©2010 McGraw-Hill Higher Education. All rights reserved. Chapter 7 Growing Up in an Alcoholic Family System ACA is a social reform movement

©2010 McGraw-Hill Higher Education. All rights reserved.

Chapter 7

Growing Up in an Alcoholic Family System

ACA is a social reform movement


National Association of Children of Alcoholics (NACOA) Charter Statement (1983)

An estimated 28 million Americans have at least one alcoholic parents.

More than half of all alcoholics have an alcoholic parent Children of alcoholics are at the highest risk of developing

alcoholism themselves or marrying someone who is alcoholic

In up to 90 percent of child abuse cases, alcohol is a significant factor

Children of alcoholics are frequently victims of incest, child neglect, and other forms of violence and exploitation.


Characteristics of Adult Children of Alcoholics (ACA)

1. Fear of losing control2. All-or-none, black-or-white thinking3. Fear of experiencing feelings4. Overdeveloped sense of responsibility or irresponsibility5. Difficult with intimacy and with asking for what is wanted

or needed6. Flashbacks of childhood but many memory gaps7. Feelings of being like a child when under stress8. Unreasonable loyalty9. Inadequate; don’t trust their talents, skills, and

accomplishments


ACA Characteristics cont’d

10. Addiction to excitement11. Difficulty relaxing12. Feelings of guilt, abandonment, and/or depression13. Tendency to confuse love with self-pity14. Backlog of shock and grief15. Compulsive behaviors16. Living in a world of denial17. Guessing at what is normal18. Tendency toward physical symptoms (e.g., headaches,

gastrointestinal problems)19. Exhibiting PTSD (Post traumatic stress disorder) symptoms (Tim

Cermak)


Behavioral Characteristics of ACAs

Being superachievers or perfectionists or exhibiting efforts that go far beyond the reasonable criteria of every task.

Exhibiting an inordinate need to control their environment and therefore becoming anxious with the slightest threat to their security (e.g., a teacher’s comment on homework or an unusually low grade may provoke emotional upset)


Behavioral Characteristics of ACAs cont’d

Displaying social disengagement from or excessive attention to the peer group (as an isolated loner or a class clown)

Exhibiting signs of physical neglect (untidiness, soiled clothing, poor hygiene) and/or physical abuse (bruises, cuts, etc.)

Being unable to concentrate and sometimes showing marked variations in academic performance, especially when parents are in a binge pattern of alcohol use or in codependent conflict

(Robert Ackerman [1978])


Second-Order Change

A cognitive-behavioral technique to change the way one traditionally responds to situations and interpersonal interactions.

First-order interactions are often mechanical, automatic, and even rhetorical.


Defining Codependency (Tim Cermak, M.D.)

Cermak defined codependency in diagnostic terms in the hope that codependency would be recognized as a psychiatric disorder. The following are diagnostic criteria for codependent personality disorder:

1. Continual investment of self-esteem in the ability to influence or control feelings and behaviors in the self and others in the face of obvious adverse consequences.

2. The neglect of oneself while preoccupied or obsessed with changing the partner.


Defining Codependency cont’d

3. Assumption of responsibility for meeting others’ needs to the exclusion of acknowledging one’s own needs.

4. Anxiety and boundary distortions in situations of intimacy and separation

5. Enmeshment in relationships with personality-disordered, drug-dependent, and impulse-disordered individuals.


Defining Codependency cont’d

a. Constriction of emotions with or without dramatic outbursts

b. Depressionc. Hypervigilanced. Compulsionse. anxiety

f. Excessive reliance on denial

g. Substance abuseh. Recurrent physical or

sexual abusei. Stress-related medical

illnesses

5. Maintenance of a primary relationship with an active substance abuser for at least two years without seeking outside support and/or exhibiting three or more of the following characteristics:


Codependency Metaphor

Being a lifeguard on a crowded beach, knowing that you can’t

swim


Overseparation and Overattachment (Coleman & Colgan, 1987)

OverseparationThoughtsYou’re not good enoughThey want so much.They give so little.I’m ambivalent.If only they would…I am a rock.You should be grateful.

OverattachmentThoughtsI’m not good enoughI want so little.I give so much.You don’t care.What am I doing wrong?I’m nobody without you.I’m so unappreciated.



OverseparationFeelings

Fear, abandonment

Out of control

Needy, burdened

Unsafe alone

Shut-out

Desperate

OverattachmentFeelings

Fear, smothering

Self-controlled

Indifferent

Unsafe with others

Trapped

Numb



OverseparationBehaviors

Is self-protective

Controls others

Acts to guard feelings

Denies

Is compulsively independent

OverattachmentFeelings

Is self-sacrificing

Please others

Acts contrary to feelings

Explains

Is compulsively dependent


11 Curative Factors of Group Psychotherapy (Irving Yalom, M.D.)

1. Instilling hope

2. Sharing universality

3. Imparting information

4. Fostering altruism

5. Recapitulating the primary family group

6. Developing socializing techniques

7. Imitating behavior

8. Sharing interpersonal learning

9. Developing group cohesiveness

10. Sharing catharsis

11. Exploring existential factors

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©2010 McGraw-Hill Higher Education. All rights reserved. Chapter 7 Growing Up in an Alcoholic Family System ACA is a social reform movement