Effects of Alcoholism on the Family - Research Paper Example

?Running head: EFFECTS OF ALCOHOLISM ON THE FAMILY Effects of alcoholism on the family (school) Alcoholism has a significant impact on the family. First and foremost, it affects the alcoholic physically, making him vulnerable to various illnesses like cirrhosis of the liver, alcoholic hepatitis, and other organ dysfunctions. It also affects him emotionally, impacting on his ability to fulfill his family responsibilities, and making him vulnerable to depression, anxiety, and irritability. His alcoholism also affects his spouse, making the spouse co-dependent and a prime enabler. Attempts to maintain the family mythology causes the spouse to protect the alcoholic’s habits and to enable and excuse his alcoholism. It also affects the children with some of the children taking on the roles of the hero, the scapegoat, the mascot, and the quiet one as a means of coping with the parent’s alcoholism. It affects adult children, making them less able to function normally in society as they go through failed relationships and careers. The management of alcoholism includes cognitive-behavioral therapy for the alcoholic and for the patient. Family therapy and a drug regimen can also manage the alcoholism and teach the family proper coping techniques. The Effects of Alcoholism on the Family I. INTRODUCTION Alcoholism is one of the most pervasive substance addictions which many people suffer from. According to the US Centers for Disease Control and Prevention (CDC, 2010), about 52% of adults 18 years of age and above were regular drinkers in the year 2010; and only 13% of these adults were infrequent drinkers. Alcoholism is considered a dangerous addiction because it has been known to lead to alcoholic-related deaths and alcoholic-induced deaths, including homicide and accidents. Although the individual actively engaging in the addiction process suffers a variety of effects (physiological, emotional, etc.), the family of the alcoholic is not without effect or consequence. In fact, three out of ten adults reveal that drinking is a cause of trouble in their family, leading to various physical, emotional, financial, and social issues in the family (Alcohol Drug Abuse Resource Center, 2011). The examination of current research outcomes will culminate in the identification of those effects on the role of the alcoholic, the spouse and the children, and the delicate balance between them. II. BODY – The effects of alcoholism on the family and the roles they play within the family unit: the Alcoholic, the Spouse, and the Children A. Effects of addiction on the Alcoholic 1. Physiological Alcoholism has various physiological effects on the alcoholic’s body. According to the National Institute for Health (2005), alcoholism can have negative effects on the liver, the endocrine system, the bones, and the brain. According to the Distance Learning for Addiction Studies (n.d), it can cause dyspepsia, nausea and vomiting, recurrent diarrhea, recurrent abdominal pain, acute and chronic pancreatitis, gastrointestinal bleeding, and it can significantly impact on the liver. It can cause alcohol fatty liver, alcoholic hepatitis, cirrhosis, or ascites (DLCAS, n.d). Due to scarring linked with nodules, advanced necrosis can manifest and eventually cause cirrhosis of the liver. It is also known to cause cardiovascular issues, including cardiomyopathy, anemia, and dilated blood vessels where peripheral blood vessels dilate and cause the loss of body heat (DLCAS, n.d). It can also have a negative impact on the blood vessels. With each drink of alcohol, about 10,000 neurons are destroyed or are disconnected from the other brain cells. Neurons do not reproduce and therefore lost neurons are permanently lost. Alcohol is also known to increase the conductive material between brain cells, decreasing their electrical impulses and impacting the frontal lobes and affecting a person’s behavior patterns (DLCAS, n.d). In effect, he is sometimes unable to make long-term plans. It can also affect the person’s short-term memory. In some alcohol-addicted individuals, alcoholism can also cause seizures 7-48 hours after cessation of drinking. Chronic alcoholism has been known to increase and then decrease seizure threshold, and along with decreased glucose and changes in the electrolytes, alcoholism can cause seizures. It can also cause Vitamin B deficiency leading to muscle weakness and numbness; ataxia; insomnia; nightmares; hallucinations; muscle atrophy; alcoholic myopathy; inflammation of kidneys; amenorrhea; impotence; polyuria; and electrolyte imbalance (DLCAS, n.d). 2. Emotional Aside from the physiological effects, alcoholism can also cause emotional effects on the alcoholic. Due to damaged neurons and due to excessive alcohol in the brain’s cerebral cortex, a person’s thought processes may be affected, often causing a person to exhibit poor judgment (Addiction Intervention, 2010). Alcoholics who are intoxicated may be unable to control themselves and cry, be hysterical, become angry and physically abusive. Their moods may be very erratic and unpredictable (Addiction Intervention, 2010). Abstinence may cause them depression and anxiety, which then again triggers more bouts of drinking. Their inability to resolve their emotional issues often causes them to keep drinking in an attempt to block emotional pain (Addiction Intervention, 2010). Alcoholics are also known to manifest higher levels of aggression which is easily triggered and is greater in intensity (Bushman and Cooper, 1990). As a result, these alcoholics are easily irritable and often resort to aggressive methods to express their displeasure or assert their authority over other people. 3. Social Alcoholism has also various social effects on the alcoholic. An alcoholic who may sometimes manifest with erratic, irritable, and aggressive behavior can cause himself to be alienated from his friends. He may also have a broken and dysfunctional home life due to his alcoholism (About Alcohol, n.d). It can also destroy one’s relationship with a significant other who may not be able to handle and endure the constant drinking and the negative behavior associated with the alcoholism. B. Effects of alcoholism on the Spouse 1. Co-dependency Co-dependency is a behavioral condition which affects a person’s ability to have a health relationship (Mental Health America, n.d). It is sometimes known as relationship addiction because these people often create relationships which are lopsided or emotionally abusive. Spouses are usually affected by this type of relationship. Due to numerous interactions between an alcoholic and a non-alcoholic spouse, one spouse may develop co-dependency. According to Mendelhall, in Carruth and Mendelhall, 1991, p. 65), “co-dependence is defined as a primary condition resulting from stress produced by living in a committed relationship with an alcoholic person”. In this case, the non-alcoholic spouse seems to develop a programmed set of behavior as a reaction or response to the alcoholic spouse’s behavior (Carruth and Mendelhall, 1991). Such reaction may sometimes intensify, and these reactions often exacerbate the drinking, and cause a vicious cycle to take effect. This term was considered as a combination of other earlier terms like, co-alcoholic and para-alcoholic and it was used to describe the family members who were impacted by another member’s substance addiction (Beattie, 1987). As mental health professionals considered combining alcoholism with other substance-related issues under the term chemical dependence, they also started to talk about co-dependency (Kitchens, 1991). Co-dependency is mostly an unconscious addiction to the spouse’s alcoholism (Wekesser, 1994). Many alcoholics undergo moments of sobriety, and during such times, their spouses often believe that their problem can be resolved. Other people often actually do not know or believe that a person has a drinking problem. The lengths at which family members actually go through to hide the problem and protect their family’s reputation is such that most people believe them to be a perfect family (Parsons, 2003). These family members even avoid inviting their friends to their homes in order to hide their family member’s problem. These acts and behavior are part of the co-dependency problem. These co-dependent spouses often forget about their own needs and desires in life because they often devote their lives towards managing and controlling their partner’s drinking problem (Parsons, 2003). In the process, these co-dependent spouses often end up being the alcoholic’s enabler. 2. The primary or “chief” enabler An enabler is someone who “unknowingly helps the alcoholic by denying the drinking problem and helping the alcoholic to get out of troubles caused by his drinking” (Silverstein, 1990, p. 65). These enablers help the alcoholic get through the problems which alcoholism is causing. They are there to mop up the alcoholic’s vomit, to sober them up enough to go to work, to school, or to meet with friends. The enabler also lies for the alcoholic, both to protect the alcoholic and himself or herself from the shame and the questions which the alcoholism might bring (Parsons, 2003). These protective behavior, as well as attempts at making excuses for the alcoholic all help enable the drinking behavior, allowing the latter to drink again and enabling the alcoholic’s addiction. Experts point out that family members are often the enablers of the alcoholic’s addiction (Cummings and Cummings, n.d). In one instance, they would unknowingly provide temptation for the alcoholic in the form of a bottle of champagne or of wine brought home and put in full display. For recovering alcoholics, this may be too much of a temptation to resist, and they often end up drinking the alcohol. In another instance children reported by school authorities to police authorities for underage drinking or drug possession may later find themselves ‘saved’ by their parents who are likely to deny about their children’s addiction (Cummings and Cummings, n.d). The enabling process is a problem for both the alcoholic and the ‘enabling spouse.’ For the enabling spouse, some of them may have indoctrinated the feeling of being needed by their spouse, that because of their addiction their spouse would never leave them, and they would remain in charge. Some spouses also end up being the enabler because they see the need to maintain the family mythology (Cummings and Cummings, n.d). They feel the need to portray to the world the picture of a perfect family and so when instances manifest involving the alcoholic’s addiction, they would go to great lengths to conceal their spouse’s behavior. If they are physically abused, they cover their bruises with make-up or even physically hurt themselves in order to excuse their injuries. They even teach their children to be enablers, telling them not to tell anyone about their parent’s addiction. The children are even taught that their parent was just blowing off steam because he had been working hard all day (Cummings and Cummings, n.d). Consequently, the addiction is further supported and continued until it reaches the point of serious and inexcusable, sometimes fatal injury, to the alcoholic or to any family member. C. Effects of alcoholism on the Children 1. The development of distinct roles Due to the alcoholism in the family, the children are often forced to cope with their family situation, and they often cope in different ways and eventually they end up playing distinct roles within the family in order to cope with their parent’s alcoholism. a. The family hero The family hero role usually belongs to the eldest child. The family hero would likely feel the need to be perfect, to do good in school, to be involved in a variety of activities, and to appear successful and well-adjusted in their lives (Saul, 2010). By doing these things, they feel that they are doing what they can to manage their parent’s alcoholism. On a deep and emotional level however, these children often feel useless and helpless because despite their efforts, they are still unable to stop their parent from drinking. Nevertheless, they would continue to be the perfect children – to even as act second parents to their siblings by cooking, cleaning, and performing other parental duties in order to be the perfect child to their parents. For the most part however, many of these children would still feel helpless and feel like failures because of their inability to stop their parent’s alcoholism. b. The family scapegoat Other children also end up taking the role of scapegoat. Scapegoats often act out their feelings of anger and confusion (Saul, 2010). These children often act this way because they want to act out their feelings as well as their family’s frustrations. In order to divert attention away from their alcoholic parent, they cause a lot of disturbances and gain attention for themselves. They usually are the opposite of the family hero, in that they often have low grades, they get into fights, they are lazy, and they sometimes steal or get involved in misdemeanors (Saul, 2010). They also are likely to gain the attention of law enforcement authorities. Eventually, these children end up being the scapegoats of parents for their alcoholism and for the problems which the family is going through; they are blamed for the stress which they bring to their parents and the family (Saul, 2010). For the most part, the relationship of parents with these children often ends up being destroyed or disconnected. c. The lost child This child is also known as the quiet child who is often overlooked or ignored. In many instances, this is the middle child (Saul, 2010). These children do not actively try to gain attention for themselves because they fear that they might trigger the family alcohol problem. In order to avoid triggering the issue, they end up being anti-social, and eventually develop feelings of depression and rejection (Saul, 2010). Being the lost or quiet child, they are usually in their rooms, avoiding social contact with other family members, friends, classmates, and neighbors. d. The family mascot Some children, usually the youngest child, often end up playing the role of family mascot in order to cope with their parent’s alcoholism. This child often develops feelings of fear and anxiety and considers his role to be that of drawing attention away from the alcoholic parent, and to do this, he would try to be funny or cute (Saul, 2010). He would also likely act immaturely for his age, acting instead like the class clown. This is his way of protecting himself from his parent’s alcoholism. But even as he portrays a happy facade, he is however totally the opposite on a deep emotional level. 2. Adult children of alcoholics/addicts Adult children of alcoholics are also significantly affected by their parent’s alcoholism. These children sometimes to not see their issues as products of their problems growing up with an alcoholic parent (Parsons, 2003). These children manifest with depression, aggression, and even impulsive tendencies; they also often have substance addiction problems; and some of them find it hard to establish long-term and healthy relationships with other people (Parsons, 2003). They are sometimes failures as parents as well and have difficulties in gaining successful careers. They often feel like failures and are unable to provide for their families due to their own parent’s inability to provide them with their needs and with proper education (Parsons, 2003). These children have issues with trust, and they find it hard to bring down their guard enough to allow feelings of love for anyone because they fear being hurt of rejected. Eventually, they may end up having relationships with an alcoholic or becoming alcoholics themselves (Wekesser, 1994). D. A family’s ability to heal and restore functioning 1. Treatment for the addict There are various treatment options for alcoholics. In a paper by Longabaugh and Morgenstern (1999), the authors set out to consider cognitive-behavioral therapy in the treatment of alcoholism. This approach is aimed at improving the alcoholic’s cognitive and behavioral processes and changing their drinking habits. This approach covers various approaches which differ in terms of duration, content, and treatment setting. It is considered one of the more effective therapies for alcoholism as it considers the very core of the addiction and helps the patient-respondent make changes in his behavior and reaction to stimuli or alcoholic triggers (Longabaugh and Morgenstern, 1999). This therapy is about changing the alcoholic’s perception and cognition of a phenomenon or of triggers, teaching the patient to not act in the usual way, which is to resort to alcohol; instead, it teaches him to adjust his behavior and respond to the phenomena in other ways. Drug treatments are also recommended for alcoholics. In a paper by Johnson, (2010) the authors set forth that drugs which impact on the neural pathways which modulate activity of the cortico-mesolimbic dopamine system have manifested efficacy in changing drinking behavior. Some of these drugs include Ondansetron, naltrexone, topiramate, and baclofen (Johnson, 2010). In order to gain maximum efficacy with these drugs, it is important to classify the alcoholics first into any of the following: early-onset type, with chronic symptoms and strong biological predisposition to the disease; and late-onset type, caused by psychosocial factors and mood swings (Johnson, 2010). Even as initial results on pharmacogenetics have been promising in managing alcoholism, treatment is still dependent on proper assessment processes on the patients. Proper assessment can provide a proper diagnosis and evaluation of the patient’s alcoholism. 2. Treatment for the family Family therapy is being recommended as a means of treating alcoholism. This type of therapy focuses on the emotional life of the entire family, not just its individual members. Family therapy can either cover couples or the whole family, from the parents to the children; this type of therapy is meant to alter the family’s relationship, and helping the family avoid the occurrence of issues (Collins, 1982). This family therapy process is a helpful process for alcoholics and their families because it can help address their issues as a family. It can also give them a chance to define their perceived roles in the family, and to evaluate and discuss how it affects their lives, their activities, and their normal processes (Rotgers, et.al., 2006). Family therapy also helps identify the strains in the relationships and it helps define the goals for the family. Such strains in relationships can help establish the different issues which affect the relationships of each member with each other, especially the alcoholic parent. Moreover, by defining and identifying each member’s goal, the goals of the entire family can also be established and a plan to meet such goals can then be formulated (Rotgers, et.al., 2006). In these instances, the members of the family are no longer playing distinct roles as the “family hero,” or “the alcoholic” or “the scapegoat.” Through family therapy, they are just identified as either parents or children who want to seek better goals for each other and for the entire family. Cognitive-behavioral therapy can also work well in counseling the family. This type of therapy can assist members of the family in improving their coping skills for adversity and for the alcoholism in their family circle (Lipps, 2008). Behavioral therapy can be integrated into the family therapy aspect of alcoholism care. It can teach the members of the family how to behave in ways which would not be as destructive to their psyche or to their family relationship. This therapy also allows the members to recognize their issues and to teach them how to deal with said issues, not as alcoholics, but in logical, and healthier ways. III. CONCLUSION A. Analytical summary 1. A family household system The family household system includes the parents, children, and for some families, the extended family network. They are all affected by the alcoholic’s habits and the family system is sometimes skewed based on the member’s coping mechanisms. 2. Effects of addiction on family members and their roles Addiction affects family members in terms of their roles, with the alcoholic unable to fulfill his responsibilities, and with his behavior being erratic, irritable, aggressive, and in some instances, abusive. The non-alcoholic spouse often acts to protect the family mythology and in the process conceals and makes excuses for the alcoholic’s behavior and habits. The non-alcoholic spouse becomes co-dependent and becomes the primary enabler of the alcoholic’s habits, covering up for his absences at work, and making excuses for his abusive and aggressive behavior. Children of alcoholics also eventually take on various roles while they cope with their parent’s alcoholism. They become the family hero and try to be the good and responsible child; or they try to be the scapegoat and act out negatively to draw attention to themselves and away from their alcoholic parent; or they become the quiet child who hides himself in his room, acting ambivalent towards the things happening in the family; or they become the mascot, the clown, or the seemingly unaffected party in the parent’s alcoholism. As these children get older, they often have difficulties establishing strong relationships as they are distrustful of other people; they also experience difficulties financially and in their careers. Many of them end up being alcoholics themselves. 3. Impact of treatment and family therapy Treatment and family therapy can serve to assist not just the alcoholic but the family as well. Cognitive behavioral therapy can help manage the alcoholic’s behavior, breaking him out of his habit of drinking and teaching him other means of reacting to certain alcoholic triggers. Drugs which impact on the neural pathways which modulate activity of the cortico-mesolimbic dopamine system can also be used to assist the alcoholic into breaking his habit. As for the family members, family therapy can help the family cope with the alcoholic’s habit, teaching them proper ways to cope without having the alcoholism totally damage their lives, their careers, and their future. B. General summary Alcoholism has a significant negative impact on the family. It affects the alcoholic negatively by putting him at risk for liver cirrhosis, low blood sugar, and other physiological affectations; and it also affects him psychologically, causing depression, aggression, anxiety, and irritability. It affects the family in terms of coping abilities and family roles, forcing them to perform functions which they would not normally have played in a normal family setting. C. Closing statement Alcoholism is unfortunately a pervasive problem in our society and it has a negative impact on the family and on the alcoholic himself. It potentially damages their relationship with each other and it can sometimes destroy their future. These family members may sometimes manifest adequate coping skills, when they present as heroes or as mascots, but they are harboring deep feelings of pain. With adequate therapy and assistance, these members can potentially gain improved skills in coping and thereby gain better futures. 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