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.