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Addiction Dilemmas
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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
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Thiseditionfirstpublished2012
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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
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1 2012
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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
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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
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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
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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
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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
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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.
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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.
