Navigating Family Ties: Alcoholism And Boundaries

Alcohol addiction is a complex disease that affects not only the individual but also their family, creating emotional and psychological challenges for everyone involved. It is a pattern of alcohol use that involves difficulty controlling one's drinking, preoccupation with alcohol, and continuing to use despite negative consequences. The family dynamic, including mental and physical health, as well as finances, can all be negatively impacted by a loved one's drinking. When a family member is struggling with alcohol addiction, it can be challenging to know how to support them without enabling their behaviour. So, is it okay to dissociate from an alcoholic family member?

Recognising the signs of alcohol addiction

Alcohol addiction is a complex disease that affects not only the person struggling with addiction but also their family. It is characterised as a pattern of alcohol use that involves difficulty controlling one's drinking, preoccupation with alcohol, and a compulsion to drink despite personal and professional consequences. While the exact cause of alcoholism is unknown, it is believed to develop when frequent drinking results in chemical changes in the brain, increasing the release of dopamine and leading to a state of dependence. Recognising the signs of alcohol addiction is crucial for seeking help and supporting a loved one struggling with this disease. Here are some key indicators:

Behavioural Signs

• Impaired judgment, inappropriate sexual behaviour, aggressiveness, and mood changes.
• Poor social functioning, including problems in personal and professional relationships.
• Neglecting personal care and hygiene.
• Frequent falls or accidents.
• Recurring absences from work or school.
• Other substance use, such as cannabis, cocaine, or sedatives.

Physical Signs

• Unsteady gait and rapid, uncontrolled eye movements (nystagmus).
• Impaired attention or memory, including memory blackouts.
• Lack of coordination.
• Rapid heart rate (tachycardia).
• Slurred speech.
• Excessive sleepiness or stupor, which can progress to a coma in severe cases.

Drinking Patterns

• Craving alcoholic beverages and an inability to stop drinking.
• Drinking more or for longer than intended.
• Spending excessive time obtaining, consuming, or recovering from alcohol's effects.
• Repeated attempts to reduce alcohol intake, coupled with failures to meet obligations due to drinking.
• Giving up important social, recreational, or work activities in favour of drinking.
• Drinking in hazardous situations or despite having a medical condition exacerbated by alcohol.
• Developing a high tolerance for alcohol, requiring more to achieve the desired effects.
• Experiencing alcohol withdrawal symptoms, including negative physical and mental effects when reducing or stopping alcohol consumption.

If you recognise these signs in yourself or a loved one, it is important to seek professional help. Alcohol use disorder is assessed based on criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Treatment options include behavioural therapy, medication, inpatient medical treatment, and residential rehabilitation. Support groups and counselling can also aid in understanding and managing alcohol addiction.

Understanding the impact on the family

Alcohol addiction is a complex disease that affects not only the person with the disorder but also their family. The family dynamic, including mental and physical health, as well as finances, are all negatively impacted by a loved one's drinking. Children are particularly vulnerable to the adverse effects of parental alcohol use disorder (AUD). They may experience feelings of loneliness, depression, anxiety, guilt, anger issues, and an inability to trust. They may also be more likely to engage in substance use and develop obesity and smoking habits.

When a parent is preoccupied with maintaining their alcohol dependency, they often fail to meet their child's basic needs, including nutrition, safety, education, structure, consistency, affection, and healthcare. This can result in households filled with chaos and uncertainty, where children may be exposed to violence or a lack of stability in their family environment. Children may also take on a caregiver role for their parents or siblings, which can put a lot of pressure on them at a young age. However, some positive character traits can develop from this experience, such as resilience, empathy, responsibility, and determination.

The impact of a parent's AUD can also contribute to internalizing problems such as depression and anxiety disorders, as well as externalizing problems like delinquency and early onset of alcohol use in children and adolescents. Parental problem drinking can interfere with parenting skills and marital relations, leading to inconsistent and unpredictable behaviour that undermines a child's sense of order, control, and stability. It can also result in ineffective coping strategies and other problem behaviours being modelled for children, increasing their risk for alcohol and drug use and psychological problems.

It is important to note that the effects of parental alcohol misuse may also be influenced by co-occurring risk factors, such as poverty, conflict, and lack of family structure. These factors can impact children even in the absence of a substance use disorder. Understanding the patterns and dynamics of addiction can help family members prepare for and deal with the consequences. Seeking support through counselling, local support groups, or intervention services can assist families in managing the impact of a loved one's alcohol addiction.

Knowing how to support an alcoholic family member

Alcohol addiction is a complex disease that affects not only the person with the disorder but also their family. It can be challenging to know how to support an alcoholic family member without enabling their behaviour. Here are some ways to know how to support an alcoholic family member:

Understand Alcohol Use Disorder (AUD)

AUD is a pattern of alcohol use that involves difficulty controlling one's drinking, preoccupation with alcohol, and a compulsion to drink despite negative consequences. It leads to both physical and psychological dependence on alcohol. Understanding AUD can help you know what your loved one is going through and empower you to guide them towards professional help.

Learn about Enabling Behaviours and Set Boundaries

Enabling behaviours refer to intentionally or unintentionally protecting someone struggling with addiction from facing the consequences of their actions. It's important to set healthy boundaries and stick to them to hold your loved one accountable for their behaviour and encourage them to seek help. This also protects your own well-being and prevents codependency.

Encourage Safe Behaviours and Seek Professional Help

Focus on encouraging your family member to seek professional help for their addiction. Avoid making ultimatums or placing blame, as this may push them away. Instead, express your concerns from a place of care and compassion, sharing how their drinking has affected you and others. Prepare what you want to say in advance, balancing honesty with kindness.

Create a Supportive Environment

Once your family member begins their recovery, your role shifts to supporting their long-term sobriety. Create an environment that encourages sobriety by removing alcohol and triggers from their surroundings. Help them develop new, healthy routines and encourage activities that don't involve alcohol, such as exercise, hobbies, or spending time outdoors. Foster open communication and let them know they can talk to you without judgment.

Seek Support for Yourself

Supporting an alcoholic family member can take a toll on your well-being. Attend counselling or support groups, such as Al-Anon, to help you cope with the challenges of having a loved one struggling with addiction. It can be a relief to talk to others going through similar experiences.

Setting boundaries and seeking support

Setting Boundaries

• Understand the patterns and dynamics of addiction: Educate yourself about alcoholism, its causes, and its effects. This knowledge will help you prepare for dealing with the consequences of your loved one's addiction and better understand what they are going through.
• Recognize enabling behaviours: Enabling refers to intentionally or unintentionally protecting your loved one from facing the full consequences of their actions. Examples include making excuses for their alcohol use, covering up for them, or giving them money. Instead, focus on encouraging safe behaviours and assisting them in getting help.
• Set firm and healthy boundaries: Decide what is acceptable and unacceptable behaviour for you and communicate these boundaries clearly to your family member. Be consistent and stand your ground if they try to push back against these boundaries.
• Hold them accountable: Do not bail them out or cover up for them. Instead, hold your alcoholic family member accountable for their actions and the consequences of their addiction. This helps break the cycle of entitlement and creates a healthier dynamic within the relationship.
• Prioritize self-care: Take care of yourself and your own well-being. Set an example for healthy living by giving up recreational drug and alcohol use. Detach with love, meaning focus on your own mental health and do not allow the consequences of their addiction to harm you.

Seeking Support

• Attend support meetings: Consider attending family sessions or support groups such as Al-Anon, both of which can provide valuable information and guidance on dealing with a loved one's addiction. These groups can offer emotional support and help you feel less alone in your struggles.
• Utilize employee assistance programs (EAPs): If available through your workplace, EAPs can offer free counselling, referrals, and other resources for families dealing with substance use issues.
• Reach out to helplines: Several organizations offer free and confidential helplines that provide information, referrals, and emotional support. These include SAMHSA's National Helpline (1-800-662-HELP), the 988 Suicide & Crisis Lifeline, and the Partnership to End Addiction.
• Access online resources: Organizations such as the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and SMART Recovery provide research-based information, educational materials, and tools grounded in CBT and motivational interviewing.
• Seek therapy or counselling: Consider individual therapy or family therapy sessions to help you navigate the complexities of your loved one's addiction and its impact on your family. Therapy can provide a safe space to process your emotions and improve communication within your family.

Treatment options and recovery

Education and Understanding:

Start by educating yourself about alcohol use disorder and the nature of AUD. Understand that alcoholism is a complex disease involving both physical and psychological dependence on alcohol. Learn about the patterns and dynamics of addiction, including any accompanying medical and mental health issues such as depression or anxiety. The more you understand alcoholism, the better equipped you will be to support your loved one.

Intervention Services:

Consider seeking professional help through intervention services. Credentialed interventionists can guide you and your family in confronting your loved one about their addiction while demonstrating care and concern. Intervention services have a high success rate in getting individuals into treatment and can help your family member recognize the need for professional help.

Outpatient and Inpatient Programs:

Outpatient programs offer counseling and therapy while allowing your family member to live at home and continue daily responsibilities. Intensive Outpatient Programs (IOP) provide structured support and several hours of therapy sessions per week. Inpatient rehabilitation, on the other hand, involves intensive treatment in a structured environment for individuals who need full-time support to break their addiction.

Detox Services and Medical Supervision:

Detox services provide medical supervision to safely manage the symptoms of alcohol withdrawal, which can sometimes be dangerous. Medical professionals can help your family member navigate the physical and psychological challenges associated with withdrawal and reduce the risk of relapse.

Behavioral Therapies and Counseling:

Therapies such as motivational enhancement therapy can help your family member change their thought processes and develop skills to cope with triggers and avoid alcohol misuse. Contingency management approaches use tangible rewards to reinforce positive behaviors such as abstinence and regular attendance at treatment sessions. Couples and family counseling can also play a crucial role in repairing and improving family relationships affected by addiction.

Support Groups and Ongoing Support:

Encourage your family member to attend support groups such as Al-Anon or Alcoholics Anonymous (AA). These groups provide ongoing support, help individuals maintain sobriety, and connect them with others going through similar experiences. Additionally, seek support for yourself through friends, family, community, or support groups specifically for family members of addicts.

Set Boundaries and Avoid Enabling:

It is important to set healthy boundaries and avoid enabling behaviors. Enabling refers to protecting your loved one from facing the consequences of their actions. Instead, support them in getting help for their addiction, hold them accountable, and focus on encouraging safe behaviors.

Remember, recovery is a journey, and setbacks may occur. Be patient, compassionate, and supportive throughout the process. The treatment options outlined above can guide your family member towards a healthier and sober life.

Frequently asked questions