In September, the US and Canada celebrate recovery at the national level by highlighting the benefits of prevention and treatment for alcohol use disorders (AUD). Consequently, the most recognizable and celebrated aspect of recovery is often that of the individual with an AUD. Little or no mention is made of how their families and friends are affected; yet according to addiction professionals that participated in a panel of professional speakers sponsored by Al‑Anon Family Group Headquarters, those closest to the drinker can benefit from their own recovery, but they must first recognize that they have been adversely affected.

When alcohol addiction or an alcohol use disorder are present in families, everyone is affected, including the children. Non‑drinkers often suffer with issues such as depression, emotional, mental, and sexual abuse, etc. Children and adolescents may not verbalize what is happening going in their home, but there are clues that teachers, school psychologists and others can see, such as signs of neglect, dressing inappropriately, poor hygiene, or they may be withdrawn.

Although professionals in fields such as psychiatry, psychology, and education may be able to see the signs of a family dealing with an alcohol or substance use disorder, those affected may not. They may readily talk about by what is wrong in their lives and what they are trying to correct but are often not ready to broach the subject of addiction within the family. If asked directly about this issue, they may become defensive and uncommunicative. In order to help them see the impact of a loved one’s addiction to alcohol upon the family, professionals listen for their clients’ emotions, ask questions, and move with the patient until they are ready to move into the topic of addiction.

The goal is to help the patient realize that although they are not the one with the alcohol use disorder, they have been adversely affected and they can experience recovery even if their loved one continues to misuse alcohol and/or drugs.

Al-Anon Family Groups, which includes Alateen for teenagers, provide support to anyone affected by someone else’s problem drinking. *Ninety-three percent of members report that their lives have been very positively affected by Al‑Anon Family Groups and forty‑two percent that receive professional services and attend Al‑Anon meetings feel that since coming to Al‑Anon, they have seen an improvement in their treatment, counseling, or therapy.

*2018 Al‑Anon Family Group Membership Survey.

This professional panel interview was recorded at the Al‑Anon International Convention 2018 in Baltimore, Maryland. The professionals interviewed were:
Nancy Duff‑Boehm, PH.D., Clinical Psychologist, Cleveland, Ohio, USA
Mintie Grienke, M.ED., Counselor/Psychotherapist, Winnipeg, Manitoba, Canada
Ann McGreevy, MA, Supervisor of Psychological Studies at FCPS, Frederick, Maryland, USA
Hugh A. King Jr., MD, Psychiatrist, Mandeville, Louisiana, USA

Disclaimer:

Al‑Anon cooperates with therapists, counselors, and other professionals, but does not endorse, oppose, or affiliate with any professional, organization, or entity. The opinions expressed here were strictly those of the person who gave them. Their comments reflect their professional expertise and use of Al‑Anon as a resource for their clients and patients who are or have been affected by an individual’s addiction to alcohol.

Moderator (off-screen): How do you identify when a family member is being affected by a relative or friend’s drinking?

Hugh A. King Jr., MD, Psychiatrist: Most of people that I’ve seen lately, as I said, I’m primarily in a general psychiatry practice, and our standard procedures to try to take some sort of a history about everything that might be a stress in a person’s life. And for the most part, people are willing to talk about that pretty easily. They talk about financial problems, economic problems, in-law problems, and addiction problems. And so, they’re not unwilling to talk about these particular sort of things, sometimes it’s difficult to have people realize that they need to do something about it too, as well as the alcoholic. That by stepping into their own 12 Step recovery program they sometimes can begin to modify some of the other person’s behavior, but certainly they can begin to take care of themselves, and that’s the most important thing at that time. Whatever’s going on in the addiction is going to make their underlying basic psychopathology worse if they’re mentally ill. In some sense schizophrenic, manic depressive, or major depressive, or personality disorders whatever additional stress in the form of alcohol addiction is going to make that particular problem worse.

Mintie Grienke, M. Ed., Counselor/Psychotherapist: The clients I see who are spouses of alcoholics are have an array of symptoms they present with and they are fairly open about it. They’re really emotionally broken down from many years of suffering in silence. They’ve sort of built a wall of isolation around them. They don’t have a social network. Their family and friends they have wanted to disclose what they are living with, but it’s too embarrassing and they have the shame factor; and finally they can talk to someone, and it’s safe for them to talk about what they’ve been experiencing. And it’s really – it’s evident that there’s a level of anxiety and depression that’s – that’s very evident there. They’re disappointed, all their hopes and dreams have been dashed. This is where they had invested so much of lives and their energy and they worked so hard to make this work and it’s – they just feel defeated. Yeah, so it’s a real emotional drain and they’re at a state of readiness, often when they come.

Nancy Duff-Boehm, Ph.D., Clinical Psychologist: Yeah, I have general psychology as well, like Doctor King and so my standard assessment includes questions about all areas of life, and one very specifically is about health-related issues, so I ask them about their exercise, I ask them about their nutritional habits, and I ask about tobacco, and I ask about alcohol in the family. And then I ask very specifically, in an adult, how much they drink, how often, and how many they will have, and then also about their spouse. So, it’s in the context of so many other questions that it’s very innocent. So people don’t have their defenses up, which is a good thing because really if I just start off going, “Ok, so what about the alcohol?” they’re absolutely – it triggers their denial and they’re not going to tell me the truth. Not because they are trying to deceive me, but because they’re– they’re denying it themselves that it’s a problem. So, I do feel I have to kind of pan back and look at the general in order to find where there’s an issue.

Ann McGreevy, MA, Supervisor of Psychological Studies at FCPS: When we’re doing psychological evaluations of children or when we are doing therapy with kids in school, and we are doing the same thing – doing a clinical interview. We are doing a background information, we’re getting parents – we’re getting information from parents. So often, it may be the parent who is the non-alcoholic parent who is filling out questionnaires and sharing information. And sometimes they share information, and sometimes they don’t. But as we are working with children, we can start to see that something is happening in their life, that is not going well. And sometimes it can be subtle, and sometimes we need to you know, we may never know but we know but we understand that something is going on in this child’s life that is really affecting their functioning. And then there are times when kids are just going to be right out there with it. And so, for example, I was talking to a therapist, and a child was having a significant behavioral eruption. He was in an alternative program already. So, he was already a child who could not function in his home school. He now had to go to an alternative school for kids with significant behavioral issues, and he was just having a terrible day and having a lot of disruptive behavior; but the therapist got him in her office, and she was talking to him, he finally said, “this is the only place I can come, where adults are not drunk.” So, I think we get the range of knowing how it’s impacting gets, but it’s impacting kids.