Addiction and the Family (cont.)

For men, there's often a cultural admiration for the capacity to drink a lot. The beginning of a man's alcoholism is not shrouded in secrecy, but more often in the company of friends, where a woman's drinking is likely to be alone.

There is a great likelihood that woman alcoholics have been sexually assaulted at sometime in their life. Many in childhood, and an equal number as adults, most often when they've been drinking. That also predicts a higher level of shame about being alcoholic. When these two groups are treated separately, then the secrets get talked about. In mixed groups, women are less likely to share those painful life experiences. They also tend to talk less when men are there.

In group therapy for men, they also talk about the secrets in their life, and they are often different. Many men have a history of childhood abuse, physical or sexual, and a great number talk about the loneliness they experienced because their fathers weren't around.

FORD BALES:
When we opened the Betty Ford Center, more than 22 years ago, we didn't have gender specific treatment and we saw that women were doing better in women's halls and men were doing better in men's halls. That's why we made the change, and we are one of the leaders in the business having done that.

MEMBER QUESTION:
What is the difference between abuse and addiction?

WAITE-O'BRIEN:
People who abuse alcohol or any other drug, have a problem that they drink too much then get arrested or drink too much and lose their car. When a person does that repeatedly then goes on to make excuses about that behavior, "It wasn't really me", "The police officer was being picky" or something like that, when it's persistent and the person continues to drink or use and then shape their life around accessing the drug, and may even try and stop and fail, or try and control it and fail, then it's dependence.

MEMBER QUESTION:
I am seven weeks pregnant and my fiance is addicted to crack and we are trying to get help but Narcotic Anonymous is not enough.

WAITE-O'BRIEN:
He may need a treatment center that gets him out of the environment where he keeps getting the drug. That would be my best recommendation, that he get into a treatment center and get away physically from his dealer and the crack house. Go to NA (Narcotic Anonymous), AA (Alcoholics Anonymous) and CA (Cocaine Anonymous).

MEMBER QUESTION:
How does one approach someone with a drinking problem? Should it come from a friend or better yet a family member?

WAITE-O'BRIEN:
It should come from everyone.

FORD BALES:
I agree. One of the things we use is called intervention. There are interventionists out there who do this as a profession to get a group together to confront the individual. Usually one-on-one confrontations don't work as successfully as a group intervention.

WAITE-O'BRIEN:
I agree that the more people who can be present and talk in a way that's loving but direct to the person who is using, and usually under the direction of an interventionist, the more likely that person is to get help.

"Our spirit is where our hope is. When we help people access a source of hope, the possibility for change emerges."

MEMBER QUESTION:
What percentage of alcoholics die from the disease, either directly or indirectly (i.e. accidents, suicide)?

WAITE-O'BRIEN:
Without treatment, nearly all die of their disease. This person included what makes sense; the accidents, suicide -- things that are not directly related to the physical part of addiction but are part of the whole disease. When you put all of that together without treatment, the person will most likely die of their disease.

MEMBER QUESTION:
Is it true that an alcoholic has to hit bottom before he has the ability to truly break the cycle?

WAITE-O'BRIEN:
No. What happens is that the bottom hits them. By that I mean that when friends and family confront the person, that essentially brings the bottom up. When friends and family express their concern and then refuse to enable the person, the likelihood is that the person is going to get help, and they don't have to hit bottom.

MEMBER QUESTION:
How do you handle it when someone you love refuses to get meaningful treatment?

WAITE-O'BRIEN:
I would get help for myself. That might mean going to a family program in a treatment center, and it certainly means going to Al-Anon. Out of that, what's likely to happen is that the person can make a plan to how to stay in the relationship or how to leave it.

MODERATOR:
The Betty Ford Center considers spirituality vital for recovery. Why is this so important?

WAITE-O'BRIEN:
Our spirit is where our hope is. When we help people access a source of hope, the possibility for change emerges. So, without attending to the spirit, there is no hope.

FORD BALES:
The other point to all of that is what the family members and patients are holding onto desperately is hope. There is help and there is hope.

MODERATOR:
Could you please tell us more about how addiction affects family dynamics?

WAITE-O'BRIEN:
Addiction, like any other life-threatening illness, changes the dynamics of a family. The attention shifts toward the person with the illness. The energy shifts toward the person with the illness. Individual needs of family members don't get attended to because the demands of the illness are bigger than any one person. Think of what treatment is -- it is, in part, a rebalancing of family dynamics so people can take a breath and have a life that is separate from this disease.

FORD BALES:
To follow up on what Nancy said; that's why every member needs to be treated, because it does affect the entire family. The family members get lost in the disease and forget about themselves.



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