Thursday, August 1, 2013

Do: Learn The Facts About Alcoholism

As I listed in my post of the Do's and Don'ts, one of the Do's is "Learn the facts about alcoholism."  Though the goal of Al Anon is to offer support, hope and recovery to those affected by alcoholism, the program also encourages us to understand our alcoholics.  By learning about the disease, which is a family illness, we can have compassion for our loved ones who suffer from it, and we can start to truly accept the Three C's:

We didn't CAUSE it
Can't CONTROL it
Can't CURE it

There are many ways to educate ourselves about alcoholism - attending open AA meetings, family meetings at recovery/rehabilitation centers, researching online, or going to Al Anon.  Here I've compiled a little "Alcoholism 101", a nice little combo plate of information about addiction and recovery.  And it's calorie-free.

One definition of alcoholism is "a mental obsession that causes a physical compulsion to drink."  It's like having a song stuck in your head, maybe even a song you despise, that somehow got there and you didn't put it there.  But it keeps playing and playing.  It's there first thing in the morning, at lunch, after work, when they get home, maybe even when they wake in the middle of the night.  And the only way it stops playing is if the alcoholic drinks.  And as the disease progresses, the alcoholic needs to drink more and more to make it stop, which can eventually turn into passing out to make it stop.

This doesn't mean it's always conscious; in fact, the alcoholic may not "hear" that song or know it's there - all they know is that they have a physical compulsion to drink.

Something that's important to remember: it is not a choice to drink.  It it not a matter of "willpower"; alcoholics drink because they have a disease.  So many of us have begged, complained, nagged, asked, discussed, questioned our loved ones about their drinking to no avail.  Some may say "I make a choice every time to drink - it's a choice I'm making."  Indeed, an alcoholic family member who is decades into recovery told me "Back when I was drinking, I never had a drink when I didn't think it was the right decision at the time.  But that's part of the disease - I was deluding myself into thinking I could control it, I could figure it out.  Everyone else in AA had just failed - but I was going to figure out how to keep drinking without screwing myself over, without waking up hungover everyday, without it affecting me."

As for another definition, the American Psychiatric Association's DSM (Diagnostic and Statistical Manual of Mental Disorders) diagnosis of alcoholism is:

"... maladaptive alcohol use with clinically significant impairment as manifested by at least three of the following within any one-year period: tolerance; withdrawal; taken in greater amounts or over longer time course than intended; desire or unsuccessful attempts to cut down or control use; great deal of time spent obtaining, using, or recovering from use; social, occupational, or recreational activities given up or reduced; continued use despite knowledge of physical or psychological sequelae (pathological condition resulting from the disease; chronic complication of an acute disorder, example: fatty liver disease, alcoholic hepatitis)."

So let's go down the list:

1) Tolerance - constant amount of alcohol over time produces a lesser effect; thus increased amount are necessary to produce the same effect.

2) Loss of control - of how much, or how long - drinking in larger amounts or over a longer period than intended.

3) Perpetual desire to control it - Smaller servings, switching types of drinks (liquor for wine, whiskey for vodka), drinking at different times of day, buying smaller bottles, attempting to stick to a set number of drinks - all in attempts to decrease amount consumed.

4) Withdrawal - A counselor explained it this way. "The first day I stop drinking, I'm pretty much okay, maybe a little irritated but ok.  The second day I'm shaky, feel flu-ish, irritated.  The third day I can't work until lunchtime when I have a scotch & soda."  Also, drinking, or using a closely related substance to relieve or avoid withdrawal symptoms.

5) Social/Occupational/Recreational activities - Activities given up or reduced because of drinking, isolating to continue drinking uninterrupted.  Life becomes an impediment to getting, buying, or using alcohol.

6) A great deal of time spent in activities necessary to obtain, to use, or to recover from the effects of drinking.

7) Continued use despite physical or psychological effects and other consequences.

In recovery circles it's said that alcoholics don't quit before their consequences, and as it says above even then don't quit, and some will continue drinking until they are dead.  As for the consequences each has their own - for some it is the loss of a job, illnesss, family concern, breakup, divorce.

But our disease as the often codependent other-half is that we assume we are, will or should be their consequence or bottom, that after all - if WE left or threatened to leave, surely they would realize what they are doing and stop.  And when they don't stop we feel rejected, hurt, abandoned, and suddenly afraid of what we will do without them.  Because I think for some of us, we see our self-worth reflected back to us through them.  When they love us we are happy.  When they are cruel we are lost.

Indeed, the family member I mentioned previously told me: "Oh, I lost my spouse, my three kids, and I didn't care.  I kept drinking.  But when I thought I might lose my job?  I thought, 'Whoa...I gotta stop this.'"

Our struggle is to accept that we may not be their consequence - and that it has nothing to do with us, our self-worth or who we are.  It doesn't even mean that our alcoholics do not love us.

Alcoholism is a primary, chronic, progressive and fatal disease.

"Primary" meaning that it is assumed that the alcoholic's psychological or mental issues cannot be resolved unless the alcohol is out of the picture completely.

"Chronic" meaning life-long - alcoholics cannot drink like non-alcoholics.

"Progressive" meaning the disease gets worse over time, and drinking will eventually become the center of the alcoholic's life - their schedule-maker, their main concern.  It will be why they travel to certain places, why they drive certain ways home from work, why they eat at certain restaurants, why they prefer to spend time with certain friends who also drink, why they forget to do things because they were thinking about their next drink, why they blame you for their need to drink, why they cannot stop drinking despite the pain it has caused you.

"Fatal" meaning it can and will kill some of those afflicted by the disease if they continue to drink.

Recovery, Rehabilitation Center or Hospital Family Support Meetings

It is important to remember that alcoholism is a disease of addiction.  Alcoholics are addicts, and their disease is no different than that of a heroin addict whose drug of choice is heroin, or a food addict whose drug of choice is food, etc.  Sure, the consequences of alcohol addiction may not come as fast or as hard as heroin or meth or crack, but that just means they get to keep staying addicted for longer, and some die a slow, very painful death.

One evening at a family support meeting at the local recovery center, the counselor who was teaching that evening fielded a question from a man in the audience, whose son is a heroin addict.

"Are you more ashamed because he's doing heroin and not say, alcohol?"

"...Yes. I suppose I am."

"Well let me tell you something.  Alcohol is a drug - we don't call it that, but it is.  And lemme tell you, there ain't nothin' like an alcoholic's death, phew.  You go down to the hospital in some of the wards and see alcoholics dying, you'll never forget it.  Now that's a way to die."

You see, we don't call alcohol a "drug" in this country because it's legal, and it's the most popular legal drug next to cigarettes.

The Roles in an Alcoholic Family

It was at the recovery center family support meetings that I learned that addiction is a "family disease" - each member comes to assume certain roles as their way to survive, to placate the alcoholic's reactions and stress, allow the addiction to progress, and to help the family "function" despite the disease.

It's important to understand that these roles are taken on completely unconsciously, and roles can sort of "bleed into" one another - for example, some of us may identify ourselves as both The Chief Enabler, and also The Hero and The Mascot from our family of origin.

The Alcoholic ("Victim")

The Alcoholic (or chemically dependent) family member can be charming, has rigid values, can be hostile, manipulative, aggressive, blaming and self-pitying.  Inside, The Alcoholic feels shame, fear, guilt, pain and hurt.

The Chief Enabler ("Caretaker")

The Chief Enabler is the closest emotionally to the victim (for most people reading this - probably you).  They are the protector of the family, and can seem super-responsible but also self-righteous, sarcastic, passive, and a "martyr."  They are often physically sick, experiencing somatic symptoms as the stress of living with the alcoholic manifests itself.

The Hero

Typically the oldest child, The Hero's job is to be the parent that the alcoholic parent is not.  To everyone else, they are the typical overachiever, follows the rules, is very responsible and seeks approval.  Inside, The Hero feels inadequacy, guilt and hurt.

The Scapegoat

The Scapegoat is the "problem child", whose job is to "get in trouble" and take the heat off of the alcoholic parent.  They are hostile, defiant, and rule-breakers.  Inside, they feel rejection, hurt, guilt, jealousy and anger.

The Lost Child

The Lost Child is sometimes called "The Forgotten Child" - their job is to not be in the way, to not be a bother, to be mediocre (to avoid competition with The Hero).  On the outside they are shy and quiet.  They enjoy a fantasy life, are often in solitude (read: video games, reading, television, hobbies), and attach to things or animals (pets are very important!), not people.  Inside, The Lost Child feels anxiety, rejection and hurt.

The Mascot

The Mascot, or "Family Clown", distracts everyone from the alcoholic's behavior by acting as the family comedian.  To others, they may seem immature, fragile, and "cute"; also, they are hyperactive.  However inside, The Mascot feels insecurity, fear and anxiety.

When I first read about these roles, it was just like the old cliche of someone opening up a box and shining a spotlight.  "Ohhhhhhh" was the sensation that shot through me.  This makes sense.  Though I did not grow up in alcoholism, I have come to realize that chronic depression in one of my parents created a dysfunctional dynamic, and caused the same issues of emotional neglect that children of alcoholics can recall experiencing.  It was clear to me that I was a mixture of The Hero, The Mascot and The Lost Child.

Open AA Meetings

When I attended my first open AA meeting it was abundantly clear that I was not in Kansas anymore.  Nope, I was definitely in an AA meeting.  First of all, WAY more people than in most Al Anon meetings I've attended - which makes sense, as these alcoholics are attending AA meetings to survive, which means staying or getting sober (or because they're court-ordered to do so).  Most of them smell of cigarette smoke, and usually most are men.  Also, most have a beverage of some kind in their hands - coffee, sports drinks, soda, something.

I introduced myself as a visiting Al Anon who was encouraged to "see the other side of the street", and thanked them for sharing their story, and remembered feeling a little nervous and embarrassed to be there, feeling so just, well, obviously Al Anon.

But don't let that discourage you - a few people introduced themselves after my first meeting, and one man even told me that the was glad I came, because I had reminded him of why he was still sober; because in his recovery he is able to see the pain he caused his wife all those years.  That was humbling to say the least, but more than that it was that little break into my remaining denial, something that told me "This is for real." Others came to offer their viewpoints as a recovering alcoholic.  It's funny - a lot of them were very upfront about calling my husband on his "bullshit", and were way less tactful than say, anyone in Al Anon.  But maybe that's because they just know.

Mostly, those in AA will talk about how insane their thinking was when they were drinking, that they really thought they could get it under control and drink like other people.  One woman said "When I realized that normal people don't spend this much time trying to think of how to control their drinking, I realized I was an alcoholic."  A man shared that when he was drinking, he would ride his motorcycle on the freeway (drunk) at 90 mph, "Shaking my fist at god because I didn't have the balls to shoot myself."

Let me tell you - one of the most common threads that I hear in AA shares is how selfish they admit to having been, or still can be.  That part of the disease meant that they were only thinking of themselves, even when they weren't drunk, how much they blamed their wives for their drinking so they could keep on drinking.  There's something about grown men sobbing and choking up as they give the details of the ways in which they weren't there for their children that just guts you.  When I hear the pain that they went through, even when they were selfish, my anger at my husband shifts, and I feel more compassion than finger-pointing.  I may still be angry (and have every right to be) about his treatment of me, but my perspective has changed.  And how I deal with that anger changes.

Lastly, another man said this, and it's something I will always remember: "Alcoholism is the only disease where part of the disease is convincing yourself that you don't have the disease."

So there we have it, everyone.  No - this isn't everything.  I am constantly learning something new about the disease, and I certainly don't know it all.  But I felt compelled to share more in-depth information because I see so many of you struggling, as I did and still do.

When we first start to discuss our loved one's drinking, whether on this blog, to friends and family members, or in the rooms of Al Anon, we're usually in crisis.  And in that crisis, when we first venture into the world of alcoholism recovery, whether for ourselves (Al Anon) or for them (research, counseling about the disease) we are still in "Fix It" mode.  We're still trying to figure it out.  "Sure, I'll learn how to focus on me - but can you tell me how that will fix my husband's drinking problem?"  And even the "Do" of learning the facts about alcoholism is tricky, because some of us may still want to use that information to try to get our loved ones sober - whether by outright sharing it with them, or using it to somehow control or manipulate them.

I have made quite a bit of progress in the last year, to the point that maybe half the time I can recognize the disease talking to me, and separate my husband from it.   And a lot of that progress is credited to understanding the disease and the way it manifests itself in words and behaviors.  To those of you still reading this long post, I hope this is of some help to you also.


  1. marriedtoafa, your blog and perceptions are so insightful and enlightening. I am still searching for answers even though I divorced my FA. I have a question: What do you think about interventions? Does Al Anon have a stand on interventions? Do they work long term? They appear to break through the denial and get the alcoholic to rehab/12 step program. (Ok, those are several questions.)-MT

    1. Thank you so much for your kind words and for reading my humble blog. Interventions...I myself have questions on them, as to whether they are effective or the "right" thing to do. In Al Anon there is no mention of interventions, as the focus is on us and our own recovery. But I can kind of answer your question.

      "Do they...get the alcoholic to rehab/12 step program" - if you mean interventions, then I suppose that yes, sometimes they do. But from what I understand, the purpose of interventions is not to "get" them into rehab, but rather to voice the collective concerns of family and friends to the alcoholic. If a group were to go into an intervention with the goal of getting the alcoholic into a program, it seems more like they are trying to control the person rather than communicate, and that's a very tricky place to be. Because then, if the loved one doesn't enter rehab or stop drinking, we feel that effort has failed, that *we* have failed, and we may try other tactics.

      There's a saying in Al Anon, "If I say something more than once, I'm trying to control."

      I also know, based on recovery center meetings, that it takes on average 7 times for an alcoholic/addict to stop drinking/using. That includes stopping on their own, or going to rehab.

  2. Does your husband know you're involved in Al Anon? I feel like mine would wonder why I was going or may even be angry. Honestly, I have never had compassion or empathy towards him when it comes to drinking. I guess I have felt like he CAN stop and just chooses not to. If he really is an alcoholic - and I believe he is - I need to reframe my thinking and attitude. Thanks so much for your insight.

    1. Hi Robin, thanks so much for your comment. Yes, my husband does know I attend Al Anon. When I first let him know, he wasn't aware of what Al Anon was - he thought I was referring to AA, and so I explained the difference between the two programs. Sometimes in arguments it would be thrown back at me in different ways - that I was "being brainwashed" and that "hanging around all those people with problems has made you think that *I* have a problem," etc. (And I wanted to say - yes, these are people with similar problems and it highlights and gives a language to the problems we have as well).

      The less anger and more understanding and compassion I have help me focus on myself, stop focusing only on him and stop living in my own disease.

  3. Thank you once again for this. I simply can't thank you enough for the education and insight.

  4. You got it girl! Keep your mind seem to be on a roll. I have my folder on my dresser and refer to it often. Although my AH is living in another town and I miss him, I know for certain what I DONT MISS! I have been much happier on a daily basis since he left. I have been through exactly what you are going through. Youre right, you will know when you are ready. Then, make your decision and dont look back! Stay or go...being in the middle is exhausting! Keep going out and forget what he thinks. He doesnt worry what you think, so continue to be selfish. Its necessary for you and your marriage!

  5. I am reading this and really thinking. My husband is a very functioning alcoholic. I hate that he drinks because I myself am a recovered alcoholic. I quit drinking about 17 years ago and when we met he rarely drank. It has been escalating to the point where he drinks alone and often stays up late to drink by himself. All summer he has been drinking more, though he knows it bothers me. We had guests at our cabin and it's "Okay" there, because other people drink with him. Now we're home and holidays are over and he's still at it. Alone. Fell asleep at his computer with the TV on the other night because he was drunk. Last night he started drinking again, said he had a "limit" but went over it. This morning when I told him it bothered me, he turned it on me and told me to stop nagging him because when he quit, it was going to be his idea not my nagging. I started to cry because man I can't believe I'm living this life with an alcoholic. He yelled at me for crying and so I said, "fine I'll just pretend everything is fine like usual." And he was good with that.

    He doesn't abuse me, but he tends to be very controlling. Of course I am blamed for being controlling. He makes good money usually but overextends himself (commission job) and then has to "handle" it by drinking again.

    He has admitted to having a drinking problem. Even calling himself an alcoholic and will stop for awhile and then go back to it. He always tells me not to try to control him, or blames me for his drinking or stress that leads to drinking.

    I am seriously depressed today. I can't stand being intimate with him because we're living such a lie. I am blamed for my lack of intimacy but he's never ever willing to look at his role in it. He goes on and on buying things, getting us in debt, blaming, fixing, doing it all over again, going for bigger and bigger toys and more and more debt, all trying to fix whatever it is that bothers him.

    I feel sometimes like I'm waiting for him to die, because I don't know how he can keep on this way adding so much stress to his life and then getting pass out drunk. He's in his late 40's and is now overweight and doesn't take care of himself.

    I'm no angel. I've put on 30+ pounds and deal with all the unhappiness by drinking and disappearing in myself.

    I don't know what to do. I never did AA because I didn't like the blame aspect of it. I was never an every day drinker but a binge drinker who would have serious personality changes when drunk and black out and slut around. When I quit I joined a group called Women For Sobriety and I have no desire to ever be the person that I was ever again. Drinking is in my family. My dad was also a binge drinker growing up and my sister is definitely a functioning alcoholic.

    I am so sad right now and so lost about what to do.

    Thank you for listening and sharing. I know I have to do something. I just don't know what to do yet. I keep thinking I have to fix myself. I worry about my son too. He is 12 and has no hope with the alcoholic genes. He doesn't see too much of my husband's problems. My husband is a happy drunk and generally just drinks himself to drink these days. BUT I know it's got to be effecting him and he probably sees more than I think he does.

  6. Your Blog has been so helpful to me. I have talked to my FA many times about how much he drinks, on and on, for many years. I'm at the end of my rope, my kids are nearly out of the house. I want out of the marriage, I don't think my FA knows how I feel because I have tolerated it for so long. I have always felt like I really can't do anything about the drinking. I have never actually told him he is an "alcoholic". I think I owe him my final outreach/confrontation for my own piece of mind. I avoid confrontation terribly. Have you or any of your readers had experiences that could help me get started with this conversation?

  7. Wow...I just found your blog, and have spent the last 3 hours reading entries. Where have you been all my life?? I have been attending alanon off and on for 3 years now, and need to attend all the time. Maybe more than once a week. I have been married to an alcoholic for 26 years, but only realized the extent of his drinking problem 3 years ago. I feel like I'm crazy some days because he is so in denial about the issue, and thinks he can successfully be a social drinker. Thank you for starting this blog and reaching out to all of us who are confused and silently suffering.
    I am beginning to realize (in a horrified way) that my husband is very self-absorbed. As I move forward in my own recovery and practice (some days with success, some days not so much) healthy detachment, the self-absorption seems to grow. I'm beginning to think that he is not able to see me as anything but a cog in the wheels of his world, and he can't see past his own nose to understand the needs of his family. I wanted to throw this observation out there in the wind - do you - or anyone else who follow this blog - see this type of self-absorption in their drinking loved one?
    Thank you, thank you, thank you.

  8. Thank you for sharing your story. I have been reading and coming back to the site several times in the last month. I noticed there have not been recent posts and I hope you will start to post again as your experiences and insights touch so many of us.