Betty Gibb

Bob drew his hand back in horror. Rage drained into humiliation. His fingers stung. He had just slapped his wife of 20 years hard across the face. He couldn't dodge the implications: he was both drunk and violent two things he'd vowed never to be.

Pictures of childhood flooded his mind: drinking, fighting grandparents; a stepfather who more than once tried to kill both him and his mother; a dysfunctional home ravaged by alcohol and abuse. "I'll never drink, and I'll never hit a member of my family," Bob had promised himself repeatedly.

Gradually, ever so gradually, drinking had crept into his adult life. At first it had been "a better way than medication" to cope with an illness. Imperceptibly drinking evolved into the gear-up for a difficult business encounter. Finally it became his coping crutch to get through the everyday. "At least I'm not violent," he'd reassure himself when the nagging worry of excess drinking would prick at him.

He could no longer find shelter in that rationalization. His wife's casual remark about the unpaid bills had ignited a rage he couldn't hold in. He struck her furiously. She was walking toward the bedroom in disbelief. His worst fears faced him. "I can't control either my drinking or my temper."

Bob had become a statistic. He was officially and undeniably a spouse abuser. Yet, Bob was also a victim brought down by two giants that stalk the world, often together; alcohol and family violence.

The specialists who study both behaviors are careful to say the evidence doesn't prove one is caused by the other. Not all drinkers are violent; not all abusers drink. But almost everyone agrees that the two are connected. It's not just chance that these two problems show up together in many families. Consider just a few items of evidence:

• A British study asked lawyers, social workers, doctors and health visitors to list possible explanations for violence within a family. Doctors and lawyers put alcohol at the top of the list. Social workers ranked it as the number two problem. Health visitors listed it as the third major cause.¹
• Time recently quoted U.S. Secretary of Health Otis Bowen as saying alcohol is the culprit in 40 percent of family-court cases. It accounts for between 25 and 50 percent of violence between spouses. In addition alcohol is involved in at least 33 percent of reported child-molestation incidents.²
• Norwegian researchers analyzed trends in alcohol consumption since World War II and compared those figures with
  the incidents of violent death during the same time. Their finds: "a significant correlation between changes in alcohol consumption and rates of violent death."³
• A U.S. Department of Justice survey estimates that nearly one-third of the nation's 523,000 state-prison inmates drank heavily before committing such crimes as rapes, burglaries, and assaults.
• Nine out of ten manslaughter and murder cases during one year in one Danish community involved alcohol. Forty-three percent of violent assault cases treated at hospitals in the same community during the same time were also related to alcohol use.⁴
• Steven F. Bucky, dean at the California School of Professional Psychology at San Diego, and Claudia Black, a
  psychotherapist, recently completed a two-year study comparingadult children of alcoholics with adults raised in nonalcoholic homes. One of the facts they discovered: "Each family member within the alcoholic family demonstrated significantly more abusive behavior than members of the nonalcoholic families."
• According to a U.S. Navy study of abused/neglected children:

1. Fifty-seven percent of the abuse/neglected children had at least one grandparent who was alcoholic or who used alcohol.
2. Sixty-five percent of the suspected child abusers/neglectors were alcoholics or used alcohol.
3. Eighty-eight percent of the previously abusing parents were abused as a child by an alcoholic or alcohol-using parent.
   Eighty-four percent of the abuse or neglected children had at least one parent who was alcoholic or who used alcohol.⁵

Each study tells a similar story. When violence is present in the family, it is likely alcohol will be there too. Troubled families in which alcohol is used will probably be more violent than those in which no one drinks.⁶

Alcohol use increases the risk for violence within a family in several ways.

Although the initial effect of alcohol brings the drinker a "high," the body's reaction in the second stage is marked by feelings of depression, fatigue, nausea, and general bad feelings. It's hard to reign in irritability when one feels just plain rotten.

"Alcohol use also frees up inhibitions and allows one to act on aggressive tendencies," explains Bucky. It dulls the value system, making it hard for the individual to think through the consequences of his behavior.

One person's drinking usually puts the whole family under stress. "Alcoholism creates a series of escalating crises in family structure and function, which may bring the family system to a catastrophic state," says Edward Kaufman, professor of psychiatry at the University of California at Irvine. "Alcoholics don't have relationships; they take hostages," is a saying often used to describe the interaction that goes on in alcoholic families.

Drinking frequently triggers anger in the drinker and provocation in others. This triggers further anger, which the
alcoholic tries to absorb with alcohol. The problems continue to build.

Subjected to this growing stress, each member of the family is apt to react more violently. "No one in the family learns to deal with the normal frustrations in life," says Bucky. "Each little stress is potentially the straw that breaks the camel's back."

The abusing person may not be the one with the drinking problem, but rather the nonalcoholic parent or spouse. Often people living in alcohol-troubled homes don't even recognize violence because it has become a way of life. They have become accustomed to the tension, the arguments and name calling, the pushing and shoving.

Though the problems of alcoholism and violence are separate, they are very much alike in several ways, according to Sally Baker, a psychotherapist and author in Waterville, Maine.

Both problems are usually passed from one generation to another. "People always live by that which they learn," says
Baker.

Bucky and Black's study found that 40 to 60 percent of children of alcoholics will become alcoholic themselves. An additional 21 percent marry alcoholics. The children of alcoholics are about eight times more likely to be violent than are children of nonalcoholics.⁶

Partners in both situations tend to be dependent, with extremely low self-esteem. Promises to change are constant, but behaviors continue.

Silence is the unwritten rule in families made dysfunctional by alcohol or violence. Children keep deep fears and uncertainties bottled up. When they ask questions about Dad's drunken behavior, he slaps them; Mom tells them they're wrong. No one talks about the bruises, the threats, the broken furniture. The child feels ignored.

Both alcoholism and violence are progressive disorders, getting worse with time instead of any better. Family members develop a high tolerance for inappropriate behavior.

Alcoholism and abusive behavior know no class, age, or sex. Their victims come from everywhere. "A battered wife who finds refuge in the family Porsche may have different problems from the poorer woman whose only safety is the community shelter," says Baker, "but they both are experiencing enormous roadblocks to a healthy, whole life."

The two problems also share the elements of denial, minimization, and rationalization.

Denial. "I don't have an alcohol problem," says a drunken mother. "If I'd wanted to hurt you, you'd be dead," shouts an abusing husband.

Minimization. "It's not that bad," says a badly bruised child. "A friend of mine got a broken arm when his dad was drunk." "I don't drink that much," says a teen. "I just lost control."

Rationalization. "You'd drink too if you were married to her." "She drives me crazy; the kids are driving me nuts." "It won't happen again."

The havoc and ruin alcoholism and violence cause in families is almost impossible to estimate.

Doctors Bucky and Black followed 400 men and women raised by alcoholics and a control group with nonalcoholic parents. Their findings were startling:

• Twice as many adult children of alcoholics reported having been sexually abused as children.
• Everyone in the alcoholic families was significantly more violent than in the comparison group. Nearly 70 percent of the adults with an alcoholic parent had violent fathers, and 26.5 percent had violent mothers. Almost 20 percent reported violent brothers or sisters. Nine percent said they themselves were violent.
• Two-thirds of those from alcoholic homes said their parents argued "often or all the time."
• Children in alcoholic homes don't use outside resources (ministers, counselors, doctors, and other helping people) as
  other children do. If they talk about their problems at all, it's usually to brothers and sisters. They get little input from normal adults.
• Sixty percent of those surveyed said that even today they have difficulty trusting people, expressing their feelings, or
  experiencing intimacy.
• Half of the adult children of alcoholics described themselves as confused and depressed much of the time; less than 25 percent of the other group described themselves in this way.⁶

Violence wears many faces, says Baker, "It's like a large pie made up of equal slices: emotional, physical, neglect,
intimidation. The hub of all those forms of abuse is an excessive need for power, control, and mastery." Abuse can be many things in addition to physically harming another person.

A husband doesn't lay a finger on his wife, but he beats the family dog to death in her presence. That's violence.

A father hangs the children's Cabbage Patch dolls in a hangman's noose from the ceiling light. That's violence.

A nurse if unusually rough with her hospital patients. That's violence.

A husband forces his unwilling wife to have sex with him. That's violence.
A mother locks her children in their bedroom so they won't "bother" her. That's violence.⁷

Fortunately there is hope for families devastated by drinking and violence.

"The problems are separate and both must be treated," says Bucky. Each member of the family will need care, support, and treatment.

For the alcoholic the chemical dependence must be dealt with before anything else can begin to change. "You are not going to be able to treat other disorders while the person is actively abusing alcohol," says Richard Famularo, director of psychopharmacology at Children's Hospital in Boston, Massachusetts, and consultant to Boston's Juvenile Court. Cognitive impairment may last a year or more in some of the worst cases.

Also, removing alcohol from the tragic equation is no guarantee that the violence will also cease. Dr. Famularo studied 50 parents whose children had been removed from the home by the court because of severe child maltreatment. Nineteen of the 50 had a history of alcoholism, but 11 were not alcoholic when the children were removed. "This may suggest that a past history of alcoholism is a risk factor for severe child maltreatment, even if
the parent is not currently using alcohol, says Famularo.

"The alcoholic who is sober and does not want to be, or who is sober and has not changed his behavior, is still psychologically ill," says Dr. Kaufman. These "dry drunks" may punish those around them because they don't receive the expected exceptional rewards for giving up alcohol. If members of the family don't learn new behavior patterns in relating to each other, the abstinent alcoholic will probably resume drinking.

Before, during, and after the person with the alcohol or violence problems is treated, each member in the family needs help on several fronts. "Those being battered need safety and separation first," says Baker. They may need medical treatment and proper food. Each will certainly need extended counseling to learn living skills and to develop self-esteem. As a basis to all of this the dependent and his family must also seek spiritual help.

"What it takes to recover from either syndrome is hard work and willingness to admit the need for help," says Baker. "With competent, consistent, caring professional help both individuals and families can get well."

Take Bob for example. After he hit his wife and she walked out on him, he walked into Alcoholics Anonymous and into extended personal therapy. He's been sober for 11 years. He and his wife were able to put the family back together and raise the children. Now as an alcohol counselor, he is offering to others the hope and help of this training and experience.

Betty Gibb is a freelance feature writer in Columbia, Missouri who specializes in health topics.

References

1. Borkowski, Margaret, Mervyn Murch, and Val Walker, Marital Violence The Community Response
   (London: Tavistock Publications, 1983) pp. 55-80.
2. "Out in the Open: Changing Attitudes and New Research Give Fresh Hope to
   Alcoholics," Time, November 30, 1987, pp. 80-90.
3. Skog, Ole-Jorgen, "Trends in Alcohol Consumption and Violent Deaths," National
   Institute for Alcohol Research, Oslo, Norway, June 1986.
4. Moller-Madsen, B., et al., "Alcohol Involvement in Violence: A Study from a Danish
   Community," Journal of Legal Medicine, October 1986, pp. 141-146.
5. Behling, Daniel W., "Alcohol Abuse as Encountered in 51 Instances of Reported Child
   Abuse," Clinical Pediatrics, January 1979, pp. 87-91.
6. Black, Claudia, and Steven F. Bucky, "The Interpersonal and Emotional Consequences
   of Being an Adult Child of an Alcoholic," The International Journal of the Addictions, February 1986,
   pp. 213-231.
7. Flanzer, Jerry P., and Kinly Sturkie, Alcohol and Adolescent Abuse: The ALCAN Family Services Treatment
   Model, (Holmes Beach, Florida: Learning Publications, Inc. 1987), pp. 1-5.

© copyright 2000 Health 20-20