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Tuesday, February 2, 2010

Treatment Tuesday - Alcohol Abuse v. Alcohol Dependence

This week's assessment is for Vickie, who wrote in with quite a few questions about Taylor*, her hero who grew up with an abusive, alcoholic father. Taylor often took the brunt of his father's abuse in order to save his youngest brother and mother. When his father died when Taylor was 14, Taylor never grieved a day, but took on a part-time job and did everything he could to make sure his brother and mother had a good life. He drew into himself, never trusting anyone but his immediately family and never opening up to anyone else. Vickie wrote that his biggest fear is rejection. He was the epitome of control, masking his emotions and reactions--which led to a career as a Hollywood A-lister. Eventually, Taylor will meet Charity*, a woman who will lead him to a knowledge of Christ.

* Names have been changed to protect the fictional.

Vickie wants to know: What would Taylor find most compelling about Charity and her dependence on Christ? What would it take for him to make that leap to believe and trust in a loving heavenly Father?

She also wants to know if the following scenario would be indicative of a realistic alcoholic problem:

Throughout the story Taylor drinks when he's stressed or worried. He turns to alcohol to calm himself and relax. He wants a drink when he knows he can't have one, but he never gets drunk in public because he knows it would land him on the front page of every tabloid in America, and he wouldn't allow that kind of loss of control or invasion of privacy. But when he's alone, he sinks into a downward spiral of despair and emptiness and turns to alcohol to induce numbness. Only near the end of the story does that spiral spill out into a public setting, and it's after that occurrence that he decides to get help.

Oooo! Great stuff to work with, so I'll jump right in.

I want to start with the abusive history, as it plays a huge role in his present-day alcoholic problem. Seeing as how Taylor's dad wasn't much of a "dad" in the traditional sense, Taylor took on that role early. In my field, we call this "parentification." Taylor essentially lost his childhood and had to grow up entirely too early. 14-year-olds shouldn't be worried about who's going to get the next blow from Pop or bringing home money to take care of Mom. They should be into chicks and concerts and malls.

But Taylor's experience with his dad definitely scars him. He grew up with one heck of a role model. (Research highly supports the idea that those who grow up from abusive families will go on to become abusers themselves. Statistics vary depending on what you read, though.) But Taylor doesn't abuse people, he just abuses alcohol--like father, like son. His behavior is partly learned and partly situationally induced, I'm sure, as Hollywood A-listers aren't exactly known for their abstinence from alcohol and drugs.

You're big challenge will be to portray Charity in such a way that Taylor wants what she has, even though he "has it all." Her simplistic style of living, maybe, or the fact that she doesn't seem to need or seek his attention like everyone else he knows (because she's focused on serving Christ).

Taylor will likely struggle over a heavenly Father being any different from his earthly one. In truth, the discordance between an "ideal" divine Father and the real deal, warts-and-all Pop hinders many people from developing a relationship with Christ. So Charity might want to steer clear from the imagery of a father all together when she's witnessing to him. She could focus on Jesus instead as a "friend," or "confidant," someone Taylor could turn to with his problems and just talk to.

It would be fascinating for Taylor to discover that Charity came from a background situation much like his. If she had a father that was similar to Taylor's own work-of-art dad, then he might put more stock into her conversion or into what she has to say. If she comes from some pristine perfect family, though, he'd be more likely to pin her lifestyle difference on that. If Charity came from a really dark place--perhaps sexual abuse?--I think Taylor would really stand up and take notice of her faith as what "got her through," or what she turned to after being down so low.

You wrote that his biggest fear (as you've written him so far) is rejection. You could definitely play with this, going off the fact that his dad essentially rejected him as a son and rejected their family when he went to beating on them like punching bags. However, I think Taylor's character could be so much stronger if you up the ante on his biggest fear by giving him a nasty little flaw of needing anger management.

Think about this. Let's say Taylor is the epitome of self-control--as you've written him--until the right set of circumstances will blow his top faster than even he can get under wraps. If he's doing all this turning inward--also called "bottling things inside"--this is unhealthy. These people don't just get mad, they usually explode like Mount Vesuvius or they implode like a grenade went off inside. His dad obviously erupted outwardly with physical violence. What if Taylor had this tendency? Maybe he's never hit someone, but his biggest fear is that he could turn out to be just like his dad and be abusive? He's already half-way there with this alcohol it's just something to consider. Take it or leave it, of course. :)

So on to the alcohol problem (I could have done a whole post on just this question...and I might later!). There are 15 alcohol-related diagnoses in the DSM-IV, the most common probably being Alcohol Abuse, Alcohol Dependence, Intoxication, and Withdrawal. Taylor fits the bill for Alcohol Dependence, and he fits that bil rather well (kudos!). You can read about the criteria here. Alcohol Abuse is much more severe, and depending on what type of public spectacle he makes, he just might cross the line, so you'll want to read about Alcohol Abuse here.

A comprehensive explanation of treatment for alcohol abuse or dependence can be found at Psych Central. They go into medical treatment for withdrawal and psychosocial treatment to handle urges, find a community of support, and deal with what led the person to drink in the first place. So definitely check out that link. He could do an inpatient or outpatient program.

If Taylor really fears rejection, and you couple his public display with the younger brother's threat of "Get help or leave us alone," I think you've definitely given him motivation to seek treatment. If his greatest fear is turning out to be just like his dad, then if the public incident has something to do with violence (maybe toward some paparazzi or something?), then that might be enough for him to see he's hit bottom...he will end up just like his dad if he doesn't do something.

Hopefully this will give you some things to work with. I welcome any additional questions you (or anyone else) might have in the comment section.

Q4U: What are some other ways to describe your relationship with Christ besides a "heavenly Father," "friend," or "confidant?" How would you reach someone whose earthly father left a bad taste in their mouths?

This service is for fictional characters only, so any resemblance to real life examples is entirely coincidental. Any other fictional character assessment questions can be directed to charactertherapist (at) hotmail (dot) com.

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