This was my passion paper that was 40% of my final grade in a course I just finished as part of a crisis intervention and trauma support certificate. I wrote it with the intention of sharing it publicly, which helped me meet the minimum 1500 word prerequisite, seeing a “purpose” to it. My goal is to invite people who qualify as Al-Anon members to view this disease and their loved ones afflicted by it, with more compassion.
Intergenerational trauma leads to self-destructive behaviours, addictions, suicide ideation and suicide, family violence, anxiety, poor attachment, neglect, and repeated behaviours in multiple generations. This paper will focus on alcoholism, and will review some interventions that have demonstrative success rates.
This paper will use “alcoholism”, “alcohol-related problems”, “heavy drinking”, “problem drinking”, “drinking problem”, “alcohol use disorder”, and “alcohol dependency” interchangeably. Alcohol-related problems result from drinking too much, too fast, or too often (NIAAA, para. 2), and this type of drinking can cause a physical and mental dependence on alcohol. (Legg, 2019, para. 1). Chronic alcoholism has adverse effects on the body and mind, on the family, on the community, and in business.
In 2018, Statistics Canada reported 19.1% of provincial drinkers (not including the territories), aged 12 and older (roughly 5.9 million people), reported alcohol consumption that classified them as heavy drinkers. (Statistics Canada, 2019).
In Canada (amongst other high-income countries), alcohol consumption ranks second (behind tobacco use) as an etiologic risk factor (causing or contributing to the development of a disease or condition) (Oxford Languages) in the World Health Organization burden of disease studies. Based on 2002 data, the estimated annual cost in Canada for health care directly related to alcohol consumption was $3.3 billion, and the total direct and indirect cost was $14.6 billion. (Giesbrecht et al., 2011).
Intergenerational Trauma and Alcoholism
There is a direct correlation between intergenerational trauma and alcoholism. Up until just a few generations ago, people who had a drinking problem were mistreated in society. The central idea was that people who struggled with addictions were different from the rest of the population, even prior to their substance use. They were thought to possess traits such as abnormality, weakness, and psychopathy. (Lindesmith, 1940). These traits were thought to be the reason why they developed a drinking problem.
In the not-too-distant past, alcoholics were considered psychopaths, a term coined by German psychiatrist Julius Koch in 1888, to describe people who were believed to have had a flaw in their constitution at birth. In 1909, Austrian linguistic Solomon Birnbaum suggested that sociopath might be a more suitable label (Scholarpedia, Psychopathy).
The problem drinker did not have autonomy over themselves once through the medical system. Because they were considered lesser people, carrying a psychopathic label, once admitted for treatment, their basic human rights were denied, and they were subjected to controversial rehabilitation such as bilateral prefrontal lobotomies (Talbot et al., 1951). Around the 1930’s and 40’s however, society began to consider alcoholism as a disease, akin to cancer or diabetes, and the judgement of alcohol dependency began to lessened its grip. The group Alcoholics Anonymous advocated for rights to proper and dignified medical treatment (Mann et al., 2000), and with this recovery as its foundation, the problem drinkers began to rebuild their lives.
This growth in understanding and compassion was only a few generations ago, and so the intergenerational trauma can show itself by feelings of fear or shame around admitting that one might have a drinking problem. There is still a stigmatization of alcoholism in our society, and the results of this include: not having affordable healthcare, believing that the problems could be handled without treatment, not knowing where to go for services, concerns about confidentiality, fear of reputation, fear of loss of job, fear of being committed, inadequate or no coverage of mental health treatment, and thinking that treatment would not help. (National Academies of Sciences, Engineering, and Medicine, 2016).
As a result of the secrecy and deceit that alcoholism can incur, there are a couple of specific results that can stem from heavy drinking, which is arguably used as a way to conceal the intergenerational trauma.
Issues That Can Arise From Alcoholism
One of the issues that can come from alcohol dependence is codependency. Codependency refers to the state of being mutually reliant on your partner to the point where the relationship becomes dysfunctional, disproportionately dependence-oriented, and sometimes even addictive. (Kelley, 2021, para. 17). Codependency can be defined as a learned helplessness which requires empowerment of those who grew up in the types of dysfunctional family units that are run by dysfunctional family rules, and where the alcoholic family is one of the family systems that generates large numbers of people who identify as codependent. (O’Gorman, 1993).
Isolation is another byproduct of alcohol-related problems. Alienation is generally defined as feelings of powerlessness, normlessness, and social isolation. Powerlessness, normlessness, and social isolation have been associated with alcoholism, while also suffering from a sense of hollowness and defeat. Frustrated power needs, and difficulty relating to others are also factors that result in isolation. (Calicchia et al., 1975). It is interesting here to note that the authors of the paper cited researched further that successful alcoholic rehabilitation involved actions that are opposite to alienation.
Forms of Intervention
Alcoholics Anonymous (AA) and Twelve-Step Facilitation (TSF) programs offer higher healthcare cost savings than outpatient treatment, clinical interventions such as Cognitive Behaviour Therapy (CBT), or no AA or TSF interventions. Furthermore, AA and TSF treatments are being more effective for increasing abstinence than other established treatments, such as CBT. (Kelly, 2020).
Whether a problem drinker wants or doesn’t want to quit drinking, the Concerned Other can attain their own intervention, irregardless of what the person drinking does. Research shows that more intense, sustained attendance to Al-Anon meetings over the first six months is more helpful than less intensive and discontinued attendance to improve functioning and psychological status, as well as ongoing contact with the drinker. (Timko et al., 2016). Al-Anon also has proven effects of being successful through its passage to bonding, goal direction, access to role models, and rewarding activities. (Timko et al., 2015).
A third intervention is inpatient or outpatient treatment facilities for the problem drinker, located throughout urban and rural settings. These centers provide sociability, wellness resources, addiction education, and various forms of therapy such as psychotherapy, psychiatry, and CBT. These are more secular forms of intervention, which might be more palatable to the problem drinker, but they are often higher in cost, and provide only short-term treatment.
A fourth method is the Alateen program. This intervention is an offshoot of the Al-Anon program, and gives a platform for the youth in the family unit to receive relief from the stressors of living in an alcoholic home, as well as providing coping tools. Intervention for a youth might look different from that of an adult, because with adolescence comes many biological, psychological, and social changes. Parents/caregivers who engage in problem drinking can negatively affect adolescent development and adjustment, and their drinking can lead them to model ineffective coping strategies and other problem behaviours. Children with problem drinking parents/caregivers are at a risk for alcohol and other drug, as well as psychological, problems. (Windle, 1996).
Approaching the Family
Assuming that the problem drinker wants help and accepts an intervention, all family members might want to look at individual treatment. Because alcoholism is a product of intergenerational trauma, and because studies show that a parent/caregiver’s drinking can influence the adolescent to also become a heavy drinker, the person’s drinking is not an isolated event. Furthermore, the drinking was in all likelihood progressive, meaning there was a build-up to the breaking point where an intervention was needed, and therefore negative circumstances have infiltrated the psyche of the family unit.
Whether a Twelve Step Program, an inpatient or outpatient treatment facility, or clinical therapy, the heavy drinker might need to experiment to determine which method is most effective. If the problem drinker takes a Twelve Step route, there are sister groups for all family members, which is a favourable outcome, and permits familiar and familial healing on a nuclear unit level.
Crisis hotlines are also excellent sources for short-term relief, and particularly challenge the isolation and shame components that tend to engulf alcoholic homes.
Codependency which can result from enmeshed boundaries in alcoholic homes, as well as the isolation and alienation that can exist within family units that suffer from intergenerational trauma, can make interventions a bit more challenging. As we on a societal level work through the collective shame and mislabeling of alcoholism, we still might fall short of intervention choices. To date, Alcoholics Anonymous remains the most efficient and sustainable source of long-term recovery, and with “group conscious” traditions, ensuring group autonomy, the problem drinker is sure to find the right meeting for them, provided they do not give up too quickly.
To note, the Indigenous peoples are not represented in this paper. Half of the communities in the territories were not visited for the Statistics Canada surveys, and this can be indicative of continual isolation and alienation in Canada’s Indigenous communities, as well as not being represented fairly in its culture.
There are many academic journals on alcohol dependency and intergenerational trauma within Indigenous communities, but collectively, Canada has left the Indigenous voice out of the conversation. With the recent discovery of almost 1,000 human remains in unmarked graves at residential schools, we are now openly admitting to the intergenerational trauma that colonization has inflicted upon the Indigenous people, and it is appropriate to have acknowledgements in this paper.
In 2015, the Truth and Reconciliation Commission of Canada (TRC) published its final report detailing the experiences and impacts of the residential school system, creating a historical record of its legacy and consequences. The TRC recorded testimony of more than 6,000 survivors affected by residential schools. Over more than a century, it is estimated approximately 150,000 Indigenous children were separated from their families and communities and forced to attend one of 139 residential schools across Canada. (Government of British Columbia).
In order to lead an intervention for systemic abuse, we must have understanding, compassion, and empathy. We must listen, instead of talk, and we must discern what was taken from people, and the pain involved, so that we might consider innovative ways to reach reconciliation.
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Ending Discrimination Against People with Mental and Substance Use Disorders
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