Alcoholism is a Family Disease

The debilitating and destructive nature of alcoholism is never contained to just the afflicted individual. It spreads its harmful effects far and wide, with those closest to the alcoholic bearing the brunt of its force.

If you are a family member of an alcoholic, you are most likely confused, frustrated, angry, and hurt by his behavior – and with one question burning foremost in your mind: “If he loves me, why won’t he stop?”

Why can’t he just stop?

The inability to “stay stopped” is a better indicator of alcoholism than whether the drinker can stop after one or two drinks.

A genetic predisposition to addiction has been shown to exist in many studies. This makes the drinker vulnerable to addiction, and this vulnerability varies among ethnic groups and within families. Alcoholism has been a diagnosable disease by the American Medical Association since 1957. The metabolization of alcohol produces a subjectively different effect for the alcoholic drinker than for the non-alcoholic. Cellular adaptation of the nervous system to the presence of alcohol produces dependence, and cravings on withdrawal or decreased use.

She promised that she was done drinking.

Alcoholics truly wish to put an end to their loss of control with alcohol, but they can’t. Every episode of over-consumption follows the same arc of rationalization, consumption, guilt, and resolution to quit. When an alcoholic tells a loved one that he or she is going to quit, they are usually sincere. But this sincerity is based on a strong sense of urgency or resolve to try harder to stay stopped. The alcoholic is ignorant of the illness, its effect on the brain, and the nature of withdrawal symptoms—both short term and long-term symptoms. Alcoholics can’t keep these promises. The goal therefore is to accept responsibility for getting treatment, and this is where the focus of family and friends should be.

He said it was my fault.

Alcoholics are deeply in denial about their problem and will do almost anything to shift the blame elsewhere. Because loved ones are often the ones who press the alcoholic the hardest about his problem, they also are most vulnerable to accusations that they are to blame for all the problems.

You are not at fault. Alcoholics don’t drink too much because they are under stress. They don’t drink too much because their spouses nag them. They don’t drink too much because they hate their bosses. These are simply rationalizations the alcoholic makes in order to continue drinking.

Alcoholics drink too much because they are addicted to the physiological effects on the nervous system from alcohol metabolization.

I keep having to cover up.

Family members of alcoholics often feel embarrassment at the alcoholic’s behavior and respond to this embarrassment by minimizing the problem or shielding the alcoholic from the negative consequences of their actions. This type of behavior by the loved one of an alcoholic is known as enabling. Its long-term effect is to make it easier for the alcoholic to avoid the direct or indirect consequences of the alcoholic behavior. The best way to help an alcoholic is to stop interfering with the natural progression of consequences.

How do I make him stop?

Unfortunately, no one can make an alcoholic stop drinking except the individual afflicted with the problem. Most alcoholics are unable to stop until their lives have become so unmanageable that it is no longer possible to deny that there is a problem. This bottom can be “raised”. This is done by intervention.

Intervention to confront the alcoholic about his problem can be an effective way to shock an alcoholic out of denial, but also may lead to anger, withdrawal, and further damage to the relationship. Only a trained professional should coach you in intervention, and only one with whom you feel comfortable and who is experienced in treating alcoholism. Interventions involve friends and loved ones of an alcoholic. Everyone is trained and rehearses their role prior to meeting with the alcoholic.

If she won’t stop, what should I do?

Family members of alcoholics are generally advised to detach themselves from the behavior of the alcoholic without detaching themselves from the person that they love. The art of detachment is best learned through counseling and a 12-step group called Al-Anon. Al-Anon was founded by families and friends of alcoholics so they could share their strength and hope with each other. Attendees benefit from their mutual support of others in similar situations, regardless of whether their loved ones are in recovery or attending Alcoholics Anonymous.