Expert: Rebos - 8/13/2005

Question
Hi,
About 2 1/2 yrs ago my sister's husband had back surgery. While in the hospital she said he had a reaction to meds. She didn't want any family at the hosp. I went anyway,it wasn't a med reaction. He was going through the DT's. Shaking, hallucinating, thinking my sister, who he didn't recognize half the time, was trying to poison him. The dr's talked to him at the time and told him (and her) that he had to stop, suggested AA. As soon as he got home he started drinking again. And she wouldn't talk about it. In the past he has been the kind of alcoholic who doesn't fall down, stumble or anything he is what I have heard people call a functioning alcoholic. He was always able to go to work and do what he had to do but he always had some beers in him too. Well 1 week ago my husband had to be operated on for a bladder tumor (cancerous), my sister had to work and my B-I-L offered to go with us. My husband and him are closer to each other then to their own brothers. While my husband and I were in post-op, the hosp advocate said that my B-I-L had,had a grand mal seizure in the waiting room! Fell, hit his face, needed sutures. Thankfully I got a hold of my sister and she came right away as my husband was getting discharged. They did MRI, EEG, etc and it comes down to alcohol again. The drs told him as did she. He was in the hosp for 4 days. Yet, yest, (4 days after discharge) they came over and the moment my sister and I ran out to get take out for us, my husband told me that he ran to our frige and got a beer and drank it in record time. My husband said we weren't even out of the driveway. My sister said that when she worked the day before that when she came home, she found him trying to hide a can of beer. She lost it and he finally said he would go to AA. As a added feature he is thin to begin with, lost more weight in the hosp. and I think he is also malnourished. The hosp told my sister of a bunch of vitamins to give him. My sister won't tell anyone in the family about this except my husband and me. My parents are coming in 2 weeks to stay with me. Should my sister tell the family which includes her daughter? My B-I-L babysits for her kids 2 and 4 often. I already try to insinuate to my niece about this and she wouldn't even here of it. How can I convince her to go to Ala-non? My husband doesn't want me to tell her about the beer he had at our house because then he won't trust my husband. It is not like I am his wife and see him every day (we see them at the most once a week) But what can I and my husband do  and what can I do to help my sister. Sorry this is so long.

Answer
Good afternoon Dianna:

I apologize for not answering your question earlier, but we had a very bad rainstorm and I lost power for the past two days. In any case thank you for your question. Hopefully I will provide you with some information and options that may help you with your B-I-L's drinking problem… and your sister's apparent role as an “enabler”.

First let me say that it is of prime importance that your bil NOT be trusted to take care of the children. Your bil has as much control over his drinking as a pedophile has to not molest kids. I am not stating that your bil is a child molester but he should not be trusted to baby sit your sister's grandchildren…to an alcoholic a drink may be the most important thing in the world to him at any given time. And it is usually at the most in-opportune time. Your grand niece will be very upset to find that all this time your sister knew about her husband's drinking and said nothing about it. I wouldn't be surprised if he has already drank and drove with the kids in the car. If your sister realized that she was being an enabler, and killing him with what she perceives as kindness that she would stop and start to hold him responsible for his actions.

Not that it is important from his recovery standpoint, you have not said if you think that your bil is an alcoholic. Not to joke about it, but…to make a point, from what you described… “If it looks like a duck, quacks like a duck it probably is a duck.” Your bil's symptoms describe an alcoholic of the first order! However, alcoholism is as terminal a disease as is cancer or any other of the dreaded diseases that effects mankind. Unfortunately, there is no cure for alcoholism, but it can be arrested “one day at a time”.  

If you really want to get involved in helping you sister, the best advice that I can give you is for her to start attending Alanon meetings. You can offer to go with her if that will help her to go. If she doesn't already know, Alanon is a world–wide “anonymous program” attended by people who have an alcoholic in their lives and don't know what to do about it. By attending Alanon meetings she will find that her situation is not quite as unique as she may think. At Alanon she will learn about the disease of alcoholism and how she can manage “her” unmanageable life as a result of her husband's alcoholism. She will be relieved to know that there is hope for her, (as others have) whom she will meet there. There is no cost to attend, and meetings usually last about an hour. As a fringe benefit, in addition to learning how to help herself with her husband's drinking she may (if she chooses) also make many long lasting friendships. At the meetings she will learn how to “say what she means… mean what she says and… not be mean when she says it”. She will learn how to emotionally detach from her husband's alcoholism… with love. She will also learn how to live “guilt free” when she finds that she is not the problem but the “victim”. She will also learn how to be strong enough to resist the negative influence that he has over her life. Alanon is intended to help her, not the alcoholic directly. If it is at all possible to help she must first learn to help herself. Alcoholism is a societal disease that affects everyone (friends, family, and employers etc) who comes into contact with an active alcoholic. Alcoholics are not bad people, they are sick people who need help, but they must be held responsible for their actions! She may not be able to do anything about her husband's drinking but she can do something about the problem that has developed in her life by having an alcoholic in it. Until she are armed with the right kind of information and understand the disease for what it really is, her efforts to help will be a waste of time. Alcoholism is deadly and it destroys everything and everyone who comes into contact with it. For meeting locations, she can call her local Al-Anon chapter by checking the local phone book under "Alcoholism" or calling the following toll-free numbers: 1-800-344-2666 (United States) or 1-800-443-4525 (Canada). If she chooses not to go to Alanon the least she can do is to stop trying to control a situation that is uncontrollable, but most of all keep him away from baby sitting the children!

Just for your education…It is believed by many in the field of alcoholism that it is a three-fold illness…mental, physical and spiritual.

The “mental” part of the illness refers to the alcoholic's mental obsession to drink. If you will, the thought that precedes the first drink... a pre-occupation with thinking about drinking which is so powerful that the alcoholic must drink. In so many words, thinking about the drink in between the drinks. The alcoholic never seems to worry about the drink in front of them, but they continually think of the next one. The “physical” aspect of the disease is that once the first drink is downed a physical compulsion takes over in the form of a deep incessant craving that the alcoholic must continue to drink until some outside incident stops them or they pass out. The “spiritual” part of the illness (not spiritual in a religious way) is in the loss of the alcoholic's values, and a willingness to settle for less and less as the drinking continues. It becomes difficult for the alcoholic to determine the difference between right and wrong or good and bad. The alcoholic develops a change in priorities where drinking becomes more important than health, family, job and friends. A determining factor of alcoholism is that it makes no difference… how much a person drinks, where they drink it, what they drink or who even who they drink it with, the key is; what does it do to them when they drink? If drinking causes problems then it is a problem!

Stopping drinking is not a matter of willpower. Alcoholism is a disease. Drinking alcoholically is but “a symptom of a deeper underlying problem” that must be faced up to in order for an alcoholic to recover. Without learning what that problem is, trying to stay away from a drink is known as "white knuckle sobriety", or being on a “dry drunk”. It isn't very long before the alcoholic has to drink again. There is an old saying; “that once you turn a cucumber into a pickle you can never change it back to a cucumber again”. For the alcoholic there is no such thing as cutting down… drinking only on weekends… changing what they drink… or even switching to “near beer” with 0.5% alcohol. For the alcoholic nothing will work that is short of total and complete abstinence from any thing that contains alcohol or other mind-altering substances (drugs). Of course the exception is a medical doctor's prescription as long as the doctor understands that he or she is dealing with an addicted person. Unfortunately, all alcoholics must hit their own bottom before they do anything about stopping drinking. A bottom can be likened to going down on an elevator. The alcoholic can get of at any floor they want to. There is no need for him to go all the way to the bottom floor. I am sorry to say that hitting a bottom for some may mean going as low as a person can go...plus six feet! There is hope, for there are many “low bottom” and “high bottom” alcoholics that have stopped drinking and stayed stopped. On the other hand, even when a person is in a recovery program and has stayed sober for an extremely long period of time there is little guarantee that they can stay sober unless they remain vigilant and continue with their recovery on a one day at a time basis. There can be no let up, not even for a moment!

It is very easy for those who are close to an alcoholic to become “enablers”. An enabler is a person who allows an alcoholic to continue drinking, primarily by their acceptance of the alcoholic's actions and not holding them accountable for their unacceptable behavior. Many enablers are impelled by their own anxiety and guilt to rescue the alcoholic from their predicament. The enabler may be meeting a need of their own rather that the need of the alcoholic. If an enabler has no special knowledge about alcoholism and they try to help, the alcoholic can sense the ineptness and weakness of the enabler and they continue on drinking because they know that they will be forgiven and rescued again and again. In a backhanded way an enabler is giving the alcoholic “permission” to drink by their continued acceptance of the alcoholic's unacceptable behavior. Making “excuses” for the alcoholic has to be stopped in order for the alcoholic to pay the price for drinking. Because alcoholism is a progressive disease it only gets worse it never gets better on its own. Every time the enabler gets the alcoholic out of a jam, lends money, or in any way allows the person to get away with being irresponsible, they are really buying the alcoholic their next drink. Alcoholics are users! They are too self-centered to think about any thing other than their next drink. They don't really have family, lovers, wives, husbands, children or friends they have victims and they will take hostages as long as they can get away with it. In the long run enabling will not only destroy the alcoholic, but also their family and friends.

Until your bil “admits and accepts” that alcohol is causing him problems there is little you can do for him. Even those poor unfortunates that are in shelters “admit” that they are having a problem with drinking, but it is their “acceptance” to the point of doing something positive about it, is what counts. No one can scare an alcoholic into stopping drinking. Cajoling, hand-wringing, threatening, begging and even putting him away against his will, will not get him to stop doing what he has not made up his own mind to do. Don't think that he does not want to stop drinking… he can't stop when left to his own devices. Also, don't be lulled into thinking that an alcoholic will stop drinking just because they say that they will. It's not that they purposely lie to you… but they will lie to themselves because down deep they are afraid to stop. Alcoholism is powerful, cunning, baffling and insidious. An alcoholic's choices become limited to: attending a recovery program like AA, or entering an in-patient detoxification clinic that has an after care outpatient program. If an alcoholic does nothing about stopping drinking then they are destined to die a drunk's death, get involved negatively with the law or end up in a mental institution. I am sorry to be blunt, but I am only stating what you probably already know. I have never seen an alcoholic stop drinking on willpower alone. The disease is too powerful. However, it is sometimes dangerous for an alcoholic to stop drinking on their own without proper medical supervision. Withdrawal from alcohol can be very difficult and sometimes physically dangerous.

He's “gottawanna” stop drinking in order for anything to work! He may need professional help at a detoxification clinic, where the process of withdrawal is closely monitored 24 hours a day until the danger of seizures or heart attack pass. After a detoxification period and some in house counseling at the detox, or even a long-term halfway house may be what he will need. Eventually it would be wise for him to enter some type of recovery program, like Alcoholics Anonymous. They will welcome him with open arms. In AA “if he is really serious” about staying stopped they can help.

He will stay sober for only as long as he wants to. I guarantee that if he wants to stay stopped and change his life for the better, AA will help. Sobriety is not a one shot deal it is a lifetime proposition of hard work, persistence, discipline and achieving some level of humility. It won't be easy for him but it will be worth it. AA works for those who want it to work. Your bil is not unique, many others who have been given up on have gotten sober and have led full and productive lives. Unfortunately recovery programs and sobriety is not for people who need it, but for people who want it.

Emotions being what they are will tend to cloud your sister's ability to think rationally, and cause her to see her situation in a distorted way. The level of her emotional pain is directly related to her need to run the show and control the situation. The more she tries to control the situation the deeper her pain will be. It cannot be done alone when emotions are in charge. It is natural for us to want to retreat into ourselves. She must allow those who have the answers for her (Alanon) to help her through it. When we allow others to help it is not a sign of weakness it is a sign of your strength. There is no reason for her to feel that she have failed at something she has no control over.

Below I have included a listing of actions that are recommended by the US Government as to what they recommend. Read them over, there are some good ideas in it.

Trying to get an alcoholic to stop drinking can be a challenging situation. An alcoholic cannot be forced to get help except under certain circumstances, such as when a violent incident results in police being called or following a medical emergency. This doesn't mean, however, that you have to wait for a crisis to make an impact.

Based on clinical experience, many alcoholism treatment specialists and the US Government recommend the following steps to help an alcoholic accept treatment:

Stop all "rescue missions." Family members and friends often try to protect an alcoholic from the results of their behavior by making excuses to others about their drinking and by getting him out of alcohol-related jams. It is important to stop all such rescue attempts immediately, so that the alcoholic will fully experience the harmful effects of his or her drinking--and thereby become more motivated to stop.

Time your intervention. Plan to talk with the drinker shortly after an alcohol-related problem has occurred--for example, a serious family argument in which drinking played a part or an alcohol-related accident. Also choose a time when he or she is sober, when both of you are in a calm frame of mind, and when you can speak privately.

Be specific. Tell the family member that you are concerned about his or her drinking and want to be supportive in getting help. Back up your concern with examples of the ways in which his or her drinking has caused problems for both of you, including the most recent incident.

State the consequences. Tell the family member that until he or she gets help, you will carry out consequences--not to punish the drinker, but to protect yourself from the harmful effects of the drinking. These may range from refusing to go with the person to any alcohol-related social activities to moving out of the house. Do not make any threats you are not prepared to carry out.

Be ready to help. Gather information in advance about local treatment options. If the person is willing to seek help, call immediately for an appointment with a treatment program counselor. Offer to go with the family member on the first visit to a treatment program and/or AA meeting.

Call on a friend. If the family member still refuses to get help, ask a friend to talk with him or her, using the steps described above. A friend who is a recovering alcoholic may be particularly persuasive, but any caring, nonjudgmental friend may be able to make a difference. The intervention of more than one person, more than one time, is often necessary to persuade an alcoholic person to seek help.

Find strength in numbers. With the help of a professional therapist, some families join with other relatives and friends to confront an alcoholic as a group. While this approach may be effective, it should only be attempted under the guidance of a therapist who is experienced in this kind of group intervention.

Get support. Whether or not the alcoholic family member seeks help, you may benefit from the encouragement and support of other people in your situation. Support groups offered in most communities include Al-Anon, which holds regular meetings for spouses and other significant adults in an alcoholic's life, and Alateen, for children of alcoholics.

I hope that I have helped you with my answer. I wish you the very best and hope that you resolve your present situation. Unfortunately there is no good fairy that will tap your bil on the shoulder and make him “all better”. It will take a lot of hard work. Until your bil gets tired of being sick and tired there is not too much your sister can do except to learn all that she can by going to Alanon and seriously consider the list of information above. Hate the disease not the patient. But don't be afraid to hurt her feelings by letting her know the TRUTH as to how you feel about her husband's drinking. When you do talk to her “say what you mean…mean what you say…but don't be mean when you say it”! Don't ever make any threats to her or to your bil that you are not 100% willing to carry through with.

If there is anything further that I can do for you please do not hesitate to contact me again through Allexperts. Thank you, Rebos.