Many problem drinkers are unable to admit to this problem. The cry for help may therefore come from someone close who suffers as a result. The cry often comes at a time when he or she is unable to cope any longer with the drinker. As such, the drinker may self-righteously feel they do not have a problem as they had been drinking like this for years. They may resist treatment and often blame others for problems. Many marriages fail at this point. One spouse can no longer tolerate the alcohol and the alcoholic refuses to take responsibility. This makes treatment of alcoholics extremely difficult.

It is important for people to understand the stages of recovery and that each stage carries challenges that some alcoholics will not overcome. Five stages of recovery are discussed: pre-contemplation, contemplation, preparation, action and maintenance.1

In the pre-contemplation stage, the alcohol problem has not yet been identified let alone accepted by the alcoholic. During this stage, their defences, most notably denial are strong. They actively reject any notion of alcohol problems and show anger towards anyone suggesting a problem. They reject treatment and may rely on the support of their drinking buddies to affirm they do not have a problem.

In the contemplation stage, the alcoholic toys with and finally accepts they have a problem with alcoholism. This acceptance can be overwhelming, at times leading to depression and/or anxiety. These intense feelings must be expected and planned for as part of a treatment process.

In the preparation stage, the alcoholic learns what treatment is necessary in order to recover. Depending on the severity, this can include detoxification, inpatient or outpatient counselling and marital and/or family therapy and even prescribed medications.

The next stage, action, is when the treatment plan is implemented and activities are undertaken to address the alcoholism. The support of family and sober friends is crucial here as alcoholics learn to defend themselves, not from admitting alcoholism, but from being pulled back towards drinking by former drinking buddies. Also crucial at this stage is developing an understanding of one’s own family history that may have been contributory to drinking.

The final stage involves relapse prevention and is referred to as maintenance. This stage can be life-long. One of the best-known maintenance programs is Alcoholics Anonymous (AA). This program is based upon a self-help, group model. Members meet regularly to manage the challenges of sobriety.

Recovery from alcohol starts with clear, blunt information from friends and family and by trained professionals such as physicians, social workers or psychologists. Some family and even some professionals beat around the bush when confronting an alcoholic. This is music to the alcoholic’s ears. Fuzzy messages allow them to maintain their denial. Thus, one must clearly and fully confront the alcoholic. Clear messages leave no wiggle room.

If you think your spouse has a problem with alcohol:

1. Confront him or her forthrightly. If you are concerned for your safety, then do so in the company of a friend or professional.
   
2. Get help for yourself too. Learn about alcoholism, your role in the recovery process and of the impact on your family’s well-being.
   
3. Recognise that it may take some time if your spouse is in the first stage of recovery. He or she has yet to even acknowledge a problem. This can be an insurmountable challenge for some people.
   
4. Recognise that alcoholism can pose a risk not only to the alcoholic but also to those around him or her. At all times, make sure children are appropriately supervised and cared for. Alcohol related problems are a major cause for referrals to child protective services.

Lastly, can a therapist help? Yes, but not in all cases. Much will depend on the stage of recovery, the willingness of the alcoholic to change, the social supports available and a good treatment plan.

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Gary Direnfeld, MSW, RSW
(905) 628-4847
gary@yoursocialworker.com
www.yoursocialworker.com

Gary Direnfeld is a social worker. Courts in Ontario, Canada, consider him an expert on child development, parent-child relations, marital and family therapy, custody and access recommendations, social work and an expert for the purpose of giving a critique on a Section 112 (social work) report.

Search Gary’s name on GOOGLE.COM to view his many articles or visit his website. Call him for your next conference and for expert opinion on family matters. His services include counseling, mediation, assessment and assessment critiques.

Visit the Divorce Wizards bookstore for more information on Gary’s book, Raising Kids Without Raising Cane,

1. DiClemente, C.C., Bellino, L.E. and Neavins, T.M. Motivation for Change and Alcoholism Treatment. National Institute on Alcohol Abuse and Alcoholism. Alcohol Research and Health .23:2. 1999.