Chapter 7
Growing Up in an Alcoholic Family
System
ACA is a social reform movement
©2010 McGraw-Hill Higher Education. All rights reserved.
National Association of Children of Alcoholics
(NACOA) Charter Statement (1983)





An estimated 28 million Americans have at least one
alcoholic parents.
More than half of all alcoholics have an alcoholic
parent
Children of alcoholics are at the highest risk of
developing alcoholism themselves or marrying
someone who is alcoholic
In up to 90 percent of child abuse cases, alcohol is a
significant factor
Children of alcoholics are frequently victims of incest,
child neglect, and other forms of violence and
exploitation.
©2010 McGraw-Hill Higher Education. All rights reserved.
Characteristics of Adult Children of
Alcoholics (ACA)
1.
2.
3.
4.
5.
6.
7.
8.
9.
Fear of losing control
All-or-none, black-or-white thinking
Fear of experiencing feelings
Overdeveloped sense of responsibility or irresponsibility
Difficult with intimacy and with asking for what is wanted
or needed
Flashbacks of childhood but many memory gaps
Feelings of being like a child when under stress
Unreasonable loyalty
Inadequate; don’t trust their talents, skills, and
accomplishments
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ACA Characteristics cont’d
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
Addiction to excitement
Difficulty relaxing
Feelings of guilt, abandonment, and/or depression
Tendency to confuse love with self-pity
Backlog of shock and grief
Compulsive behaviors
Living in a world of denial
Guessing at what is normal
Tendency toward physical symptoms (e.g., headaches,
gastrointestinal problems)
Exhibiting PTSD (Post traumatic stress disorder) symptoms (Tim
Cermak)
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Behavioral Characteristics of ACAs


Being superachievers or perfectionists or
exhibiting efforts that go far beyond the
reasonable criteria of every task.
Exhibiting an inordinate need to control their
environment and therefore becoming anxious
with the slightest threat to their security (e.g.,
a teacher’s comment on homework or an
unusually low grade may provoke emotional
upset)
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Behavioral Characteristics of ACAs
cont’d



Displaying social disengagement from or excessive
attention to the peer group (as an isolated loner or a
class clown)
Exhibiting signs of physical neglect (untidiness, soiled
clothing, poor hygiene) and/or physical abuse
(bruises, cuts, etc.)
Being unable to concentrate and sometimes showing
marked variations in academic performance,
especially when parents are in a binge pattern of
alcohol use or in codependent conflict
(Robert Ackerman [1978])
©2010 McGraw-Hill Higher Education. All rights reserved.
Second-Order Change


A cognitive-behavioral technique to change the
way one traditionally responds to situations
and interpersonal interactions.
First-order interactions are often mechanical,
automatic, and even rhetorical.
©2010 McGraw-Hill Higher Education. All rights reserved.
Defining Codependency (Tim Cermak, M.D.)
Cermak defined codependency in diagnostic terms in the
hope that codependency would be recognized as a
psychiatric disorder. The following are diagnostic
criteria for codependent personality disorder:
1.
2.
Continual investment of self-esteem in the ability to
influence or control feelings and behaviors in the self
and others in the face of obvious adverse
consequences.
The neglect of oneself while preoccupied or obsessed
with changing the partner.
©2010 McGraw-Hill Higher Education. All rights reserved.
Defining Codependency cont’d
3.
4.
5.
Assumption of responsibility for meeting
others’ needs to the exclusion of
acknowledging one’s own needs.
Anxiety and boundary distortions in situations
of intimacy and separation
Enmeshment in relationships with personalitydisordered, drug-dependent, and impulsedisordered individuals.
©2010 McGraw-Hill Higher Education. All rights reserved.
Defining Codependency cont’d
5.
Maintenance of a primary relationship with an
active substance abuser for at least two years
without seeking outside support and/or exhibiting
three or more of the following characteristics:
a.
b.
c.
d.
e.
Constriction of emotions
with or without dramatic
outbursts
Depression
Hypervigilance
Compulsions
anxiety
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f.
g.
h.
i.
Excessive reliance on
denial
Substance abuse
Recurrent physical or
sexual abuse
Stress-related medical
illnesses
Codependency Metaphor
Being a lifeguard on a crowded
beach, knowing that you can’t
swim
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Overseparation and
Overattachment (Coleman & Colgan, 1987)
Overseparation
Overattachment
Thoughts
You’re not good enough
They want so much.
They give so little.
I’m ambivalent.
If only they would…
I am a rock.
You should be grateful.
Thoughts
I’m not good enough
I want so little.
I give so much.
You don’t care.
What am I doing wrong?
I’m nobody without you.
I’m so unappreciated.
©2010 McGraw-Hill Higher Education. All rights reserved.
Overseparation and
Overattachment (Coleman & Colgan, 1987)
Overseparation
Overattachment
Feelings
Fear, abandonment
Out of control
Needy, burdened
Unsafe alone
Shut-out
Desperate
Feelings
Fear, smothering
Self-controlled
Indifferent
Unsafe with others
Trapped
Numb
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Overseparation and
Overattachment (Coleman & Colgan, 1987)
Overseparation
Overattachment
Behaviors
Is self-protective
Controls others
Acts to guard feelings
Denies
Is compulsively
independent
Feelings
Is self-sacrificing
Please others
Acts contrary to feelings
Explains
Is compulsively
dependent
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11 Curative Factors of Group
Psychotherapy (Irving Yalom, M.D.)
1.
2.
3.
4.
5.
6.
Instilling hope
Sharing universality
Imparting information
Fostering altruism
Recapitulating the
primary family group
Developing socializing
techniques
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7.
8.
9.
10.
11.
Imitating behavior
Sharing interpersonal
learning
Developing group
cohesiveness
Sharing catharsis
Exploring existential
factors