Children of Alcoholism: The Struggle for Self and Intimacy in Adult Life

CHAPTER 1. Alcoholism and Co-Dependence

I ALCOHOLISM AND CO-DEPENDENCE THE PREVALENCE of addictive disorders in the United States today challenges mental health professionals in complex and frustrating ways. Current research and theory in this field are concerned principally with unlocking the riddle of psychic and physical compulsion, but the solution remains elusive . We are confronted with the likely, and intimidating, prospect that there are many addictions-just as there are many cancers-and that treatment must be creatively tailored to individual need and circumstance. As professional interest in the addictions increases, while the literature that forms our foundation of knowledge about this problem expands, practitioners of clinical psychiatry and psychology are recognizing what the "Anonymous" organizations have understood for years: The debilitating effects of alcoholism and other chemical dependencies are not confined to the addicted individual alone. Spouses, parents, children, even friends and colleagues of addicts, may suffer a progressive psychological , emotional, and spiritual deterioration that mirrors that of their chemically dependent loved one. The phenomenon of "codependence " is now accorded an attitude of respect and concern in the literature and in the consulting room, and this is as it should be. It should come as no real surprise that entire families fall ill 2 Children ofAlcoholism when one member develops a chronic dependence on psychoactive chemicals. After all, any severe, long-term illness tends to preoccupy a family and create an atmosphere of tension, anxiety, and conflict. Chemical dependency is especially problematic in this regard, since it is so little understood in general, and so badly misunderstood by the lay community and so many members of the medical and mental health professions as well. Families experience intense shame about addictive problems, since they mistakenly believe that compulsion is a moral failing. This shame causes them to isolate themselves from potential sources of support, comfort, and assistance. Furthermore, when spouses, parents, or children from chemically dependent families do reach out for help, they often receive advice that is bad or confusing in that it conflicts drastically with the judgments proffered by some other authority. Or they may receive no advice at all. For these reasons, addicted families turn in on themselves, and struggle all alone to contain and subdue an affliction that they do not understand. In most cases they sink more and more deeply into the problems created by the illness, and are consumed by them. The dependent individual usually suffers the most obvious deterioration, since chronic heavy use of most psychoactive drugs exacts a substantial physical toll. This is especially true when the drug of choice is alcohol, a substance that is so profoundly devastating to all the major organ systems of the body. The psychic devastation of addiction is equally profound, however , as the addict's available mental energy becomes increasingly organized around the pursuit and use of chemicals, and the need .to preserve his or her failing self-esteem by denying and compensating for the progressive loss of control. The pain of a spouse, or parent, may be less immediately visible, but it is no less severe. Though these unhappy people are spared the direct physical consequences of addiction, they likely suffer from one or more psychosomatic conditions that are caused or aggravated by chronic stress. They may also be Alcoholism and Co-Dependence 3 physically abused by the addict, who is intermittently and progressively stripped of normal inhibitions against violent behavior . They almost always suffer great emotional abuse from the addict, who unconsciously defends against the humiliation and terror of loss of control by blaming it on the people closest at hand. Saddest of all, the lives of spouses and parents are often diminished, year after year, by a vain, preoccupying effort to control and hide what can never be truly Hcontrolled" and what is rarely capable ofbeing concealed from any sensitive, relatively objective observer. In the end, however, it is the children of alcoholism and other drug dependencies who are the most tragic victims of this disease . Since their parents are, in most cases, devoted to concealing what they consider to be a shameful problem, and since the medical and mental health professions have only just begun to discover the problem of co-dependence, children are usually silent victims as well. The varied and severe forms of disability that are common to this group often go unrecognized and untreated , or are, in many cases, misdiagnosed and inefficiently treated. Yet, the portion of their suffering that is...