Alcoholism: Children of Alcoholics: Part 2 of 4

In the last post we looked at Alcoholism. If you have not read that yet, click HERE to get up to speed.

Before we start in on the next part of this picture, please keep in mind the idea of a spectrum.  Every person whether they experience substance abuse or psychological problems has their own complex story. When it comes to this type of stuff, the rules are never hard and fast. The human condition allows for generalities to exist but usually not the whole picture. The severity or presentation of symptoms is not black or white, all or none. Like this spectrum below, individual truth falls somewhere in between black and white.

For the ease of readability, I may use language that may suggest black or white, but please know that when it comes to humans, anything is possible. Think grey. 

The topic of Children of Alcoholics is very complex.  There are a number of ways this scene may be happening. Some examples are young children in the home of a mild/moderate/severe alcoholic, teenagers with a mild/moderate/severe alcoholic parent, young adult children that live in the home part time, one or both parents have a substance abuse problem, or being an adult child of a person with mild/moderate or severe alcoholism.  Considering all these different types of situations, you can imagine that the developmental process of each stage is different and the family is therefore affected differently.  

Because I already wrote one dissertation (this is my actual dissertation!)

And I don't ever want to do that again... I'm having a slight traumatic flashback just looking at that picture... ack!

I'm going to focus on one piece here in this post, (at one end of the spectrum) which is a young child who is raised by an alcoholic parent.  A number of sources agree that 1 in 5 kids has experienced an alcoholic parent.  That number is staggering... and so sad.  

There are lots of resources and foundations out there for this topic, which is great.  Here is one, and FYI,  I also got lots of information from different organization's websites for this post... (sources are at the end)

Ok, so the level of dysfunction that a child experiences is related to how "non-recovering" (or not sober or trying to get sober) that a parent is.  If there are two parents in the home, the relative psychological health of the non substance abusing parent also matters.  Alcoholism (or any other kind of substance abuse) can be defined as a major stressor. This stressor has shown -through years and years of research- that children raised by alcoholic parents tend to score lower on intelligence tests, their development is negatively impacted, their coping skills are lower, they have higher levels of depression and anxiety, higher levels of delinquency and an overall negative self image. 

Here are some examples of the psychological effects of parents of alcoholism:

Guilt/Shame: the child may see him or herself as the cause of the stressor, a young child often blames the parental drinking on his/her behavior. 

Anxiety: fears about anything and everything. will my mom/dad be drunk tonight? will they be angry at me? will anyone make me dinner? will I have to take care of my dad tonight? will my parents fight tonight? 

Inability to have close relationships: the alcoholic parent has disappointed the child many times, can she trust that others will not let her down?  Is it normal to be sad and drunk, is that what being married as an adult is like?

Limited "emotional intelligence": The alcoholic parent has limited emotions because the addiction works to numb negative emotions. The child is not modeled a wide range of emotions and therefore may not possess emotional skills above the basic and negative emotions. 

Confusion: Consistency is usually not a part of the alcoholic household.  Mealtimes, schedules, etc are rarely maintained. Parental emotion and love is unpredictable. 

Anger: The child feels angry at the parent for drinking and angry at others for not protecting them from the situation. 

Depression: Feelings of helplessness occupy the child's mind. hopelessness = depression

Spousification- Bluring the boundary of spouse and child. Children often share beds with the non alcoholic spouse. Children are often left in charge of inappropriate responsibilities (like the check book or all the cooking).  Parents tend to rely on their children to meet their emotional needs, which is very confusing and harmful for children. 

Overachieving:  Buckle down and do. better. to. get. the. heck. out. 

Isolation:  There is usually much embarrassment and shame about the drinking parent as a bad secret. Friends are not typically invited to visit the house because of the unpredictability factor. Asking for help can be scary too, because it means admitting a problem. 

It's important to mention that there are plenty of kids who show great resiliency and can be a product of this type of home and show little to no effects. But, resiliency is another blog topic for another day...

So, what happens when this child launches him or herself from their home nest? We all know life is hard, but imagine facing our all too often ugly world with that set of tools.

Adult Children of Alcoholics is next up. 

Stay tuned!

note: If you know a child who is in this situation, don't be afraid to reach out to him or her and offer support or help. There are many organizations equipped to help a child and his or her family cope with this serious problem.  Reaching out can be risky and often awkward, but it will be undoubtedly a good thing if you help to protect a child and help a family system that is fighting the battle of addiction. 

Sources:

http://www.nacoa.net/impfacts.htm

http://alcoholism.about.com/cs/alerts/l/blnaa09.htm

http://www.aacap.org/cs/root/facts_for_families/children_of_alcoholics

A personal note to you from me.

Dear readers, thanks for being so great.

I write about what I'm passionate about because I want to share with you what is in my brain. My last post about Alcoholism had the highest number of hits of any post so far-  thanks for reading. I have had the privilege of beginning some great therapeutic relationships just because of this blog.  I truly hope that the topics I present here touch someone or encourage they to get the help they need. And if they do either of those things, I will feel that my job has been done.

Pass along my website to people who may be interested in what I'm writing about, and keep sending me messages and comments!

Thanks so much!

Alcoholism: Part 1 of 4

The topic of alcoholism may seem old hat, a topic that is common knowledge and easily spotted. It's protrayed in media:

Celebrities can make it look glamorous:

But the truth is that alcoholism is a terrible disease of addiction that wreaks havoc on entire family systems for multiple generations- even after the last drink has been drunk.

"Alcoholism" is the common umbrella term for what we in the biz call alcohol abuse or alcohol dependence. The two terms are different in that abuse is the misuse of alcohol in ways that negatively impact life and dependence means that there is physiological tolerance with an uncontrollable drive to continue use despite the negative impacts on life.

Risk of developing alcoholism is increased with certain age, gender, social environment, stressors and genetic predispositions.  If you are a relative of someone with alcoholism, you could have the genetic marker that  responds addictively to alcohol.  And just because you have the genetic marker does not mean you will automatically become an alcoholic if you drink occasionally.

The brain becomes addicted to alcohol (or any substance) when physiological changes occur due to the substance you put into your body. Alcohol hurts more than the brain, it effects every organ in your body, because alcohol is a toxin.

Healthy liver:

Liver with severe cirrhosis:  (ummm, gag)

As soon as alcohol enters your blood stream your body goes to work processing it and ridding the bloodstream of the chemical ethanol. A person becomes intoxicated when the level of ethanol in the blood is higher than the body can clean up, annnnnd drunk occurs.

Most of us have either felt the effects of ethanol in our blood stream, or at least seen someone in that state.  And, it can be all fun and games in small doses. But when drinking becomes a habit and it interferes in a person's ability to function, take care of themselves, be in a relationship, or hold a job- its now called alcohol abuse. (P.S. binge drinking is alcohol abuse too.)

And then... well, its not so glamorous anymore.

While people do call me Dr. Mazzio while I'm at work, I'm not actually a doctor of the liver. I'm what one client calls me, "the Feelings Doctor" and that's what we are really here to talk about. feelings.

People who are suffering in alcoholism use the mind numbing substance as the ultimate escape hatch.

People want to feel good about themselves, to function well and experience love from others.
When, for whatever reasons, this does not happen a person finds ways to avoid the resulting negative feelings.  The escape may be the temporary elation from drunkenness, or the slow empty numbing that alcohol can bring.

Restated simply: We often turn to drugs and alcohol when we don't want to deal with emotional pain.

Alcoholism is really difficult to treat and recover from because its a damn good band-aid.  There are negative effects, which usually is what ends up forcing people to seek treatment (AKA hitting rock bottom), but all in all, alcoholics don't have to feel their emotional pain when they hang out with their best friend- ethanol. Convincing someone that its actually a good thing to face their demons, and feel their emotional pain is hard. And totally counterintuitive to someone who is suffering. Life is so painful for substance abusers that, while they choose to remain on earth, they choose to not live fully.

When you think about all that-  what emotion does that prompt in you? Does it increase your empathy for people who suffer in alcoholism? it should. Alcoholics or any other substance abuser is not inherently "evil" "bad" or "worthless." They are broken and they need help.

Addiction usually feels like hell for the suffering person. It's easy to focus on the most obvious problem: the alcoholic. But like I mentioned earlier, this disease always occurs within a family system. That means the rest of the people (family and friends) around him or her suffer too.

Even though the surrounding people might not be drinking, they definitely are suffering.



Next up, effects of alcoholism on children and adult children of alcoholics.

A Declaration.

No, not like this...

A favorite professor of mine gave me this declaration a number of years ago. I loved it then and I still love it now.

My Declaration of Self Esteem

I am me.

In all the world, there is no one exactly like me. There are persons who have some parts like me, but no one adds up exactly like me. Therefore, everything that comes out of me is authentically mine because I alone choose it.

             I own everything about me: my body, including everything it does; my mind, including all its thoughts and ideas; my eyes, including the images of all they behold; my feelings, whatever they may be: anger, joy, frustration, love, disappointment, and excitement. I own my mouth, and all the words that come out of it: polite, sweet or rough, correct or incorrect; my voice, loud or soft and all my actions, whether they be to others or myself.

            I own my fantasies, my dreams, my hopes and my fears.

            I own all my triumphs and successes, all my failures and mistakes.

            Because I own all of me, I can become intimately acquainted with me. By doing so, I can love me and be friendly with me in all my parts. I can then make it possible for all of me to work in my best interests.

            I know there are aspects about myself that puzzle me and other aspects that I do not yet know. But as long as I am friendly and loving to myself I can courageously look for the solutions to the puzzles and for ways to find out more about me.

            However I look and sound, whatever I say and do, and whatever I think and feel at a given moment in time is me. This is authentic and represents where I am at that moment in time.

            When I review later how I looked and sounded, what I said and did, and how I thought and felt, some parts may turn out to be unfitting. I can discard that which is unfitting and keep that which proved fitting, and invent something new for that which is discarded.

            I can see, hear, feel, think, say and do. I have the tools to survive, to be close to others, to be productive and to make sense and order out of the world of people and things outside of me.

            I own me, and therefore, I can engineer me.

            I am me, and I am okay.

Satir, V. (1988). The New Peoplemaking. Mountain View, CA: Science and Behavior Books, Inc. 

What I love about this statement is that it provides real ideas of empowerment to people who struggle to appreciate their own value. I really believe what this declaration says: you are uniquely you, and you own your own life.  Does that feel like good news or bad news to you? Consider this: you actually are responsible for everything about your life, AND you can choose to stay the same or you can effectively change the ways that you respond to the things that you don't like.

 "I can courageously look for the solutions to the puzzles.." 

Which parts of your life puzzle you? Honest consideration of what troubles you is the first step in correcting the areas that are really tough. And, lets be honest, we ALL have those rough times. It may be a relationship, a memory, or a situation that feels hopeless. Identify your "puzzles" and get started changing stuff. 

The second step is courage. 

Courage pushes us to move outside our comfort zone and take a risk in hopes of a new experience. Courage may have you stare down fear, intimidation or pain- but that's part of the deal. It's not supposed to be easy... it takes guts!  Sometimes, when I struggle to have courage, I ask myself... what's the worst that could happen? This logic will often help me decide if responding with courage is worth the risk. How do you measure your own risk taking?  The picture below is not courage, its stupidity. So, be smart about how you apply courage. Please, don't act stupidly. 

"I have the tools.... to be close to others"

This last section is really beautiful. Being close to others is the essence of life.  Without relationships, the emptiness of the heart can be devastating. Sadly, our negative emotions and messed up understanding of relationships sometimes keep us from being successful (in relationships).  If this feels familiar to you, remember to have [smart] courage, use the tools you already have, seek counseling and most importantly believe in yourself. 

You alone own your life. Be your biggest fan. Get out there, believe in yourself and make those changes you have always hoped you could change. Hope may be just around the corner for you. 

A preview

Dear blog friends,

Private practice is really busy. And, I have 2 two years olds. And a husband. And a house that gets really dirty, and two labradors. And 6 parents, and a bajillion friends and a yard and a Church...

le sigh.

My absence is excusable, but really when things settle down at the end of the day, I feel a small tug towards this wonderful hobby and clinical outlet. I love writing to you about what I love.

I dusted off the ol' blog this afternoon and renewed my commitment to writing weekly.

Just for fun, here is the list of the upcoming blog topics that have started to be formed in my draft folder:

• Alcoholism, part 1- Alcoholics
• Alcoholism, part 2- Children of Alcoholics
• Alcoholism, part 3- Grandchildren of Alcoholics
• Can a person really change? The five stages of change
• Radical Acceptance
• Why do bad things happen to good people?
• Social relationships and technology
• Negative emotions, we all have them so how do we deal with them?
•  How therapy works
• Self- soothing
• Inside the psychiatric hospital
• Attachment
• Insert your psychology blog topic here... (leave me a comment with requests!!!)

It seems I have some writing to do.  Check back soon, as in- this week! See you then.

Grief: Good, Bad and Ugly.

this post isn't filled with humor... sorry, readers! if you feel especially emotional today, grab a tissue- justincase.

Grief is a topic that I seem to encounter with many people about a variety of topics. Grief crosses cultural and social boundaries.

Your own grief experience could be attached to losing someone to death, but grief also comes from the deep wounds and big disappointments of life. Maybe it was marriage that didn't work, or a job that didn't pan out. Maybe it was a chronic illness or a baby that you couldn't have. Maybe you have a parent that just didn't do what he or she should have. Maybe you grieve your own personal limitations, and hate to accept what won't ever change.

Regardless of your circumstances, grief is a universal experience. It can vary in its intensity, but its always a response to loss.

Have you heard of the five stages of grief?  In case you have not been to Psych101 lately,  the stages  are:
1. denial
2. anger
3. bargaining
4. depression
5. acceptance

The inventor of this theory is Elisabeth Kubler-Ross. She wrote a really famous book "On death and Dying" published in 1969.

She worked with people who were dying and observed how they dealt with the reality of their fate. This framework is about how people LIVE admist LOSS. Which, I think is really important to remember.  Because in the face of tragedy, you actually only have two choices: live or die. Usually, people choose life, which leaves them facing loss on a daily basis.

Some interesting facts about grief: Animals have been observed showing behaviors related to death, like staying with a deceased member of their pack or herd. Primates often carry their dead offspring for a short time.  The picture below is a mother gorilla, inspecting her 3 month old baby who died suddenly.  And If you are a glutton for punishment and momentarily embracing some cathartic depression, you can read the rest of the story HERE. warning: It's really sad.

Also, there is lots of research that show how people's brains respond when prompted with grief inducing stimuli (like words or pictures).  PET scans show electrical activity in different parts of the brain, showing us that words, images and thoughts activate areas in the brain responsible for our feelings. The picture below is not a PET scan picture of grief but an excellent PET scan comparison of a depressed and not depressed brain. Notice how only three areas of the brain are "lit" up on the depressed brain.

So...grief is not just some random bunch of terrible feelings, it is biologically driven and supported by our brains. 

Lets transition and discuss the actual experience of grief. While there are stages of grief (denial, anger, bargaining, depression and acceptance) these labels are not meant as a structured script. The only very fixed stage is acceptance, which is usually experienced last, but the four other stages can rise up even after you have accepted your circumstance. The four stages (denial, anger, bargaining and depression) are often experienced in the order that they are listed but its common for people to go back and forth between them, shuffling between the emotions as they progress through grief. 

Denial

That's right. It's not just a river in Egypt, but it is a living defense mechanism we use to protect ourselves. Denying the facts of reality protect us from the negative emotions that we experience as we face loss. When fully entrenched in denial, life can seem confusing and overwhelming. You may feel nothing at all, again, a way to resist the awfulness of your reality.  Denial helps pace our feelings of grief, and it is a way we give ourselves grace. Your heart can only handle so much, so you only allow so much to be felt. 

Anger

This is an intense picture, but a good representation of anger. All those feelings that denial was containing rise to the surface during anger. Historically, anger is often viewed as an inappropriate emotion. Lies.  

Public Service Announcement: Acting out in anger is not good, and feeling anger is not bad. 

Anger is necessary, and it can be a form of strength. Be willing to feel your anger, even if it scares you a little. If you accept it, it will fade. If you resist it, it will build. Simple to say, but difficult to do. Anger can extend across people and situations and you may feel angry with God. 

The truth about anger is that it's a 3 dimensional emotion. You first notice the anger, but underneath is a complex web of intense feelings fueling the angry fire.  One of the most notable emotions linked with anger is pain. Pain is the universal emotional, connecting every human to each other. Your grief may be unique to you, but your feelings of pain are not. Even though society seems to fear anger, there is an even deeper fear of pain. What do you do with pain? What do you say to a person in active emotional pain? Pain allows for vulnerability, which again- many people are uncomfortable with. Embrace your pain, cry your tears. Stifling your emotion only leads to emotional frustration and internal chaos. 

Bargaining

Have you ever felt like this faceless little character?  I know I have. This phase is tricky because not all grievous experiences allow for bargaining. For example, if someone you love is dying a long painful death from cancer,  bargaining may be a big part of your process... you may have the time to strike up a deal with God. On the other hand, if a trauma occurs to you in a moment,  and it can't be changed or taken back, your bargaining may look more abstract.  In that case it might be like asking for emotional relief instead of a situational change. 

Bargaining can bring us into the maze of "If only I...." or "What if...." The bottom line is that we want life back to what it was before this thing happened to us and we felt the avalanche of grief. You may experience guilt in this phase. Guilt is, after all, a motivator for bargaining. Remember that when try to bargain, you are grasping for the removal of the negative emotion that you are feeling. You might just want it all (the situation and the feelings) to go away. This stage can last hours or days or years. Remember grief is not linear, and neither is bargaining.  

Depression

When we are no longer in denial and we accept that we can't strike up a bargain, we are forced to look grief in the eye. Emptiness arrives and we feel the grief deeply. When we are in the middle of it, it seems infinite. Keep in mind that situational depression is not necessary mental illness. A diagnosable depressive episode may have situational factors, but is usually organic in nature (i.e. involving brain chemicals, like Seratonin). Grief can certainly contribute to a clinical depression, but it is not an automatic thing. 

Depression looks like apathy; we don't feel the desire to do what we normally do. We withdraw from the world, in a fog of intense sadness, perhaps wondering... "what now?" Depression during grief should not be seen as a task to be fixed. Ask yourself if the situation you face is actually depressing. If the answer to that question is yes, then it would be unnatural to not be depressed.  Right? 

Depression should lessen over time but if it does not, you should always seek help from someone you trust or is trained to support you during this phase of your grief. 

Acceptance

I like this quote because of its emphasis on understanding as an important part of recovery. That's exactly the point of this long blog post.  It is critical to understand that as you accept where you are, you won't necessarily feel better. If something terrible happened to you, you may not ever feel "ok" about that thing.  But, that does not mean you can't ever feel ok about anything else.  

Acceptance within grief is really about accepting your new reality. You don't have to love it. But you have to learn to live with it.  We resist the hardship of grief through denial, anger and depression. But when we move towards acceptance, we acknowledge the facts, accept the feelings that go with it and choose to take the next step forward with our lives. 

Finding acceptance comes in bits and pieces at first. It might be a moment of hope, or an isolated laugh with a friend at first. It may mean having a few more good days than bad in the span of a week. Remember that you are not betraying the memory of your grief by having a good day! You can't change what happened to you, but you can change what will happen to you next. You can make new relationships, you can find new joy. 

If you are facing grief today, take a moment to think about where you are at. Notice your feelings, and give them the space to exist. Hear me saying to you, that you can live again despite what you have lost. This is just a season in your life, so be encouraged that these days filled with grief will eventually give way to days with joy. 

Give grief its time, and you will emerge stronger, having experienced a greater depth and breadth of life. 

Life has held me hostage...

Really, its been a ridiculously over scheduled spring for me and my family. Blogging is my hobby, and so like all hobbies, it often falls to the bottom of the list.  But, I wanted to share one fun detail with you guys about what my over scheduled life has included:

This is me (and my better half) after FINALLY walking across the graduation stage with my 6 sided Tam (silly looking hat) over sized sleeves, and velvet trimmed gown. The year I was supposed to walk, I was in a hospital bed with shiny new 4 pound and 5 pound newborns. Then, for the next year, I chose to nurse my children around the clock, making it difficult to finish my dissertation. I finally finished that 5 year project in 2010, but had to wait almost a whole year to don the regalia and shake the hand of our chancellor. It was a lot of waiting...but well worth it!

So, 11 years of education post high school, thousands of hours of training, and hundreds of thousands of school loan dollars is whats behind that picture from last week.

It's nothing short of a miracle that i finished it. I'm so grateful to my whole family who supported me in tangible ways daily. Though its cliche, I could not have done it without them.

I'm also happy to announce I will not be seeking any another degree. ever. thank you.