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Addiction: A Ubiquitous Problem

“Daddy’s Head Is Broken”: The Treatment of Children of Severe Alcoholics

, Ph.D.
Pages 234-248 | Published online: 01 Apr 2021
 

ABSTRACT

The author explicates the complex family relationships of children of severe alcoholics, and internalizations of these relationships, which can be addressed in the treatment of children and in corollary parent work. Children of serious alcoholics (or other substance use disorders) share features with other children whose parents are troubled. However, the author suggests that it is useful to consider what children of severe alcoholics have in common. Children of serious alcoholics can experience the substance of abuse as a mysterious potion, which their alcoholic parent prefers to them. Additionally, alcoholics (along with other substance abusers) expose their children to the specific results of inebriation or withdrawal from alcohol. The author discusses the following common experiences of the children of severe alcoholics: extreme difficulty in understanding parental addiction, particularly for very young children; an unconscious struggle to repair the damaged parent and to try to protect that parent from strain; and guilt at the often-necessary exclusion of the addicted parent from the household unit. Another confusing issue is mourning for a parent who is still alive and in some contact, yet severely impaired. The author describes parent work in these situations (collateral to a child psychoanalysis or psychotherapy), both with the “co dependent” parent and the alcoholic parent.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

1. I have written elsewhere on substance abuse in adolescence (Brady Citation2016a, Citation2016b)

2. With the exception of a paper on mother-infant group psychotherapy (Belt and Punamaki Citation2007).

3. Al-Anon recognizes the role of the spouse of an alcoholic as potentially an’enabler’ of addiction. The concept of co-dependence emerged out of the treatment of alcoholics. Spouses can unconsciously support the behavior they are ostensibly trying to control, by protecting the alcoholic from the consequences of his or her actions, e.g. by covering for them, trying to manage them, etc. This can become a shared system of denial and avoidance of the pain of facing difficult choices. The codependent partner’s focus on their spouse can reveal a tendency to merger and mask a problem with being able to make his or her own decisions and with being able to conceive of a life without the addicted spouse.

Additional information

Notes on contributors

Mary T. Brady

Mary Brady, Ph.D., is an adult and child psychoanalyst in private practice in San Francisco. She is on the Faculty of the San Francisco Center for Psychoanalysis and the Psychoanalytic Institute of Northern California. Her books, Analytic Engagements with Adolescents: Sex, Gender and Subversion and The Body in Adolescence: Psychic Isolation and Physical Symptoms were published by Routledge in 2018 and 2016 respectively. Her upcoming book, Braving the Erotic Field in the Treatment of Children and Adolescents will be published by Routledge in 2021. She is a member of the Committee on Child Analysis (COCAP) of the International Psychoanalytic Association. She also co-leads a private study group on The Treatment of Adolescents and Young Adults and another group, Trauma on Film.

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