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Alcohol Use Disorder: Adult Children of Alcoholics

LukeNotes, Fall 2023

Like a ripple in a pond, the mental health impact of alcohol use disorder extends far beyond the individual suffering from it to family members, friends, and coworkers. The Substance Abuse and Mental Health Services Administration (SAMSHA) estimates that alcoholism affects one in 10 children in the United States. Mental health impacts on children affected by alcohol use include increased incidence of depression and anxiety, behavioral difficulties, and increased likelihood of developing substance use disorders.

Adult children of alcoholics (ACAs) often internalize the trauma of familial instability and unhealthy messages that can result from alcohol use. As children, they develop coping mechanisms for survival, but the trauma often lingers into adulthood. Common coping mechanisms include people-pleasing, approval-seeking, need for control, and strong judgment of self and others. These skills have a protective benefit in younger years. As adults, however, consistent use of these behaviors or thought patterns can result in difficulties in many areas of an ACA’s life.

ACAs can find help for these issues through individual and family therapy or support groups, including ones based on the 12-step model for recovery from substance addictions.

Twelve Step Programs

Al-Anon and Alateen, organizations formed to help families and friends of alcoholics and problem drinkers, are based on the 12-step principles of Alcoholics Anonymous and recognize that alcohol use disorder is a family disease. These groups provide mutual support for the family members living with or impacted by alcoholism. As those living with a family member with alcoholism grow up and create a life outside of the family, they begin to realize that they have dysfunctional behavior patterns. These groups can help address the family members’ desire to “rescue” the person suffering from alcohol use and focus on developing healthy coping behaviors independently.

Adult Children of Alcoholics (ACA), started in 1978, developed from Alateen. The fellowship respects the impact of living in a challenging and emotionally unhealthy family system and provides ACAs with resources to address the emotional and mental health consequences of growing up in that environment.

Common Traits and Behaviors

In 1978 ACA published a “Laundry List” describing common behaviors and traits people who interact with ACAs may notice. Among these traits are isolation and fear of authority figures, harsh self-judgement and low self-esteem, approval-seeking, and an overdeveloped sense of responsibility. Some behaviors can meet the ACA’s need to gain a sense of control that was lost in childhood. An ACA may have a tendency to deny their difficult childhood out of embarrassment or to avoid the pain of the distressing memories.

Growing up with a parent with alcohol use disorder can affect the ACA’s interpersonal relationships, resulting in difficulty trusting others, fear of rejection or abandonment, and tolerance of others’ unhealthy behaviors. They may suffer from spiritual disengagement or disillusionment, as well as anxiety and depression. All of these issues, including the increased likelihood of developing a substance use disorder, can negatively impact their personal and professional life and ability to form healthy relationships. These concerns can be addressed through a multi-dimensional approach.

Therapeutic Approaches

An evaluation by a mental health professional can determine the need for medication, group psychotherapy, or trauma-informed psychotherapies. Active involvement in ACA meetings can reduce the ACA’s emotional burden. An ACA in recovery learns to offer him or herself what they may have missed in their childhood.

Self-compassion, accepting mistakes as inevitable, and being less guarded are some hallmarks of recovery. Others may notice changes in behavior as the ACA begins the recovery process. These could include:

  • A renewed connection with God
  • Less reactivity to criticism and more receptivity to others’ ideas
  • More engagement with others
  • Increased self-assuredness and less self-criticism
  • Improved concentration and more confident decision-making

Ultimately, the ripple effect of familial addiction can be stopped, and the ACA can integrate their past experiences with alcoholism into a fulfilling, healthy life.

Nancy Parfitt Hondros, MA, ATR-BC, LGPAT, LGPC is an art therapist at Saint Luke Institute in Silver Spring, Maryland.