Another Chance: Hope And Health For The Alcoholic Family, by Sharon Wegscheider Cruse
Warning: This book does not make for pleasant reading. If you come from a family where alcoholism and other types of abuse have run rampant for generations (unfortunately that is the case for me) you will probably find yourself in this book. The book begins with several chapters on a conceptual framework looking at myths and insights into alcoholism that took place in the 1970’s and 1980’s (the version I read was the second edition, published in 1989). Then came a couple of chapters on the addiction spiral and the shared family disease as the family serves as a “mobile” that twists in order to cope with the addiction in the family and remain whole, despite the damage done to family members.
The real core of the book is in its examination of the different roles that family members serve in an alcoholic family. There is the dependent—the alcoholic or addict, the enabler (usually either a spouse or a parent, if the dependent is a child), the hero (usually the oldest child), the scapegoat (often a second born), the lost child, and the mascot. I was intrigued that in my own particular nuclear family we ended up having a lost child (me) and a scapegoat/mascot (my brother) but no heroes. Of particular note, scapegoats tend to grow up to become dependents and alcoholics and heroes tend to grow up as enablers in the next generation. Lost children, it should be noted, tend to struggle horribly with loneliness, and tend to shy away from intimacy particularly strongly.
The third section of the book looks at the treatment plan for an alcoholic family. At the start is the often dreaded intervention, and the book gives some sound advice on how to make it as factual as possible, devoid of recriminations and emotionalism. Then there is a look at primary care—this is the immediate care of the damaged family, as well as after-care, which can continue for years afterward, involving family therapy. There are also chapters on the endless nature of recovery (no one is ever recovered in this life), the importance of Alcoholics Anonymous as a treatment ally (albeit an independent one) and the whole counselor (who avoids getting sucked into the family’s trap and becoming a professional enabler). Of particular importance are the author’s notes about pastors and their difficulty serving as effective counselors, as well as the comments that the sick family as a whole needs treatment, not just the alcoholic, because the sickness of alcoholism is a systemic problem and not a personal problem.
The book then closes with three extremely painful for me) chapters on “adult children” and co-dependents, family reconstruction (which is compared explicitly in the book to emotional surgery), and professional denial. These chapters were personally painful, because they are at the basis of my own difficulty when it comes to the elusive process of reaching a state of mental health. The book very pointedly condemns the practice of medicating psychological difficulties with drugs, seeking instead of cognitive development where people come to terms with their past and their families. The book then closes with a vague and moderately unsatisfying chapter on spirituality as well as two appendices that give exercises for healthier families and the whole person inventory.
It is striking that the author herself was a hero as a child and then moved into the counseling profession. Knowing from family experience, it is very common for people from troubled families to enter into the nursing profession (it is very common in my family, and generations ago the pastorship, another avenue for troubled families, was also common in my family, even if not in recent generations). The book is highly troubling, and suggests that alcoholic families are everywhere and extremely common. In fact, I can think of plenty of families where I can identify heroes, scapegoats, and mascots (it is harder to find lost children) with ease. I find this troubling. The book would have been more useful had it been more broad in its focus—it is not until the end of the book that the author concedes that alcoholism is but one sign of a related suite of difficulties that a family can face, but it is one factor that is often prevalent in troubled families. Based on my own family experience I would suggest that alcohol abuse is often secondary to other difficulties (such as sexual abuse), but this book is primarily focused on those families dealing with substance abuse and only in a minor and tangential fashion on those problems I care more about personally. That said, the book would be of great help to many, as alcoholism is an extremely common problem in today’s society.