Wednesday, January 23, 2013

Alcoholism, a merry go round named denial

 

By MACHURA KAMAU

Setting the stage

Dependent but acts otherwise

Alcoholism is a tragic three-act play in which there are at least four characters, the drinker and his family, friends, co-workers and even counsellors may have a part in keeping the merry-go-round turning. Alcoholism rarely appears in one person set apart from others; it seldom continues in isolation from others.

One person drinks too much and gets drunk and others react to his drinking and its consequences. The drinker responds to this reaction and drinks again. This sets up a pattern of blame and denial, and eventually the downward spiral that characterises alcoholism. We must look not at the alcoholic alone, but view the ‘illness’ as if we were sitting in the audience watching a play and observing carefully the roles of all the actors in the drama.

As the play opens, we see the alcoholic as the star of the First Act. He does all the acting while others react to what he does. A male between the ages of 30 and 55, he is usually smart, skilful and often successful in his work, but his goal may be far above his ability.

We see that he is sensitive, lonely and tense. He is also immature in a way that produces real dependence. However, he may act in an independent way in order to deny this fact. He also denies he is responsible for the results of his behaviour. From the dependency and denial comes the name of the play, A Merry-Go-Round Named Denial.
For him to act in this way, others must make it possible.

The alcoholic has learnt that the use of alcohol makes him feel better. To him it is a blessing, not a curse; his medicine, not a poison. For a few hours, it floats away his troubles; it melts away his fears, reduces his tension, removes his loneliness and solves all his problems.

Act One

Drinking too much, too often is not a matter of choice, it is the first sign of alcoholism

The play opens with the alcoholic stating that no one can tell him what to do; he tells them. This makes it very difficult for the family to talk about drinking and its results.

Even when the drinking is obviously causing serious problems, he simply will not discuss them. Talking is like a one-way street. No one seems to hear what the others are saying. On both sides, people say one thing yet do another.

This is why it is necessary to see the play to understand alcoholism. To observe the alcoholic alone, to need a scientific description of the illness or to listen to the family’s tale of woe is only a small part of the drama. The key word in alcoholism is denial. Again and again people do what they say they will not, or deny what they have done.

Denial is refusing to see the reality of the disease, and can come in many forms — minimising or belittling the drinking, blaming others except yourself, producing alibis or excuses, stone-walling or giving cunning answers to evade the extent of one’s drinking, among others.

Early in the First Act, the alcoholic needs a drink, so he takes one. He drinks hard and fast, not slow and easy. He may drink openly, but more likely he will conceal the amount he drinks by drinking off-stage and not in the presence of other actors in the play.

This is the first part of the denial, hiding the amount he drinks. But it proves to us that he knows he is drinking too much. He drinks more than others, more often than others, and above all, it means far more to him than to others.

Drinking too much, too often is not a matter of choice, it is the first sign of alcoholism.

Repeated denial, by hiding the bottle and drinking alone, reveals how important alcohol has become in helping the alcoholic feel better. After one or two drinks he cannot stop, he has lost this ability.

After a few more, we see a profound change in the alcoholic. He reveals a sense of success, well-being and self-sufficiency. He’s on top of the world and may act as if he were a little god. Now he is right and everybody else is wrong.

There is no one way all alcoholics act while intoxicated, but they are not rational or sensible; they are not responsible. They are apt to ignore the rules of social conduct, sometimes even to a criminal degree, of which driving under the influence is a clear example. If a sober person acted this way, we would consider him insane. If drinking continues long enough, the alcoholic creates a crisis, gets into trouble, ends up in a mess.

This can happen in many ways, but the pattern is always the same; he is a dependent who behaves as of he were independent, and drinking makes it easy to convince himself this is true. Yet the results of his drinking make him even more dependent upon others.

When his self-created crisis strikes, he waits for something to happen, ignores it, walks away from it or cries for someone to get him out of it. Alcohol, which at first gave him a sense of success and independence, has now stripped him of his mask and reveals him a helpless, dependent child.

Act Two : The Enabler

The guy who helps you home is in a fix himself

In this act, the alcoholic does nothing but wait for and expect others to do it for him. Three others in the play act out their roles and the alcoholic benefits from what they do. He does little or nothing, everything is done for him in the Second Act.

The Enabler

The first person to appear is one we might call the Enabler, a ‘helpful’ Mr Clean who may be impelled by his own anxiety and guilt to rescue his friend, the alcoholic, from his predicament. He wants to save the alcoholic from the immediate crisis and relieve him of the unbearable tension created by the situation.

In reality this person may be meeting a need of his own, rather than that of the alcoholic, although he does not realise this himself. The Enabler may be a male outside the family, perhaps a relative; occasionally a woman plays the role.

It is also played by the so-called “helping professionals” — clergymen, doctors, lawyers, and social workers.

Many have had little, if any, of scientific instruction on alcohol and alcoholism, which is essential in such specialised counselling. Lacking in knowledge, they handle the situation in the same manner as the non-professional Enabler.

This denies the alcoholic the process of learning by correcting his own mistakes and conditions him to believe that there will always be a protector who will come to his rescue, even though the Enabler insists they will never again rescue him. They always have and the alcoholic believes they always will. Such rescue operations can be just as compulsive as drinking.

Act Two : The Victim

Colleagues step in for the hung-over workmate
The Victim

This is the next character on stage. This may be the boss, the employer, the supervisor, a business partner or at times a fellow employee. The victim is the person who is responsible for getting the work done if the alcoholic is absent due to drinking or is half-on and half-off the job due to a hangover.

The boss has become a real friend after the alcoholic has worked in the company for a long time. The alcoholic has become completely dependent on this repeated protection and cover-up by the victim; otherwise he would not continue drinking in this fashion.

He would be compelled to give up drinking or give up the job. It is the victim who enables the alcoholic to continue his irresponsible drinking without losing his job.

Act Two : The Provoker

The wife, caught in the game, makes the situation worse

The third character in this act is the key person in the play, the spouse or the parent of the alcoholic, the person with whom the alcoholic lives. This is usually the wife or the mother. She is a veteran at this role and has played it much longer than others in the Act. She is the Provoker.

She is hurt and upset by repeated drinking episodes, but she holds the family together despite all the trouble caused by drinking. In turn, she feeds back into the marriage her bitterness, resentment, fear and hurt, and so becomes the source of provocation.

She controls, she tries to force the changes she wants, she sacrifices, adjusts, never gives up, never gives in, but never forgets. The attitude of the alcoholic is that his failure should be acceptable, but she must never fail him!

He acts with complete independence and insists he will do as he pleases and he expects her to do exactly what he tells her to do or not to do. She must be at home when he arrives, if he arrives. This character might also be called the Adjuster; she is constantly adjusting to the crises and trouble caused by drinking.

The alcoholic blames her for everything that goes wrong with the home and the marriage.

She tries everything possible to make her marriage work to prove he is wrong. She is wife and housekeeper and may, in addition, feel compelled to earn part of the bread.

She attempts to be nurse, doctor and counsellor. She cannot play these three roles without hurting herself and her husband, or without adding more guilt, bitterness, resentment or hostility to the situation which is already almost unbearable. Yet the customs of our society train and condition the wife to play this role. No matter what the alcoholic does, he ends up at ‘home’. This is where everybody goes when there is no other place to go.

Act Two is now played out in full. The alcoholic, in his helpless condition, has been rescued, put back on the job and restored as a member of the family. This clothes him in the costume of a responsible adult. As everything is done for him and not by him, his dependency is increased and he remains a child in an adult suit. The results, effects and problems caused by drinking have been removed by others.

They have cleaned up the entire mess made by the alcoholic. The painful results of the drinking are suffered by persons other than the drinker. This permits him to continue drinking as a way to solve his problems.

Act Three

The alcoholic is well aware of the truth he denies

Act Three begins in much the same manner as Act One, but something has been added by the first and second acts. The need to deny his dependence is now greater and must be expressed almost at once, and even more emphatically. The alcoholic denies he is an alcoholic, denies that alcohol is causing him trouble. He refuses to acknowledge that anyone helped him — more denial.

He denies he may lose his job and insists that he is the best or most skilled person at his job. Above all, he denies he has caused his family any trouble.

In fact, he blames his family, especially the wife, for all the fuss, nagging and problems. He may insist that his wife is crazy, that she needs to see a psychiatrist as the illness and the conflict gets worse. The husband often accuses his wife of being unfaithful, of having affairs with other men, although he has no reason for these accusations.

Some alcoholics will not discuss anything related to their drinking. The memory is too painful. The wife never forgets what the husband does. The husband may not remember what he did while intoxicated, but he never forgets what his wife tells him he did or tried to do.

The real problem is that the alcoholic is well aware of the truth he so strongly denies. He is aware of his drunkenness. He is aware of his failure. His guilt and remorse have become unbearable, he cannot tolerate criticism or advice from others. Above all, the memory of his utter helplessness and failure at the end of the first Act is more than embarrassing. It is far too painful for a person who thinks and acts as if he were a little god in his own world.

In time, the family adjusts to their way of living together. The alcoholic may deny he will drink again and others in the play may vow never again to help him. The Enabler says he will never again come to his rescue. The Victim will not allow another job failure due to drinking. The Provoker, whether wife or mother, tells the alcoholic they cannot live together under these conditions.

What is said is completely different from what everyone has done and will do again. The Enabler, Victim and Provoker have said this before but did not carry it out. The result is that the alcoholic’s sense of guilt and failure is increased, he is challenged in every aspect and all this adds to his heavy burden of tension and loneliness. His mental pain is made unbearable, especially by the changed attitudes and actions of the other members of the cast. There can be only one sure way for him to relieve his pain, overcome his guilt and sense of failure, and recover a sense of worth and value.

However, if Act Two is played out as described, it is inescapable that in Act Three the alcoholic will drink again. This is his one sure means of relieving all pain, solving all problems and a sense of well-being.

The memory of the immediate comfort and benefits of drinking blot out the knowledge of what will happen if he drinks. Also, always in the back of his mind is the hope that this time he can control it and reap the great benefits he once did from drinking. So the alcoholic begins to drink again.

What happens when those associated with the alcoholic determine to create a change in the alcoholic’s life?

Recovery

Advice is good, but also fatal if given wrongly

Recovery begins in Act II

A planned recovery from alcoholism must begin with the person in the second Act. They must learn how people affect each other in this illness and learn the most difficult part — that of acting in an entirely different fashion.

New roles can be learned only by turning to others who understand the play and putting into practice their insights and knowledge. If Act Two is rewritten and replayed, there is every reason to believe the alcoholic will recover. He is locked in by his illness, others hold the key to the lock.

We cannot demand that he gives up drinking as a means of solving his problems, but if we unlock the door, he will be free to come out. If the alcoholic is rescued from every crisis, if the boss allows himself to be a victim again and again, if the wife acts as the provoker, there is not one chance in ten that the alcoholic will recover.

He is virtually helpless, he himself cannot break the lock. He may recover if the other actors in the play learn how to break his dependency on them by refusing to give in to it. The alcoholic cannot keep the merry-go-round going unless the others ride it with him and help him keep it going.

It is not true that an alcoholic cannot be helped unless he wants help. It is true that there is almost no chance that the alcoholic will stop drinking as long as other people remove all the painful consequences for him.

The Enablers and the Victims must seek information, insight, and understanding if they plan to change their roles. The wife or mother must become active in a counselling and therapy programme if she is to make a basic change in her life.

The Enablers

The Enabler is a person who feels he must not let the alcoholic suffer the consequences of his drinking when he can easily prevent this by a simple rescue operation. To him it is like saving a drowning man. But this rescue mission conveys to the alcoholic what the rescuer really thinks: You cannot make it without my help. The Enabler thus reveals a lack of faith in the alcoholic’s ability to take care of himself, which is a form of judgment and condemnation.

The role of the professional Enabler — clergyman, doctor, lawyer or social worker — can be most destructive if it conditions the family to reduce the crisis rather than use it to initiate a recovery programme. When the family turns to professionals to deal with alcoholism before the anti-social behaviour has become obvious, the family may be told that this is not alcoholism and that there is nothing they can do until the drinker wants help.

When the alcoholic turns to such people who help in the reduction of his crisis, this again keeps the merry-go-round going.

The family, which was told initially that there was no signs of alcoholism, is taught that the only way to deal with it is to remove the symptoms, rather than to deal realistically with the illness.

Initiating Recovery

If a friend is called upon for help, this should be used as an opportunity to lead the alcoholic and the family into a planned programme of recovery. Specific help is available in rehabilitation centres like Jorgs and Asumbi Treatment Centres, among others.

The alcoholic learns how to stitch back the values he has violated through drinking and how to build on his self-esteem. The alcoholic further learns that alcohol damages the mind, alters the attitude and changes his behaviour. The first step towards healing is accepting that one has a drinking problem and working on breaking the denial walls.

Do you need more help and guidance? E-mail the author at [email protected]

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