Growing Up in an Alcoholic Family System Chapter 7 Growing Up in an Alcoholic Family System

Chapter Objectives Describe the scope of the problem and awareness of adult children of alcoholics. List several behavioral characteristics of adults who grew up in alcoholic homes. Compare growing up in an alcoholic family system with post-traumatic stress disorder (PTSD) and describe the five major symptoms of PTSD. Identify the scope of the adult-child of an alcoholic problem, including an estimate of how many people are affected.

Chapter Objectives Describe the behaviors and communication patterns of parents and children in an alcoholic family system. Describe the kinds of denial that children in an alcoholic system maintain and some behavioral characteristics of children of alcoholics. Define codependency and list the criteria of codependency. Describe the family disease model.

Chapter Objectives Describe the impact of alcoholism on marriage. Describe the thoughts, feelings, and behaviors of overseparated and overattached individuals. Discuss the rationale for doing grief work with adult children of alcoholics. Describe second-order change and changing interactions with family members. Identify the 11 curative factors of group psychotherapy and their applications to adult children of alcoholics therapy groups.

The Adult Children of Alcoholics Movement Bosma (1972) – ACAs as victims in a hidden tragedy 28 million Americans have at least one alcoholic parent. Children of alcoholics are frequently victims of incest, neglect, and other forms of violence and exploitation. ACA movement was a wildfire of information, education, and treatment.

Characteristics of ACA’s Fear of losing control All-or-none Fear of feelings Overdeveloped sense of responsibility Difficulty with intimacy Flashbacks of childhood, but many memory gaps Unreasonable loyalty Feelings of being like a child when under stress Addiction to excitement Difficulty relaxing Feelings of guilt Confuses love with self-pity Backlog of shock/grief Compulsive behavior Living in denial Guessing at what is normal Physical symptoms

Post-Traumatic Stress Disorder The following major symptoms of PTSD are similar to symptoms experienced by ACAs” Reexperiencing trauma as evidenced by: Nightmares Recurrent obsessive thoughts Sudden reemergence of survival behavior in the fact of events that resemble the original trauma Emotional overload Psychic numbing, as evidenced by Sense of depersonalization Sense of not fitting into one’s surroundings Feeling of emotional anesthesia

Post-Traumatic Stress Disorder Constriction of emotions Lack of feelings Sudden experience of a wall between self and feelings Confusion Physical reactions instead of feelings Feelings that emotions will be overwhelming Hypervigilance, as evidenced by Inability to relax Frequent startle responses Chronic anxiety Panic attacks

Post-Traumatic Stress Disorder Survivor guilt, as evidenced by Chronic depression A sourceless sense of guilt Intensification of symptoms by exposure to events that resemble the original trauma

Childhood in an Alcoholic Home Children in alcoholic homes learn to distrust their own observations and feelings, and they feel powerless to change the family system. Children do not realize that alcoholism and drug addiction is a disease that results in unpredictable behavior.

Identification of Children in Alcoholic Families Behavioral characteristics Superachievers or perfectionists Need to control their environment Display social disengagement from or excessive attention to peer groups Signs of physical neglect and/or physical abuse Unable to concentrate and sometimes showing marked variations in academic performance, especially when parents are in a binge pattern

Denial of Feelings Children maintain the illusion of normalcy. The following factors product damage in the lives of children of alcoholics: Role reversal Unpredictability Unavailability Social isolation

Codependency Diagnostic criteria for codependent personality disorder: Continual investment of self-esteem in the ability to influence or control feelings and behaviors Assumptions of responsibility to meet others’ needs Anxiety and boundary distortions Enmeshment in relationships with personality-disordered, drug-dependent, and impulse-disordered individuals

Codependence Maintenance of a primary relationship with an active substance abuser for at least two years without seeking outside support and/or exhibiting three or more of the following characteristics: Constriction of emotions Depression Hypervigilance Compulsions Anxiety Excessive reliance on denial Substance abuse Recurrent physical or sexual abuse Stress-related medical illnesses

Family Disease Model The family suffers from alcoholism, codependency, and enabling behavior. The family is organized around the alcoholic’s drinking and the consequences of that drinking. The family responds to the alcoholic in a codependent fashion. Family members disconnect from their own feelings, distorting their perceptions and invoking the “no-talk, no-feel, no-trust” rule.

Impact on Marriage Feelings of betrayal Continuous conflict Chaos Resentment Sexual problems Ambivalence

Grief Work Children in alcoholic families experience loss, violation, and trauma. Mourning allows feelings of loss to surface. Grief work requires the help of a professional therapist trained and experienced in ACA recovery.

Choice Making Changes involve integration and congruency with feelings and choosing not to respond in dysfunctional, codependent ways. Positive choices can establish the foundation for more significant growth-related choices later.

Second-Order Change Second-order change is a cognitive-behavioral technique to change the way one traditionally responds to situations and interpersonal interactions.

Changes in Family Interactions ACA’s may need to let their parents know how they feel about continued use of alcohol/drugs. Many ACA’s must let go and accept that their parents may never choose to stop using alcohol/drugs.

Group Psychotherapy Group psychotherapy is a process in which each group member gets feedback from other group members. The following 11 curative factors make group psychotherapy an effective process: Instilling hope, sharing universality, imparting information, fostering altruism, recapitulating the primary family group, developing socializing techniques, imitating behavior, sharing interpersonal learning, developing group cohesiveness, sharing catharsis, exploring existential factors