Helping someone with a drink problem can be a daunting challenge. But there is a course that may help. Anne Dempsey reports.
If you live with someone and are concerned about their drinking, you may feel there is nothing you can do. Perhaps you've tried everything - the rows, the pleading, the withdrawing - and now you settle for keeping the peace.
But there is a better way. 'Preparing the Ground for Intervention' explains how as part of a course called 'Facing up to Alcohol Misuse' beginning on February 1st. The subject is explored by Gerry Cooney, an addiction counsellor at the Rutland Centre, in Dublin.
First, how does he define alcohol misuse? "I don't find labels particularly helpful because all they can do is to make people defensive. In talking to someone, I would want to know if they sometimes cross the line, how their drinking impacts on important areas of their life - behaviour, relationships, family, work, health and finances. Typically there will be changes in behaviour, mood, temperament, as the situation progresses. Work tends to be the last area to suffer, partly because they often try to protect work, believing if they're still able to pitch up, still earn a wage, then the drinking can't be that bad.
"In the past, the workplace tended to be more accommodating in terms of excessive drinking. While most of the major companies are admirable in wanting to support an employee, today they are less likely to put up with poor performance and expect someone to get help. It used to be thought that this help could be offered effectively only when the drinker had reached rock bottom and accepted they had a problem. Current thinking is more proactive.
"We would be saying that early intervention is possible and if problems can be faced sooner rather than later, why wait? Spouses usually struggle to contain the situation partly because they can feel guilt and shame. Women are more likely to blame themselves, feel if the relationship was better, the person would not be drinking. Blame, denial, minimisation, deflection are part of addictive behaviour - the drinker might say 'it's not my fault', 'I don't drink that much', 'everybody does it', 'you drive me to it'. Also, there may be co-dependent behaviour where the non-drinker does not challenge and the situation becomes perhaps not the acceptable but the familiar," says Mr Cooney.
"It's difficult to generalise, but in my experience men are often less supportive if a partner is drinking," he says.
While it can still be more difficult for a woman to seek help, the ratios in Rutland's residential programme have moved from 70:30 men to women to 60:40, and, occasionally, says Mr Cooney, there may be more women then men in residence.
Families/partners need support if they are to act, and Rutland offers a family mobilisation programme. "We would encourage them to get information, find out what is available. They could join Alanon [providing support for partners/families].
"One of the things we would also suggest is that most drinkers have an awareness that things are growing out of control. I believe that a drinker wants help but does not know how to ask for it. So spouses may often have a window of opportunity. Perhaps after a row or particular incident, the person might apologise, be taken aback by their own behaviour. It may be possible at that time to ask if they would talk to someone about their drinking, and that is how intervention often begins."
Or engagement may need a more formal set-up. "We would often encourage involving more people in the intervention," says Mr Cooney. "A partner doing it on their own may be too subjective. They may be able to involve someone the drinker may trust, a best friend, a sibling. Children can be very powerful in intervention if they can explain to their parent how the drinking has affected them. 'I don't bring my pals home from school any more because I don't want you to embarrass me.' It is very hard for the person to hear this from their children but it is something they may have to listen to."
What of parental intervention when a young adult's drinking is disrupting the whole family? "That may need a different dynamic because of the angst of youth who may not accept they have a serious problem," he says. "We would ask parents to look at what is and is not okay in their family. They have a right to know a son or daughter is safe when they are out and not behave when they come home in a way that disrupts the whole household. The best approach may be for parents to spell out what they want and need and to allow the young person to make the decision - as in 'if you decide you can't agree to this, then you may need to move out'."
The object of all intervention is to have the drinker agree to do something about the drinking. This could mean joining a residential or day programme, attending AA, going for counselling, life skills or life coaching, cutting down or cutting out. Some professionals suggest that someone whose drinking is out of control can return to controlled drinking. However, others believe abstinence is the only option.
Either way intervention in a drinking problem is the beginning of a whole new process. Some treatment programmes involve detoxification, most focus on the primary nature of the addiction, its harmful consequences for all concerned, and the underlying reasons for the addictive behaviour.
The personal growth perspective is also a core component in many programmes, in which the individual is encouraged to take more responsibility for their behaviour, and - in some programmes - get more in touch with their innate goodness and potential. The family aspect is an integral part of the Rutland programme which has family days during the active treatment phase and a follow-up aftercare programme for client and family.
Overall, Gerry Cooney is positive about the role for intervention. "Alcoholism is a progressive illness, but it is possible for many who cross the line in terms of their drinking to reverse that trend. With the help of early detection/intervention, they may manage to change their relationship with alcohol.
"All can achieve a better quality of life, and deserve that opportunity."
Help at hand