Addiction Dilemmas: Family Experiences from Literature and Research and their Lessons for Practice PDF
Preview Addiction Dilemmas: Family Experiences from Literature and Research and their Lessons for Practice
P1:OTA/XYZ P2:ABC JWST080-fm JWST080-Orford June30,2011 13:26 PrinterName:YettoCome Addiction Dilemmas P1:OTA/XYZ P2:ABC JWST080-fm JWST080-Orford June30,2011 13:26 PrinterName:YettoCome Addiction Dilemmas Family Experiences from Literature and Research and Their Challenges for Practice Jim Orford Alcohol,Drugs,GamblingandAddictionResearchGroup SchoolofPsychology UniversityofBirmingham Birmingham,England A John Wiley & Sons, Ltd., Publication P1:OTA/XYZ P2:ABC JWST080-fm JWST080-Orford June30,2011 13:26 PrinterName:YettoCome Thiseditionfirstpublished2012 ©2012JohnWiley&SonsLtd. Wiley-BlackwellisanimprintofJohnWiley&Sons,formedbythemergerofWiley’sglobal Scientific,TechnicalandMedicalbusinesswithBlackwellPublishing. RegisteredOffice JohnWiley&SonsLtd,TheAtrium,SouthernGate,Chichester,WestSussex,PO198SQ,UK EditorialOffices 350MainStreet,Malden,MA02148-5020,USA 9600GarsingtonRoad,Oxford,OX42DQ,UK TheAtrium,SouthernGate,Chichester,WestSussex,PO198SQ,UK Fordetailsofourglobaleditorialoffices,forcustomerservices,andforinformationabouthowto applyforpermissiontoreusethecopyrightmaterialinthisbookpleaseseeourwebsiteat www.wiley.com/wiley-blackwell. TherightofJimOrfordtobeidentifiedastheauthorofthisworkhasbeenassertedinaccordance withtheUKCopyright,DesignsandPatentsAct1988. Allrightsreserved.Nopartofthispublicationmaybereproduced,storedinaretrievalsystem,or transmitted,inanyformorbyanymeans,electronic,mechanical,photocopying,recordingor otherwise,exceptaspermittedbytheUKCopyright,DesignsandPatentsAct1988,withoutthe priorpermissionofthepublisher. Wileyalsopublishesitsbooksinavarietyofelectronicformats.Somecontentthatappearsin printmaynotbeavailableinelectronicbooks. Designationsusedbycompaniestodistinguishtheirproductsareoftenclaimedastrademarks.All brandnamesandproductnamesusedinthisbookaretradenames,servicemarks,trademarksor registeredtrademarksoftheirrespectiveowners.Thepublisherisnotassociatedwithanyproduct orvendormentionedinthisbook.Thispublicationisdesignedtoprovideaccurateand authoritativeinformationinregardtothesubjectmattercovered.Itissoldontheunderstanding thatthepublisherisnotengagedinrenderingprofessionalservices.Ifprofessionaladviceorother expertassistanceisrequired,theservicesofacompetentprofessionalshouldbesought. LibraryofCongressCataloging-in-PublicationData Orford,Jim. Addictiondilemmas:familyexperiencesfromliteratureandresearchandtheirchallengesfor practice/JimOrford. p.cm. Includesindex. ISBN978-0-470-97701-9(cloth)–ISBN978-0-470-97702-6(pbk.) 1. Substanceabuse–Psychologicalaspects.2. Substanceabuse–Socialaspects.3. Families.I. Title. RC564.O7582012 616.86–dc23 2011022724 AcataloguerecordforthisbookisavailablefromtheBritishLibrary. Thisbookispublishedinthefollowingelectronicformats:epdf:9781119978831;WileyOnline Libraryonline:9781119978824;ePub:9781119978695 Setin10.5/13ptMinionbyAptaraInc.,NewDelhi,India. 1 2012 P1:OTA/XYZ P2:ABC JWST080-fm JWST080-Orford June30,2011 13:26 PrinterName:YettoCome Contents Preface vii SourcesandAcknowledgements xiii 1. We’llBeThereforHim:AFamilyRespondstoRelapse 1 2. LongDay’sJourneyintoNight byEugeneO’Neill 9 3. ToughLove:ATelevisionStudioDiscussion 15 4. WivesofGamblers 21 5. TheTenantofWildfellHallbyAnneBronte¨ 31 6. BritishSikhWivesandDaughtersStandUptoMen’sDrinking 38 7. NilByMouth:AFilmbyGaryOldman 46 8. WorryingforDrinkersinAboriginalAustralia 52 9. AProdigalSon:TheMother’sStory 65 10. ParentsofProblemGamblers 75 11. TheTaleofCaitlinThomas 88 12. DylanThomasinAmericabyJohnMalcolmBrinnin 103 P1:OTA/XYZ P2:ABC JWST080-fm JWST080-Orford June30,2011 13:26 PrinterName:YettoCome vi Contents 13. AnImaginaryConversation:WivesinMexico,England, SouthKoreaandItaly 111 14. FatherFigurebyBeverleyNichols 124 15. GrowingUpwithMyMother byVirginiaIronside 131 16. MrsSaraColeridgeandFriends 138 17. FiveHusbandsofWiveswithDrinkingProblems: AFocusGroup 153 18. AChancer byJamesKelman 169 19. GrowingUpwithParentsWhoDrinkExcessively:FourStories 175 20. BaudelaireandHisMotherinChains 185 21. FeverPitchbyRichardBrooks 194 22. IOnlyHadtheBaby’sWelfareatHeart:Concerned Grandmothers 199 FurtherReading 207 Index 209 P1:OTA/XYZ P2:ABC JWST080-Preface JWST080-Orford June10,2011 2:36 PrinterName:YettoCome Preface Addiction, in its various forms, is unfortunately extremely common. Be- causepeoplewhoarethemselvesaddictedusuallyexperienceamixtureof confusion,guilt,shameanddepressionabouttheiraddiction,andbecause theyareoftenambivalentaboutseekinghelpandchanging,theproblemis in large part a hidden one. The availability of treatment is at best patchy andinmanypartsoftheworldisvirtuallyorcompletelyabsent.Thehid- dennatureoftheproblemisfurthercompoundedwhenitcomestofamily members who are affected by the addiction of a close relative. It is those family members – the partners, parents, sons and daughters, sisters and brothers, grandmothers and others – who are the principal protagonists ofthechaptersofthisbook.Theirproblemscometolightonlywithgreat difficulty.Forthemthebarriersthatstandinthewayofobtaininghelpare multipliedbymanyfactors.Thelatterincludelackofawarenessofanyhelp thatmightbeavailabletothem,thesenseofshameathavingsuchaproblem in the family, a fear of gossip, ridicule or criticism by others, a belief that suchproblemsshouldbedealtwithwithinthefamily,andalackoftrustin theservicesthatdoexist. Thatfearofcriticismandlackoftrustinservicesmay,sadly,havebeen wellplacedinthepast.Evenwhenserviceshavebeenalertandresponsive to problems of addiction they have tended to ignore the fact that addic- tionoftenprofoundlyaffectsthelivesandhealthofclosefamilymembers. Family members have mostly been on the periphery in addiction treat- mentservices.Evenworse,whenprofessionalattentionhasfocusedatallon P1:OTA/XYZ P2:ABC JWST080-Preface JWST080-Orford June10,2011 2:36 PrinterName:YettoCome viii Preface family members, in the past it has often contributed to the very criticism that family members fear. Not only have family members been marginal- izedbuttheyhavealsobeenmisunderstood.Foronethingithasoftenbeen presumed,oratleastimplied,thattheyaresomehowtoblamefortheorigin orperpetuationoftheirrelatives’addiction. Becausetheproblemsfacedbythecharactersthatappearinthechapters ofthisbookarehiddenandill-defineditisalmostimpossibletoputafigure ontheirprevalencewithanyaccuracy.But,usingfiguresfortheprevalence of alcohol, drug and gambling problems in those countries where there has been research, and making very cautious estimates of the numbers of closelyaffectedfamilymembers,mycolleaguesandIarrivedataminimum estimateofclosetoahundredmillionadultsworldwideseriouslyaffectedby theexcessivedrinking,druguseorgamblingofcloserelatives(citedinour bookOrfordJ.etal.,CopingwithAlcoholandDrugProblems:TheExperiences of Family Members in Three Contrasting Cultures). Indeed many would consider that to be a gross under-estimate. What this means is that every primarycaremedicalpractitionerornurse,everysocialworker,teacheror communityworkeriscertaintobeintouch,whethertheyknowitornot, with people who are experiencing the effects of living with someone who hasaseriousalcohol,drugorgamblingproblem. It is towards the correction of the state of neglect, marginalization and misunderstandingoffamilymembersthatthepresentbookisaimed.For anumberofyearscolleaguesandIhavebeenengagedinaprogrammeof research and development designed to try to understand the experiences that family members face, and to develop and evaluate ways of helping familymembers.Inthecourseofthatresearchwehaveheardmanyfamily members tell their stories, and a number of the chapters in this book are basedonthoseaccounts(Chapters1,4,6,8,10,13,17,19and22).Those storiescomefromourworkinEnglandbutalsofromothercountriessuch as Mexico, Australia and Italy where we have collaborated in research on addictionandthefamily.Themostcommonaddictionthatfamilymembers are concerned about is addiction to alcohol. Others are worried about theirrelatives’addictiontodrugs.Inafurthersetofstoriesitisaddiction to gambling that is the cause of concern. The most frequently occurring relationship of affected family member to addicted relative is that of wife to husband, but other family members who tell their stories are mothers, fathers,husbands,daughters,sons,grandmothersandin-laws. As that programme of work has progressed I have occasionally come across,usuallybyaccident,biographiesorautobiographies,writtenabout P1:OTA/XYZ P2:ABC JWST080-Preface JWST080-Orford June10,2011 2:36 PrinterName:YettoCome Preface ix orbypeoplewhothemselveshaveexperiencedwhatitwasliketolivewith someone suffering from an addiction problem. When such a writer has recognizedtheimportanceofaddictionandhasfocusedatsomelengthon howithasaffectedthesubjectofthebiographyorautobiography,thisgives usanincomparableopportunitytoextendfurtherourknowledgeofhow addictionaffectsfamilymembers.Severalofthechaptersinthisbookare thereforesummariesofsuchworks.OneoftheearliestIdiscoveredwasthe autobiographyofthewriterBeverleyNicholswhorecountshisexperiences in relation to his father’s alcohol problem (Chapter 14). Only later did I find Virginia Ironside’s book about her relationship with her mother who also had a drinking problem (Chapter 15). I was excited to discover CaitlinThomas’sco-authoredbookaboutherlifewithDylanThomasand Isubsequentlysoughtoutanumberofbookswrittenbyoraboutherand her experience of Dylan Thomas’s drinking (summarized in Chapter 11). It was only some time later that I discovered John Brinnin’s book about his relationship with Dylan Thomas. That has a special role in this book becausetomyknowledgeitisauniqueaccountoftheexperienceofbeing aclosefriendandcolleagueofsomeonewithadrinkingproblem(Chapter 12).TheotherthreechaptersofthiskindareconstructedaroundJacqueline Doherty’sstoryofherexperienceofherson’sdrugdependence(Chapter9); MollyLefebure’sbiographyofSaraColeridge,thewifeofthepoetSamuel TaylorColeridgewhobecamedependentonopium–abiographythathas theadditionalinterestofhavingalottosayabouttheeffectsofColeridge’s drugaddiction,notonlyonhiswifebutalsoonhisfriends(Chapter16); andFrankHilton’sbiographyofBaudelaire,highlightinghisdrugaddiction, whichisveryrelevanttothethemeofthisbookbecauseBaudelaire’smother issuchanimportantfigureinHilton’sbook(Chapter20). Theinclusionoffivechaptersreproducingshortextractsfromworksof fiction may at first sight seem strange, but each has been included for a specialreason.Chapter2istheonlyonethatdrawsonadramaticwork– EugeneO’Neill’splayLongDay’sJourneyintoNight.Idecidedearlyonto include it, not only because of the powerful scene that I have included, whichrangtruetomeasastudentofaddictionandthefamily,butalsofor the good reason that the play is widely recognized to be, and was offered byO’Neillhimselfas,autobiographical.Theparticularscenethatfiguresin Chapter2concernsthemother,Mary,who,likeO’Neill’sownmother,has amorphineaddiction.ButO’Neillwasalsowellacquaintedwithexcessive drinking, which also featured in the play, since his father, himself and an elderbrother,andtwosons,allhadproblemswithalcohol.AnneBronte¨’s P1:OTA/XYZ P2:ABC JWST080-Preface JWST080-Orford June10,2011 2:36 PrinterName:YettoCome x Preface TheTenantofWildfellHall (Chapter5)isoneoftwonovelsIhavedrawn on.Theparticularreasonforincludingitliesinthepeculiarstructureofthe book,alargepartofwhichconsistsofthecentralcharacter’sdiaryinwhich shewritesatunusuallengthaboutherperceptionofherhusband’sdrinking problemandthechangingwaysinwhichshetriestocopewithit.Coupled with the fact that there is good reason to believe that Anne Bronte¨ was drawing on her experience of witnessing her elder brother’s addiction, this insightful piece of, admittedly fictional, writing was always a strong candidateforinclusion.Chapter7consistsofanextractfromafilm,Nilby Mouth.Onceagainwehavehereaworkoffictionthatdrawsonpersonal experience.Thedirector,GaryOldman,whowrotethescriptandproduced, directedandpartlyfinancedthefilm,hadhimselfexperiencedatfirsthand havingadrinkingproblem.Whenitcomestogamblingthereareanumber ofrelevantnovelsfromthenineteenthcenturythatImighthavedrawnon– notablyDostoevsky’sautobiographicalTheGambler,andfromthefirsthalf ofthetwentiethcentury–forexampleGrahamGreene’sBrightonRockand WalterGreenwood’sLoveontheDole.ButforChapter18Ihavechosento quotefromamoremodernnovel,AChancer byJamesKelman.Although I have no reason to think that Kelman was drawing directly on personal experience,hisreputationforaccuratedescriptionofthehardships,often revolvingaroundpubsandbettingshops,inhisnativeGlasgow,isagreat one.TheextractthatappearsinthatchapterIchosebecauseitseemedto metocapturesowellwhatpeoplehavetoldmycolleaguesandmyselfabout the tense family situations that can arise when addiction is present. The lastofthefiction-basedchaptersreturnstothemediumoffilm,specifically thefilmFeverPitch(Chapter21).Again,althoughitisaworkoffiction,it is much more than purely imaginative, based as it was on the advice of a numberofexperttechnicaladviserswhoknewaboutcompulsivegambling. The book is therefore based on a mix of personal accounts given to researchers,autobiographiesandbiographies,andwell-informedworksof fiction.Infactitwasmyslowdiscoverythatthesamethemesabouttheway addiction affected the family were to be found repeatedly in these varied sourcesthatinspiredmetoputtogetherthiscollection.Thereisonefurther chapter that remains to be mentioned and which does not fit any one of those three categories. It appears as Chapter 3. It is built around a BBC televisiondocumentaryaboutdrugaddictionandthefamily.Itwasanearly entry.Indeeditwasastronginfluenceonmydecisiontogoaheadwiththe book. There have been many television documentaries since then on the subjectofaddictionbutnonehascomesoclosetothisbook’scentraltheme. P1:OTA/XYZ P2:ABC JWST080-Preface JWST080-Orford June10,2011 2:36 PrinterName:YettoCome Preface xi Inthetelevisionstudio,participantsdebatedtheveryissuethatparentshad discussedwithusinourresearchandwhichformsthecentralquestionfor ushere–howdofamilymembersrespondinthefaceofalovedone’sserious addictionproblem? Ihopesomemembersoffamiliesafflictedwithaddictionmayfindthis bookhelpful.Itmighthelpthemrealizethat,afterall,theyarenotaloneand completely misunderstood in their dilemmas; rather, that the difficulties they have been grappling with are very common and universal, and that manygoodpeoplehavebeenflummoxedanddriventodespairaboutwhat todo.Ihopeitmighthelpthemthinkofnewideasabouthowtocope. TheaudiencethatImosthadinmind,however,consistsofpractitioners of one sort or another who are consulted by family members affected by addictionandwhoareoftenequallyperplexedabouthowtoadviseorhow tobeofanyhelp.Ihopethisbookmightprovideadditionalunderstanding ofthecircumstancesfacedbyfamilieswithanaddictedmemberandmight therefore usefully inform professional practice. In the process my hope is thatitmightcontributetoreducingthemisunderstandingthathasexisted aboutfamilymembersinthesecircumstancesandaddtoanappreciationof whattheyaregoingthrough.Eachchapterconcludeswithacommentary, drawingoutwhatIbelievearesomeofthemostsalientpoints,plusanumber of questions and exercises that an individual or group of professionals or trainees might undertake. The separate chapters are each complete in themselves and can be used individually or in any order. The questions and exercises at the end of the chapters can be ignored if desired but my hope is that they will add to the value of the chapters, and the book as a whole, by serving as a training tool. They are designed to be challenging andtoprovokedebateanddiscussionondifferentaspectsofasubjectabout whichtherearenosimpleanswers.Justasfamilymembersthemselvesface dilemmasabouthowtocope,sodothosewhoprovideservicesforthemface theirowndilemmasabouthowtounderstandandhowtorespond.These personal and professional dilemmas are a reflection of the much wider societaldilemmaabouthowtocopewithhighlyprevalentaddictions. This is not a ‘How to do it’ book. Its aim, rather, is to aid better un- derstandingbyallowingreaderstoheardirectlyfromfamilymembers–in literatureorinresearch–andtocriticallyreflectonwhattheyarehearing. Ibelievethatisabetterroutetoknowledgeandthencetoconstructiveways ofhelping.Attheendofthebookaresomesuggestionsforfurtherreading thatmighttakethatprocessfurther.
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