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FAMILY INTERVENTION: ALCOHOLISM. By: Nancy D. Losinno, LCSW, CASAC BNL EAP Manager. Effects of alcoholism on the family. Development of alcoholism in 1 family member affects all the other members; The longer-lasting & more subtle the process, the greater the acceptance of it as the “norm;”

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family intervention alcoholism

FAMILY INTERVENTION:ALCOHOLISM

By: Nancy D. Losinno, LCSW, CASAC

BNL EAP Manager

effects of alcoholism on the family
Effects of alcoholism on the family
  • Development of alcoholism in 1 family member affects all the other members;
  • The longer-lasting & more subtle the process, the greater the acceptance of it as the “norm;”
  • Rigid patterns of behavior for all, attempts to change can become thwarted until a crisis disrupts the norm-steady state-homeostasis.
  • See the scales in background-alcoholic family is always in a delicate state of balance.
parallel defenses symptoms
Parallel defenses & symptoms
  • Jellinek model: denial, projection, isolation, rationalization, personality change;
  • A simultaneous process in the members of the family;
  • Social isolation leads to emotional isolation
  • Fears, anxiety, & guilt parallel those of alcoholic;
  • Family members experience decline in their own health, may question their sanity, and suffer rages, frustrations & self-pity when situation does not change, as “promised.”
what is codependency
What is “Codependency?”
  • A dysfunctional pattern of living/problem solving developed by family rules in childhood;
  • CODA have a greater tendency to love the unreliable, emotionally unavailable, needy, “wounded birds” who need “rehabilitation”
  • CODA tries to provide & control every part of the relationship while denying their own needs, desires, dreams, setting themselves up for more unfulfillment;
  • Creation of the “emotional debt” phenomenon out of fear of abandonment.
codependent behaviors
Codependent Behaviors
  • Controlling
  • Distrust
  • Perfectionism
  • Avoidance of feelings
  • Fears of being engulfed (intimacy issues)
  • Caretaking
  • Hyper vigilance
  • Stress-related physical illness
how did i get here
How did I get here?
  • Families of origin: what were the patterns/dynamics in yours?
  • How did my family handle conflict, anger, love, etc.?
  • Many people are taught not to be assertive or to ask directly for needs to be met;
  • How do I become more fulfilled & feel better about myself and the life I live?
the rules of codependency
The “Rules” of Codependency
  • Don’t rock the boat.
  • It’s not okay to talk about problems.
  • Keep your feelings to yourself.
  • Be strong, good, right, perfect.
  • Do as I say, not as I do.
  • The “best” communication is indirect.
  • Don’t be so selfish.
what is enabling
What is Enabling?
  • Enabler makes it easier for alcoholic to function;
  • Spouses take over the financial & home responsibilities;
  • Spouses make allowances for & forgive bad behavior;
  • May continue to be loving/giving in the face of physical/mental/emotional abuse
  • Parents close their eyes to suspicious behavior, hand out generous allowances, write sick notes
enabling s purpose
Enabling’s Purpose
  • Remember the delicate balance!
  • Enablers do it to meet their own needs, to restabilize the relationship, to lure the alcoholic back to them after alcohol has taken them away;
  • Enabling is a poor-quality glue;
  • Behind enabling is fear of abandonment
  • Only allows disease to grow to more serious stage
the disease concept
The “Disease Concept”
  • The “Jellinek” model poses 5 types of alcoholism based on male drinking patterns;
  • Is the most widely used model in treatment programs, with abstinence as the primary goal;
  • Most Americans in AA would be classified as “gamma” type;
  • Sharply contrasts with growth of psychiatric treatment programs for alcoholics who cannot recover without aid of anti-depressant meds
how do people change the prochaska model
How Do People Change?The “Prochaska Model”
  • Stage 1: Precontemplation—Resisting change. Precontemplators rarely take responsibility for themselves or their behavior, they do not like living with short & long term consequences. They may have tried & failed in the past, and believe that it will keep happening. Problem is how to become unstuck.
stage 2 contemplation change is on the horizon
Stage 2: Contemplation Change is on the Horizon
  • Being aware of your problem with passivity & depression;
  • Struggling to understand causes & cures;
  • Seriously thinking about solving problem;
  • Lets down defenses & welcomes others into his life;
  • Some people can get stuck in Contemplation for many years.
stage 3 preparation getting ready to change
Stage 3: PreparationGetting Ready to Change
  • Brings you to the edge of action;
  • Takes you from the decisions you make in Contemplation to specific steps to solve the problem;
  • Some may wish that admitting a problem will make it go away; some wait for a “magic moment;” others get stuck;
  • Making a commitment during this stage makes success more likely (set a date, “go public,” have someone hold you accountable)
stage 4 action its time to get moving
Stage 4: ActionIts Time to Get Moving
  • Action without preparation will last only temporarily;
  • Cheap change will not last long, real change takes work & mental sweat;
  • All change creates anxiety & you need ways to deal with the anxiety of change;
  • The myth of the “magic bullet”, there are no simple solutions.
  • Changing your thinking about your problem can result in a better, more productive outcome.
stage 5 maintenance staying there
Stage 5: MaintenanceStaying There
  • The myth of “just one” (drink, cigarette, piece of cake, etc.)
  • Successful change is sustained over a period of years & involves sweat effort;
  • Must be aware of danger signs & times, warning signals, areas of vulnerability;
  • In alcoholism treatment, it is called Building Up to Drink (BUD) syndrome or use HALT.
intervention what is it
Intervention: What is it?
  • Dynamics within alcoholic family are inter-twined, and involve response from other members;
  • By working with the most motivated family member, and changing the way they are responding to the alcoholism, intervention is made;
  • Is in contrast to glamorous/confrontational type of intervention, often high-priced. If family has not yet changed how they respond to the drinking—intervention may prove unsuccessful.
intervention how is it done
Intervention: How is it done?
  • Any method that creates change in the family member that is lasting, sincere, and reinforces positive behavior in the drinker can be part of intervention process;
  • For family members: Al-Anon, private therapy, even efforts to improve self-esteem (weight loss, depression, etc.)
  • EAP can be a valuable first step in the process of intervention;
  • Remember, intervention is a process, not an event!
  • After taking steps to intervene, no looking backward, no sideward glances to check if someone is noticing!
treatment resources
Treatment Resources
  • Get more information. Go online & Google. Call your 24/7 EAP at Cigna: 1-877-622-4327. Do something!
  • Visit www.cignabehavioral.com to visit library of topics, or Personal Stress Navigator to check your own stress level (user ID: bnl, password: employee)
  • Come talk to EAP. Call X4567 for short-term assessment/counseling/referral; help is confidential.
  • Access your mental health benefit through your insurance. Ask for someone with experience in alcoholism & substance abuse.
  • Find local Al-Anon Family Group meetings for free in your community. Visit: www.al-anon-suffolk-ny.org
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