Benefits and Costs of Alcoholic Relationships and Recovery Through Al-Anon

Abstract

Background: Codependence is an ambiguous and disputed term often used to characterize both those who maintain relationships with alcoholics and those who seek help through resources such as Al-Anon Family Groups. Objectives: The purpose of this article is to better understand non-pathological reasons for maintaining alcoholic relationships and for help-seeking by detailing the costs and benefits of those choices. Methods: The costs and benefits both of remaining in an alcoholic relationship and of seeking help in Al-Anon were identified through a review of available research on alcoholic family systems, Al-Anon, and other mutual-support groups. Results: Alcoholic relationships may benefit concerned others by preserving self-identity, social identity, values, security, stability, and hope. Costs of alcoholic relationships include physical symptoms, injury, mental problems, financial difficulty, legal troubles, and relational distress. Al-Anon is perceived beneficial for six primary reasons: Al-Anon philosophy, format, social support, accessibility, effectiveness, and potential to change the drinker's behavior. Possible costs of Al-Anon include marginalization of the concerned other, blame, codependent pathology, sexist stereotyping, substitute dependency, and perpetuating victimization. Conclusions/Importance: The identified costs and benefits of alcoholic relationships and help-seeking in Al-Anon can help to model decision-making processes using existing behavioral health frameworks without defaulting to the stigmatized and ambiguous codependence terminology.

Keywords :

• alcoholism
• Al-Anon
• Twelve Step
• codependence
• enabling
• social support
• barriers
• mutual help group

THE AUTHORS

Brendan Young, PhD, MBA, is an Assistant Professor in the Department of Communication at Western Illinois University-Quad Cities. At age 37, he left a business career to pursue a Ph.D. in Communication Studies at the University of Iowa, where he dissertated on the relationship between Alcoholics Anonymous members and their sponsors. He completed a postdoctoral research fellowship with the Department of Veterans Affairs, and continues to conduct VA grant-funded research on interventions to facilitate social support among veterans seeking recovery from substance use disorder. He lives and works on the banks of the Mississippi River, where he shares a home with his partner and their two dogs.

Christine Timko, PhD, is a Senior Research Career Scientist, Health Services Research and Development Service, Department of Veterans Affairs (00-0001), and Consulting Professor, Psychiatry and Behavioral Sciences, Stanford University School of Medicine. Within her addiction research at the Center for Innovation to Implementation in Menlo Park, CA, Dr. Timko's interests are evidence-based practices to facilitate transitions between levels and types of health care, such as detoxification to substance abuse treatment, and helping family and friends of individuals with substance abuse problems.