QUESTION
Why is she so afraid?
Dear Shokooh,
I am dating a great woman and we have always been very close. Lately I have noticed that she drinks a lot. When we first met, we used to go out a lot and drink and I guess I never noticed. I have been paying close attention and I think she drinks close to a bottle of wine every night. When I asked her about this very gently she said that it helps her sleep better and that it is harmless. My question is when does drinking get or become dangerous and at what point do I have to worry about this behavior. She smokes also and I am afraid that she gets more and more dependent on these substances. When is it too much and what can I do to help her?
A Reader
REPLY
Dear Reader,
I can imagine how difficult and upsetting this situation must be for you. It sounds like you truly care about the woman that you are dating, and are worried about her relationship with alcohol. Before I begin addressing your questions, let me first express that I am very impressed with your strength and your courage to open up a topic that is difficult and often taboo. The fact that you use the word “gentle” to describe your discussion of this topic with your partner tells me that you are a sensitive person. I applaud your caring and desire to help.
You pose two challenging questions in your letter. First, when does drinking cross the line into problem behavior? Second, what can we do to help a loved one if we believe she has crossed that line?
Many social mores involve drinking — we celebrate weddings with champagne, we create beautiful meals and spend hours pairing wines, and beer overflows at sporting events. It is difficult to escape alcohol in our society. And yet, the topic of alcohol abuse and dependence remains taboo. We feel uncomfortable when someone drinks too much or too often, but we keep quiet because we feel even more uncomfortable broaching the subject.
When has drinking become too much? How is that line drawn? The answer is complex, because it depends upon the individual involved, their personal history, and drinking habits. I have not met your partner, so I will not make assumptions. However, regardless of how much or how often she drinks, the very fact that you are worried about her drinking habit is a red flag for me. Studies have shown that friends and family members are often the first to notice drinking problems. They are also the first to seek information and assistance. Many times, the alcoholic does not realize the severity of the problem.
Psychologists use two categories of diagnosis for alcohol problems: abuse and dependence. Alcohol abuse is defined as a maladaptive pattern of substance use leading to significant impairment or distress, as manifested by one or more of the following, occurring within a 12-month period:
1. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home. Examples include: repeated absences, poor work performance, suspensions/expulsions from school, neglect of children or household.
2. Recurrent substance use in situations in which it is physically hazardous. Examples include: driving an automobile or operating a machine while impaired.
3. Recurrent substance-related legal problems, such as arrests for disorderly conduct.
4. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance. Examples include arguments with spouse about consequences of intoxication or physical fights.
The line between alcohol abuse and dependence is crossed when alcohol use is accompanied by factors such as tolerance, withdrawal, increases in drinking, a persistent desire or unsuccessful efforts to control drinking, spending a great deal of time obtaining, using, or recovering from alcohol, giving up important social, occupational, or recreational activities because of alcohol use, or continued use despite knowledge of problems. Only a trained professional can diagnose alcohol abuse or dependency. However, you spend a great deal of time with your partner and clearly have observed her drinking habits. The bottom line is this: if you think it is a problem, then you are right to be concerned and seek assistance.
I recommend that you begin by asking yourself some questions. Perhaps even take some time to write down the answers so that you can better think through these issues. Is your partner missing work or school because she is intoxicated or hung over? Is her drinking affecting the appearance of her house or her personal care? Does she drink in dangerous situations or do dangerous things while drinking? Is she getting into trouble with the law? Is she having problems with family, friends, or social contexts due to her drinking? What is she like when she drinks? These questions are a good place to start. Also think about your own role. What is driving your concern? What is your own relationship with alcohol? These are all issues to consider and perhaps reflecting on them will assist you.
How can we help someone we suspect has an alcohol problem? It sounds like you would like to speak with your partner about the issue of alcohol. If this is true, then it is important that you remember how you speak is as important as what you say. In other words, prepare your attitude as well as your speech. Your previous gentleness will be a great asset to you should you discuss this topic with her. The greatest help you can offer is support. Search your soul, think long and hard about the situation, and communicate kindly. A therapist can assist you in preparing for this discussion and in processing the emotions that will inevitably come to the surface.
We tend to forget that alcoholism has effects that reach far beyond the individual alcoholic. Friends, family members, and loved ones are all impacted. Al-Anon is an outstanding resource that provides support for loved ones of individuals with alcohol problems. They can be reached online at www.al-anon.org. I urge you to remember to take care of yourself. As you think about your partner and her situation, remember that self-care is vital. You can only help others if you care for yourself. Al-Anon is a wonderful organization that can help you as you work to help her.
You sound like a wonderful and caring person. I wish you all the best and hope that the New Year is a happy and healthy one for you and your partner.
Shokooh
About
This column is for general educational purposes only– it is not a substitute for medical attention, counseling, or therapy of any kind. The Couch and the staff of this website urge you to seek immediate medical attention if you are in an urgent, harmful, or potentially dangerous situation. Psychiatric emergencies or urgent matters should be handled by calling 9-1-1 or going to the nearest emergency room. Please note that your emails will not be answered on an individual basis and your confidentiality cannot be guaranteed. Top
