seem to be either the life of the party or a loner?

20) At the mention of alcoholism, bristle and get defensive, or abruptly leave the room?

Reflection/Action Guide

Write On:

1) Describe how you may have needed an Al-Anon meeting to recover from a family therapy session.

2) Describe the ways you believed your ineffective communications with your child caused the addiction.

3) Describe your feelings when you read or hear that you are an enabler.

4) Using the process of detachment just described, visualize a scenario in which you can see yourself no longer reacting to the alcoholic in one of the situations you find chronically troublesome.

Suggested Activities:

1) Make a list of family members who were probably alcoholic (use the twenty questions as a guide).

2) If your current therapy is not address­ing the alcohol or drugs as the primary problem, con­sider getting a second opinion or evaluation for your child at an alcoholism treatment center.

3) Make a call to a treatment center and ask for a brochure to be sent to you.

PART TWO: The Treatment Process

Chapter 7: Tough Love Is Too Tough for Most of Us: How Professionals Can Help Do the ­Intervention for You

Most family members are too fright­ened to give the alcoholic an ultimatum saying, "Get sober or else!" without hav­ing gone through lots of time in Al-Anon or coun­seling. But there are a num­ber of effective steps you can take which will put you in charge, without hav­ing to neces­sarily resort to ultimatums and drastic actions.

Parents have all kids of untapped ways for utilizing their power and authority. De­pend­ing on the circum­stances, you might say:

$ "If you want to go to college, first you have to go into treatment. Other­wise you pay your own way."

$ "You're restricted. You can't go out. You can't have the car. You get no allow­ance."

$ "You complete alcoholism evaluation and treatment, and then you can go out, have the car and your allowance."

$ "If you get into trouble with the police, I will not bail you out. Instead, I will suggest strongly to the juvenile author­ities that you be sent for treatment for what is causing all this behavior."

If you want additional help from pro­fes­sionals to make your child go to treat­ment, probation officers and schools as well as intervention specialists can help.

The juvenile justice system can do the intervention

Since many kids have gotten into legal trouble because of addiction, talking with the probation officer is probably the sim­plest and most immediate way for parents to ­arrange for their child to be confronted about his or her drug or alcohol problem.

No way is easy. However, once you learn methods for finding your way around the labyrinth of the juvenile justice system, you may find it much easier to rely on their assis­tance to do most of the con­front­ing. And most likely, they will be very happy that you want them to help your child. Juven­­ile-justice professionals, who must often deal with hostile parents and children, as well as punitive facilities that are severely overcrowded, would often be grateful if all parents of addicted children would use them to help get kids to proper evaluation and treatment.

Many parents have a history of res­cu­ing their children from the consequences of their disease. How­ever, the vast major­ity of these parents are not thinking in such terms when they do the rescuing. They are merely acting instinctively as any parent would. Parents protect their child in order to protect their family's reputation as well as to protect the child from what they perceive as the only alternative: horrific jails or juvenile deten­tion centers where kids are beaten or violated.

It never occurs to many parents that there is an alternative. Parents don't see that they can use the juvenile justice sys­tem as an ally to get their children to safety, to treatment. When a parent tells me, "Well, it's happened. He got arrested," I ask, "Have you talked to his pro­bation officer?" Most of them have not.

I have often advised parents to call the probation officer and tell him or her the truth about alcohol and other drug use at home. Most probation offi­­cers are totally aware of what is going on with kids and alcohol and drugs.

If you've lost the name of the officer, or were never notified directly, you can phone the Family Court in your juris­diction and get the person's name. Be sure you have been connected with the juvenile probation office and not the adult office.

Once you've established a truthful rela­tionship with the officer, he is almost certain to help you help your child. When your son or daughter has to go back in front of a judge, the probation officer can put a forced choice to the adolescent: "Go to this program for treatment or go to de­tention." Need­less to say, almost all the kids choose treatment.

A counselor told me of a mother she worked with whose son was her "prized possession." The son refused to come in for counseling sessions. So the counselor set up a meeting at a treatment facility with the mother and the son's probation officer. The mother felt it was humiliating to tell the officer that her son had a drug problem. But the probation officer just looked at her and asked, "Well, what do you want from me?"

"Make him go to treatment. But make it come from you, and leave me out of it," she answered.

The next time the officer saw her son he said, "You have to go to the meet­ings." He went to AA for the three years of probation. After the first nine months or so, he started to lose his resentment, and the meetings took. He's been sober for five years now.

School-based programs can do interventions

Another very effective way for parents to initiate intervention by an outsider is through organizations like IMPACT which develop school-based programs for pre­vention, education, and intervention.

In order to find out more about such pro­grams, I spoke with Dr. Jeri Schweigler, director of National Train­ing Associates, the organization that trains partici­pants involved in the IMPACT League of Schools. Here's how they operate:

IMPACT currently has fifteen trainers who are experts in addictions. A number of former principals and teachers are among them.

Several of the trainers go to a partici­pating school for one week. They link-up the school with a nearby addiction-treat­ment facility and they train and edu­cate a core team of teachers and other school personnel to be able to iden­tify addiction in students and to document their findings. Participation in the original core-team is strictly voluntary. There is no coercion to require school staff members who are hesi­tant to deal with the problem to become involved.

The core-team then gets referrals from other teachers and guidance counselors about students who may have a problem with alcohol or drugs. The team gathers documentation of each student's delinquent and truant behavior from teachers and counselors. Then the child is required to be assessed and diagnosed by pro­fessionals at the designated treatment facility.

If the child is found to be addicted, in consultation with the parents, he or she is sent to inpatient or outpatient treatment or directly to Alcoholics Anonymous or Nar­cotics Anonymous.

The beauty of the IMPACT process, and others like it, is that it works well for all concerned:

$ Parents do not have to be "the heavies"; they can allow the school to do the intervention, just as Employee Assis­tance Programs in industry have been doing so successfully for years with troubled adult employees.

$ Frightened teachers do not have to stick their necks out; only the teachers who are actually willing to confront students form the original core-team.

$ The cost to the school is reasonable. The contract with the cooperating treatment center stipulates that they make no charge for assessing and diag­nosing referred students. Of course, for those who do go to treat­ment at the center, the cost of treatment is almost always 100% paid by the parents' third-party insurance.

Groups like IMPACT do much more than prepare schools for once-a-year inter­ven­tions. They teach the core-team to edu­­cate the school, students, parents, and com­munity, to understand addictions. And they help the core-team to grow and expand.

To inquire about getting IMPACT to come to your school or community, call or write: National Training Association, P.O. Box 1476, Ukiah, CA 95482, Phone: (707) 468-0140

An intervention specialist can facilitate an inter­vention

Sometimes, when all else fails, it is necessary to force the child's hand and not allow him back into the house unless he goes to treatment.

However, it can't be said enough that it is so much easier to carry through if, (1) the parent gets much help from Al-Anon and counseling, and (2) the par­ent and inter­vention specialist use some of the techniques illustrated in the follow­ing story. The techniques are designed to "pave the road" to treatment so the child has almost no other choice, and to "close the door" on his street life.

In this story, the son is seven­teen. He has a stepfather that he does not like.* No matter how hard the step­father has tried, the boy always has turned his back on him. He would not obey any of the rules of the house. He re­fused to come in at night at all, often staying out for days at a time. He kept visiting his real father who was more lenient since he felt very guilty for "not being there."

But it was the real father who called the counselor. He too was being used, and he saw that his son was going to die if no one did anything. He also knew that he was the one with the most clout; if anyone could get his son to listen, he could.

The father also was scared to death that he would lose whatever love his son had for him. Still, he couldn't ignore the facts. He couldn't lie to himself any­more.

When the intervention session was set up, they all agreed that the father should go to the son's home and participate with the mother and the step­father. And all agreed that the choice should be put to the child: Go to treat­ment or go with your druggy friends. (The father had seen his son hanging out with a young man who lived down the street who was almost five years older than he was.)

Before the intervention began, the mother said, "He'll never agree to go to treatment."

The counselor said prophetic words: "If you let him go out of the home, and don't pay for anything, eventually he'll go to treatment because his friends will only cover for him financially for a weekend or so. Also, the older friend may very well tell your son that, as his parents, you cannot kick him out because legally he is not an adult and you have to take care of him financially until he is. He may be encour­aged to go to the police to try and force them to make you feed and clothe him."

In fact, the older friend did tell the son, "Your parents can't do that! They have to take care of you, no matter what!" And the son did "report" the par­ents. But the par­ents had taken some precautionary steps ahead of time by con­tact­ing the police and child protective services, so that door was blocked. And just as the coun­selor pre­dicted, rather quickly his "friends" got tired of keeping him.

During the intervention at home, the son had come in and sat next to his real father. The counselor said who she was, where she worked, what she did, and that the whole family was concerned about his drug and alcohol be­havior. She told him that they would like to tell him a few things about what had been going on. She said she wanted him to listen and he could talk later.

He rudely interrupted. Again, the coun­selor told him that he had to keep quiet, and that he'd have a chance to talk later.

It is most important that the counselor not allow the child to speak during the intervention until it is all over. There is a reason for this. The alcoholic child can "throw the parents off the track" and dis­tract them with guilt and anger and dis­orient them in order to avoid the real ­issue of their drinking or drugging. The coun­selor cares very much for the child but also is very pro­tective toward the parents in an inter­vention setting.

Keep in mind this slogan: "Let go and let the interventionist." It does not have to be as frightening for the parents as you might think. The ball will be in the pro­fessional's court. An intervention specialist has "seen it all" and knows what to expect and exactly how to handle it.

The family members all told how the drug behavior was affecting them. The counselor then told the son he would have to go to treatment. He said he wouldn't go and that he was leaving home.

The counselor said to the son, "You're leaving now, and I just want you to know that your parents will not let you back into the home unless you go to treatment." When he started to go to his bedroom to collect his possessions, she said to him, "No! Your parents are not allowing you to take all your things to sell them for drugs. You can go with your jacket, sweater, scarf, and hat because it is cold out there tonight." He was not allowed to go back into his bedroom.

He left. His parents were crying. His mother cried, "He'll never agree." The coun­­­­selor reassured her, "Yes, he will. Make sure you have my number. Call the police now, and tell them what we talked about, about how the older friend will tell your son that you have to take him back in. Tell the police how we had this inter­ven­tion. Tell them my name and phone number and which treatment center I work for."

The police found the son and ques­tioned him. Of course, he denied any con­­tact with drugs or alcohol. The parents urged the police to call Protective Ser­vices. They did so and Protective Services worked with the treatment agency in offer­ing a room in a treatment facility for the child. The police told the son that there was alternative housing he could use if he needed it, at which point the boy refused and was driven back to his "friend's" place.

Later, the son called and wanted to come home. His friend had urged him to go home and just not stop the drugs. His parents said no.

Soon the other kids were tired of the situation with the police coming around. They were scared and urged him to try the "alternative housing." They were too stoned to realize it was a set-up for a drug treatment center.

Frustrated, he called his parents again and once more asked to come home. The par­­ents told him that he could, just long enough to wait for the driver to pick him up and take him to the "alternative housing."

He was "blocked in" and had no alter­native but the treatment center.

* I chose to describe a step-parenting home to describe the methods that were used because so many parents feel that, with two homes involved, it is too difficult to attempt intervention.

Reflection/Action Guide

Write On:

1) Describe your feelings about enlisting the aid of your child's probation officer or school to help him or her be made to go to treatment.

2) Describe how you (at least intellec­tually, if not emotionally) see your child not only "forgiving" you, but being grateful to you, when he has completed treatment, and he is func­tioning well, and his head is not fogged over.

3) Sometimes we think we've tried every­thing when all we've really tried is the same thing over and over. Often we're upset and can't see the whole picture until we write it down. Make a list of the strategies you may have used to get your child to treatment. Go through the chapter again and write out the things you have not yet tried.

Suggested Activities:

1) During this time, get help from a coun­­selor who will be gentle with you. Shop around for the right coun­selor who will allow you to back off at the times when you are especially afraid.

2) Remember that there are now over three million recovering, sober alco­holics in Alcoholics Anonymous (and most of their families once felt like you do).

Chapter 9: If Your Child Also Is Mentally Ill

For the child who is addicted to alco­hol or other drugs and also is mentally ill, finding the right treatment is especially important. Some parents find a treatment center with a staff that understands exactly what to do with an addicted child, but is baffled by what to do with the mentally ill child. Others find centers with people who think they know what to do, but do not have the necessary expertise in the mental health area. Still other parents may take their child to a therapist who under­stands mental illness and how to treat it, but if the child continues to take alcohol or drugs, the getting well process will be thwarted. Too many times, the drinking and drugging is seen as a byproduct of the mental ill­ness, and not as a separate illness that needs its own treatment.

Elaine, a mother I met while I was on a speaking tour in New England, solved this problem for her daughter, but only after several years of anguish.

Elaine's Story: "My daughter also is schizophrenic."

Having always seen myself as a wife and mother, my greatest fear while the kids were growing up was to fail as a parent. That fear was realized when I found out my daughter, Bertha, was binge-drinking at the age of fourteen. And then, when she was sixteen, she started to have frequent hallucinations. At first I thought it was because of the drink­ing, but both problems turned out to be chronic. Eventually she was diagnosed as being schizophrenic.

I took her to several mental health cen­ters in the first few years. She would get better and then would be released. But she wouldn't keep taking the medication, so she'd wind up needing to be taken to ­another hospital. Each time, they recog­nized the schizophrenia, but no one diag­nosed the alcoholism.

Generally, my encounters with helping professionals weren't good. I always be­lieved the counselor knew so much. And the prevailing philosophy at the time was that schizo­phrenia was caused by the mother. Things have changed quite a lot. But then, that was the message that was strongly implied to me, her mother.

I was afraid to answer any questions about Bertha. It seemed like no matter what I said, it was interpreted as some deep-seated problem that I hadn't taken care of.

At the same time, I was trying to deal with my alcoholic husband. So I was so afraid of everything. At certain times, I even felt jealous around Bertha. She was the favorite in the household. My husband used her against me; he used everyone to make me jealous. Even strangers. It was just particularly hard when he used our daughter. And then I felt so ashamed that I could feel jealousy toward my own child.

I was always told, in therapy, that it was my fault. I was told it was my fault that I had stayed with my husband. If I hadn't, so the thinking went, then maybe my daughter would not have gotten so sick. These were not specialists in alco­hol­ism. All they saw was the schizo­phrenia. At the time very, very few places recog­nized that there could be alcoholism and illness in the same person.

While Bertha was in the hospital, I was trying to deal with my husband, too. We were separated at that point and I was trying to get him to go to treatment. At the same time, I was trying to help Bertha plan her weekends at home. It was a lot to try to do. I was desperate.

The counselor and I were getting very hostile with each other. Bertha was twenty and in her sixth psychiatric center. In all this time, she hadn't gotten any better. She was even sneak-drinking at the hospital, and her alcoholism was still not being addressed. When we would talk about Bertha, I would say, "But she's an alcoholic too, not just schizophrenic." The therapist wanted me to accept that Bertha had a mental illness only. She would say to me, "You know an awful lot about alcoholism, but you don't know anything about mental illness."

They brought in the psychiatrist. He was very annoyed with me. He saw me as arrogant because I knew a lot more about al­co­holism than they did. I felt despairing, because I felt they should have known more about alcoholism than they did! They were the professionals! Why did I know more than they did, or more than they were willing to find out?

When I first brought Bertha to their treatment facility, I told the psychiatrist and social worker who met with me that ­Bertha came from an alcoholic home and had abused alcohol and other drugs. They asked me what I had done about it, so I explained that I went to Al-Anon and that I had learned to detach. As soon as I used that word, they jumped on me. Because Bertha was herself detached, in a schizophrenic way, they inferred that my Al-Anon type detachment got her that way. As if Al-Anon's sense of the word "detachment" was a cause of schizo­phrenic detachment! They didn't even bother to ask me what I meant by the word. And I was too scared, too unable to explain it. All I could feel was guilt and fear and confusion. They just went on with their questions and diagnosing and I felt powerless to stop them. I even forgot that I objected to their changing the meaning of detachment on me. After that initial in­take, all the sessions were predicated on the basis that Bertha was sick because I was.

When I told the psychiatrist that I loved my husband, he said I was crazy. I told him that, right or wrong, that was how I felt. I said to him, "How do you feel about mentally ill people? You still love them, don't you, even if they do things that you don't like?" He didn't have a straight answer for that.

Later, I found out that his son had com­­mit­ted suicide. I wondered if he had been on drugs or alcohol, and also if the doctor was in his own family-denial about alco­holism.

When Bertha jumped off the low roof of the hospital and broke her ankle trying to get away to find a bar, I asked the "experts" at the center if they now believed that she had a drinking problem? (This was not the first time she had gotten into serious trouble over alcohol - dangerous situations, all of them.) I got very angry with them and said, "Would you have believed she had a problem with alcohol if she had jumped from a third-floor window and died? Or would you say she just had a mental illness and com­mitted suicide?" They didn't answer me. Whenever I con­fronted them about their ignor­ing her alco­hol­ism, they just ignored me. I didn't know how to con­front them about their silence. They were the professionals. I felt with them like I was constantly defending myself.

For example, I continued going to Al-Anon, but then the therapist implied there was something wrong with me, because I con­tinued going after I was sep­­­arated from my husband. However, I also was blamed for having stayed with my husband in the first place, with the implication that this made Bertha sicker. So I was going away from those "family sessions" feeling worse each time.

My Al-Anon meetings were telling me that I did the best I could. And I wanted to believe that - because I did do the best I could, at the time. I upped the number of meetings I went to; I had to, because I would leave "family therapy" feeling so rotten. We were all so angry with each other; we weren't getting anywhere. They blamed me for causing her schizophrenia; I blamed them for not addressing her alco­hol­ism; I knew that if they did, she could get at least partially well. But Bertha stayed sick. So when I clearly saw that nothing was getting anywhere, I dropped out of the family sessions.

After searching for two more years, I found an alcoholism treatment center that also knew what to do with schizophrenic alcoholics. Bertha's now off the alcohol and attending AA and taking her medication on a daily basis. She's much better.

Expert advice: What to do, where to go?

Many alcoholics display symptoms of severe psychotic disorders while drinking or drugging, or during withdrawals, but they are not true psychotics. Such alco­holics suffer from alcohol- or other drug-induced mental illness.

How does one know if a child is truly mentally ill, or if the symptoms will go away, once the alcohol and other drugs are out of their systems? Dr. Jerry Shulman and I talked about this, and other vital aspects of treatment.

Recognizing the "dually diagnosed"

"More and more, referrals to chemical-dependence treatment specialists are com­ing from psychiatrists and mental health practi­tioners," Dr. Shulman ­ex­­plained. "You know, I remember never get­ting re­ferrals from psychiatrists. In fact, because they're psychiatrists, they are more apt to have a caseload that includes more psychotic people who also are alcoholic. But what many mis­­­­informed alcoholism coun­selors are doing to these people who are what I call 'dually diagnosed' is they are denying them an oppor­tunity to get well. What the coun­selor often says is, 'This guy really is strange. He's not alco­holic; there's some­thing else wrong with him. We've got to send him to the local mental-health center.' So they send him there, he gets put on medica­tion, and he gets to be okay. The people at the mental-health center are pleased and say to him, 'Why don't you go outside at night? You can get a pass.' So he goes outside and gets drunk. This poor guy bounces back and forth. And there's no reason for that to happen. There's abso­lutely no reason.

"What do you do? You stabilize him on the medica­tion. You treat him for chemical dependence. You let the client know he is dually diagnosed, that he has both prob­lems. People who are mentally ill have to do the same thing for their chemical depen­dence as other alcoholics and addicts, in order to maintain their sanity."

Is it temporary toxic psychosis?

"We have a psychiatrist on our staff who can evaluate who is psychotic and who is not," Dr. Shulman explained.

"Is it true," I asked him, "that you should wait six months after sobriety to know whether it's a real psychosis?"

Dr. Shulman answered, "That would be wonderful if you had the time! Often, we must make a quicker diagnosis. If the psychosis is from alcohol or other drugs, it will be manifest only during active drinking or withdrawal. If it is manifest in someone who's no longer in withdrawal, then it's not toxic, or chemically-induced psychosis.

"We can monitor this because we know that psychotic-type reactions to the chem­icals in alcohol and drugs happen within a certain time frame. But we'll also want to know who else in that person's family has a depression, for instance. I'm talking about people who have a clearly defined de­pres­sive disorder because these run in families. Just knowing that de­pression runs in that family makes it more likely this may be a real depression. I'll want to know about the depression during periods when there's been no drinking or drug taking.

"I'm saying that you do have to get the person off the chemicals, but you don't necessarily have to wait six months before you can do a good evaluation. There are paper-and-pencil tests; psychological tests. There also are blood tests for some kinds of depression. There are many different things one can do to make an evaluation."

Finding a treatment center

"How do you find a place that treats both disorders?" I asked Dr. Shulman.

"I suggest a parent calls up and imme­diately says to the people at the treat­ment center, 'My child is chemically dependent and also is acting out in very bizarre ways that I think might mean she also has a severe mental problem. I want to know whether you're willing to evaluate and treat this child.'

"Parents should ask a number of ques­tions, includ­ing: What are you going to do for my child? Who's going to adjust his or her medication, if it is needed? Do you have a psychiatrist? How frequently will my child have an opportunity to be seen by the psychiatrist? Will he or she be tested?

"The answers should be: The psychia­trist will see your child on admis­sion. The psychiatrist will be available to prescribe or adjust any needed medication. An eval­uation will be done. The treatment center will work with the psychiatrist.

"A lot of times the psychiatrist needs to be available only a few times dur­ing the whole treatment. Other times, they need to be there every other day. It depends on what's needed. A psychiatrist should be able to be on call.

"Now, if the treatment center responds over the phone, without having observed the child, 'No, we can't take kids like that; he's probably just chemically dependent,' then I wouldn't send anybody to them be­cause that speaks of a clinical ir­responsibility."

*  *  *

If you feel weary that there is so much to cope with, remember that the extra ­effort it may require to find a competent facility for the treatment of both disorders will greatly lessen your worry in the future. Fortunately, many alcoholism centers now recognize and successfully treat dually-­diagnosed adults and young people.

Many persons in AA have several disorders, and are sober, and sane, for many, many years. They and their families despaired as you do, never thinking they'd make it. But they have.

Reflection/Action Guide

Write On:

1) Describe your child's behavior history, as you have seen and know it, (a) before the drinking or drugging ever started, (b) during it, and (c) after episodes of using. This could be quite beneficial for the evaluator.

2) Describe your very natural feelings of anger towards your child and your guilt about the anger.

3) Describe the feelings of shame you have. (They, too, are very normal feelings.)

Suggested Activities:

1) When you begin to feel overwhelmed, remind yourself that treatment is getting much more sophisticated and can help your child.

2) Call some centers and explore their brochures, talk to them about their treatment plans for dually-diagnosed children.

PART THREE: Crazymaking Issues

Chapter 10: Caught in the Middle: When Adult Children of Alcoholics Are Also ­Parents of Alcoholics

What's happened since you've grown up?

For most children of alcoholics, when you become adults, even though you may not drink, you still are affected by the disease. While you think you are okay, your behavior indicates you're not.

Some of you didn't drink. Some of you teetotalled and assumed that would fix it - forever. Some of you "got into" religion. Some of you "got into" sex. Some "got into" work; others "got into" gambling. Perhaps you "got into" eating disorders.

Whatever the case, you were never able to lay to rest the anxieties about your child­hood. You thought you did because you were busy, because you achieved.

Either you were very, very rigid, or very, very lackadaisical. You put yourself and others down, if you were rigid, for not toe­ing the line at all times and under all con­ditions. It was not uncommon for you not to take a day's sick leave in thirteen years. You became ill because of this, but were secret­­ly proud of it. (Or, maybe not so secretly.)

You beat yourself about your dis­organi­zation if you were lackadaisical. But, you compensated by calling yourself "flexible" and "adaptable." You knew no middle ground. You scorned it, actually.

You didn't see the forest for the trees, even though you were dying to "see" something that made sense. You felt "weird" much of the time, but you didn't know where to put that weirdness or what to attribute it to. You love the exception; you are bored with the rule.

On the surface, all seems okay. But often, all the activity and success cannot end the uneasiness lurking beneath the ­surface.

The denials, the diversions

One corporate head, interviewed in a magazine, said nothing stopped him from succeeding. Many power-drivers in busi­ness are alcoholics or adult children of alcoholics, and success becomes an accept­able way to channel the anxiety, to get applause that makes one feel like they are okay, that one's parents may finally be pleased. Everybody - society, the world, etc. - comes to sym­bolize the parents. "Tell me I'm wonderful. Then, maybe, I'll believe it." But ACOA's don't need just to divert from the anxiety and the restless­ness; they need to deny its very cause - the alcoholism.

The adult child of alcoholics who also is the parent of alcoholics learned the alcoholic denial-behavior that said, "My dad still has a job, so he can't be an alco­holic. I still have a good job. I'm sending myself through secretarial school at night. I have a late-model car. I'm not a dys­functional adult child of an alcoholic.

"My child gets A's in school, so I feel okay. I don't have to look at the fact that he is 'four sheets to the wind.' "

Other denials ACOA's commonly use are, "You can't be an alcoholic:

$ if you have a job

$ if you never lost a job

$ if you get promotions

$ if you are talented

$ if your home looks elegant

$ if you look polished and speak well

$ if you read lots of books

$ if you jog

$ if you take vitamins

$ if you are nutrition-conscious

$ if your kids are bright

$ if your husband is successful (Would he be there with you if you were an alco­holic? Of course not! So you aren't one!)"

For example, a mother tells me about her son, saying, "But, he's still doing well. There are so many areas of his life where he is doing well. He is basically such a kind person. He is so generous with others. He has such a sense of family. He's a won­derful teacher. He doesn't make a lot of money, but his values are good. He doesn't place emphasis on mak­ing money or on mater­ialism; he's much more inter­ested in being a decent human being. In his music, he's so in­volved - so passion­ate about his art!"

Her description of her son is her way of saying he does not have the disease of alcoholism. Denial, diversion, perfection­ism, and anger are all behaviors which describe adult children of alcoholics who also are parents of alcoholics.

Getting help for the anger

Sandra's eighteen-year-old, Rob, made her "see red" even if he just walked into a room where she was. Her hostility toward him, and his toward her, started long before his active drinking. For Sandra it was so intense that it actually hurt.

"It's this big glob!" she cried. "I don't know where to start dealing with it. It's never going to get taken care of. It's too big."

Sandra was tiny, with red hair and a lovely face. Her petite elegance belied her way of life. Hers was a coarse household; it reminded me of exactly how I grew up.

Most of those in the group Sandra was in were ACOA's. That's not why they joined the group, osten­sibly. They came in "for problems." They talked mostly, at first, about their spouses who were drink­ing away all the money. Then, guiltily, they spoke of their children, who were "so much like their fathers." They seemed surprised that nearly everyone in their group had kids "like that."

What was even more shocking to them was the discovery that 90 percent of them, whose children were addicted, also were themselves children of alcoholics.

"Did I make him like that?" was the re­curring question we had to deal with. When we thought the issue had been settled with one of the group members, the guilt would pop up again in another member. While it was somewhat com­fort­ing to see that the script was the same (that there was a positive "cookie-cutter" effect going on), the guilt also seemed infectious.

When the guilt calmed, the anger and the depression began to surface. And that was what seemed too 'globby' to deal with. It was one big glob of feeling. Of course it was too much to handle. It needed to be sorted out - cut down into manageable bites.

In Sandra's case, it was all entangled: the anger, fear, and frustration toward the alco­holic parent - and the same intense feel­ings towards her child. Plus the guilt from knowing she was "pouring the past" onto Rob, her son. More stuff to sort out, to lay aside, kept creeping back into the glob, threat­ening to make it too much to handle again.

*  *  *

Sandra was one of the lucky ones in the group; she already knew she was angry with her addicted parent. The others weren't actu­ally denying, in the sense of 'lying,' when they said they weren't angry. They were totally unaware of any feelings of anger.

Those same persons realized that it would take awareness of feelings be­fore they could hope to lay the past to rest. To allay their fears of hope­less­ness about ever getting in touch with those feelings, I told them about myself.

I've found that it often takes years of listening, patience, hope, to let the sharing of others in groups filter in through my petrified layers of fear.

I had been involved for many, many years with families of alcoholics. My own mother had been very ill with addiction and hatred. She used to joke about my having been an accident.

One day, on a train going to my home in Maryland, from Massachusetts, I was think­ing rather peacefully about the scenery, and all of a sudden, the realiza­tion came to me that my mother had not loved me. I felt terribly sad, and silently cried all the way to Philadelphia. I couldn't stop crying. I felt strange, know­ing that I wasn't feeling ­anger, but very, very intense sadness. I knew I was doing some letting go, and I was sad about that, too. Just a lot of sadness. When it was over, I felt older, in a good way.

I remember feeling surprised that I hadn't worked on this issue; in fact, I thought I had avoided it. But, I had gotten my body to the recovery groups, and even though I worked on other issues, the program was washing over me.

Instead of it being like surgery without anesthetic, the letting go process was so gentle and mindful of my fears, that it just did it to me. I didn't have to force it.

Experiences like this (my own and those of others) - all the time - tell me that treat­ment works. We all think we're ­beyond help in certain issues and that the craters of pain left over from childhood can never be healed. That's so untrue.

This isn't to say that we shouldn't "work" at all, in treatment, and "stretch our­­selves" at times. But, instead, that when we are weary, and cannot grow one more inch by ourselves, God often does for us what we cannot do for ourselves, if we let Him.

Whittling down the anger

When Sandra confronts her anger, now, she sits down and asks herself, "Who am I mad at?" She assigns percentages to each: 10 percent is heavy annoyance at the people who keep knocking on the door when she's busy, looking for the people who used to live there; 3 percent is directed toward the local grocer who never seems to have change, especially when she's in a hurry; 25 percent is at her father who was slow (Was it always on purpose? His sly smile when it happened seemed to indicate to her that this was probably so.); 42 percent is at her son, every day; and the other 20 percent is at herself for not being able to stop feeling angry!

After sorting it out in this way, it was so much easier for her to tone down it all down, and actually get rid of some of that anger baggage. When the anger at the ­grocer was seen in perspective, she was pretty much able to tell herself: "The heck with it!"

This ability stems from her knowledge of the Serenity Prayer: "God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference."

As for the collectors who kept knock­ing on the door not believing the former tenants had really moved, she promised herself to be able to look to see who was coming, and not have to again explain that they had moved. And she promised herself that she did not have to feel guilty. (She knew from experience that the guilt would "just go" if she did what she was supposed to do for a long enough time.)

Those responses took care of the anger toward the grocer and the collectors, but what about the rest?

As soon as she saw that the extra burden she was putting on herself for not ­being able to drop her anger was silly, she was able to whittle it down.

And the anger toward her son? She tried doing what AA suggested: every day, for three weeks, she asked God to give him health, wealth, and happiness - every­thing she would wish for herself.

Now, it didn't start out that way! Her first prayers were, "Go get him, God!" When she screamed that out, she even­tually could laugh. She said to her Higher Power, "You know I don't like him! Tell you what, God. You make him well so he'll be nice. Okay?

"I'm not going to pray for him!"

And when she hurt real bad, she prayed, "God, help me. Help me to let go. Let me not fear his worst."

Some days she could not bring herself to pray for her son. That's okay. Other days, when she felt good, she forgot. Isn't it nice that she felt good enough to forget? It's good to remember to pray, but it's also good to feel good.

Letting others live - so that you can live

Thelma called me from Tulsa. Much of her anger centered around the fact that her alcoholic father had gotten sober, and after a ten-year absence, had returned home. Her mother welcomed him.

"How can he just sit there, watching tele­­­vision, being happy, after all the pain he caused? He should pay for it! Look at all I still have to put up with!" Thelma cried.

She was a divorced teacher and mother of a twelve-year-old who was starting to sneak-drink. She taught ballet in the eve­nings, and had accumulated an enviable coin collection. Everyone thought she "had it made" - especially her brothers who married young, worked hard, didn't finish high school, and each had children from former marriages to support.

Thelma had settled for teaching. She wanted to have the courage to try her hand at running her own ballet school full-time. She was good enough, but she didn't try. This was because she realized that if she failed, she would lose the dream. And the dream was more exciting than the reality. She felt so frustrated with herself.

And she wanted it all - now. Only thirty-eight, she thought she should be accom­­plished in four careers, own $10,000 worth of stereo equipment and be part owner in a vacation home. She didn't want to wait for anything and was annoyed when her mother reminded her that "when she was young, people didn't get things like that at all, or they were in their fifties when they achieved them."

*  *  *

Over-achievement . . . impatience to the point of depression and anxiety . . . per­fec­tionism . . . low boiling point . . . inability to trust . . . inability to be pleased . . . this is a portrait of an adult child of an alcoholic.

Is Thelma really that angry at her ­father? Or, is it masking anger at her son that she can't admit without guilt? Or, is she mostly afraid that she'll never get what she wants, or even know what she wants?

It is so much easier to be gracious with other people when we are able to enjoy what we have, when we have hope that we can continue to do so. Even if those others are people in our families who have hurt us.

That personal joy in what we already have gained and accomplished gives us a blanket in which we can wrap ourselves that no past injury can penetrate.

We can't change the past. We can't change "him" or "her." We can enjoy who we are now - in the present, with help. "But they should pay!" we feel. We all have felt that, and still do, sometimes. But, we never stop beating our heads against a brick wall until we get sick and tired of being sick and tired. We cannot "let live" unless we are living, now.

Don't compare your progress in ­treatment with the progress of others

Adult children of alcoholics are always comparing their progress in treatment with the progress of others. If you had heart disease, you certainly wouldn't beat yourself for not getting well at the same rate as the person in the next hospital bed. You would be concerned, you would feel down about it, but you would not blame yourself.

This is another area where we must start to see alcoholism as a disease. It is not a ­mat­ter of a weakness or a strength of char­ac­ter - this getting the disease; nor are these ­fac­tors in the treatment of it. After all, if I had diarrhea, you certainly would not think of feeling morally superior to me and pro­claim­ing, "Well, I don't know what's wrong with you! My bowel movements are firm!" It is just as absurd to feel that anyone is mor­ally or intellec­tually superior because they did not get alcoholism or because their treatment seems to be "taking" faster in them. For­tunate they are. Superior they are not.

*  *  *

This comparing one's progress to that of another in treatment also is a mani­­fes­ta­tion of the disease: alco­holism's constant attempt to drag us down, one way or ­another.

If we can't find any other thing to put ourselves down about, we compare our­selves to anyone who is "doing better."

When people call me for telephone coun­­­seling, invariably one out of every three calls is from a person who says, "Oh, you're going to think I'm so stupid, but . . ."

They go on to tell me that they are sep­arated from their alcoholic husbands, and they are still entangled and spinning, that they can't deal with his alcoholism and their son's alcoholism and drug addiction, and do all that the program of recovery they are in asks them to do.

I say to them, "What is the program actu­ally asking you to do? Where is it ex­pecting that you 'be at' now? Has anyone actually said that you should be ashamed of your­self because you are not more well and detaching so wonderfully from the whole mess? Is anyone actually saying that to you?"

"Oh, no," she answers. "It's just that I think I should be further along. I should be doing better and not feeling so bad; dealing with this whole thing better. After all, I know the answers. I go to the recovery meetings!"

She says she takes her husband back; she's let her child back in; she gives him his allowance even though he drinks; she signs the paper to let him back in college when she said she wouldn't; she pays her husband's car loan when he is seeing another woman; etc, etc. And she always says, afterwards, "Oh, I'm so stupid. How could I do such a thing? I know better! I've been in Al-Anon for a year-and-a-half! I go to counseling! I help others in the same mess. I'm so ashamed; I could never tell others that I did that. It's like I never got any help. When will I learn?"

We absolutely forget that alcoholism (as AA says) is "cunning, baffling, and power­ful." We mouth that phrase and it sounds good. But, do we take it in? Do we think about what cunning, baffling and powerful really mean?

The words mean that alcoholism gets us extremely and bizarrely embroiled emo­tion­ally with an alcoholic. It is so powerful that when we crawl to the disease - we think we are crawling to the alcoholic.

It makes us forget that we are not dealing with the alcoholic; that what is coming out of his mouth is the disease. That his actions are those of his disease. That he is brain-soaked with alcohol.

Since it is absolutely necessary for you, at times, to take two or three steps backward before you can go on to the next part of your journey in getting well, you must accept some backward steps, and not put yourself down. For, when you spend valuable time putting yourself down, you stay stuck in that part of the journey, and make less overall progress.

So how do you get unstuck? Keep it simple. When you find yourself saying, "I should have," or "I shouldn't have," tell yourself, "Stop it. The heck with it. Big deal. So what?"

And then, change your thoughts, and go on and do something else that is pleasant - watch TV, go walking. Make yourself feel good about yourself.

Practice self-acceptance. In three weeks, if this can be your daily growth activity, you will find yourself far ahead of schedule - as far as where you want to be - in terms of being able to find peace of mind, make decisions, and carry through.

Reflection/Action Guide

Write On:

1) If you are an ACOA, did you "get into" work, sex, alcohol, gambling, eating?

2) What anger or fear did you think you "left behind" in childhood that has, in reality, chronically been a problem?

Suggested Activities:

Increase the "fluff" time in your life; i.e., films, books (not on therapy), con­certs, laughter time. Nothing speeds up recovery like fun. Not introspection. Not "working on it." Nothing.

This "fluff" time must not be in ­pursuit of excellence. It must not be in activities that involve awards or rewards, winning, seeing levels of achieve­ment, or any other kid of comparing or "proving." It must be simply for fun!

Chapter 12: Surrounded by Alcoholism: If Your Spouse and Children Are All ­Alcoholic

Samantha, forty-four, is married to a "raging, late-stage" alcoholic, and is the mother of three alcoholics: the oldest two, a boy and a girl, are away at college and her youngest boy is fifteen. Her youngest daughter insists that she "has no prob­lems." This "no-problem" child, Geor­gina, is ten-and-a-half, very bright, very precocious, and sips wine with the guests when they visit.

Samantha is a professor of economics at a well-known university. Her husband, Karl, despite the pro­gression of his alco­holism, manages to hold on to his posi­tion in one of the world's leading com­panies. His genius at turning many potentially los­ing situations into very profitable ones encour­ages his colleagues to ignore his drinking. They are afraid of alienating him, or even angering him into leaving the com­pany and going over to the com­petition. Samantha has very mixed feelings about his job. She fears that he'll lose it and that they'll have to alter their lifestyle dras­tically. She also fears that he won't lose it. Then, he'd "be right," and that "she is crazy" when she calls him an alcoholic.

She breathed a big sigh of relief when her oldest children went off to college. She had been through five years of hell at home with them all. There was no way she could do anything to confront their drink­ing, or use the threat of withholding college tuition in order to get any one of them to go to treatment.

My heart went out to her. I could under­stand her exhaustion. It is so easy to stand on the sidelines and say to a parent, "Now, if you really cared, you would do this or that." Baloney! This woman did her very best. Prob­ably even more than her best. Just her surviving in that house­hold was in­credible! There were daily crises. Most days, there were three to seven crises of varying intensity. Before she got to a family support group, every small problem was terribly magnified. It was only after one-and-a-half years of attending family re­cov­ery sessions, sometimes two or three times a week, that she was able to start seeing the situation more clearly. She began to be able to let go of the smaller problems, to focus on only dealing with the big ones. She began to allow herself to leave the house when the screaming started, going for a drive, a walk or shopping. She also bought headphones and listened to music instead of the insane diatribes.

When you looked at Samantha, you'd never think there was a problem in her life, much less in her entire family. Always fashion conscious and made-up beau­ti­fully, she and her family could have posed for a magazine cover. Un­fortu­nately, it would have been appro­priate for that magazine to be entitled "Families in Trouble."

Sam (as she called herself) told me she was a little ashamed of how she looked, and at the same time, rather proud of it. "Isn't it denial, to look like nothing is wrong?" she questioned.

I told her I felt that any way she sur­vived was wonderful. And that perhaps that was one of her tools for actually surviving so well. At least, one thing in her life remained normal.

Sam told me how, now that the older children were away, she felt more capable of dealing with her younger child's addic­tion. But she said she felt ashamed that she was "abandoning" the older children's needs, that she had "ignored" their alco­holism in past years.

I assured Sam that millions of people found that the way they were able to begin dealing with the insanity of a whole household of alcoholics, was to focus on only coping with one alcoholic at a time.

*  *  *

Jim owns his own business in the South­west. Pamela, his wife of fifteen years, is alcoholic, as is their thirteen-year-old son, Tommie. Their eleven-year-old daughter, Susanne, is just beginning to display signs of addiction. Jim is dis­gusted, wants to run, feels surrounded and trapped.

Jim's mother was alcoholic and so was his father. His wife, Pamela, seemed like a lot of fun before they got married and before he saw the ugly side of her drinking.

Now, Tommie, their thirteen-year-old, was drinking and smoking pot and getting to Jim's jugular the same way Pamela could. There were moments when he ­really hated his child. The shame he felt about his hate, and about wanting to hurt a person half his size, kept him from getting the help he needed. He was so sure that a counselor would put him down for these very normal feelings. I could see that one of the worst things for him about his family's drinking was that it still ­always surprised him.

His "insanity" was that he believed his wife and his son when they said "it wouldn't happen again." Of course he wanted to believe them! But, it set him up for such disappointment - such rage and anguish.

I suggested that he try to expect them to drink, for the time being. This is not "letting them get away with it" - this idea of expecting them to drink.

"They'll just figure, 'Good - now he'll let me alone, and I can drink and drug to my heart's desire!' " Jim argued.

I answered, "Jim, let me show you how this works. This tactic gets two things accomplished. It lets you get relief from their problem, and it will make them very scared about their drinking."

Here's how it works:

$ Your wife and child tell you that it'll be different this time.

$ You don't say anything. You just tell yourself, "Remember the facts."

You haven't set yourself up for dis­appoint­ment. They're going to do what they were going to do anyway - whether or not they told you that they wouldn't drink - and whether or not you believe it. They drink. It's no different from how it was for the last number of years, no ­matter what is promised. You're just not going to appear to be a patsy, by believing their baloney.

You aren't feeling betrayed because you weren't down 'in there' with them believing them, and feeling like you were fooled. You knew what would happen this time.

You uneasily tell yourself, "Yeah, but, now they'll think I condone their drinking."

But, how you come off is nonchalant - not caring whether they drink or not. You do not come off, in their eyes, as a condoner or a con­demner of their drink­ing. You are not mentioning it; you are not listening to or believ­ing or not believing what they say; you are pretending (the real feel­ings will come later) that you no longer care what they do about their dis­ease. You act as if you have finally caught on to the fact that this is not your problem! That you are not the one who is drinking yourself to death! That you aren't a fool, anymore, in your eyes, or in theirs. That you don't have to hurt because they drink. Let them suffer their hangovers alone!

When Jim saw how this process worked, it was so much easier to do what he needed to do.

His wife got furious that he was so detached from her disease that she "threatened" to go to AA to show him he couldn't hold that over her head anymore and act so indifferent about whether she lived or died!

After she was sober awhile, together they intervened and made their son go to treatment. He's now in a halfway house.

Fear of being left

Most spouses and parents of alcoholics that I've counseled tell me that they had tremendous guilt about the fact that because they were so fearful of the possi­bility that their alcoholic spouse would leave them (for whatever reason), that they either did not notice the depth of their children's problem, or it took second place in priority. I very strongly believe that this ambivalent reaction to family alcoholism is totally normal.

No one escapes the terrors of family alcoholism when you are living in the diseased family! And those terrors are your manifestation of the dis­ease! Don't put yourself in a double bind. Don't blame yourself for having the symptoms of this family disease as well as having to get well from it.

How do you get out from under the immobilizing feelings that come from living with both a spouse and children who are alcoholics?

If you allow yourself to be afraid without putting yourself down for being afraid, your fear will start to dissipate. Stop fighting yourself for having the symp­toms, and save your energy for fighting the disease - and you will begin to see you are not so powerless.

AA says that alcoholism is "cunning, baffling, and powerful."

Yes, it is. It is so cunning that it comes out of the mouths of alcoholics, and makes us think that they are powerful - that they are to be feared - and we back off.

It is so baffling that it makes otherwise normal-thinking spouses of alcoholics, mothers of alcoholics, fathers of alcoholics, believe that you are the crazy ones, the ones with the faulty judgments. It is so cunning and baffling that it makes families half-believe the alcoholic when he or she claims that alcohol is not the problem.

Try doing what a friend of mine did when she visited her husband in the detox center. He is a psychologist, and an alco­holic. Whenever they argued about alco­hol, he used his skills as a therapist (even when he was drunk) and he was able to convince her that he was the reasonable one, and that she was the patient.

After a few sessions of family treat­ment, however, she told me, "I was able to go visit him when he was in the treat­ment center, and when he still spoke to me in that social-worker tone of voice, I would start to feel helpless and enraged. And then, I remembered: He was the one wearing the pajamas!"

Reflection/Action Guide

Write On:

1) Do you see "early-stage" alcoholism as it is; that it is alcoholism as much as is late-stage alcoholism? Do you see that alcoholism exists on a continuum and not in separated stages?

2) What are some of the ways you have been able to do well in your life despite the alcoholism all around you?

3) Write about some of your feelings that you thought were "wrong," and that now you realize are very normal.

4) Figure out, on paper, how many years your alcoholic child (and spouse) have been telling you "It'll be different this time."

Suggested Activity:

Spend thirty minutes this week viewing the alcoholics in your house­hold as "persons you are observing for signs and symptoms of alcoholism." See if this gives you some distance from the junk that comes out of their mouths.

Chapter 13: Recovering Alcoholics Deal with Their Children's Alcoholism

Thomas is fifty-two years old, nineteen years sober, and believes that his next-to-youngest son "isn't an alcoholic" because "he's a good kid."

Some people, after reading this, might point a finger, and say, "Aha! Denial!" - as if denial were a conscious, deliberate avoiding of the truth.

I believe that these parents are acting quite naturally, and lovingly. They want the best for their children. They know how difficult it is to be an alcoholic. They wish it were not so. Even when admitting to the alcoholism, their mixed feelings come out not as mixed feelings, but as not believing the whole truth.

Denial doesn't mean striding about, chin up, refusing to see what you obviously do see. It is a terror; brief glimpses of reality; and a retreat into the fog of un­knowing so that the pain may stop.

But, what does this unknowing do to us? What does it do to the alcoholics we love? Let's look at Maysee.

Maysee (not her real name) is fifty-seven years old, and fifteen years sober, in Alcoholics Anonymous. She also works as a therapist in private practice, helping other recovering alcoholics. She told me that her "three daughters are alcoholic but they're not in active alcoholism yet" and "my kids say 'they can control it.' "

She knows her daughters are drinking. She knows they've gotten into trouble over it (hence her saying she knows they are alcoholic). She knows that both she and her husband of thirty years are alcoholics, therefore, the kids have close to 100 per­cent chance of becoming alco­holics if they drink.

She says that they're not in active ­alcoholism yet, but in the next sentence, she says they are controlling their drink­ing, which means they are drinking. Which means they are active in their alcoholism, albeit not necessarily a late stage of it. And she also knows that social drinkers do not go around claiming to be able to control their drinking. It's just not that important to them - they don't think about it that much - they don't think about it at all! They don't bother controlling it.

But what does this line of thinking do to Maysee? When she is with her children, she often is churning inside. She is torn between what she wishes, and what she sees. She feels that much of the time she must hold in her thoughts and feelings. She does not want to alienate her children by preaching at them. She, and they, want to pretend it does not happen, and that "it" will "just go away by itself."

I am not advocating a constant talking about alcoholism, but it is a matter of ­reinforcing inside us, first, our belief that it is a disease, and not a shame. When I see loved ones killing themselves with ­alcohol or drugs, I must constantly tell ­myself, when I get tight in my stomach, that part of this tightness is my feelings about the stigma of alcoholism. And that comes from the part of me that has not totally accepted that this is a disease.

And part of that non-acceptance of the disease concept is my feeling that this person's anger makes him very powerful. It is my forgetting that the disease is the powerful, cunning, and baffling thing - not the suffering alcoholic. That the anger and threats coming from their mouths is the disease telling me to back off, to have mixed feelings, to be afraid of it and afraid of the alcoholic.

When we begin to accept, in ourselves, all those terribly important ramifica­tions of the disease concept - then we send the alcoholic certain messages:

$ That we feel certain, in our eyes, and in God's, that we are allowed, without guilt, to end the rescue operations that we were formerly trapped in.

$ That we know that this will help the alcoholic as nothing else can.

$ That we know that we do not, any longer, have to stand around and listen to the child's disease talking - that we have permission, now, to leave the room or house, or just tune out.

$ That we are freed from the guilt that "we somehow set the stage" for his or her alcoholism.

These long-term, lasting benefits, for the alcoholic's sobriety, and for the par­ent's peace of mind, come from an inner knowledge that it is okay and important to no longer deny the alcoholism.

*  *  *

One winter afternoon in downtown Chicago, I talked at brunch with several recovering alcoholics in AA. Sandra told me that "no matter how much I tell myself it is a disease, part of me doesn't believe it. I guess I don't want to believe it - don't ask me why. I don't know. I guess there's some deep-seated sick reason for why I don't want 'off the hook,' but I guess that's just it. I feel like it's letting us off the hook, and we don't deserve to be. It's like we were bad people, and deserve to be forever punished."

*  *  *

I believe alcoholics have a choice. A choice to continue thinking, despite all the medical evidence, that alcoholism is a moral problem, the choice to continue to feel lousy during recovery, or the choice to make that tough decision to learn how to live differently, and be happy. For many alcoholics, this is one of the toughest ­decisions ever.

I believe that that's part of what AA means when it says that in order to totally recover, alcoholics must make a 180-­degree turn in think­ing. To make a con­scious decision to believe, and act like one believes, that God is a loving God, and that the time for punishment is over. But I don't think we get to that point until we are sick and tired of being sick and tired.

Getting rid of false guilt

Michael told me how much guilt he felt when he remembered that he used to send his little girl, when she was seven, to fetch beer from the fridge for him. She's now fifteen, and drinking a lot.

Sam told me he used to take his son around with him when he was eleven or twelve years old, to different bars. He'd introduce him to all his buddies, telling them how smart his son was, how good he was in all his school subjects. He'd glow with all that attention. Sam said, "I set him up to like the bars."

I asked Michael and Sam if they ­be­lieved that their children would have be­come alcoholics even if they, the par­ents, had been perfect examples.

"Yeah, I guess so," they both answered.

"Let me ask it this way," I said. "Do you think they could have become alcoholics as easily if you had been perfect?"

"No," they both answered imme­diately.

"Why?"

Sam answered, "I think I showed him a very Bohemian existence that he's tried to live ever since."

*  *  *

Marcia interjected with her exper­i­ence. "I've often wondered where my hus­band's alco­holism came from. He was raised by teetotaling Baptists. They didn't even have a deck of cards in the house, much less a bottle of beer. Three of their five sons are alcoholics."

Then, Sam said, "You know, you're right. I couldn't have had a blander father. He was the complete opposite of me! I certainly didn't turn out bland! I chased excitement! So he didn't make me into an alcoholic! Maybe I didn't 'make' my son into an alcoholic!"

Marcia continued, "Besides, we're less important as a total role-model than we think. When we grew up, there cer­tainly weren't the drugs, and no one drank so openly, so early, as these kids do. So, there is peer pressure. It's not just our example."

"It occurs to me," I reflected, "listening to you all, that you're always ask­ing a lot of yourselves. You're not only dealing with your own alco­holism, but you also feel you must always have this won­derful, dis­passionate, saint-like attitude toward your child."

"Yeah!" Marcia agreed. "That 'walk­ing on eggs' will cure him! It's that guilt again, creeping back in. 'If only I hadn't been an alcoholic myself, he'd be all right.' So, I'd better 'make up' for it all, and be wonderful, at all times, and not allow myself to be human, and get angry. After all, 'if I'm an alcoholic, I better under­stand how he feels, and always be loving and kind even when I want to scream at him!' "

We met four more times. The shar­ing, finally telling each other of the guilt and the anger, brought a tremendous relief. I never met with them again, but I hear that they keep in touch with each other. Some go to Al-Anon; some don't. But they don't hold those feelings in any longer. And it's not at all as frightening as it used to be.

Reflection/action Guide

Write On:

1) Do you find yourself wanting to maintain a "hard-edged" image for yourself - telling yourself that this problem "doesn't bother you" as much as it really does?

2) Do you talk to others about it, and not keep it bottled up?

3) Does it seem "wrong" to go to Al-Anon for help; that AA "should be enough"?

4) If you have gone to Al-Anon, despite the welcome you received there, were you uncomfortable because you are an alcoholic?

5) Do you feel you are betraying your fellow AA's when you go to Al-Anon and participate in "talking about alcoholics"?

6) Do you see ways of resolving this? Do you see how what you learn in family treatment can help your child and you?

Suggested Activity:

Begin talking about these issues you just wrote about, with other parents who have gone to family treatment. Ask them specifically how Al-Anon or counseling helped them.

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