Al-Anon - in-person groups and helpline - telephone 0800 0086 811 [2]
Bottled up - online support - registration page at bottled-up.com [3]
We Are With You - online chat via website - wearewithyou.org.uk [4]
Support line - for victims of alcohol-related domestic abuse - telephone 01708 765 200 - email info@supportline.org.uk [5]
Support For Children Of Alcoholics
Alateen - for 12 to 17-year-olds - telephone 020 7593 2070 [6]
The Children's Society - online advice and links to local groups - website www.childrenssociety.org.uk/information/young-people [7]
National Association for Children of Alcoholics - can be accessed by adult children of alcoholics - telephone 0800 358 3456 - email helpline@nacoa.org.uk - website www.nacoa.org.uk [8]
Alcohol Education Trust - telephone 01305 259 142 or contact via website www.alcoholeducationtrust.org/contact [9]
Avoiding these behaviours reduces family members' future suffering and helps when dealing with the drinker in day-to-day life because:
Removing the cycle of bargaining and discussion removes the drinker's ability to exhaust the family member into giving up protects the family member's emotional wellbeing
Family members are not in a position to help the alcoholic when suffering themselves - including going into debt or taking on stressors on behalf of the drinker.
Become Non-Reactive
Being non-reactive to the alcoholic's behaviour means:
Not shouting when frustrated - indirectly breaks the pattern of the alcoholic's behaviour being affected by the families' behaviour
Maintaining a sense of routine separate from the drinker and not allowing this to be interrupted - sends an underlying message to the alcoholic that the family cannot be manipulated
Not trying to control drinking habits - the alcoholic stops looking for a reaction from the family from drinking, and begins to take responsibility for their own behaviour
Being ambivalent to extreme emotions or mood swings from the addict - discourages co-dependent patterns
Understand The Underlying Intention
Separating the alcoholic's behaviour, from the underlying intention, can help families alter the meaning of the behaviour, for example:
Understanding that the alcoholic is only motivated by maintaining alcohol as a coping mechanism - aggression, emotional instability and lies are not intended to upset loved ones personally
Realising that, as the drinker has unconsciously decided that alcohol is the only means to cope with life, they are heightened to any behaviours, events or statements that could result in the loss of alcohol, including family intervention [18]
Understanding that addiction is both physical and psychological, meaning that cravings are extremely powerful and drinkers have no control over them
Understanding that, if the alcoholic sees you as preventing them from drinking, they may say personal or offensive things to alienate the loved one, in order to maintain access to alcohol
Being aware that alcoholics will use any effective behaviours to keep drinking - it is important not to associate stereotypically nice behaviour with the alcoholic being sober as this can be manipulation
Set Expectations And Reset Boundaries
Families can set expectations and change boundaries with the alcoholic by:
Making expectations clear - how is life supposed to look, sound and feel when expectations are met? - having clear expectations ensures the family members maintain boundaries until expectations are met
Setting timelines for expectations, and stating the consequences of relapsing or continuing drinking - breaks the cycle of attempts to manipulate families' behaviour or resources
Following through with the consequences immediately after a relapse - allowing the alcoholic to continue their behaviour without consequences will exacerbate issues for the family in the long term
Doing odd things at normal times and normal things at odd times - this helps communicate to the alcoholic the underlying subtext that things have changed, and expectations are changing also - not allowing co-dependency to develop
Since it is not possible to force someone into treatment, realistic objectives for families of alcoholics are:
Setting appropriate and realistic expectations - taking into account the alcoholics' current addiction level before setting goals
Creating an environment where it is possible to learn the consequences of drinking and where reaching out to external sources of support is encouraged
This reduces the frequency of family members prompting the alcoholic to get help, with no real action being taken or recovery being sought.
Reinforce Positive Attempts For Help, Avoid Criticism
Reinforcing positive attempts to get help supports families of alcoholics as:
Praising positive attempts to seek help is more likely to result in the alcoholic actually seeking help
Criticism from families mirrors the alcoholic's inner thoughts, leading to negative beliefs being upheld and alcohol continuing to be a coping mechanism
Alcoholics will use criticism as an excuse, and blame the family for causing drinking [19]
Be Consistent
It is important to remain consistent in the above actions so that:
The alcoholic learns that boundaries are not negotiable and stops testing them
The family unit is not disrupted by the alcoholic's actions - providing a supportive environment for both the alcoholic and the rest of the family
Whilst emotionally painful in the short term, being consistent with the above actions is more likely to result in the alcoholic seeking, and maintaining, long-term sobriety.
Stating a potential consequence, and not following through, should be avoided, as the alcoholic will conclude that boundaries can be ignored.
Provide Resources First
For any coping mechanism to be successfully taken away, it's best to:
First, establish what the coping mechanism is doing for the alcoholic
Provide another successful coping mechanism (better resources) before alcohol itself can be taken away
Approaching alcohol use disorder in this way supports families because:
Once a successful alternative coping mechanism is put in place, the alcoholic is more likely to want to seek treatment independently
The underlying need that alcohol was previously fulfilling, is now being fulfilled in a different way. Meaning, there is no reason not to seek help for the physical symptoms of alcohol use disorder.
Intervention
Perceived Authority Of Third Party
An intervention delivered by a professional third party, who is not a family member, is likely to be more impactful than routine feedback or criticism from within the family itself.
Experience & Expertise
Family members may not recognise the more subtle behaviours of addiction, that only an intervention professional with substantial experience can ascertain and hold the individual accountable for.
Impartiality
Family members may not feel comfortable expressing their grievances about a close family member. Whereas, a third party is dissociated from these ties, and can voice concerns without hesitation.
Dealing With Stigma
Family members suffering stigma as a result of family members' alcohol use can seek therapeutic help to:
Reframe experiences of prejudice associated with a family member in active addiction
Reframe the meaning of others' behaviour - are they reacting from prejudice, or a lack of knowledge on alcohol use disorder?
Use an internal frame of reference instead of external frame of reference to change the meaning of criticism
Understand that others' external reactions are not always a true reflection of internal thoughts
Understand that pre-existing fear of others' judgements, may result in perceiving stigma from others which has not actually occurred in the external world.
Support For Family Of Alcoholics Does NOT Mean
Sacrificing own needs for the alcoholic - It's easy to conclude that giving up money, time, or resource to support an alcoholic family member through difficulty will result in less stress later. This is almost never true; assisting the alcoholic is more likely to lead to co-dependency.
Rationalising the alcoholic's behaviour - Well-meaning friends may attempt to normalise the alcoholic's intake or behaviour, in an attempt to help the family member feel better. In reality, this results in increasing denial in the family member, and delays attempts to truly help the alcoholic address their addiction.
Unsolicited advice - Friends may strongly advocate the family member follow specific advice to "fix" the alcoholic. This advice is normally misguided, as it does not take account of the underlying beliefs and drivers behind the addiction.
About the author
Harriet Garfoot
Harriet Garfoot BA, MA has an Undergraduate degree in Education Studies and English, and a Master's degree in English Literature, from Bishop Grosseteste University. Harriet writes on stress & mental health, and is a member of the Burney Society. Content reviewed by Laura Morris (Clinical Lead).
