Q. I’m a Family Therapist working on a case where a mother is in the late stages of alcoholism and I could use the input of an addiction specialist. The mother is in her early 50s and has four adult children ranging in age from 17 to 25. Her husband is beside himself since his wife has already been to four inpatient rehabilitation programs but still continues to drink. One of the rehabs she completed was an eight-month-long extended care program. Even with that, she started drinking within a week of arriving back home. Do you have any ideas or suggestions about this case you could offer me? The idea of just sending her off to treatment, yet again, seems inadequate.
– Sandy L., LCSW (Family Practitioner, NJ)
We understand your frustration, Sandy: working with a family where the alcoholic continues drinking, even after completing numerous treatment programs, can be very discouraging. Don’t give up! When it’s the wife who has the drinking problem, as opposed to the husband, it usually is a more challenging case for the Family Therapist to handle. We can’t explain why, but from our experience, anecdotally, it’s true.
Our reading of this situation: The wife appears as if she just wants out – out of her marriage, maybe even out of being a mother. At home, drinking provides her a means to escape from her husband and the life she has created. Her willingness to complete four inpatient rehabilitation programs suggests that the physical separation from her family that rehab requires provides her a similar freedom from her husband and family as the alcohol does. When she returns home, she probably faces codependency and healthy boundary setting issues with her family that are very challenging to an alcoholic in early sobriety. If the alcoholic is emotionally unable to leave or set adequate boundaries in a burdensome relationship, unconsciously he or she will try and get the other person to leave them instead. The wife’s act of drinking within a few days of completing an eight-month extended care program is an example of what we are describing.
Involve the whole family
You don’t provide much information about the husband and children, but we suspect they don’t understand how addiction really is a family disease. Husbands, whose wives are alcoholic, are often very controlling and condescending toward them. They are generally slower than wives are in deciding to ask for help for their addicted spouse. In fact, it is usually the children, not the husbands, who reach out for help. Husbands will cooperate if other family members seek help, but typically they do not assume the leadership role you would anticipate from a loving spouse.
When it comes to the children in this family, we think of the wise old saying that “one mother can take care of 10 children but 10 children can’t take care of one mother.” These adult children need to know they are not the cause, nor can they cure, their mother’s drinking problem. They need a thorough understanding of how addiction has affected them and that they are at considerable risk of becoming alcoholic themselves.
Our suggestion to you is to have this family do an Invitational Intervention. When someone like this woman takes responsibility for her drinking problem, it is usually because the people around her have hit bottom and have begun to address their enabling behaviors. The wife has been made the target by the family and possibly the rehab community as well. That needs to change. The Invitational Intervention can do that.
Vincent Casolaro, LCSW, MAC, CASAC, and Robert Smith, LCSW, are addiction specialists in private practice in New York City. In 1999 they founded the Together Family Foundation (TFF), a not-for-profit 501(c)(3) corporation, now the parent organization of Togethermagazine and Together Warmline. Send your questions to: asktheinterventionists@casolaroandsmith.com.
