It is common for family members of alcoholics, especially wives, to struggle relentlessly to pull the patient away from alcohol. However, such efforts, relying solely on love and common sense, often prove ineffective and sometimes even worsen the patient's drinking habits. Let us explore the recommendations of experts in this field on how to interact with these patients, motivate them to seek treatment and quit drinking, and what family members can do to reclaim their peace of mind.
When to Worry About Drinking
Alcoholics often downplay the severity of their drinking, making it difficult for family members to determine whether their intervention is necessary. Modern medicine does not consider occasional, controlled drinking a disorder. However, adolescents, individuals from families with a history of alcoholism, those with physical or mental conditions exacerbated by alcohol, and pregnant women should completely abstain. Signs that drinking has escalated into a disorder requiring treatment include:
- Experiencing withdrawal symptoms like tremors or insomnia when not drinking.
- Needing increasing amounts of alcohol to feel intoxicated.
- Failing to fulfill work or other responsibilities due to drinking.
- Losing control over the amount consumed.
- Spending excessive time thinking about or obtaining alcohol.
- Having no hobbies or social activities beyond drinking.
Physical, mental, legal, or social problems caused by drinking should also be taken seriously.
First, Reclaim Your Mental Health
Feelings of shame, guilt, fear, anxiety, anger, and despair are natural and common among family members of alcoholics. To effectively guide the patient away from alcohol, patience, resilience, self-confidence, and hopefulness are essential.
Reignite interest in your own health and hobbies that were neglected during the turmoil. Dedicate at least 15 minutes daily to activities that bring you joy. Avoid blaming yourself with thoughts like, "I am the reason you are like this." Alcoholism is a disease, and no shortcomings on your part could have caused it. Do not interpret broken promises like "I will never touch alcohol again" as a lack of love. Alcohol alters brain function, making it hard for many to resist relapse. Let go of unnecessary guilt over occasional outbursts. Share your struggles with relatives and friends without fearing societal judgment. Seek counseling if needed. Practice relaxation exercises and problem-solving techniques to manage stress.
General Precautions
Educate Yourself About Alcoholism
Speak with psychiatrists or addiction counselors. Recognizing alcoholism as a disease, not a moral failing, helps you view the patient in a new light and reduces stigma. This knowledge also dispels myths like "quitting suddenly is dangerous" or "treatment leads to worse relapses," enabling you to respond objectively to the patient's excuses. Attending Al-Anon meetings can help you realize that alcoholism is not unique to your family, connect with survivors, and boost your confidence. If Al-Anon meetings are held locally, make sure to attend.
Stop Enabling Behaviors
{xtypo_quote_left}Avoid indirectly encouraging drinking in any way.{/xtypo_quote_left}Avoid indirectly encouraging drinking in any way. Do not trivialize the problem with statements like, "Men will drink a little." Refrain from buying alcohol for the patient under the guise of "safer home drinking." Avoid participating in rituals involving alcohol.
Most patients decide to quit when they realize the extent of their alcohol-related losses. Therefore, avoid actions that mitigate the consequences of their drinking. Do not carry a drunk person to bed or clean up vomit and broken bottles before they wake. Do not lie to employers about absences. Do not take over the patient's neglected responsibilities. Do not cover up their broken promises. Avoid bailing them out of legal trouble.
Do not give money, even for car repairs or fines. Pay only essential bills like rent and utilities. Many patients consider treatment only when financial desperation or withdrawal symptoms set in. Do not deprive them of this opportunity.
When you start behaving this way, the patient may protest. Some family members may side with them. You might even feel "inhumane." Remind yourself that continuing old habits delays the patient's awakening.
Stop mocking, berating, belittling, or constantly blaming the patient. Such behavior not only fails to reduce drinking but also drives the patient to alcohol as a coping mechanism for their distress, guilt, or anger. Avoid framing discussions as if the problem lies in your reactions rather than the drinking itself.
Things to Avoid
- Do not pour out or hide alcohol. This only forces the patient to spend more money, including funds needed for household expenses, on alcohol.
- Avoid arguing with someone under the influence.
- Do not ride in a car driven by a drunk person.
- Do not assume changing residences will reduce drinking.
- Do not let the patient's whims dictate your daily routine.
- Avoid forcing promises. Patients cannot keep vows, and this only wastes time and breeds resentment.
Communication Tips
When speaking with the patient, the following strategies can reduce the likelihood of angry reactions:
Avoid negativity. Replace "You embarrassed me again today" with "We would all be happy if you joined us for soup and juice instead." Instead of accusing, "You’re lying again," say, "I want to trust you, but something feels off here."
Express your feelings instead of criticizing. Replace "You’re going to kill someone driving drunk" with "My heart races when you drink and drive."
Angry outbursts strip you of control and give the patient an excuse to drink. Walk away when furious. Practice deep breathing, relaxation techniques, prayer, or immerse yourself in calming activities.
Avoid prolonged arguments. Choose a calm moment to present your points. State your case once and resist revisiting it. If the patient argues, do not engage. Excuse yourself if necessary.
Acknowledge the patient’s perspective to reduce resistance. For example, say, "I know job hunting isn’t easy right now, but if you take this step..." Offer to share responsibility if appropriate.
Small Steps to Curb Drinking
Identify triggers like specific events, people, places, or times that prompt drinking, and minimize their impact. Find alternative remedies for issues like insomnia or boredom. Seek help if needed.
List activities the patient enjoys that are incompatible with drinking. Create opportunities for these during usual drinking times. Keep preferred non-alcoholic drinks and snacks at home.
Reflect on whether your reactions to the patient’s drinking inadvertently encourage it. Adjust your behavior accordingly.
Preventing Physical Abuse
{xtypo_quote_right}If the patient has a history of violence, proceed with extra caution.{/xtypo_quote_right}If the patient has a history of violence, proceed with extra caution. Assess whether changes might provoke abuse. Remember, abuse does not stop on its own; inaction only allows it to escalate. Avoid blaming yourself or believing the patient’s excuses. Do not discuss your "role" in the incident with anyone.
Keep an emergency bag with essentials for you and your children. Identify one or two safe places where the patient cannot enter. Enlist help from family, friends, or support groups.
Recall details of past abuse: where it started, how it escalated, and what was said or done. Identify missed opportunities to intervene. Notice warning signs like flushed faces or pacing. Document these signs and brainstorm preventive actions. For example:
- If told to leave, say, "I’ll go, but I just wanted to mention the time," and exit.
- If glared at, say, "If you dislike what I said, I’ll drop it," and change the subject.
Visualizing these scenarios daily prepares you to act effectively. If abuse recurs, relocate to a prearranged safe place immediately. Return only with accompaniment after a few days. Avoid discussing the incident. Clearly state that physical abuse is never acceptable.
Medications Given Without the Patient’s Knowledge
Advertisements for secret remedies for alcoholism are common in newspapers. Many contain disulfiram, a psychiatric drug that causes severe reactions with alcohol, sometimes fatally. Administering such drugs without medical supervision is dangerous.
When Other Disorders Are Present
Some alcoholics also suffer from depression or paranoia. Treating these conditions is crucial for addressing their drinking. Individuals with antisocial personality disorder rarely respond to treatment. They exhibit chronic disregard for social norms, impulsivity, aggression, blame-shifting, lack of empathy, and absence of guilt.
Encouraging Treatment
{xtypo_quote_left}Thorough preparation is essential before discussing treatment with the patient.{/xtypo_quote_left}Thorough preparation is essential before discussing treatment with the patient. Research local treatment centers and document the patient’s drinking patterns and related losses.
The best time to broach treatment is immediately after a major alcohol-related crisis. However, delaying too long risks irreversible organ damage.
What Wives Can Do Alone
Choose a private, calm moment when the patient is sober. Express concern without pressure. State that treatment is non-negotiable but offer full support. Focus on consequences, not blame. List problems with dates, financial losses, and quantities consumed. Highlight how drinking has harmed their career, children, or intimacy. Avoid labels like "drunkard" or "addict." Frame treatment as a way to improve your relationship, not fix flaws. Demand an immediate response.
Expect resistance. Counter objections with evidence. For example, point to empty bottles if they deny excessive drinking. Insist on medical tests if they claim good health. Warn of consequences for non-cooperation, emphasizing self-protection, not punishment. Only issue credible threats.
If the patient agrees only to minor changes like not driving drunk, accept this temporarily. Wait for the next opportunity. If they vow to quit alone, allow one or two chances, provided they lack severe withdrawal symptoms.
If they refuse to acknowledge a problem, shift the discussion to recent incidents. Ask why they lost a job or caused an accident and how they plan to prevent recurrence.
At signs of aggression, change the subject. Exit gracefully, saying, "I only wanted to help." Avoid arguments; revisiting the topic later will be easier.
Even if the first attempt fails, take comfort in having planted seeds of doubt that may grow into a willingness for treatment later.
Interventions With Others
{xtypo_quote_right}Group interventions are often more effective than solo efforts.{/xtypo_quote_right}Group interventions are often more effective than solo efforts. Gather five or six respected individuals, including recovered alcoholics. Exclude those with substance abuse, mental illness, or marital conflicts. Plan thoroughly. Choose a neutral time and place. Keep the plan secret. Each member should prepare what to say and how to respond to refusal. Surprise the patient with the meeting, perhaps under the guise of a family event.
Effective Communication Techniques
Some patients simultaneously desire and resist quitting. Confrontation may backfire, reinforcing pro-drinking thoughts. Others reject advice out of general defiance. Engage both groups with empathy and respect. Use open-ended questions like:
- What complaints do others have about your drinking?
- Where do you see yourself in five years?
- What opportunities has drinking cost you?
- How has drinking harmed your life?
- What benefits could quitting bring?
Encourage any anti-drinking remarks. Ask for details. Summarize their points periodically. If they argue, deflect with:
- Topic shifts.
- Rephrasing their statement. For example, if they say, "Counseling is a scam," reply, "So you believe counseling never helps anyone?"
- Linking their argument to earlier pro-change statements. For example, "You admitted drinking harms your health, job, and family, yet you say you drink less than your friends. How does this fit?"
- Affirming their autonomy: "It’s your decision."
If advice is unavoidable, seek permission first. Present it as a friend’s experience. Offer multiple options. Ask for feedback.
Remember, years of drinking have shaped both your lives. Change takes time. Focus on small, planned steps. Document goals, actions, obstacles, and solutions. Review these notes regularly.
When All Efforts Fail
Free yourself from guilt and focus on rebuilding your life. Count remaining blessings. Relearn self-love. Gradually release anxiety and guilt about the patient. Engage in fulfilling activities when thoughts of them distress you. Remember, their current path is unsustainable. Detach your mood from their actions.
Reconnect with old friends. Explain that shame over alcoholism caused the distance. Seek employment or vocational training. Spend time away from home. Save money secretly.
Considering Separation
While contemplating divorce early is unwise, there may come a time to weigh its pros and cons. Years with an alcoholic can cloud judgment. Some wives blame themselves or develop Stockholm syndrome, sympathizing with their abuser. A trial separation can provide clarity. Those staying "for the children" should consider how life with an alcoholic affects them.
(Published in the May 2013 issue of Mathrubhumi Health Magazine.)
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