Problem drinkers and their families

It is often assumed that problem drinking is only a problem for the drinker.  This may be linked with the idea that all problem drinkers are ‘alcoholics’ or heave-end dependent drinkers who live on the streets and are isolated from normal social contacts.  Both of these stereotypes are very far from the truth.  The vast majority of problem drinkers are in employment.  They may be dependent drinkers or binge drinkers or people who just drink too much on a regular basis.  Similarly the great majority of problem drinkers live in families and those families are greatly affected by the consequences of the drinking.  It is estimated that for each problem drinker in this country, three or four other people are directly affected and many more suffer indirect harm.  Nor should the scale of the problems families suffer be underestimated.  Those problems are all-pervasive; they affect the functioning of family systems, relationships and routines; they damage the quality of individual life experience and the life opportunities of those who suffer them during their formative childhood years.

Husbands, wives, partners

Alcohol is clearly a factor in marital discord and is cited as such by more than a third of those petitioning for divorce in the United States.  Imagine living with someone who is permanently depressed, who suffers from mood swings and who comes home drunk at predictable or unpredictable times.  Or maybe the drinker you’re living with drinks at home and either withdraws from all interaction with the family or presents themselves as a vibrant dominant personality who monopolises your attention.  Some drinkers behave in all of these ways at different times; sometimes becoming maudlin and self-pitying, sometimes becoming verbally or physically aggressive.  In company they may present as charming, well-functioning and amusing; at home they may be mean-spirited, manipulative and spiteful.  Dr Jekyll and Mr Hyde is a phrase frequently heard on the lips of partners.  Typically the drinker denies responsibility for the problems they are causing and blames the partner directly for them or suggests that it’s the problems that are causing the drinking, rather than the other way round.  An attractive wife I once interviewed told me, through her tears, that here heavy-drinking husband refused to have sex with her because she wasn’t sufficiently good-looking.  She had no idea that heavy drinking causes impotence in men and it hadn’t occurred to her that her husband’s refusal to have sex was his defence against admitting this.  Imagine too the distress you might feel if your partner constantly blames you for things that go wrong, and that all their friends and work colleagues keep telling you what a great person they are and how lucky you are to have netted such a catch.  Partners often say they feel as though they are going mad.  Their own self-esteem suffers and they may feel they lack the energy to try to change anything.  Another factor which may lock the partner into the situation is economic dependency.

The drinker may be the chief breadwinner and without their income the partner may have no means of securing accommodation.  Even when there is domestic violence the partner may be reluctant to leaver.  She may be emotionally attached to Dr Jekyll, and when, in the morning, he tells his partner that he couldn't manage without her, she knows this is true and feeds her self-esteem on the only sincere praise she ever hears.  Perhaps it is for this reason, or perhaps it is because of the traditional caring roles of females that women stay with problematic male drinkers much longer than men do with female drinkers.

Gradually the problem drinker shows less interest in non-essential activities.  They ten to relinquish their roles within the family and to cease making any contribution to the work of the house.  The partner is thus obliged to take on more and more.  They become exhausted and resentful.  Sometimes they come to accept and even appreciate the control this gives them and they stop trying to change things.  Sometimes the unpredictable interruption to family routines that comes with bouts of drunkenness makes it impossible to plan any sort of routine activity – like collecting the children from school – let alone any major project like a holiday.  If the partner prepares a meal it may go uneaten, if they do not, they may be abused for their failure to service the drinker’s needs.  Often all the members of the family live in a permanent state of anxiety, wondering when and in what mood the drinker will arrive home.  Paradoxically, although the drinker is no longer a productive contributor to any aspect of family life, nevertheless their needs and wants come to dominate it.

Partners still have their original obligations to meet.  They may have jobs to hold down, caring roles for children or elderly relatives to fulfil, and other commitments to the wider community.  They may find these increasingly difficult to manage.  The behaviour of the drinker may render them unpunctual, unreliable, irritable and stressed and pre-occupied.  The overall psychological strain can lead to partners seeking help from the medical profession, to their taking tranquillisers, anti-depressants or themselves self-medicating with alcohol.

People have cultural expectations of what family life should offer.  Religious festivals like Christmas or Divali, rites of passage like Barmitzvahs or weddings, all of these are celebrated in ways which are broadly mapped out by tradition.  For the family of the problem drinker however, nothing is sacred.  Such occasions tend to offer drinking opportunities; they often also become scenes of discord and upset.  Whilst other families are giving each other presents, the drinker’s family is trying to mend the hurt feelings and broken furniture or mop up the vomit.  Bad memories are stored.  Moments of intense embarrassment are rehearsed.  Invitations cease to be made.  The whole family is likely to become stigmatised and isolated.  The partner may feel ashamed and somehow responsible for the drinker’s behaviour and may stop trying to make any contact with the outside world least the world discover the awful family secret.

If the drinker’s behaviour becomes unreliable they may, of course, lose their job.  In any case the fact that a large proportion of the family’s income is spent on alcohol means there is less left for other things.  Financial priorities become irrational.  Money is spent on alcohol that should go on rent or mortgage and families may end up without electricity or gas, without food and eventually without a roof over their heads.

Not surprisingly issues such as these lead to conflict between partners.  Rows and recriminations may occur when the drinker is drunk or sober.  Rational discussion may be replaced by morose withdrawal and a refusal to discuss important family issues.  Alternatively things may be said in anger which irrevocably damage the emotional quality of the relationship between partners.

Impossible dilemmas face the partner in trying to prioritise the needs of all the family members.  Attention which he or she would normally devote to the children is often claimed by the drinker and the children’s emotional and physical needs are neglected.  Alternatively the partner heroically insists on giving the children the care and support they so desperately need, only to be accused of disloyalty by the drinker.  In order to avoid the consequent scape-goating of the children, the partner learns to pretend to ignore their needs and chooses in doing so to protect them and placate the drinker.  Often the children see only what is going on on the surface.  The partner is overworked, short-tempered, inattentive but takes responsibility for discipline.  The drinker is powerful, jolly, amusing and indulgent at least some of the time.  It is not uncommon for the children to side with the drinker and to see the partner as a weak and boring kill-joy.

A child’s eye view

A drinker’s mood swings described above obviously affect the children too.  Their ages at onset of the problematic drinking have an important effect on the way they interpret the behaviour.  If they have experienced it all their lives they may come in some sense to see it as normal; to expect some adults at least to be unpredictable, angry, indulgent and depressed.  Indeed adult survivors of such family systems say that they have difficulty in knowing what normal human reactions are and they may not make the association between the drinking and its behavioural consequences.  Older children may see clearly what is going on and have difficulty in reconciling the behaviour with their expectations of a same-sex role model.  They may need to blame the non-drinking partner in order to retain their own self-esteem.  If the drinker is of the opposite sex they may conclude that all members of the opposite sex are worthless.  In either case these children’s abilities to form adult relationships are often severely impaired.

Children may witness violence between their parents or have it directed at themselves.  They may lie awake in bed waiting for the arguments to start and fearing that one of the parents may be killed by the other.  Drinkers with children almost always say that their children are asleep when rows occur.  Children tell you they hear everything; there is no way they could sleep through these traumatic events.  At school, children are often pre-occupied and inattentive.  They get into trouble for failing to concentrate.  They are wondering if the drinker will turn up to collect them or how things will be when they get home; whether the drinker will be happy, aggressive or unconscious.  They may be invited to their friends’ houses for tea but won’t go in case there is a reciprocal expectation and their friends see the state or the behaviour of their drinking parent.

Children of problems drinkers tend to exhibit a variety of behavioural problems.  They are frequently themselves aggressive, hyper-active and unruly.  They have learning difficulties, they truant more often and may be disruptive in class.  They tend to suffer from an extreme lack of self-esteem, they may be shy and withdrawn, constantly anticipate criticism, wet the bed and exhibit poor personal hygiene.  As adolescents they may isolate themselves from their peers or they may seek the attention and approval from a gang of peers that they do not get at home and effectively sever the home connection.  It appears that when the drinking repertoire includes violence, parental conflict, separation or divorce, children’s social development fares worse in the long-term.  Inconsistent or ambivalent parenting on the part of the non-drinking parent also has a negative effect.  The security which comes from living in a predictable world is absent for many of these children and many believe themselves to be to blame.  Directly or indirectly they get the message that if they were better behaved, cleverer, better looking etc, their drinking parent wouldn’t need to drink.  The effect of this on their self-esteem is unimaginable.

There are factors which seem to protect children though.  If the non-drinking parent or another significant adult figure (e.g. a grand-parent or a teacher) can provide a stable emotional atmosphere and can give the child love and attention, the child is much less likely to suffer negative emotional consequences.  Providing a predictable daily routine and maintaining good relationships outside the family are also positive protectors.

In the long-term may children of problem drinkers make a good adjustment in adulthood.  Difficult experiences can strengthen determination and develop maturity.  There is a small tendency for such adults to be more depressed, anxious and dissatisfied with life and a slightly increased risk of their drinking to excess or taking illicit drugs.  Most at risk are those from families where both parents drank problematically and where there was a great deal of discord.  Generally though this tendency to assumption of severe psychological damage should not be exaggerated; a bad outcome is by no means inevitable.  Children’s experiences and feelings are often forgotten by warring or separating parents.  Drinkers want to believe that children don’t know or understand.  Our advice is to face these issues.  If you or you partner has a drinking problem, an early intervention is the best indicator of a successful outcome.  apas provides advice, guidance and counselling for all the family.