1. Chapter Eight: Effects of Alcohol Problemson the Family

2. points for consideration • Alcoholism as family disease • Early research • Family system approach • Children in the family • children in the home • adult children • Facts versus beliefs

3. family: early research • Classic monograph 1954 • Alcoholism and the Family by J Jackson • parallels work by EM Jellinek on natural history of alcoholism • survey of “AA Auxiliary” (Alanon) • Introduced view of alcoholism as “family disease”

4. “Alcoholism and the Family” • Seminal study by Joan Jackson • Seen as defining family’s efforts to live with alcoholic • Six stages

5. Jackson’s 6 stages 1. Denial • both partners “explain away” problems 2. Attempts to eliminate problem • partner recognizes drinking is abnormal • partner tries to intervene

6. Jackson’s 6 stages (cont) 3. Disorganization and chaos • family structure has broken down • family goes from crisis to crisis 4. Reorganization despite problem • partner’s coping improves • energy not spent on having spouse shape up

7. Jackson’s 6 stages (cont) 5. Efforts to escape • possible separation or divorce • live around the alcoholic 6. Family reorganization • new stability established • true whether treatment and abstinence or continued drinking

8. caveats on Jackson paradigm • A product of its era • Assumes husband is alcoholic • Now recognize differences depending on when alcoholism emerges

9. Vernon Johnson paradigm • “Hitting bottom” then seen as needed to promote treatment • Family seen as able to prompt alcoholic’s entry into treatment • Draws upon family system theory • Assumes alcoholic has inadequate sense of events

10. Johnson’s view of family • Family members also affected • Co-dependency = dysfunctions from living with alcoholic • Enabling = behaviors that unwittingly allow continuation of drinking

11. family system approach • Underlies much of thinking • Efforts by members to maintain equilibrium • Alcoholic family = escalating system • Common strategies of family members • keeping out of way • care-giving, counseling, efforts to control • resignation

12. family: current thinking • Differences between families • Characteristics of “alcoholic family” common to families under stress • Increased risk for family members • increase in health problems • increase in domestic violence

13. children of alcoholics • First gained attention in late 1980s • Early approaches not science-based • Children in the home • Also adult children of alcoholics

14. children of alcoholics (cont.) • Models describing children’s response • Two models • family hero, family mascot, lost child and scapegoat • responsible one, adjuster, placator • Not empirical support for views

15. children of alcoholics (cont.) • Adult Children of Alcoholics • Roles from childhood carry into adult behavior 0 %

16. children of alcoholics (cont.) Current Understanding • Emphasis on resiliency • Emphasis on risk and protective factors • Major risk factor is genetic predisposition • Extended family can be a resource for child