Alcoholism: Accepting People As They Are?

Alcoholism, or alcohol use disorder, is a legitimate medical condition that can have a detrimental effect on the lives of both the person suffering from it and those around them. It is often challenging for people to accept the unacceptable behaviours that come with it. However, it is crucial to understand that the person suffering from alcoholism is grappling with a lot of fear and shame and that their brain chemistry may have changed due to alcohol abuse, making it difficult for them to quit. This article will explore whether one should accept people for who they are as alcoholics and provide strategies for dealing with a loved one's alcoholism while taking care of one's own well-being.

Alcoholism is a disease, not a personal choice

Alcoholism, or alcohol addiction, is a chronic disease of the brain characterised by compulsive decision-making, impulsive behaviour, and relapse. It is caused by genetic and environmental factors, which lead to biological changes in the brain. These changes make it extremely difficult for those suffering from alcoholism to abstain from alcohol without medical treatment.

Alcohol use disorder (AUD) is defined by the National Institute on Alcohol Abuse and Alcoholism as a "chronic relapsing brain disease characterised by compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state when not using". Brain scans have revealed atrophy, or wasting away of cells, in the brains of alcoholics, particularly in the frontal lobe, which is responsible for memory, decision-making, behaviour, and executive function. Other scans have shown damage to the nervous system and brain stem, causing issues with problem-solving and emotional regulation.

The disease model of alcoholism is not universally accepted, with some arguing that it is not needed to justify medical intervention or a caring approach to those dependent on alcohol. However, the majority of sources assert that alcoholism is a disease, and that this is supported by scientific evidence.

Alcoholism can have a devastating impact on the lives of those suffering from it, as well as their loved ones. It can affect daily routines, relationships, work, eating habits, sleep, and exercise. It is important to remember that it is not the fault of those close to the alcoholic, and that the alcoholic is often unable to control their drinking, no matter what others may do or say. While it can be difficult to accept the unacceptable behaviour of a loved one, it is important to set clear boundaries and encourage them to seek treatment.

How to talk to an alcoholic

Talking to a loved one about their alcohol consumption can be challenging, but it is a necessary step towards helping them. Here are some strategies to approach this conversation effectively:

Prepare and Plan:

Before approaching your loved one, educate yourself about Alcohol Use Disorder (AUD) to understand what they might be experiencing. Making a plan and writing down your ideas can help structure your thoughts during the conversation. Focus on expressing your concern about their drinking and how it impacts you. Use "I" statements to convey your feelings and avoid accusations or blaming language.

Choose the Right Time and Setting:

Select a calm and private setting, like their home, where they are likely to feel comfortable. Avoid approaching them when they are intoxicated, as they may not be receptive to your concerns or able to engage in a meaningful discussion.

Express Concern and Empathy:

Genuinely express your worry about their health and well-being. For example, say, "I'm concerned that drinking so much every day is harming your health. I've noticed you're sleeping all day on weekends." Use empathetic statements like, "I know you've been under a lot of pressure at work lately."

Offer Options, Not Demands:

Instead of making demands or giving ultimatums, present options and suggestions. For instance, say, "I was wondering if you would consider seeing a doctor to talk about your alcohol use."

Avoid Enabling and Accepting Unacceptable Behavior:

Do not take responsibility for their actions or make excuses for their behavioral lapses. Avoid accepting unacceptable behavior, no matter how small the incident. It is not your job to "fix" or control their drinking.

Encourage Treatment and Provide Support:

Encourage your loved one to seek professional treatment, counselling, or support groups. Offer to accompany them to appointments or meetings. Emphasize that quitting drinking is possible, and many others have struggled with similar issues.

Remember, this conversation may take time, and your loved one may need multiple conversations before they are ready to accept help. Be patient, persistent, and supportive throughout the process.

Setting boundaries with an alcoholic

Setting boundaries is crucial when dealing with a loved one who has a substance use disorder. Without them, the relationship can become toxic, and both parties may suffer emotional and psychological consequences. It is not your responsibility to "cure" their AUD. You just happen to love someone who is probably going to need professional treatment to get healthy again. That's their responsibility, not yours.

To set boundaries, you first have to know what they are, but also why they matter. Brene Brown defines boundaries as “what’s okay with you, and what’s not okay with you”. She also points out that without boundaries, there is no autonomy in the relationship, just enmeshment. Boundaries help us keep our sense of self in a relationship.

• No drinking or using in shared spaces: Establish a firm rule that substance use is prohibited in your home or any shared environment. This removes triggers and reinforces the idea that addiction should not dominate the household.
• No financial support for addiction: Do not provide money that could be used for drugs or alcohol. Many loved ones fall into the trap of believing they are helping by giving financial assistance, but this often prolongs the addiction.
• No covering up or lying: Do not make excuses for their behaviour or cover up their mistakes. If they miss work due to drinking or using, allow them to face the consequences rather than rescuing them. Making excuses for their behavioural lapses reinforces that their behaviours are acceptable.
• Create a plan for handling relapses: Addiction is a chronic disease, and relapses can happen. Establish a plan for how to handle relapses, such as seeking immediate treatment or implementing stricter boundaries.
• Know when to walk away: Sometimes, the healthiest choice is to distance yourself. If the relationship becomes emotionally or physically abusive, prioritizing your safety is crucial. Loving someone does not mean tolerating harmful behaviour. Setting a boundary for yourself may mean ending the relationship if it becomes detrimental to your mental or physical health.

It can be challenging to establish boundaries with an alcoholic, especially if they did not previously exist in the relationship. It is up to you to set and enforce these boundaries to maintain your own sense of safety because addiction can lead to a lack of boundaries and frequent boundary-breaking.

The impact of alcoholism on relationships

Alcohol use disorder (AUD) can have a detrimental impact on relationships, affecting every single relationship a person is part of. It can lead to lost friendships, estranged marriages, and family conflict. AUD can severely impact an individual's personality, causing them to become secretive, lie, and devise excuses to hide their drinking problems. This can result in trust issues and resentment in relationships.

The financial burden of AUD can also strain relationships, as the cost of alcohol and increased medical expenses can lead to financial difficulties. Additionally, job loss due to frequent drinking is common, further impacting finances. AUD can also result in a lack of intimacy and emotional availability in relationships, with individuals experiencing sexual dysfunction and memory loss.

The risk of domestic violence is higher when one or both partners have AUD, and infidelity is also more likely. Spouses of individuals with AUD report elevated rates of anxiety, depression, and somatic concerns, as well as decreased marital satisfaction. AUD can also negatively impact children, with studies showing that growing up in a home where alcohol use is common can leave lasting scars.

When dealing with a loved one's AUD, it is important to set clear boundaries, encourage treatment, and not enable their behaviour. It is not your responsibility to cure their AUD, and professional treatment is often needed. It can be exhausting and terrifying to cope with a loved one's AUD, and seeking support for yourself is crucial.

While it can be challenging, allowing your loved one to experience the natural consequences of their alcohol use can motivate them to seek help. Communicating directly about the changes you want them to make regarding their alcohol consumption is essential. Remember, AUD is a treatable disorder, and recovery is possible.

Seeking support for yourself

Dealing with a loved one's drinking problem can be emotionally draining and take a toll on your health and well-being. It is important to remember that you are not alone in your struggle. Alcoholism and alcohol abuse affect millions of people from all walks of life. Here are some ways to seek support for yourself:

Educate yourself

Educate yourself on the dangers of alcohol misuse, as well as treatment and rehabilitation methods. This knowledge will help you understand your loved one's situation and make informed decisions about seeking help.

Set boundaries

It is important to set clear boundaries with your loved one. While you can support their recovery, do not enable their unacceptable behaviour or take their actions personally. Protect yourself and any children from the negative impact of alcohol abuse.

Seek support

You don't have to go through this alone. Turn to trusted friends, family, or a support group. Consider joining a group such as Al-Anon, a free peer support group for families dealing with a loved one's alcohol abuse. Therapy or counselling can also help you navigate the challenges and provide you with tools for coping.

Take care of yourself

Self-care is crucial when dealing with a loved one's alcoholism. Make sure to practise self-care and seek professional help if you are experiencing symptoms of anxiety or depression. Eat well, get enough sleep, and exercise to maintain your health and resilience.

Be patient

Recovery is an ongoing process that requires time and patience. Your loved one may go through several attempts to quit before they are successful. It is important to be supportive and encouraging during this journey.

Frequently asked questions