Adult Children of Alcoholics.

Друзья, предоставляю вашему вниманию свою исследовательскую работу на тему "Взрослые Дети Алкоголиков". Выставляю ее здесь в качестве причины отсутствия в блоге на протяжении нескольких недель - вот почему я отсутствовала - писала исследовательскую работу! Кроме того, тема важная. Я перелопатила достаточно литературы и должна сказать, что не так много об этом пишут. Это мой скромный вклад в развитие этой области психологии. Статья на английском. Те из вас, кто знаком с языком, возможно решат ознакомиться с данным предметом. Для русско-говорящих граждан, берусь сделать перевод статьи, только если поступят заявки. Заинтересовало? Пишите.

Children who grew up in families with alcohol abuse often face several stressors. When combined together they form a traumatic experience for each family member and especially for children who grow up in an alcoholic's household. Some experts equate such experience to the post-traumatic stress disorder syndrome of Vietnam war veterans (R.E. Gilbert 2008) Current approximate statistic in USA shows that seventeen million families cope with effects of “heavy drinking” (P. M. Vernig 2011). The purpose of this paper is to examine possible impacts of parental alcoholism on child’s development as well as his/her adult life; and to see if there is a certain pattern that Adult Children of Alcoholics (ACOAs) have in their lives or certain features that are common for them; and how parental alcoholism shapes ACOAs’ identity.

According to Cathy Hall and Raymond Webster (2007) “while not all ACOAs experience problems, studies have shown that ACOAs often do show an increased vulnerability to life stressors and report more symptoms of adjustment difficulties” (p.425). Researchers concluded that ACOAs experienced higher levels of self-reported stress and more symptoms of personal dysfunction when compared to peers with no trauma or alcoholic childhood experience, but results did not differ significantly when were compared to the group of peers with a different traumatic experience. “This finding supports the idea of a commonality in adjustment issues between ACOAs and adult children from dysfunctional homes” (C.W. Hall & R. E. Webster, 2007, p.426).  There is evidence that multiple stressors like parental alcoholism, divorce, abuse and neglect can break down a person’s resiliency and raise adjustment difficulties, which has a direct impact on one’s adult life. In particular ACOAs often feel challenge in dealing with feeling of anger and irritability that leads to “self-detrimental behavior patterns in which minor problems, set-backs, or daily stressors can generate inappropriate angry reactions” (C.W. Hall & R. E. Webster, 2007, p. 431). Sometimes individuals may not be aware of these feelings. What they found was that “many ACOAs lack an awareness of what is “normal” because growing up in an alcoholic home often skews one’s perceptions interpretations of feelings and how they influence behavior” (C.W. Hall & R. E. Webster 2007, p. 431). 

In order to deal with life’s many challenges ACOAs develop certain defense mechanisms – such as thought stopping (when they refuse to think about certain things or events); avoiding anything that awakes certain feelings and limiting the range of emotions that they are allowed to feel and express. Overuse of some of these behaviors can also create problems in interpersonal and social relationships by limiting them from seeking out social support during times of distress (C.W. Hall & R. E. Webster, 2007).

Emotional numbing, distractibility, “spacing out” and cognitive disengagement are some problems reported by ACOAs. They also report “a reduce sense of self and their own ability to deal with the demands and challenges of life. Evidently, these individuals have learned to question their own capabilities and judgments even when they are functioning successfully” (C.W. Hall & R. E. Webster, 2007, p. 432).

Let us assume that growing up in an alcoholic’s household is a traumatic experience, which it is for many ACOAs, especially if parental alcoholism is combined with physical and verbal abuse, divorce, poverty etc. Gil Noam (1996) discusses rediscovery of biography as an essential dimension of development and concludes that any kind of traumatic experience does not necessarily cause delay in development; rather it leads to different paths of adaptation; people who went through some sort of trauma adapt to their reality. “Calverly et al. [1991] concluded that traumatic experiences are not fixated but transformed throughout development, producing ever more complex splitting at different levels of abstractions and identity constructions” (G. Noam, 1996). 

According to D. Ruben and his book “Treating Adult Children of Alcoholics: A Behavioral Approach” (2001) “ACOAs have difficulty forming trusting bonds with others and developing a sense of trust in his/her own abilities to handle issues that cause stress” (p.34) This factor is significant for ACOA may be because it is common for alcoholic families to keep problems in the family and not share emotions/feeling with outsiders. Ruben (2001) described ACOAs personality development in a very concrete way:

AOCA personality is one of two major types: passive and aggressive. Dichotomy of behavior is predictable. AOCAs raised under a random, untrusting and frequently punitive environment adapt in responding in one or two major ways. First rebellion towards that environment appears in the form of challenging the abusing adults. Expressed anger is outwardly aggressive, violent, or oppositional in terms of severe tantrums, noncompliance, running away, lying, stealing, and hyperactivity. In adolescence when verbal skills are more complex refusals and defiance intensify as the child completely distrusts his parents and assumes total control over personal goals and gratification. In adulthood this controlling behavior appears to be manipulating and dominating. Ironically, partners attracted to controlling AOCAs typically are inept or behaviorally deficient caretakers. Controlling ACOAs have low tolerance for disruptions in rigidly planned schedules. They also resist changes. Hostility over disruptions, however is not to evoke conflict, which ACOA’s strive to avoid (p.12).

According to Ruben (2001) ACOAs are not able to relax, always keeping themselves busy due to a lot of duties that they had to do in their childhood such as babysitting their relatives, cooking and taking care of the whole family at a very early age, etc. ACOAs are loyal (codependent) beyond reason, are terrified of abandonment and would do anything to hold on to a relationship; they are also overly responsible, taking far more responsibilities than the adult can handle.

“Ronald Reagan’s Presidency: The Impact of an Alcoholic Parent” written by Robert E. Gilbert (2008) demonstrates an example of characteristics of AOCA given by Ruben. R. Gilbert describes the character of Ronald Reagan based on the fact that he had an alcoholic father:

Ronald Reagan enjoyed a successful political career. Nevertheless, his political life was affected dramatically by the fact that he was the son of an alcoholic parent. Alcoholic parents leave deep marks on their children’s lives, even after those children become adults. As president of the United States, Reagan clearly demonstrated these marks. He was aloof and distant, was often a disengaged leader, showed inordinate loyalty to associates even when such loyalty became problematic, was prone to live in a world of make-believe; married compulsive women, and craved approval and applause. Each of these behavioral characteristics was part of the psychological legacy left to his president by his long-dead alcoholic father. Some of them damaged his presidency greatly; others, however, may well have assisted it (p. 737).   

Gilbert believes that the effect of parental alcoholism on their children’s life is profound. He thinks that ACOAs can be described as “population at risk”. He suggests that there are a few common features or characteristics for most ACOAs: “difficulty with intimate relationships”, emotional detachment and isolation, reliability issues, loyalty beyond measures; they are extremely adaptive – “survivors”; and finally they become alcoholics themselves. 

To argue Gilbert’s last point about increased risk of adopting alcoholism by ACOAs, let us look at the following research. Nicholas G. Martin investigated the subject of the environmental effect of parental alcoholism on offspring alcohol use disorder (2008). The results of his study suggest that “the direct causal effect of being exposed to an alcoholic parent on offspring alcohol usage disorder is modest at best” (p.534). It means that children who grow up in families exposed to alcohol dependence are not necessarily at risk of becoming alcoholics like their parents. Thus in this study there was no evidence for genetic influence in the inter-generational transmission of alcoholism.

“Recent research on the interactions among genes, social environmental factors, and history has shown how obsolete the old nature vs. nurture distinction has become” (A. Sroufe & D. Siegel, 2011, p. 39). Biological psychologist Stiphen Suomi who worked with monkeys showed that “two genetic variations that have been associated with alcohol abuse or impulsiveness in humans are linked to totally different outcomes when the infant monkeys are reared by a group of highly nurturing foster mothers rather than by their birth mothers” (A. Sroufe & D. Siegel, 2011, p.39). This study proves that alcoholism is not genetic but an adoptive outcome.  

A. Bandura argued that most of what we learn is through imitation. According to Bandura’s theory we acquire considerable information just by observing models, mentally coding what we see (W. Crain, 2005, p. 197). Thus we learn by observing the behaviors of others. Children observe their parents as models and act accordingly. Due to this theory the assumption is that a girl who grew up in an alcoholic’s household and observed her mother dealing with her often drunk father has a potential to be an alcoholic’s wife herself, as she formed a family model accordingly. However the fact is that besides primary caretakers there are other adults in child’s life who also play modeling roles for him/her. There is also abstract modeling, when children induce certain rules of behavior and use them to generate entirely new behaviors on their own, which seems to provide additional proof that ACOAs are not programmed to become alcoholics as their parents.

According to Peter M. Vernig and his article called “Family Roles in Homes With Alcohol-Dependent Parents: An Evidence-Based Review” where “alcohol dependence is described as a “family disease” in which the other members of the family not only experience the effects but also play an active role (however unknowingly) in supporting this pattern of maladaptive behavior” (2011, p. 535). There are five well defined and generally no overlapping roles in which family members fall: enabler, hero, lost child, mascot and scapegoat. Within a family without alcohol abuse members take on some roles as well, they can be: provider, caregiver, disciplinarian, etc. Roles in alcoholic families are much different because members’ responsibilities are shifted, they are more rigid and problematic, when for example a child plays a role of a caretaker for his/her siblings or even for his/her parent. Theoretically speaking there is a suggestion that when adopting one of earlier mentioned roles a child is at risk of making that role a stable and inflexible part of his/her personality, which will affect his/her adult life. There is evidence that for ACOAs’ “emotional and interpersonal problems later in life are a common result of continued attempts to play the same role that they became used to in childhood and adolescence” (P. M. Vernig, 2011, p.535). They consider misuse of alcohol or other drugs by ACOAs to be evidence of this model. 

Let us have a closer look at these roles. Enabler is usually the alcoholic’s spouse, who seem to be doing everything in his/her power to stop the spouse’s drinking but at the same time the enabler constantly accepts additional responsibilities (making excuses for employees, driving his/her drunk spouse around, etc.) that slows down alcoholic’s desire to change. Enabler reinforces other family members to play their own roles, to prevent public shame. Enablers often adopt such behaviors from their own parents. Enabler usually devotes minimum time to his/her own needs and interests, as he/she spends most of his/her time protecting and caring for someone else. 

The Family Hero (TFH) is role of the oldest child, who is responsible for the family well-being early on. TFH is often highly accomplished in arenas that are valued by the rest of the family. TFH leaves family early to pursue a career or school but is always ready to come back and rescue the family. TFH is not motivated by his/her own needs and succeeds in areas defined for him/her by others. TFH may often feel overwhelmed, thinking that the entire family depends on him/her; it is also common for TFH to neglect his/her own self-care and relationships.

 The Lost Child (TLC) is someone whose needs are ignored by the whole family. TLC develops his/her separate world from the whole family, a fantasy – often through reading or television. When at home he/she is often withdrawn and others seem to reinforce such behavior – they are too busy in dealing with their own roles. TLC’s main characteristics are loneliness and sadness; due to which TLC often fails to develop good relationships with peers – a problem that can extend into adulthood. As adult TLC tends to keep separation from his/her family as he/she learned to do so in childhood.

The Mascot is commonly the youngest child, the distracter from the problems within the family. It is normally his/her job to be funny, cute, outgoing – “life of the party”. Even though everybody in the family seems to like him/her, they do not take him/her seriously and possibly have low expectations for his/her intellectual abilities. The family is protecting the mascot by hiding information from him/her, but according to family role theorists mascot is often aware of the problems and he/she purposefully engages in this role as a means of relieving tension and lightening the mood. As an adult, the mascot is expected to have trouble coping with problems directly, having always resorted to behavioral disengagement. 

The Scapegoat is often in trouble, having difficulties in school, legal problems and other maladaptive behaviors – all that to draw attention from the turmoil elsewhere in the family. The scapegoats are likely to use drugs and alcohol themselves. All his/her accomplishments are minimized in defense of other siblings. The scapegoat is most likely to be the next child after the hero. The scapegoat is often the one to blame for all family problems, which makes him/her learn that he/she can never succeed in the eyes of the family, that uses the scapegoat as a distraction. The scapegoat usually feels out of control, he/she has a tendency to experience anger. The effects of these patterns of behavior often lead to legal problems, poor academic and vocational performance, and drug and alcohol use.

 One quality is worth looking at is the resilience. “Resilience determines a child’s ability to deal with the inevitable stresses and setbacks of life” (A. Sroufe & D. Siegel, 2011, p.38).   According to Ann S. Masten (2001) resilience refers to a class of phenomena characterized by good outcomes in spite of serious threats to adaptation or development. Parental alcoholism, which is often combined with verbal and physical abuse, becomes a serious threat to a child’s development. Masten claims that such children become invulnerable or invincible. As resilient individuals grow older, they have better cognitive test scores, more positive self-perceptions, and greater consciousness than their maladaptive peers. The competent of the resilient children continues into adulthood. Contradictory to Masten, A. Sroufe & D. Siegel (2011) state that resilience is a quality of children with a history of secure attachment, such children are less vulnerable to stress and better able to take advantage of opportunities to grow. The question is: are ACOAs able to form a secure attachment? A. Sroufe & D. Siegel (2011) think that it is possible to form a secure state of mind as an adult, even in case of difficult childhood; child’s early experiences influence later development, but it is not set in stoned: therapeutic experiences (counseling, other healthy relationships, travelling, meditation, etc.) can profoundly alter an individual’s life course. There is always hope for a better outcome in the future. To be a good therapist one has to believe in it.   

“Bowlby viewed development in terms of pathways, wherein change is always possible, but is constrained by paths previously taken” (A. Sroufe & D. Siegel, 2011, p.39) In other words if a person had a difficult childhood that contained parental alcoholism, it will influence his/her development but the change is possible due to human ability to adopt to difficulties. Bowlby’s theory states that relationships provide the foundation for child’s development and support child’s abilities for emotional regulations and the formation of mental representation of self and others; but such behaviors are subject to change. “If others are supportive, despite off-putting behavior, a child’s worldview and behavior may change. Further, early experience isn’t erased, but retains its potential to impact later developmental stages” (A. Sroufe & D. Siegel, 2011, p.39). 

   Family, with its pleasures, rewards, challenges and problems, is only one aspect of a child’s development. Besides family in which a child grows up, his/her development is affected by many other aspects or systems like U. Bronfenbrenner (1995) called them. He “proposed an ecological systems model of the lifelong progressive accommodations individuals make to the changing environments in which they develop” (M. Keegan, 2001, p. 256). He suggested that besides the microsystem (which contains a child’s family in as the immediate environment), a child is affected by mesosystem (interactions between two or more microsystems: for example family and school or family and church); exosystem (a system consisting of connection between two or more settings, but only one of them contains the developing person: for example the home and parent’s work place); macrosystem (broader culture and socioeconomic environment: for example customs or cultural believes); and chronosystem (changes over the life time of the developing person: historical events or social conditions occurring within the environment). In other words child’s development appears to be as a set of “nested structures”, where parental alcoholism (as part of the child’s microsystem) can be very influential, but it is not the only important aspect of a child’s development. Although he/she is growing up in an alcoholic’s household he/she is also influenced by his/her other relatives, teachers, peers, friends, culture, television, books, historical events, etc.

When it comes to estimation of what aspect of human’s development is more important than the other, the only realistic conclusion that comes to mind is that it is all very individual. And thinking that “it all comes from family” is not for everybody. For example Alex Wilson, the author of “How We Find Ourselves: Identity Development and Two-Spirit People” (1996) had a very loving, accepting and supportive family - simply a dream family, who acknowledged and accepted her without interference. In her article we see that the fact that she had a great family did not stop her from struggling to find her own identity and other developmental milestones. A few hurtful words said by her peer affected Alex in such a deep way that even her loving family could not ease the pain for her; which to me is an additional proof that besides with whom we grow up with (even if it’s in an alcoholic’s household) there are so many other people and settings which affect the formation of our identity. 

When dealing with ACOAs in therapy one should be well aware of how traumatic a childhood could be for them; but the therapist should also stay hopeful that although the past cannot be changed but the future is in our patients’ hands and it is our job to help them to discover that. This investigation demonstrated how challenging life of ACOAs can be, but it also showed how change is always possible. When focusing on negative outcomes life becomes negative, when shifting our attention to positive outcomes of a dramatic childhood, life itself creates a completely different meaning.

When beginning to write this paper my assumption was that parental alcoholism has a major influence on ACOAs' development. By the end of writing this paper I realized once again that every cloud has a silver lining. We all have difficult moments in our lives; we all have milestones and roadblocks. What is different about each and every one of us is the way we react to these challenges. Do we meet them with a smile and open heart, hoping to learn a valuable lesson from each milestone? Or do we try to hide from them, hoping that it’ll too pass? It is all in our heads and it is up to us to come up with our own paths.   

 Маша Марки.