Enabling, Co-dependency and Impact on Family and Social Systems No family member
ID: 3492597 • Letter: E
Question
Enabling, Co-dependency and Impact on Family and Social Systems
No family member has ever caused alcohol dependence in another, despite what the dependent member may claim. However, family members can, despite their best intentions, take actions that in hindsight can be seen as allowing drinking or drug use to continue. Vernon Johnson recognized this phenomenon and termed it enabling.
Since being introduced, this term has moved far beyond the substance abuse field. It is heard in general conversation, whether on the Oprah Winfrey Show or in the cell phone conversation of a person next to you on the bus. Rather than being a simple descriptor, the term has taken on a negative connotation. Enabling has become an accusation. As frequently used, enabling suggests that the family member is incredibly stupid or is acting without the troubled person’s best interests at heart. Along with enabling, the term co-dependency was introduced in the same era. To draw upon a metaphor from a family systems approach commonly used in psychotherapy, the family member and alcohol-troubled person are in an “escalating equilibrium.”
Children's learned response/survival roles and Adult Children of Alcoholics
One of the major developments in the alcohol field during the 1980s was the vastly increased attention to the plight of the family. For the first time, engaging families in treatment became the norm. In addition, there were efforts to reach out to family members, even if the alcohol-dependent person was not in treatment. As part of the attention to the family, alcohol dependence began to be described as a family illness.
In 2012, an estimated 7.5 million children under age 18 were living with a parent with a serious alcohol problem. Nationwide that’s 10.5% of all children under age 18. Picture kids on the playground. One of every 10 will be returning home to a parent with a significant alcohol problem. “Significant” means meeting the formal criteria for a diagnosis of substance abuse or dependence. The majority (80%) live in two-parent families. Almost all the rest live with a single mom (15%).
If alcohol dependence is defined as an illness, how does one define drinking problems in the absence of dependence? Where is the line drawn? Are there other health conditions that appear to be analogous?
Explain the term “enabling behavior” with the help of some examples.
If alcoholism (then the commonly used term) was a family illness, was not the next logical step to provide a name for the “disease” experienced by family members? Discuss support systems for the family. How are they helpful?
Assess if it is more likely that such children will have a harder time than will their peers as they enter into relationships outside the home, at school, or with playmates.
Examine is a troubled child the signal of an alcohol problem in a family. What factors influence how a parent’s drinking affects the child.
Explanation / Answer
1. As pointed out, many times alcohol consumption can cause problems even though it may not receive a diagnosis of dependence as such. In such a situation, one must first assess if the intake is causing significant problems in the individual's functioning in his/her personal and professional life. It must also be ascertained as to whether the individual's behaviour is causing harm or injury to self or others. In such a case, alcohol consumption can become problematic.
Screening tools can be used for this purpose as objective assessments to understand if an individual requires clinical intervention. Alcohol Use Disorder Identification Test (AUDIT) is a commonly used tool.
In that way, I would say that personality disorders are the most analogous mental health condition. This is so because a pattern of maladaptive behaviours become so ingrained into the individual that it may not even perceived as a condition that requires intervention. Then again, to what extent the behaviours are disruptive also needs a lot of investigation.
(Please post the other questions separately)
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