Cover Page

Contents

Cover

Title Page

Copyright

Preface

Sources and Acknowledgements

Chapter 1

Chapter 2

Chapter 3

Chapter 4

Chapter 5

Chapter 6

Chapter 7

Chapter 8

Chapter 9

Chapter 10

Chapter 11

Chapter 12

Chapter 13

Chapter 14

Chapter 15

Chapter 16

Chapter 17

Chapter 18

Chapter 19

Chapter 20

Chapter 21

Chapter 22

Chapter 1: We'll Be There for Him

Comments

Questions

Exercises

Chapter 2: Long Day's Journey into Night by Eugene O’Neill

Comments

Questions

Exercises

Chapter 3: Tough Love

Comments

Questions

Exercises

Chapter 4: Wives of Gamblers

First wife: Should I work on his communication or her coping?

Second wife: What support does she need and who will provide it?

Third wife: Should I refer them for sexual health counselling and suggest she should let the gambling look after itself?

Comments

Questions

Exercises

Chapter 5: The Tenant of Wildfell Hall by Anne Brontë

Comments

Questions

Exercises

Chapter 6: British Sikh Wives and Daughters Stand Up to Men's Drinking

Comments

Questions

Exercises

Chapter 7: Nil by Mouth

Comments

Questions

Exercises

Chapter 8: Worrying for Drinkers in Aboriginal Australia

A son and his wife worry for his father

A sister worries for her brother

A woman worries for her husband and her father worries for them both

Comments

Questions

Exercises

Chapter 9: A Prodigal Son

Comments

Questions

Exercises

Chapter 10: Parents of Problem Gamblers

Mother A

Mother B

Father B

Father C

Mother D

Father D

Mother E

Mother A

Mother B

Father E

Mother F

Father D

Mother B

Father E

Father G

Mother G

Father H

Mother A

Mother B

Mother F

Mother E

Mother B

Comments

Questions

Exercises

Chapter 11: The Tale of Caitlin Thomas

Comment

Questions

Exercises

Chapter 12: Dylan Thomas in America by John Malcolm Brinnin

Comments

Questions

Exercises

Chapter 13: An Imaginary Conversation

Esther

Sylvia

Mrs Lim

Reberta

Esther

Reberta

Esther

Mrs Lim

Reberta

Sylvia

Esther

Sylvia

Reberta

Mrs Lim

Comments

Questions

Exercises

Chapter 14: Father Figure by Beverley Nichols

Comments

Questions

Exercises

Chapter 15: Growing Up with My Mother by Virginia Ironside

Comments

Questions

Exercises

Chapter 16: Mrs Sara Coleridge and Friends

The friends

The later years

Comments

Questions

Exercises

Chapter 17: Five Husbands of Wives with Drinking Problems

John

Jack

Tom

Eric

Eric

Gordon

Jack

Gordon

Eric

John

Tom

Eric

Gordon

Jack

Gordon

Eric

Tom

John

Tom

Gordon

Jack

John

Jack

Eric

Gordon

Tom

Eric

John

Eric

John

Tom

Comments

Questions

Exercises

Chapter 18: A Chancer by James Kelman

Comments

Questions

Exercises

Chapter 19: Growing Up with Parents Who Drink Excessively

Annie's story

John's story

Alan's story

Catia's story

Comments

Questions

Exercises

Chapter 20: Baudelaire and His Mother in Chains

Comments

Questions

Exercises

Chapter 21: Fever Pitch by Richard Brooks

Comments

Questions

Exercises

Chapter 22: I Only Had the Baby's Welfare at Heart

Doreen

Pearl

Mrs Lennie

Viv

Edith

Esme

Comments

Questions

Exercises

Further Reading

Index

Title Page

Preface

Addiction, in its various forms, is unfortunately extremely common. Because people who are themselves addicted usually experience a mixture of confusion, guilt, shame and depression about their addiction, and because they are often ambivalent about seeking help and changing, the problem is in large part a hidden one. The availability of treatment is at best patchy and in many parts of the world is virtually or completely absent. The hidden nature of the problem is further compounded when it comes to family members who are affected by the addiction of a close relative. It is those family members – the partners, parents, sons and daughters, sisters and brothers, grandmothers and others – who are the principal protagonists of the chapters of this book. Their problems come to light only with great difficulty. For them the barriers that stand in the way of obtaining help are multiplied by many factors. The latter include lack of awareness of any help that might be available to them, the sense of shame at having such a problem in the family, a fear of gossip, ridicule or criticism by others, a belief that such problems should be dealt with within the family, and a lack of trust in the services that do exist.

That fear of criticism and lack of trust in services may, sadly, have been well placed in the past. Even when services have been alert and responsive to problems of addiction they have tended to ignore the fact that addiction often profoundly affects the lives and health of close family members. Family members have mostly been on the periphery in addiction treatment services. Even worse, when professional attention has focused at all on family members, in the past it has often contributed to the very criticism that family members fear. Not only have family members been marginalized but they have also been misunderstood. For one thing it has often been presumed, or at least implied, that they are somehow to blame for the origin or perpetuation of their relatives’ addiction.

Because the problems faced by the characters that appear in the chapters of this book are hidden and ill-defined it is almost impossible to put a figure on their prevalence with any accuracy. But, using figures for the prevalence of alcohol, drug and gambling problems in those countries where there has been research, and making very cautious estimates of the numbers of closely affected family members, my colleagues and I arrived at a minimum estimate of close to a hundred million adults worldwide seriously affected by the excessive drinking, drug use or gambling of close relatives (cited in our book Orford J. et al., Coping with Alcohol and Drug Problems: The Experiences of Family Members in Three Contrasting Cultures). Indeed many would consider that to be a gross under-estimate. What this means is that every primary care medical practitioner or nurse, every social worker, teacher or community worker is certain to be in touch, whether they know it or not, with people who are experiencing the effects of living with someone who has a serious alcohol, drug or gambling problem.

It is towards the correction of the state of neglect, marginalization and misunderstanding of family members that the present book is aimed. For a number of years colleagues and I have been engaged in a programme of research and development designed to try to understand the experiences that family members face, and to develop and evaluate ways of helping family members. In the course of that research we have heard many family members tell their stories, and a number of the chapters in this book are based on those accounts (Chapters 1, 4, 6, 8, 10, 13, 17, 19 and 22). Those stories come from our work in England but also from other countries such as Mexico, Australia and Italy where we have collaborated in research on addiction and the family. The most common addiction that family members are concerned about is addiction to alcohol. Others are worried about their relatives’ addiction to drugs. In a further set of stories it is addiction to gambling that is the cause of concern. The most frequently occurring relationship of affected family member to addicted relative is that of wife to husband, but other family members who tell their stories are mothers, fathers, husbands, daughters, sons, grandmothers and in-laws.

As that programme of work has progressed I have occasionally come across, usually by accident, biographies or autobiographies, written about or by people who themselves have experienced what it was like to live with someone suffering from an addiction problem. When such a writer has recognized the importance of addiction and has focused at some length on how it has affected the subject of the biography or autobiography, this gives us an incomparable opportunity to extend further our knowledge of how addiction affects family members. Several of the chapters in this book are therefore summaries of such works. One of the earliest I discovered was the autobiography of the writer Beverley Nichols who recounts his experiences in relation to his father's alcohol problem (Chapter ). Only later did I find Virginia Ironside's book about her relationship with her mother who also had a drinking problem (Chapter ). I was excited to discover Caitlin Thomas's co-authored book about her life with Dylan Thomas and I subsequently sought out a number of books written by or about her and her experience of Dylan Thomas's drinking (summarized in Chapter ). It was only some time later that I discovered John Brinnin's book about his relationship with Dylan Thomas. That has a special role in this book because to my knowledge it is a unique account of the experience of being a close friend and colleague of someone with a drinking problem (Chapter ). The other three chapters of this kind are constructed around Jacqueline Doherty's story of her experience of her son's drug dependence (Chapter ); Molly Lefebure's biography of Sara Coleridge, the wife of the poet Samuel Taylor Coleridge who became dependent on opium – a biography that has the additional interest of having a lot to say about the effects of Coleridge's drug addiction, not only on his wife but also on his friends (Chapter ); and Frank Hilton's biography of Baudelaire, highlighting his drug addiction, which is very relevant to the theme of this book because Baudelaire's mother is such an important figure in Hilton's book (Chapter ).

The inclusion of five chapters reproducing short extracts from works of fiction may at first sight seem strange, but each has been included for a special reason. Chapter is the only one that draws on a dramatic work – Eugene O’Neill's play Long Day's Journey into Night. I decided early on to include it, not only because of the powerful scene that I have included, which rang true to me as a student of addiction and the family, but also for the good reason that the play is widely recognized to be, and was offered by O’Neill himself as, autobiographical. The particular scene that figures in Chapter concerns the mother, Mary, who, like O’Neill's own mother, has a morphine addiction. But O’Neill was also well acquainted with excessive drinking, which also featured in the play, since his father, himself and an elder brother, and two sons, all had problems with alcohol. Anne Brontë's The Tenant of Wildfell Hall (Chapter ) is one of two novels I have drawn on. The particular reason for including it lies in the peculiar structure of the book, a large part of which consists of the central character's diary in which she writes at unusual length about her perception of her husband's drinking problem and the changing ways in which she tries to cope with it. Coupled with the fact that there is good reason to believe that Anne Brontë was drawing on her experience of witnessing her elder brother's addiction, this insightful piece of, admittedly fictional, writing was always a strong candidate for inclusion. Chapter consists of an extract from a film, Nil by Mouth. Once again we have here a work of fiction that draws on personal experience. The director, Gary Oldman, who wrote the script and produced, directed and partly financed the film, had himself experienced at first hand having a drinking problem. When it comes to gambling there are a number of relevant novels from the nineteenth century that I might have drawn on – notably Dostoevsky's autobiographical The Gambler, and from the first half of the twentieth century – for example Graham Greene's Brighton Rock and Walter Greenwood's Love on the Dole. But for Chapter I have chosen to quote from a more modern novel, A Chancer by James Kelman. Although I have no reason to think that Kelman was drawing directly on personal experience, his reputation for accurate description of the hardships, often revolving around pubs and betting shops, in his native Glasgow, is a great one. The extract that appears in that chapter I chose because it seemed to me to capture so well what people have told my colleagues and myself about the tense family situations that can arise when addiction is present. The last of the fiction-based chapters returns to the medium of film, specifically the film Fever Pitch (Chapter ). Again, although it is a work of fiction, it is much more than purely imaginative, based as it was on the advice of a number of expert technical advisers who knew about compulsive gambling.

The book is therefore based on a mix of personal accounts given to researchers, autobiographies and biographies, and well-informed works of fiction. In fact it was my slow discovery that the same themes about the way addiction affected the family were to be found repeatedly in these varied sources that inspired me to put together this collection. There is one further chapter that remains to be mentioned and which does not fit any one of those three categories. It appears as Chapter . It is built around a BBC television documentary about drug addiction and the family. It was an early entry. Indeed it was a strong influence on my decision to go ahead with the book. There have been many television documentaries since then on the subject of addiction but none has come so close to this book's central theme. In the television studio, participants debated the very issue that parents had discussed with us in our research and which forms the central question for us here – how do family members respond in the face of a loved one's serious addiction problem?

I hope some members of families afflicted with addiction may find this book helpful. It might help them realize that, after all, they are not alone and completely misunderstood in their dilemmas; rather, that the difficulties they have been grappling with are very common and universal, and that many good people have been flummoxed and driven to despair about what to do. I hope it might help them think of new ideas about how to cope.

The audience that I most had in mind, however, consists of practitioners of one sort or another who are consulted by family members affected by addiction and who are often equally perplexed about how to advise or how to be of any help. I hope this book might provide additional understanding of the circumstances faced by families with an addicted member and might therefore usefully inform professional practice. In the process my hope is that it might contribute to reducing the misunderstanding that has existed about family members in these circumstances and add to an appreciation of what they are going through. Each chapter concludes with a commentary, drawing out what I believe are some of the most salient points, plus a number of questions and exercises that an individual or group of professionals or trainees might undertake. The separate chapters are each complete in themselves and can be used individually or in any order. The questions and exercises at the end of the chapters can be ignored if desired but my hope is that they will add to the value of the chapters, and the book as a whole, by serving as a training tool. They are designed to be challenging and to provoke debate and discussion on different aspects of a subject about which there are no simple answers. Just as family members themselves face dilemmas about how to cope, so do those who provide services for them face their own dilemmas about how to understand and how to respond. These personal and professional dilemmas are a reflection of the much wider societal dilemma about how to cope with highly prevalent addictions.

This is not a ‘How to do it’ book. Its aim, rather, is to aid better understanding by allowing readers to hear directly from family members – in literature or in research – and to critically reflect on what they are hearing. I believe that is a better route to knowledge and thence to constructive ways of helping. At the end of the book are some suggestions for further reading that might take that process further.

Sources and Acknowledgements

Chapter 1

Based on interviews with family members from several different families who took part in the English arm of a three-country study of family members affected by alcohol or drug problems, funded by the Mental Health Foundation. The results of that research are to be found in the books: Coping with Alcohol and Drug Problems: The Experiences of Family Members in Three Contrasting Cultures (Orford, J., Natera, G., Copello, A., Atkinson, C., Mora, J., Velleman, R., Crundall, I., Tiburcio, M., Templeton, L. and Walley, G., (2005), London: Routledge), Living with Drink: Women who Live with Problem Drinkers (Velleman, R., Copello, A. and Maslin, J. (1998), London: Longman), and Risk and Resilience: Adults who were the Children of Problem Drinkers (Velleman, R. and Orford, J. (1999), Amsterdam: Harwood); and in the following series of articles: Orford, J., Natera, G., Davies, J., Nava, A., Mora, J., Rigby, K., Bradbury, C., Copello, A. and Velleman, R. (1998) Stresses and strains for family members living with drinking or drug problems in England and Mexico, Salud Mental, 21:1–13; Orford, J., Natera, G., Davies, J., Nava, A., Mora, J., Rigby, K., Bradbury, C., Bowie, N., Copello, A. and Velleman, R. (1998) Tolerate, engage or withdraw: a study of the structure of family coping in England and Mexico, Addiction, 93:1799–1813; Orford, J., Natera, N., Davies, J., Nava, A., Mora, J., Rigby, K., Bradbury, C., Copello, A. and Velleman, R. (1998) Social support in coping with alcohol and drug problems at home: findings from Mexican and English families, Addiction Research, 6:395–420; and Orford, J., Natera, G., Velleman, R., Copello, A., Bowie, N., Bradbury, C., Davies, J. Mora, J., Nava, A., Rigby, K. and Tiburcio, M. (2001) Ways of coping and the health of relatives facing drug and alcohol problems in Mexico and England, Addiction, 96:761–74.

Chapter 2

Long Day's Journey into Night by Eugene O’Neill. The play was first published in Great Britain in 1956 and in paperback by Jonathan Cape in 1966. The quotations are from the 1990 reprinting of the paperback edition, from the character introductions on pages 10–11 and 16–17, and from Act 2, Scene 2, pages 64–6.

Chapter 3

Based on a BBC television documentary, Tough Love, in the Family Matters series, broadcast on 17 June 1991.

Chapter 4

Based on interviews with wives of men with gambling problems as part of a research project, funded by the Medical Research Council, and reported in Krishnan, M. and Orford, J. (2002) Gambling and the family from the stress-coping-support perspective, International Gambling Studies, 2:61–83.

Chapter 5

The Tenant of Wildfell Hall by Anne Brontë, first published in 1848. Quotations are from the 1996 Penguin classic edition, pages 202, 260, 267, 268–9, 322 and 339.

Chapter 6

Quotations taken from the paper: Ahuja, A., Orford, J. and Copello, A. (2003) Understanding how families cope with alcohol problems in the UK West Midlands Sikh community, Contemporary Drug Problems, 30:839–73, which was based on the unpublished PhD thesis, University of Birmingham, by Ahuja, A. (2000) entitled ‘Understanding family coping with alcohol problems in the Sikh community’.

Chapter 7

From the film Nil by Mouth, directed by Gary Oldman (UK, 1997, 128 minutes, certificate 18).

Chapter 8

Based on interviews with family members in the Northern Territory, Australia, as part of a research project carried out in collaboration with the Northern Territory Health Department's Aboriginal Living with Alcohol Program. Results of the project can be found in the book, Coping with Alcohol and Drug Problems: The Experiences of Family Members in Three Contrasting Cultures (Orford, J., Natera, G., Copello, A., Atkinson, C., Mora, J., Velleman, R., Crundall, I., Tiburcio, M., Templeton, L. and Walley, G, (2005)); and in the report, Worrying for Drinkers in the Family: An Interview Study with Indigenous Australians in Urban Areas and Remote Communities in the Northern Territory, Final report to the Living with Alcohol Program, Territory Health Services, Northern Territory Government, Australia.

Chapter 9

Doherty, J. (2006) Pete Doherty: My Prodigal Son, London: Headline.

Chapter 10

Based on interviews with parents of young problem gamblers as part of a research project funded by the Medical Research Council and reported in Krishnan, M. and Orford, J. (2002) Gambling and the family from the stress-coping-support perspective, International Gambling Studies, 2:61–83.

Chapter 11

Thomas, C. and Tremlett, G. (1986) Caitlin: Life with Dylan Thomas, London: Secker and Warburg.

Thomas, C. (1957) Leftover Life to Kill, London: Putnam.

Thomas, C. (1998) Double Drink Story: My Life with Dylan Thomas, London: Virago Press.

Ferris, P. (1995) Caitlin: The Life of Caitlin Thomas, London: Pimlico (quotations with permission of the author).

Chapter 12

The main source is Brinnin, J.M. (1956) Dylan Thomas in America, London: Harborough (quotations are from the Ace Books paperback edition of 1957).

Brief reference is also made to: Nashold, J. and Tremlett, G. (1997) The Death of Dylan Thomas, Edinburgh: Mainstream Publishing.

Chapter 13

Based on extracts from the following sources:

Mora-Ríos, E.J. (1998) ‘Salud mental en la mujer: una comparación transcultural en el campo de las adiciones.’ Unpublished Masters in Clinical Psychology thesis, Universidad Nacional Autónoma de México.

Arcidiacono, C., Procentese, F., Velleman, R. and Albanesi, C. (2008) Famiglie sotto stress: convivere con chi abusa di alcol o droghe, Milano: Unicopli.

Yang, J. (1997) ‘Culture, Family and Alcoholism in South Korea.’ Unpublished PhD thesis, Goldsmiths College, University of London.

Velleman, R., Copello, A. and Maslin, J. (eds) (1998) Living with Drink: Women who Live with Problem Drinkers, London: Longman.

Chapter 14

Nichols, B. (1972) Father Figure: An Uncensored Autobiography, London: Heinemann.

Chapter 15

Ironside, V. (2003) Janey and Me: Growing Up with My Mother, London: Fourth Estate.

Chapter 16

The main source is: Lefebure, M. (1986) The Bondage of Love: A Life of Mrs Samuel Taylor Coleridge, London: Victor Gollancz (quotations with permission of the author).

The chapter also quotes from: Lefebure, M. (1977) Samuel Taylor Coleridge: A Bondage of Opium, London: Quartet Books (first published by Victor Gollancz in 1974) (quotations are from the 1977 Quartet Books edition).

Chapter 17

As for Chapter 1.

Chapter 18

Kelman, J. (1999) A Chancer, London: Vintage (originally published by Polygon Books in 1985) (the quotations in Chapter are taken from the Vintage edition, pages 100–3 with the permission of the author).

Chapter 19

Of the four stories included in this chapter, three are based on interviews carried out as part of a study of the young adult sons and daughters of problem drinking parents, reported in: Velleman, R. and Orford, J. (1999) Risk and Resilience: Adults who were the Children of Problem Drinkers, Amsterdam: Harwood. The fourth is based on a case study published in: Arcidiacono, C., Procentese, F., Velleman, R. and Albanesi, C. (2008) Famiglie sotto stress: convivere con chi abusa di alcol o droghe, Milano: Unicopli.

Chapter 20

Hilton, F. (2004) Baudelaire in Chains: A Portrait of the Artist as a Drug Addict, London: Peter Owen (quotations with permission).

Chapter 21

From the film Fever Pitch, directed by Richard Brooks, 1985, cited by Dement, J.W. (1999) Going for Broke: The Depiction of Compulsive Gambling in Film, Lanham, Maryland: Scarecrow Press.

Chapter 22

The first example is adapted from an interview held as part of research into ways of helping family members in the general practice health service setting. The research was reported in Orford, J., Templeton, L., Patel, A., Copello, A. and Velleman, R. (2007) The 5-Step family intervention in primary care: I. Strengths and limitations according to family members, Drugs: Education, Prevention and Policy, 14:29–47.

All the other examples are taken, with permission, from: Barnard, M. (2007) Drug Addiction and Families, London: Jessica Kingsley.

The chapters for this book have been assembled over a number of years. During those years, and before, I have had the pleasure of working with many colleagues, notably at the Universities of Exeter and Birmingham and their local National Health Service Addiction Services where I have worked myself, and at the University of Bath and associated NHS Trust, at the Institute of Psychiatry in Mexico City and at the Living with Alcohol Program in Darwin, Australia. This book could only have been compiled with the help of that background and those colleagues. The people I have worked with on the various projects we have undertaken together during that time are far too many to list here, but they are all acknowledged in the various research articles and books referred to above. I would, however, like to mention by name my closest and longest standing colleagues Richard Velleman, Alex Copello and Lorna Templeton in England and Guillermina Natera in Mexico. I would also like to mention Pat Evans who has been our Research Group Secretary in Birmingham for a number of particularly happy years and who kindly prepared draft and final versions of the present manuscript.

1

We'll Be There for Him

A Family Responds to Relapse

In this chapter a number of members of one hypothetical family, and a doctor, speak in turn. Each states his or her view about how the family is responding, and should respond, to the excessive drinking of the main protagonist's husband. The latter has had a drinking problem for many years and has recently had a relapse after several months of encouraging improvement. This reversion to drinking has thrown into sharp relief the different ways in which family members have been coping, and might cope, with this problem. The family is closely based on the accounts given by a number of different family members, all living with drinking problems, who have taken part in the research I and my colleagues have carried out over a number of years with families affected by excessive drinking, drug-taking or gambling. The family is introduced through the medium of a series of monologues in which each person takes it in turn to express a view.

The cast in order of appearance:

Wendy. In her mid 50s and married to Bob, her second husband.

Karen. Wendy's daughter, Bob's stepdaughter. In her 20s, now married but still living nearby.

Bob. Also in his mid 50s, and also previously married. Has had a drinking problem for many years and has received treatment intermittently. Has not worked for some years.

David. In his early 20s. Karen's young brother, Wendy's son, Bob's stepson.

Doctor. Has been Wendy and Bob's GP for a number of years.

Ken. Bob's brother, who lives in the same town with his family, but who now sees little of Bob and Wendy.

Wendy. I feel mentally totally exhausted. I feel I've tried everything in the book and nothing has worked. It's as if I've been living for both of us these last umpteen years. This time I've given him an ultimatum, and I really mean it this time. If he carries on this way I shall leave. I was so angry this time I literally blew my top. But I can see both sides of it; he hasn't got much else to live for. Getting angry probably doesn't help. Sometimes I think I cope quite well. I'm not as soft on him as I once was, but on the other hand you can't be too hard. I try to make a joke out of it. I say, ‘You know where the money is’. And it makes me feel guilty him not having anything. Should I give him money or not? It would make life easier, but then why should I watch him kill himself. But I'm not sure I have the energy to fight it any more. But if you love someone, you can't just walk away from the problem. It's a case of staying and coping or turning your back on someone.

Karen. I thought, ‘Oh no, bloody hell, he's on the piss again’. I've been in the pub with him when he's been drinking and it's so embarrassing, sometimes I just wish the floor would open up. Mum gets so upset but she's very understanding. I've wondered sometimes why she's stayed, but I learnt to take my lead from her, not giving him sympathy, but being hard but not over-hard, saying ‘Go on then’ if he says he's going to the pub. He knows he can have a drink if he wants one. I think Mum's done pretty well and by and large the family copes well. She's firm and understanding and jokey. We have the same kind of ideas and attitudes, and we help each other. We both had a real go at him this last time, but it does worry me that being angry with him might provoke him into more drinking. I do go home feeling depressed sometimes, thinking there's nothing we can do for him. We both feel so frustrated that he won't talk about what the problem really is. I think there's something in his past that he's not talking about. I've also tipped his booze down the sink, watered his drink down, and marked the bottle, turning it upside down so he wouldn't realize. We really love him and will be there for him.

Bob. I do feel guilty over what I've done to Wendy. It was nice to see them pleased about my progress. They all got a bit angry over my recent slip-up and that made me angry. Why shouldn't I have a drink if I want one? I didn't really take much notice of them. I get angry when they try to talk to me about my problems. It's my problem, and I've got to sort it out. Wendy lets me get on with it, she's knows I'll fall asleep in the end. Sometimes she hides money from me or pours the drink away. She tells me in the morning that I've drunk it, but tells me the truth later when I'm sober. Karen's really good sometimes. She's motherly, slaps my wrists if I'm drinking and makes me feel guilty, but I always have a choice. David keeps out of the way, goes to his room, with a hurt, hangdog expression. The most useful thing I suppose was Wendy and David's hurt expression and Wendy starting to cry. She had a look of genuine hurt and told me I was killing myself. All the fun's gone out of it.

David. I don't know why Mum hasn't left him. She said she would. When he's not drinking too much I get on really well with him. We've been quite good friends. We've had some drinks together in the local pub. But then he drinks too much and asks me to buy drinks for him, which I refuse to do. I've actually been round to the local pubs asking them not to serve him spirits.

Doctor. I've been increasingly worried about their health, both of them. I've advised her to take a much stricter line with him. For example I've recommended that she has no drink at home at all, and makes it a rule not to allow drinking in the house, but she seems to find that very difficult.

Ken. I keep away now. I tried talking to Bob in the past, but it made no difference. I've literally cried to see what he was doing to himself. Goodness knows why Wendy stays with him.

Karen again. He was getting on much better. He seemed much happier, he wasn't saying nasty things about people like he used to, and I never saw him tipsy. We all thought we were coping well. David used to be rather aggressive in his attitude towards Bob but he had come round to the same way as Mum and I, giving him responsibility, making it clear to him that it was up to him. We didn't insist on him promising he wouldn't ever drink too much. That would just make him feel guilty, and there has to be room for a few mistakes. I do wish he would talk about things so we can get to the bottom of it. He switches off. Talking with him only gets so far and then he changes the subject. We are a bit stuck in a vicious circle now. Sometimes Mum and I think he doesn't really want our help, but I think he does. Mum and I probably talk to each other too much, when perhaps we should be talking to him instead.

Wendy again. The doctor says I should shut the door on him, but if you love them … I had this stupid idea that when he's home at least I know what he's drinking, and if he collapsed at least he'd collapse here. I'm sure the hospital staff are annoyed because they think I'm wasting their time – ‘You're still with him’ sort of thing. Other people, particularly his family, like to turn a blind eye to it, put the shutters down, or simply don't understand drink problems, perhaps they've not had much to do with drink. I try to understand what he's been going through. Talking about it and making no secret of it has helped. It's made us more tolerant, although sometimes I feel more like a mother to him than a wife. I've tried every trick in the book, hated him and loved him, mothered him, even joined in his drinking, which wasn't useful because it just gave him an excuse. I've shut myself in a room and cried, and gone through every emotion. I wonder if I've made things worse by encouraging him to drink at home rather than in the pub, but he now drinks spirits at home. I am tempted to let him drink because at least then you get half a conversation not just grunts and off to bed. In the long run when I thought I'd made things better I've actually made things worse. I wonder if I've pushed him away by not drinking with him, and with my sarcastic comments. But now it's sinking in that there is nothing I can do. It dawns on you somewhere along the line and you become resigned. But I've told him I'm not prepared to sit and watch him die. I love him too much for that. I've said to him, ‘You know me, I like a fight’.

Bob. I sense when I'm in trouble. There's an electric atmosphere, the body language, the silence. I pretend it's not happening, I weather it out. It makes me feel guilty, and I think bugger it, I'm not going to be treated like a child. But Wendy, Karen and all their family have been very supportive, they're pleased with me, proud of me, although family support is tailing off a bit. Karen says she wouldn't bring her new baby round if I went back on the drink, but she's only joking. My family [i.e. his brother Ken, other siblings and their families] has a very bad attitude. They can't handle it at all. They treat me like a child. They're ashamed of me. They just think alcoholics are tramps, they don't realize.

Comments

There are many things about this family that are common to families where one of the members drinks, takes drugs or gambles to an extent that it is seriously stressful for the rest of the family. Notice that Wendy says she is mentally exhausted. She says she has gone through every emotion including anger and guilt. She has shut herself in a room and cried. She is now talking about leaving. Karen is now not so close to the action because she lives separately. But she spends a lot of time talking with her mother about her stepfather's drinking. She has felt embarrassed by the drinking in the past, is disappointed about the relapse, frustrated that he won't talk about what the real problem might be. She sometimes goes home feeling depressed about it. Karen's younger brother David, who still lives at home, doesn't say how he feels, but he does talk about how he has been put in the awkward situation of refusing to buy drinks for his stepfather, and has even gone to the lengths of going round to local pubs asking them not to serve his stepfather spirits. His sister says he was aggressive in his attitude to his stepfather, and Bob talks about noticing David's hurt expression. Even Bob's brother Ken, who has removed himself from the heat of the action by keeping away, says he has literally cried to see what his brother was doing to himself. The issue of Bob's drinking is clearly one that has caused a great deal of upset throughout the family. Bob himself, whose drinking is the focus of the concern, has felt guilty about what he has done to Wendy, and when his stepdaughter tells him off that makes him feel guilty again. He says he gets angry when they try to talk to him about his problems. He notices people's hurt expressions and senses the bad atmosphere. He says all the fun has gone out of his drinking. There are a lot of bad feelings around the issue of his drinking.

But there are good feelings as well. Both Wendy and Karen express love for Bob, and until the recent relapse they thought they had been coping quite well. Bob acknowledges the support he gets from them and was aware of how pleased they had been about his progress and that they had been proud of him.

A theme that we shall meet again and again in this book is the desperate search by family members for the best way of dealing with the problem. As Wendy says, she has tried every trick in the book. Like so many family members facing similar circumstances she worries that she may have done the wrong thing, and tends to blame herself if things don't work out. For example what should she do about drinking with him? At one stage she joined him in his drinking but found that wasn't useful because it simply gave him the excuse to carry on drinking. But she wonders now if she has pushed him away by not drinking with him. Karen in particular feels that there must be something in Bob's past that he is not talking about. She gets him on his own and tries to probe him about it, but it makes him angry and he doesn't open up. She has poured his drink away, watered it down, marked the bottle. These tactics, like David talking to local publicans, are common examples of the kinds of actions to which family members resort in their desperation to get a loved one's drinking under control.

Do such tactics work? And does it help if Wendy gets angry with Bob – probably not she thinks. Should she give him money or not? In some ways it would make life easier, but that might be aiding him in killing himself through carrying on drinking excessively. These are all common and agonizing dilemmas that family members face.

Many of the dilemmas collapse into one big question: should one be tough or tender towards the close relative whose drinking is so problematic? Should one err in the direction of being firm and controlling, in the process running the risk of alienating the very person one is trying to help, and thereby perhaps making the problem worse rather than better? Should one, on the other hand, err in the direction of being supportive and understanding, so running the risk of appearing to be over-tolerant of the drinking, even colluding with it, thereby helping to maintain it? Notice the way in which Wendy and Karen struggled with that central dilemma. Wendy says, ‘I'm not as soft on him as I once was, but on the other hand you can't be too hard’. Karen says she has learned to take a lead from her mother, ‘… not giving him sympathy, but being hard but not over-hard’. She describes her mother's coping as, ‘… firm and understanding and jokey’. They are clearly both trying to strike a balance. Getting the problem into the open, making it clear they recognize it as a problem, but not being too harsh over it, trying to give Bob responsibility. Wendy thinks this policy has helped. She thinks it has made them more tolerant, although she admits that, ‘… sometimes I feel more like a mother to him than a wife’. She wonders if she may have made things worse by encouraging him to drink at home. There she at least knows where he is and what he is doing, but she regrets that he now drinks spirits at home.

A second general issue that commonly arises for family members faced with someone who is drinking, taking drugs or gambling excessively, is whether to go on struggling with those dilemmas at all. Would it not be preferable to separate, or at least to put some distance between oneself and the problem? Not surprisingly this is an issue that Wendy talks about. Following Bob's recent relapse, she has given him an ultimatum, saying that she will leave him if he carries on. It sounds as if this is not the first time she has threatened to leave since she says this time she really means it. Her energy to go on fighting the problem is reaching a low ebb. But, as she says, ‘… if you love someone, you can't just walk away from the problem. It's a case of staying and coping or turning your back on someone’. Both Wendy and Bob have negative things to say about Ken and other members of the family who have a ‘bad attitude’, who have turned their back, don't understand, and can't handle it.

How do other people respond to the position that Wendy is struggling to pursue? Not always, it seems, in a very understanding fashion. Again, this is a very common finding. Karen is close to her mother, is very supportive of her and tends to see eye to eye with her. She often uses the word ‘we’ when talking about the way they cope. Their doctor, on the other hand, thinks Wendy should be much stricter with Bob than she actually is, for example over the issue of drinking at home. There appears to be a misunderstanding between Wendy and her doctor. Wendy thinks the doctor is recommending that she should ‘shut the door’ on Bob, although that is not actually what the doctor is saying. For his part, the doctor construes the issue as a difficulty that Wendy has in being stricter with Bob, whereas Wendy herself portrays it as a difficult decision that she has come to, at least for the moment, over a difficult problem where there seems to be no very satisfactory solution. Both David and Ken express surprise that Wendy has not left Bob, apparently unsympathetic to Wendy's mixed feelings of love and frustration. Interestingly, although we do not hear directly from hospital staff, Wendy senses that they are annoyed with her for staying with him, and thinks that they think she is wasting their time.

Questions

1. Do you find yourself tending to ‘take sides’, feeling more sympathetic towards one or more people in that story, compared to others? Who do you sympathize with, and why? Is there anyone whose position you feel antagonistic towards? If so, why?

2. Do you think Wendy and Karen are getting the balance right between being tough and tender, strict or tolerant? Do you agree with the doctor that Wendy should be stricter with Bob? Should Wendy, as their doctor believes, have a policy of not keeping alcohol at home at all?

3. Were Karen and David right to do things like pour his drink away or water it down, or have a word with local publicans?

4. What position should Wendy take when Bob needs money and she is not sure whether to give it to him?

5. What should Wendy's position be about leaving Bob?

6. Have you ever met someone, personally or professionally, who is in a situation similar to that of Wendy or Karen? What did you do? Did you give any advice?

7. If Wendy and Karen came to see you for help and advice, what would your goals be for them? How would you to try to achieve those goals?

Exercises