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Alcohol Use Disorder: Adult Children of Alcoholics Case Study

LukeNotes, Fall 2023

“Curious,” thought Fr. Kevin, head pastor at the parish where he and Fr. Tim both served. He appreciated the heavy load Fr. Tim willingly carried so the parish could run smoothly. Yet he was hearing complaints from the parish staff, who said that Fr. Tim expected perfection, had no tolerance for mistakes, and could be harsh and short-tempered. Their frustration peaked when he tried to control every facet of their work, sometimes taking projects away to complete them himself. Fr. Tim seemed to carry a weight that he did not want to share with others. Fr. Kevin also observed Fr. Tim’s refusal to join his brother priests for dinners and outings. He heard grumblings about his chronic late arrivals to celebrate daily Mass and complaints that he sometimes smelled of stale alcohol.

When Fr. Tim was 19, his father died from a car accident caused by drunk driving. Fr. Tim criticized himself for not having a more Christian reaction to his father’s death. The death was a relief. His father could be great fun. He’d sing, dance, and tell jokes. When he drank, he became a different person. His father’s criticism, demeaning humor, and threats to his mother and sisters were frightening. After his death, his mother started working multiple jobs to provide for the family. Wanting to ease his mother’s burden, Fr. Tim took over the care of his siblings and many household duties, but his efforts never seemed to satisfy his mother. Outside of family responsibilities, he focused on his studies and involvement in the youth ministry. All of this never seemed like enough. The perfect family life Fr. Tim wanted was not a reality.

When the parish accountant called Fr. Kevin, frustrated with Fr. Tim’s unreasonable demands, he knew that he needed to address the issue. He spoke to Fr. Tim about the complaints and his concerns for his well-being. Fr. Tim reacted defensively, citing his desire to protect the parish. He reluctantly agreed to a clinical evaluation at Saint Luke Institute out of respect for Fr. Kevin.

During the evaluation Fr. Tim shared his family history, emphasizing his childhood need to anticipate potential problems to minimize his family’s stress and connecting it with his ability to manage problems as they arose in the parish. He admitted that he did not make time for socializing or have any interest in developing friendships and acknowledged that he hated unexpected changes or problems in the parish. He acknowledged his nightly drinking to relieve stress but denied its impact on his ability to celebrate Mass on time. The evaluation team recommended Fr. Tim participate in the SLI Intensive Outpatient Program, focusing on his alcohol misuse, mild depression, his controlling behaviors, and his unresolved anger toward his father and mother. Father Tim was not convinced that he could benefit from the program but agreed to stay for treatment.

Gradually, through individual therapy and a range of peer therapy groups, Fr. Tim recognized his intense anger toward his parents, his fear of the unexpected, and his tendency to avoid people. After he started medication for depression, he noticed that his focus improved, and he was less defensive about feedback from peers. Fr. Tim accepted his therapist’s recommendation to find a support group and began to attend ACA meetings.

In the meetings, Fr. Tim heard stories that resonated with his own childhood experience and recognized that others had similar or even more difficult experiences. The meetings helped him understand that his thoughts and behaviors were ways of protecting himself from his family’s chaos. Fr. Tim was relieved to learn that he could begin healing the wounds of his childhood through ACA and his intensive work at Saint Luke Institute. With these supports and interventions, he learned skills to manage his anxiety, set healthy boundaries, and build healthy interpersonal relationships.

Upon Fr. Tim’s return to the parish, Fr. Kevin and others noticed Fr. Tim’s more relaxed approach to his work and his new energy for engaging with brother priests. The parish staff noticed an immediate difference. They responded enthusiastically to Fr. Tim’s more collaborative and trusting management style. As Fr. Tim became more engaged and less defensive, he received positive feedback for his efforts and more acceptance from others. 

For confidentiality reasons, names, identifying data, and other details of treatment have been altered.