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Alcoholism and Recovery during the Holidays
Often during the holidays there is concern that there will be an increased rate of relapse among sober alcoholics because of “holiday stress”. There are two myths here: one, that alcoholism and alcoholic relapse is due to stress, and two, that all alcoholics experience increased stress during the holidays. Much of society, and nearly all codependents, believes that alcoholism is due to experiencing high levels of stress. Not true.
The hospital I worked in had an active aftercare program for over twenty-five years. They kept patient follow-up records during that time. Every year, some of the staff and a few people in the community would want the hospital to put on a special program to deal with holiday stress for the aftercare patients in order to avoid relapse. Several of those years I checked with aftercare patients regarding their personal experience. One year when I asked for feedback from the group, there was about 75 recovering patients (from a few months to several years) and about 75 family members. Approximately half of the group was quite worried about the nearing holidays. In checking closer, it was nearly 100% family members or close friends who were concerned. They often talked about terrible Christmases from the past being ruined because of a family member’s drinking. They described their fear, embarrassment and financial hardship. The holidays had truly been a horrible experience for many of them. Several described doing their best to keep their loved one sober during the holidays with disastrous results.
When the recovering alcoholics were asked about holiday relapse, very few had any particular concerns and the few who did said New Years Eve might be a temptation. Most who discussed relapse didn’t attach it to any particular time of year. Often fear of complacency, needing mood altering medication for dental work or pain and making bad decisions were their primary concerns.
When soldiers were drafted during World War II there was a concern that the sober alcoholics wouldn’t be able to stand the stress of war. However, their records of sobriety were outstanding! It is described in the book The Twelve Steps and Twelve Traditions.
Interesting and reoccurring stories were told by the recovering crowd. The host who insisted on making them a drink that looked like an alcoholic drink but without the alcohol came up frequently. Only those very early in recovery seemed to appreciate that. They didn’t want people to know they weren’t drinking. Alcoholics who had several months to years of recovery had various reactions, from seeing it as good but misguided intentions to a few finding it annoying and demeaning. Those with the most recovery time tended to see it as humorous.
In the Big Book the story of Doctor, Alcoholic, Addict gives some insight into the nature of addiction. I happened to be fortunate enough to hear the author speak at events two times.
He explained how very late in his alcoholism when his very survival was at stake he had an insight into craving. He could not see himself like other alcoholics; he didn’t crave the alcohol or drugs, he just always returned to using sooner or later. The physician had a pharmacy in his own home. He discovered that physical craving for him was unconscious. When he had pain pills or sleeping pills in the house he didn’t crave them; instead he developed the symptom that required that medication. So if there were sleeping pills available he developed insomnia. If there were pain pills available his unconscious mind developed pain.
It is easy to over think this process, but understanding the basics of alcoholism and addiction is not difficult. The situation that gets in the way is being told myths for so many years. It is very difficult to clear our mind of this old and dangerous information. By protecting active alcoholics from the consequences of their behavior (stress) frequently we assist them in continuing their addiction onto even more disastrous consequences.
When I was a child I often entertained myself by reading what my grandmother called her doctor’s book. It was about a foot thick and contained information from the most prestigious doctors of the mid-eighteen hundreds. It was clearly stated that it was the consensus of these doctors that diabetes was due to gluttony and therefore was a moral failing. My grandmother lived to be nearly one hundred years old and to her last day on earth avoided contact with diabetics because of their moral condition. Sometimes I think a portion of our society hasn’t progressed a lot since that time.
For more insight into the nature of addiction read Beyond the Influence: Understanding and Defeating Alcoholism By Katherine Ketcham, William F. Asbury, Mel Schulstad, Arthur P. Ciaramicoli. Also, Relapse Traps by Ronald L. Rogers and Chandler Scott McMillin is excellent.
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The Difficulty of Discussing Codependency
When I have spoke to groups about family issues associated with alcoholism nearly always several controversial issues came up and it makes little difference if the group was professionals or the general public.
Here are some examples:
1. Codependency is a meaningless term so isn’t it just a way to create a problem to make money?
2. Codependents don’t respond to treatment, they’re impossible to treat, so why bother?
3. There is a fine line between codependency and helping, how can anyone tell?
4. Doesn’t stress management solve both the family problem and the alcoholism?
5. Why are the treatment centers blaming the family for the alcoholic’s problems?
6. Why worry about excessive nurturing, it doesn’t really harm anyone?
7. Can’t this all be solved by referring them to mental health services?
8. This is just the way mothers behave why is that a problem?
9. We all know those called codependents are women isn’t it just a way to blame women?
10.Codependents are high performers why is that a problem?
Let me answer some of the common questions.
1. Codependency is a meaningless term for those without a specific and realistic definition of the term. For clarity of the meaning of codependency check out Diagnosing and Treating Co-Dependence: A Guide for Professionals Who Work with Chemical Dependents, Their Spouses, and Children (Professional Series) By Timmen L. Cermak. There is an avalanche of information on codependency that is vague and general some of it is misleading. There are very limited resources for a professional level of training on the subject. I always wonder when Tina Turner sang “What’s Love Got to Do with It” if she may have been considering codependency.
2. This is frequently the belief of those that work in chemical dependency treatment centers. The primary client is typically an alcoholic whose insurance pays the bill. There is no reimbursement for treating the family issues. Very few treatment centers have more than minimal information on treating the family and there is no incentive due to the lack of reimbursement. Treatment centers use families to keep the alcoholic in treatment. In the few places that do have a professional level of staff and program the results are excellent. Patients pay for their treatment and are the primary client. I have referred patients to these facilities and each person has returned and told me after years of conventional therapy this was the first time with life changing results. Groups tend to be more helpful for codependency than one to one therapy.
3. Those that believe there is a fine line between helping and codependency have no understanding of codependency. Codependency is not helping it is supporting pathology. It is often easy to tell the difference. If the goal is simple, realistic and clearly understandable it is rarely is codependent behavior. If the goal cannot be stated clearly and ends up being vague and general usually accompanied by long explanations it is highly likely codependent behavior. And don’t forget codependency behavior always supports pathology.
4. Contrary to popular belief extreme stress is the result of codependency and alcoholism. Those with serious codependent behavior seek out stressful situations and keep the external drama slightly higher than their internal drama to avoid their internal chaos.
5. Some employees of treatment centers do blame the family however most do not. They do often fail the family by implying they have as serious a problem as the alcoholic and then offer them inadequate solutions if any at all. Many families soon sense that they are only involved to keep the reimbursed patient in treatment. Before we get judgmental about the treatment center we need to realize if there was adequate reimbursement there would be help available. Treatment centers are like any other business and need to make money to stay in business.
6. If codependency was excessive nurturing it would cease to be a problem. In 1990 at the request of several psychiatrists I started an inpatient and outpatient codependency program in a psychiatric facility. A typical patient was admitted to the hospital with a history of suicide attempts and many years of therapy. The physicians that referred there did not see the codependency issues as a minor problem they clearly said they believed it to be a life or death situation. They were admitted under a diagnosis of severe depression and their issues tended to be relationship problems associated with a significant other that was either an alcoholic or had a mental disorder. Insurance reimbursement was much more flexible at that time.
7. Various forms of treatment for alcoholism and what was originally called co-alcoholism by Joan Jackson (1954) have been around for many decades. Over the years referral of alcoholics and families to mental health service that did not specifically have addiction knowledge has been a disaster. It simply did not work. Referring families to therapists that do not have knowledge of addiction and associated issues have generally been reduced to rarely due to lack of positive results. Frequently the referrals have been limited to Alanon and to a family aftercare program if it is part of the chemical dependency treatment program. Alanon has really been most helpful to these troubled families.
8. If your mother or father behaved in a significant codependent manner you are very likely to have troubled relationships. Children grow up with what Timmen L. Cermak, Psychiatrist describes as under learning. Children grow up without the necessary skills to function well with other human being. That can leave them with the option of avoiding relationships as much as possible or living with constant relationship crises. Simply stated codependency is a form of immaturity. See Timmen L. Cermak’s work for additional information.
9. Starting about 50 years ago the Johnson Institute in Minneapolis, Minnesota started working on employee assistance program for business that included chemical dependency benefits. It was discovered that many companies were on the going bankrupt because they were not dealing with their alcoholic employees. This was costing business billions of dollars. Who was it that were heading up these programs that failed to deal with employee addiction problems you guessed it men. Later codependency was identified as a common problem in a number of the helping professions that included both men and women.
10. Codependency is a dysfunction not high functioning. Codependents are very likely to have burn out issues. They tend to have more than average disability claims and use a lot of sick leave. Those with codependent behavior have a very difficult time working with a team. A woman by the name of Susan King did professional training on codependency and I had the good fortune to attend some of her training session. She told us that the family member’s health is often as compromised as the alcoholics. This encourages us in our treatment center to do checks on blood pressure etc. and refer to a physician when indicate. I soon found out that Susan was right and the family members in most cases had severely neglected health issues.
For more information refer to Alanon or the following authors Timmen L. Cermak, Anne Wilson Schaef, Pia Mellody, information published by the Johnson Institute.
For information, referral or treatment contact one of the following agencies:
Sierra Tucson
http://www.sierratucson.com/sierratucson_articles/treating-codependency.php
800-842-4487
The Grief Recovery Institute
http://www.grief-recovery.com/ 818-907-9600
818-907-9600
I have no business relationship with either facility; however I have seen positive results due to their services.
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